Pathways between socioeconomic determinants of health

Lahelma, Eero; Martikainen, Pekka; Laaksonen, Mikko; Aittomäki, Akseli

doi:10.1136/jech.2003.011148

Cited by 371 publications

(330 citation statements)

References 32 publications

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“…Education also has been interpreted as influencing health through the acquisition of higher cognitive functions. Education might effect not only on knowledge and attitudes, but also on the degree of control individuals take about their own health (Lahelma et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Literacy and Breast Cancer Prevention: a Population-Based Study from Iran

Harirchi

Azary²,

Montazeri³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Breast cancer is the most common cancer in women worldwide and the leading cause of death from cancer among women. Evidence suggests that early diagnosis and screening interventions might help to improve outcomes. This population-based study was conducted to determine breast cancer awareness and screening behavior among Iranian women and to examine its association with women's literacy. The study was carried out in two provinces, with 1,477,045 population, located in central and eastern part of Iran. Overall, 770 women were studied. Of these, 482 (62.7%) were literate and 287 (37.3%) were not. The results obtained from the data analysis indicated that there was a significant difference between literate and illiterate women. Further analysis of the data using logistic regression showed that literacy was an important contributing factor for breast cancer prevention behavior. The findings suggest that in order to improve women's health and breast cancer outcomes providing equal educational opportunities for women seems necessary.

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Section: Discussionmentioning

confidence: 99%

Literacy and Breast Cancer Prevention: a Population-Based Study from Iran

Harirchi

Azary²,

Montazeri³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…The use of multiple indicators of SES accounts for both common and differential effects of the various SES dimensions on health and provides insights into their interrelationships, which are relevant for health over and above direct causal associations (Blane, 1995;Krieger, Williams, & Moss, 1997;Lahelma, Martikainen, Laaksonen, & Aittomaki, 2004;Singh-Manoux, Clarke, & Marmot, 2002).Unlike most studies we are able to include wealth as a measure of material inequalities. We consider this to be a major advantage of our study as wealth is a marker of SES that indicates command over assets and material resources, reflects accumulated advantage and future economic prospects, and lies in the core of material inequalities in health (Oliver & Shapiro, 1995;Ostrove, Feldman, & Adler, 1999).…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic status and health: The role of subjective social status

Demakakos

Nazroo

Breeze

et al. 2008

Social Science & Medicine

571

519

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Studies have suggested that subjective social status (SSS) is an important predictor of health. This study examined the link between SSS and health in old age and investigated whether SSS mediated the associations between objective indicators of socioeconomic status and health. It used crosssectional data from the second wave (2004-05) of the English Longitudinal Study of Ageing, which were collected through personal interviews and nurse visits. The study population consisted of 3368 men and 4065 women aged 52 years or older. The outcome measures included: self-rated health, long-standing illness, depression, hypertension, diabetes, central obesity, high-density lipoprotein cholesterol, triglycerides, fibrinogen, and C-reactive protein. The main independent variable was SSS measured using a scale representing a 10-rung ladder. Wealth, education, and occupational class were employed as covariates along with age and marital status and also, in additional analyses, as the main independent variables. Gender-specific logistic and linear regression analyses were performed. In age-adjusted analyses SSS was related positively to almost all health outcomes. Many of these relationships remained significant after adjustment for covariates. In men, SSS was significantly (p≤0.05) related to self-rated health, depression, and long-standing illness after adjustment for all covariates, while its association with fibrinogen became non-significant. In women, after adjusting for all covariates, SSS was significantly associated with self-rated health, depression, long-standing illness, diabetes, and high-density lipoprotein cholesterol, but its associations with central obesity and C-reactive protein became non-significant. Further analysis suggested that SSS mediated fully or partially the associations between education, occupational class and self-reported and clinical health measures. On the contrary, SSS did not mediate wealth's associations with the outcome measures, except those with self-reported health measures. Our results suggest that SSS is an important correlate of health in old age, possibly because of its ability to epitomize life-time achievement and socioeconomic status.

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“…Each socio-economic indicator reflects both common ranking in society as well as particular circumstances according to the specific nature of the socio-economic indicator (Liberatos et al, 1988;Lynch and Kaplan, 2000;Lahelma et al, 2004;Laaksonen et al, 2005b). Consequently, socio-economic indicators are not directly interchangeable, and any single indicator is unlikely to provide a sufficient description of people's past and present circumstances.…”

Section: Introductionmentioning

confidence: 99%

Multiple socio-economic circumstances and healthy food habits

et al. 2006

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Objective: To examine associations between seven indicators of socio-economic circumstances and healthy food habits, while taking into account assumed temporal order between these socio-economic indicators. Design and setting: Data were derived from cross-sectional postal questionnaires in 2000-2002. Socio-economic circumstances were assessed by parental education, childhood economic difficulties, own education, occupational class, household income, home ownership and current economic difficulties. Healthy food habits were measured by an index consisting of consumption of fresh vegetables, fruit or berries, rye bread, fish and choosing vegetable fats on bread and oil in cooking. Sequential logistic regression models were used, adjusting for age and marital status. Participants: Employees of the City of Helsinki, Finland (n ¼ 8960, aged 40-60 years). Results: Healthy food habits were reported by 28% of women and by 17% of men. Own education, occupational class, household income, home ownership and current economic difficulties were associated with healthy food habits. These associations were attenuated but mainly remained after mutual adjustments for the socio-economic indicators. Among women, a pathway was found suggesting that part of the effects of education on food habits were mediated through occupational class. Conclusions: Employees in higher and lower socio-economic positions differ in their food habits, and those in lower positions and economically disadvantaged are less likely to report healthy food habits. Health promotion programmes and food policies should encourage healthier food choices among those in lower socio-economic positions and among those with economic difficulties in particular. Sponsorship: Academy of Finland.

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Pathways between socioeconomic determinants of health

Cited by 371 publications

References 32 publications

Literacy and Breast Cancer Prevention: a Population-Based Study from Iran

Literacy and Breast Cancer Prevention: a Population-Based Study from Iran

Socioeconomic status and health: The role of subjective social status

Multiple socio-economic circumstances and healthy food habits

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