RT Journal Article
T1 Social inequalities and mortality in Europe-results from a large multi-national cohort
A1 Gallo, Valentina
A1 Mackenbach, Johan P.
A1 Ezzati, Majid
A1 Menvielle, Gwenn
A1 Kunst, Anton E.
A1 Rohrmann, Sabine
A1 Kaaks, Rudolf
A1 Teucher, Birgit
A1 Boeing, Heiner
A1 Bergmann, Manuela M.
A1 Tjønneland, Anne
A1 Dalton, Susanne O.
A1 Overvad, Kim
A1 Redondo, Maria-Luisa
A1 Agudo, Antonio
A1 Daponte, Antonio
A1 Arriola, Larraitz
A1 Navarro, Carmen
A1 Barricante Gurrea, Aurelio
A1 Khaw, Kay-Tee
A1 Wareham, Nick
A1 Key, Tim
A1 Naska, Androniki
A1 Trichopoulou, Antonia
A1 Trichopoulos, Dimitrios
A1 Masala, Giovanna
A1 Panico, Salvatore
A1 Contiero, Paolo
A1 Tumino, Rosario
A1 Bueno-de-Mesquita, H Bas
A1 Siersema, Peter D
A1 Peeters, Petra P
A1 Zackrisson, Sophia
A1 Almquist, Martin
A1 Eriksson, Sture
A1 Hallmans, Göran
A1 Skeie, Guri
A1 Braaten, Tonje
A1 Lund, Eiliv
A1 Illner, Anne-Kathrin
A1 Mouw, Traci
A1 Riboli, Elio
A1 Vineis, Paolo
K1 Lung-cancer incidence
K1 Socioeconomic inequalities
K1 Educational inequalities
K1 Cardiovascular risk
K1 Health
K1 Nutrition
K1 Women
K1 Survival
K1 Determinants
K1 Association
K1 Disparidades en atención de salud
K1 Mortalidad
K1 Europa
AB BACKGROUNDSocio-economic inequalities in mortality are observed at the country level in both North America and Europe. The purpose of this work is to investigate the contribution of specific risk factors to social inequalities in cause-specific mortality using a large multi-country cohort of Europeans.METHODSA total of 3,456,689 person/years follow-up of the European Prospective Investigation into Cancer and Nutrition (EPIC) was analysed. Educational level of subjects coming from 9 European countries was recorded as proxy for socio-economic status (SES). Cox proportional hazard model's with a step-wise inclusion of explanatory variables were used to explore the association between SES and mortality; a Relative Index of Inequality (RII) was calculated as measure of relative inequality.RESULTSTotal mortality among men with the highest education level is reduced by 43% compared to men with the lowest (HR 0.57, 95% C.I. 0.52-0.61); among women by 29% (HR 0.71, 95% C.I. 0.64-0.78). The risk reduction was attenuated by 7% in men and 3% in women by the introduction of smoking and to a lesser extent (2% in men and 3% in women) by introducing body mass index and additional explanatory variables (alcohol consumption, leisure physical activity, fruit and vegetable intake) (3% in men and 5% in women). Social inequalities were highly statistically significant for all causes of death examined in men. In women, social inequalities were less strong, but statistically significant for all causes of death except for cancer-related mortality and injuries.DISCUSSIONIn this European study, substantial social inequalities in mortality among European men and women which cannot be fully explained away by accounting for known common risk factors for chronic diseases are reported.
PB Public Library of Science
PB Thomas Behrens, University of Bochum, Germany
YR 2012
FD 2012-07-25
LK http://hdl.handle.net/10668/792
UL http://hdl.handle.net/10668/792
LA en
NO Gallo V, Mackenbach JP, Ezzati M, Menvielle G, Kunst AE, Rohrmann S, et al. Social inequalities and mortality in Europe-results from a large multi-national cohort. PLoS ONE 2012; 7(7):e39013
NO Journal Article; Research Support, Non-U.S. Gov't;
DS RISalud
RD Apr 18, 2025