Occupational inequalities in self-rated health and non-communicable diseases in different regions of Europe: findings from the European Social Survey (2014) special module on the social determinants of health

Abstract

BackgroundSocioeconomic inequalities in the prevalence of non--communicable diseases (NCDs) are evident across European populations. Several previous studies have addressed the question of whether occupational inequalities in health differ across European regions. It is uncertain however, the degree to which occupational inequalities in NCDs are similar or dissimilar across different European regions. MethodsUsing 2014/15 European Social Survey data from 20 countries, this paper examines occupational inequalities in poor self--rated health (SRH) and 14 self--reported NCDs separately for women and men, by European region: heart/circulatory problems, high blood pressure, back pain, arm/hand pain, foot/leg pain, allergies, breathing problems, stomach/digestion problems, skin conditions, diabetes, severe headaches, cancer, obesity and depression. Age--controlled adjusted risk ratios were calculated and separately compared a working class and intermediate occupational group with a salariat group. ResultsWorking class Europeans appear to have the highest risk of reporting poor SRH and a number of NCDs. We find inequalities in some NCDS to be the largest in the Northern region, suggesting further evidence of a Nordic paradox. Like some previous work, we did not find larger inequalities in poor SRH in the Central/East region. However, we did find the largest inequalities in this region for some NCDs. Our results do not align completely with previous work which finds smaller health inequalities in Southern Europe. ConclusionsThis work provides a first look at occupational inequalities across a range of NCDs for European men and women by region. Future work is needed to identify the underlying determinants behind regional differences.

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“…8 Casual workers, with informal contracts and limited access to social protection, such as sick pay, may avoid self-isolating if symptomatic because doing so would lead to loss of earnings. Workers in lower occupational groups are also more likely to suffer from non-communicable diseases, 9 which could place them at greater risk of becoming severely ill or dying from COVID-19. 10 …”

Association between occupations and selected noncommunicable diseases: A matched case-control among Thai informal workers

“…5 These unequal conditions are based on socioeconomic status, gender, and race. 3 A large survey in European countries and a systematic review among LMICs emphasized the linkages between social inequality and health, [6][7][8] with a higher NCD prevalence among lower socioeconomic occupations and females. 6,7 Cardiovascular diseases were found to be more common among low socioeconomic status persons, while diabetes mellitus was common among high socioeconomic status persons.…”

“…3 A large survey in European countries and a systematic review among LMICs emphasized the linkages between social inequality and health, [6][7][8] with a higher NCD prevalence among lower socioeconomic occupations and females. 6,7 Cardiovascular diseases were found to be more common among low socioeconomic status persons, while diabetes mellitus was common among high socioeconomic status persons. 8 Occupational classification is one of the social determinants that can frame ways of life and social interactions as well as opportunities that would affect health and well-being in later life.…”

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“…The fourth article, by McNamara et al 10 , is the first to document, for several NCDs and representative samples of European populations, significant crossnational heterogeneity in education-based inequalities in the experience of NCDs. For the same set of NCDs, along with self-rated health, the fifth article, by McNamara et al 11 , documents significant regional heterogeneity in occupation-based inequalities. This work finds different patterns of inequalities between Northern, North-Western, Southern, Eastern and Western European regions for different health outcomes.…”