Reducing socioeconomic inequalities in mortality in Western Europe critically depends upon speeding up mortality declines from cardiovascular diseases in lower socioeconomic groups, and countering mortality increases from several other causes of death in lower socioeconomic groups.

The results underscore the persistent nature of socioeconomic inequalities in health in modern societies. The relatively favourable trends in the Nordic countries suggest that these countries' welfare states were able to buffer many of the adverse effects of economic crises on the health of disadvantaged groups.

The papers in this special collection were presented at the seminar "Determinants of Diverging Trends in Mortality", held at MPIDR, Rostock on 19-21 of June, 2002. The seminar was organized by the Max Planck Institute for Demographic Research and the Committee on Emerging Health Threats of the International Union for the Scientific Study of Population.

This study assesses whether stroke mortality trends have been less favorable among lower than among higher socioeconomic groups. Longitudinal data on mortality by socioeconomic status were obtained for Finland, Norway, Denmark, Sweden, England/Wales, and Turin, Italy. Data covered the entire population or a representative sample. Stroke mortality rates were calculated for the period 1981-1995. Changes in stroke mortality rate ratios were analyzed using Poisson regression and compared with rate ratios in ischemic heat disease mortality. Trends in stroke mortality were generally as favorable among lower as among higher socioeconomic groups, such that socioeconomic disparities in stroke mortality persisted and remained of a similar magnitude in the 1990s as in the 1980s. In Norway, however, occupational disparities in stroke mortality significantly widened, and a nonsignificant increase was observed in some countries. In contrast, disparities in ischemic heart disease mortality widened throughout this period in most populations. Improvements in hypertension prevalence and treatment may have contributed to similar stroke mortality declines in all socioeconomic groups in most countries. Socioeconomic disparities in stroke mortality generally persisted and may have widened in some populations, which fact underlines the need to improve preventive and secondary care for stroke among the lower socioeconomic groups.

The irruption of severe mental distress into the life of an individual determines a deep biographical disruption. To cope with this crisis, individuals are involved in a laborious sense-making activity, through the composition of narratives intended to create a new link between past, present and future. This essay analyses the sense-making strategies that follow this dramatic experience through the comparison of four illness narratives composed by Italian participants. The narratives are selected from a broader textual corpus in a way that authorizes their connotation as 'flesh and blood' ideal types. These narratives illustrate three kinds of explanation for the outset of mental distress: the biomedical adopted by Vito; the spiritual-religious adopted by Marta; and the psycho-social adopted by Giacomo. Vito, Marta and Giacomo are still inside the story they are telling, and compose the events by observing them through the eyes of a patient, qualifying their diversity as a stigma. The fourth narrative is different, composed by Serena, a 'voices hearer' who comes to terms with her voices not by silencing them with drugs, but by accepting them as a charisma that has transformed her into a medium and, on final analysis, a balanced woman.