Educational inequalities in mortality and associated risk factors: German- versus French-speaking Switzerland

BMC Public Health

Research Article

Matthias Bopp¹  David Faeh¹ 

[1] Institute of Social and Preventive Medicine (ISPM), University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland;

关键词: Lung Cancer Mortality;    Educational Inequality;    Daily Alcohol Consumption;    Educational Gradient;    Health Survey Data;   

DOI  :  10.1186/1471-2458-10-567

 received in 2009-09-11, accepted in 2010-09-22,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundBetween the French- and German-speaking areas of Switzerland, there are distinct differences in mortality, similar to those between Germany and France. Assessing corresponding inequalities may elucidate variations in mortality and risk factors, thereby uncovering public health potential. Our aim was to analyze educational inequalities in all-cause and cause-specific mortality in the two Swiss regions and to compare this with inequalities in behavioural risk factors and self-rated health.MethodsThe Swiss National Cohort, a longitudinal census-based record linkage study, provided mortality and survival time data (3.5 million individuals, 40-79 years, 261,314 deaths, 1990-2000). The Swiss Health Survey 1992/93 provided cross-sectional data on risk factors. Inequalities were calculated as percentage of change in mortality rate (survival time, hazard ratio) or risk factor prevalence (odds ratio) per year of additional education using multivariable Cox and logistic regression.ResultsSignificant inequalities in mortality were found for all causes of death in men and for most causes in women. Inequalities were largest in men for causes related to smoking and alcohol use and in women for circulatory diseases. Gradients in all-cause mortality were more pronounced in younger and middle-aged men, especially in German-speaking Switzerland. Mortality inequalities tended to be larger in German-speaking Switzerland whereas inequalities in associated risk factors were generally more pronounced in French-speaking Switzerland.ConclusionsWith respect to inequalities in mortality and associated risk factors, we found characteristic differences between German- and French-speaking Switzerland, some of which followed gradients described in Europe. These differences only partially reflected inequalities in associated risk factors.

【 授权许可】

Unknown   
© Faeh et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.