Study objective: To describe mortality inequalities related to education and housing tenure in 11 European populations and to describe the age pattern of relative and absolute socioeconomic inequalities in mortality in the elderly European population. Design and Methods: Data from mortality registries linked with population census data of 11 countries and regions of Europe were acquired for the beginning of the 1990s. Indicators of socioeconomic status were educational level and housing tenure. The study determined mortality rate ratios, relative indices of inequality (RII), and mortality rate differences. The age range was 30 to 90+ years. Analyses were performed on the pooled European data, including all populations, and on the data of populations separately. Data were included from Finland, Norway, Denmark, England and Wales, Belgium, France, Austria, Switzerland, Barcelona, Madrid, and Turin. Main results: In Europe (populations pooled) relative inequalities in mortality decreased with increasing age, but persisted. Absolute educational mortality differences increased until the ages 90+. In some of the populations, relative inequalities among older women were as large as those among middle aged women. The decline of relative educational inequalities was largest in Norway (men and women) and Austria (men). Relative educational inequalities did not decrease, or hardly decreased with age in England and Wales (men), Belgium, Switzerland, Austria, and Turin (women). Conclusions: Socioeconomic inequalities in mortality among older men and women were found to persist in each country, sometimes of similar magnitude as those among the middle aged. Mortality inequalities among older populations are an important public health problem in Europe.
OBJECTIVES: Twelve countries were compared with respect to occupational class differences in ischemic heart disease mortality in order to identify factors that are associated with smaller or larger mortality differences. METHODS: Data on mortality by occupational class among men aged 30 to 64 years were obtained from national longitudinal or cross-sectional studies for the 1980s. A common occupational class scheme was applied to most countries. Potential effects of the main data problems were evaluated quantitatively. RESULTS: A north-south contrast existed within Europe. In England and Wales, Ireland, and Nordic countries, manual classes had higher mortality rates than nonmanual classes. In France, Switzerland, and Mediterranean countries, manual classes had mortality rates as low as, or lower than, those among nonmanual classes. Compared with Northern Europe, mortality differences in the United States were smaller (among men aged 30-44 years) or about as large (among men aged 45-64 years). CONCLUSIONS: The results underline the highly variable nature of socioeconomic inequalities in ischemic heart disease mortality. These inequalities appear to be highly sensitive to social gradients in behavioral risk factors. These risk factor gradients are determined by cultural as well as socioeconomic developments.
[fre] Les instituteurs avaient la réputation d'avoir la plus longue durée de vie. Pour la période 1975-1980, ce sont les cadres supérieurs et les professeurs qui ont la plus faible mortalité, tandis que les manœuvres et les salariés agricoles restent les plus défavorisés. Depuis vingt-cinq ans, les écarts entre catégories sociales se sont accrus : la mortalité des ouvriers a moins diminué que celle des cols blancs ou des agriculteurs. L'inactivité pourrait bien être néfaste, car les chômeurs et les inactifs ont une mortalité beaucoup plus élevée que les autres; de même les femmes inactives ont une mortalité plus forte que les femmes actives; mais ces corrélations peuvent résulter, au moins en partie, de ce qu'une bonne constitution physique favorise l'activité et réduit le risque de décès. Si un niveau culturel élevé est favorable pour les hommes, il ne l'est pas autant pour les femmes. Comme l'activité professionnelle, la vie de famille semble jouer un rôle protecteur, dont l'homme profite plus que la femme. Les risques plus élevés correspondent vers 50 ans à une forte mortalité pour certaines causes : alcoolisme, cirrhose du foie, tumeurs de l'œsophage et des voies aériennes supérieures. Pour les hommes, l'importance croissante de ces tumeurs a entraîné une augmentation de la mortalité par cancer, en particulier pour les employés et les ouvriers. [eng] Social inequality in front of death - Teachers used to have the reputation of possessing the longest lifespan. For the period 1975-1980, it is managerial class and high school and university teachers who have the lowest mortality rate, while unskilled laborers and farm workers remain the most underprivileged. For 25 years, the disparities between social categories have been growing: the mortality rate of workers has decreased less than that of white collar workers or farmers. Inactivity could very well be deleterious, for the unemployed and the non-working men have a much higher mortality rate than the others, just as non-working women have a higher mortality rate than working women. But these correlations may result, at least in part, from the fact that a strong physical constitution favors activity and reduces the risk of death. If a high cultural level is favorable for men, it is not as favorable for women. Like professional activity, family life seems to play a protective role; one from which men profit more than women. There are certain causes of higher risk which towards age 50 correspond to a high mortality rate: alcoholism, cirrhosis of the liver, and tumors of the oesophagus and upper respiratory system. For men, the growing numbers of these tumors has brought about an increase in the cancer mortality rate, in particular for employees and workers. [spa] Desigualdad social frente a la muerte - Los maestros tenían fama de gozar una vida más larga. Para el período que mide entre 1975 y 1980, son los cuadros superiores y los profesores los que presentan más baja mortalidad, mientras que peones y asalariados agrícolas son más desfavorecidos. Desde hace 25 año...
[fre] En 1982, les différentes nationalités qui composent les 3,7 millions d'étrangers vivant sur le territoire métropolitain sont très diversement réparties. Si les Algériens, les Marocains et les Tunisiens sont très nombreux en proche banlieue parisienne, les Portugais se concentrent plutôt dans la grande couronne parisienne alors que les Espagnols et les Italiens, immigrés de plus longue date, se sont installés dans les régions frontalières de leur pays d'origine. La répartition a peu changé entre 1975 et 1982. Toutefois, en Ile-de-France la part des étrangers, déjà forte, a plus augmenté qu'en province et leur concentration s'accroît dans les communes de faible dynamisme démographique et en déclin économique. . En Ile-de-France, à un niveau plus fin (le quartier), la concentration est plus forte pour toutes les nationalités. Les Algériens et les Marocains se concentrent davantage dans les quartiers populaires où traditionnellement vivent des salariés d'industries à main-d'œuvre peu qualifiée. Les Italiens et les Espagnols sont plus proches des activités de services aux entreprises et aux particuliers. Les Portugais, dont la localisation est très liée à l'activité du bâtiment, sont davantage dispersés. Mais, d'une façon générale, les populations étrangères restent éloignées des pôles de technologies nouvelles. [eng] The Distribution of the Foreign Population - In 1982, the different nationalities which were represented by the 3.7 million foreigners living in the French metropolitan territory were very diversely distributed. The Algerians, Moroccans and Tunisians were very numerous in the suburbs near Paris, the Portugueses tended to concentrate in the outer ring of Paris, whereas the Italians and Spaniards, who arrived earlier, settled down near the borders of their native countries. The distribution did not change much between 1975 and 1982. However in Ile-de- France, the proportion of foreigners, which was already high, increased more than in the provinces and the concentration of foreigners rose in towns whith a low birth rate and a declining economy. . When the population of Ile-de-France is analysed in more detail, (at a neighborhood level), the concentration increases for all nationalities. The Algerians and Moroccans concentrate more in working class areas where there traditionally were and still are industrial activities employing unskilled labor. The Italians and Spaniards are closer to industries supplying services to firms and individuals. The Portugueses, whose distribution is strongly connected to the building industry, are more scattered. But in general, foreign populations remain far away from the centers of new technologies. [spa] La localization de la población extranjera - En el año 1 982 se registraba una repartición muy diversificada de las diferentes nacionalidades que agrupaban a los 37 millones de extranjeros résidentes en el territorio metropolitano. Si bien los argelinos, marroquies y tunecinos eran muy numerosos en las afueras más cercanas de la region parisiense, los Portugueses, en ...
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