Indicators of socioeconomic position (part 2)

Galobardes, Bruna; Shaw, Mary; Lawlor, Debbie A.; Lynch, John; Smith, George Davey

doi:10.1136/jech.2004.028092

Cited by 590 publications

(555 citation statements)

References 65 publications

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“…Educational level is a widely used and valid PSE indicator 36 and may be especially useful for our study of pregnant women as it is relevant for people regardless of age or working circumstances. 6 Furthermore, it is closely related to the knowledge and skills that women have to manage avoiding unintended pregnancies and also plays a strong role in determining abortion behavior. 37 The concept "Intendedness of pregnancy" is complex and it would probably be better to treat it as a continuous rather than a bicategorical variable.…”

Section: Discussionmentioning

confidence: 99%

“…(E-mail: gperez@aspb.es) Socioeconomic inequalities in unintended pregnancy and abortion decision can be understood as the differences in intellectual and material resources that exist between women according to their socioeconomic position (SEP), 6 which are translated to unequal opportunities when trying to avoid unintended pregnancies or when choosing the pregnancy outcome (performing an IA or continuing the pregnancy).…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic Inequalities in Unintended Pregnancy and Abortion Decision

et al. 2007

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Pregnancy planning allows women to better control their life trajectory and contributes to the future child's health and development. Many studies that have analyzed socioeconomic inequalities in unintended pregnancy only took into account those pregnancies ending in births. Few of them that analyzed unintended pregnancy, including both induced abortion and births, and its socioeconomic determinants, concluded that unintended pregnancy is more frequent in young, poor, or unmarried women. These inequalities have been poorly studied in Europe, especially in the southern European context. The aim of the present study is to describe socioeconomic inequalities in unintended pregnancy and in abortion decision in Barcelona, Spain. The major findings are that unintended pregnancies accounted for 41% of total pregnancy and of these, 60% ended in abortion. From all pregnancies, the proportion of induced abortion reached 25.6%. Compared to women with university studies, those with primary education uncompleted had more unintended pregnancies (OR=7.22). When facing an unintended pregnancy, women of lower socioeconomic position are more likely to choose induced abortion, although this is not the case among young or single women. This study reveals deep socioeconomic inequalities in unintended pregnancies and abortion decision in Barcelona, Spain, where the birth rate is very low and the abortion rate is rising. Women in low socioeconomic positions have many more unintended pregnancies than better educated women. Except for young or single women, the lower the socioeconomic position, the higher the proportion of women who choose an induced abortion when facing an unintended pregnancy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Socioeconomic Inequalities in Unintended Pregnancy and Abortion Decision

et al. 2007

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“…We did this for two reasons: (1) not only does educational level partly reflect material resources because it structures occupation and income, it also reflects non-economic social characteristics, such as general and health-related knowledge, literacy, problemsolving skills and prestige 35,36 and (2) educational level has also been shown to be the strongest and most consistent socioeconomic predictor of cardiovascular health. 22 To various extents, our results may have been influenced by the following limitations.…”

Section: Methodsological Considerationsmentioning

confidence: 99%

Maternal educational level and risk of gestational hypertension: the Generation R Study

et al. 2008

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We examined whether maternal educational level as an indicator of socioeconomic status is associated with gestational hypertension. We also examined the extent to which the effect of education is mediated by maternal substance use (that is smoking, alcohol consumption and illegal drug use), pre-existing diabetes, anthropometrics (that is height and body mass index (BMI)) and blood pressure at enrolment. This was studied in 3262 Dutch pregnant women participating in the Generation R Study, a population-based cohort study. Level of maternal education was established by questionnaire at enrolment, and categorized into high, mid-high, mid-low and low. Diagnosis of gestational hypertension was retrieved from medical records using standard criteria. Odds ratios (OR) of gestational hypertension for educational levels were calculated, adjusted for potential confounders and additionally adjusted for potential mediators. Adjusted for age and gravidity, women with mid-low (OR: 1.52; 95% CI: 1.02, 2.27) and low education (OR: 1.30; 95% CI: 0.80, 2.12) had a higher risk of gestational hypertension than women with high education. Additional adjustment for substance use, pre-existing diabetes, anthropometrics and blood pressure at enrolment attenuated these ORs to 1.09 (95% CI: 0.70, 1.69) and 0.89 (95% CI: 0.50, 1.58), respectively. These attenuations were largely due to the effects of BMI and blood pressure at enrolment. Women with relatively low educational levels have a higher risk of gestational hypertension, which is largely due to higher BMI and blood pressure levels from early pregnancy. The higher risk of gestational hypertension in these women is probably caused by pre-existing hypertensive tendencies that manifested themselves during pregnancy.

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“…8 Differences between urban and national rates have also been observed in other countries. 9,10 Socioeconomic inequalities in the decision to abort can be understood in terms of the differences in intellectual and material resources available to women in different socioeconomic positions, 11 resulting in unequal opportunities to avoid unintended pregnancies. Socioeconomic inequalities in pregnancy planning have already been reported in the city and are similar to those of other countries: teenage fertility rates vary greatly according to income levels 12 ; pregnancies in disadvantaged women are more often unintended 10 or more poorly controlled.…”

Section: Introductionmentioning

confidence: 99%

Trends in Inequalities in Induced Abortion According to Educational Level among Urban Women

et al. 2010

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This study aims to describe trends in inequalities by women's socioeconomic position and age in induced abortion in Barcelona (Spain) over 1992-1996 and 2000-2004. Induced abortions occurring in residents in Barcelona aged 20 and 44 years in the study period are included. Variables are age, educational level, and time periods. Induced abortion rates per 1,000 women and absolute differences for educational level, age, and time period are calculated. Poisson regression models are fitted to obtain the relative risk (RR) for trends. Induced abortion rates increased from 10.1 to 14.6 per 1,000 women aged 20-44 (RR=1.44; 95% confidence interval (CI) 1.41-1.47) between 1992-1996 and 2000-2004. The abortion rate was highest among women aged 20-24 and 25-34 and changed little among women aged 35-44. Among women aged 20-24 and 25-34, those with a primary education or less had higher rates of induced abortion in the second period. Induced abortion rates also grew in those women with secondary education. In the 35-44 age group, the induced abortion rate declined among women with a secondary education (RR=0.66; 95% CI 0.60-0.73) and slightly among those with a greater level of education. Induced abortion is rising most among women in poor socioeconomic positions. This study reveals deep inequalities in induced abortion in Barcelona, Spain. The trends identified in this study suggest that policy efforts to reduce unintended pregnancies are failing in Spain. Our study fills an important gap in literature on recent trends in Southern Europe.

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Indicators of socioeconomic position (part 2)

Abstract: This is the second part of a glossary on indicators of socioeconomic position used in health research (the first part was published in the January issue of the journal).

Cited by 590 publications

References 65 publications

Socioeconomic Inequalities in Unintended Pregnancy and Abortion Decision

Socioeconomic Inequalities in Unintended Pregnancy and Abortion Decision

Maternal educational level and risk of gestational hypertension: the Generation R Study

Trends in Inequalities in Induced Abortion According to Educational Level among Urban Women

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