RESUMEN
OBJECTIVE: To assess the association between socioeconomic status and ischaemic heart disease (IHD) mortality in 10 western European populations during the 1990s. DESIGN: Longitudinal study. SETTING: 10 European populations (95,009,822 person years). METHODS: Longitudinal data on IHD mortality by educational level were obtained from registries in Finland, Norway, Denmark, England/Wales, Belgium, Switzerland, Austria, Turin (Italy), Barcelona (Spain), and Madrid (Spain). Age standardised rates and rate ratios (RRs) of IHD mortality by educational level were calculated by using Poisson regression. RESULTS: IHD mortality was higher in those with a lower socioeconomic status than in those with a higher socioeconomic status among men aged 30-59 (RR 1.55, 95% confidence interval (CI) 1.51 to 1.60) and 60 years and over (RR 1.22, 95% CI 1.21 to 1.24), and among women aged 30-59 (RR 2.13, 95% CI 1.98 to 2.29) and 60 years and over (RR 1.36, 95% CI 1.33 to 1.38). Socioeconomic disparities in IHD mortality were larger in the Scandinavian countries and England/Wales, of moderate size in Belgium, Switzerland, and Austria, and smaller in southern European populations among men and younger women (p < 0.0001). For elderly women the north-south gradient was smaller and there was less variation between populations. No socioeconomic disparities in IHD mortality existed among elderly men in southern Europe. CONCLUSIONS: Socioeconomic disparities in IHD mortality were larger in northern than in southern European populations during the 1990s. This partly reflects the pattern of socioeconomic disparities in cardiovascular risk factors in Europe. Population wide strategies to reduce risk factor prevalence combined with interventions targeted at the lower socioeconomic groups can contribute to reduce IHD mortality in Europe.
Asunto(s)
Isquemia Miocárdica/mortalidad , Clase Social , Adulto , Distribución por Edad , Anciano , Europa (Continente)/epidemiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Distribución por SexoRESUMEN
PIP: "The demographic trend of decreasing numbers of children and the rising share of elderly prevailing in most industrialized countries is considered a problem by a large part of the Austrian population. Marriage and family continue to be of central importance.... These are results of the Austrian Population Policy Acceptance Survey (PPA) carried out in 1993. On the average, Austrians born between 1953 and 1972 want 1.99 children, which is clearly above the present (1995) total fertility rate of 1.40....[They] expect the government to assume the main responsibility for family and social matters. 40 percent of the Austrians consider the government fully responsible for helping women to manage child raising and jobs. Only one third of the population are fully content with family [policies], and some 40 percent consider social benefits for families not sufficiently generous.... The effects family [policy] measures have on the desire to have children and its realization, however, [are] disputed." (EXCERPT)^ieng
Asunto(s)
Recolección de Datos , Composición Familiar , Política de Planificación Familiar , Aceptación de la Atención de Salud , Política Pública , Austria , Países Desarrollados , Europa (Continente) , Organización y Administración , Evaluación de Programas y Proyectos de Salud , Investigación , MuestreoRESUMEN
PIP: The author examines results from the 1961, 1971, and 1981 censuses of Austria and includes information on population, fertility, migration, households, residences, and places of work. The six large Austrian cities and their environs and the Rheintal agglomeration are examined. Results for the remaining 31 city regions and rural areas are summarized. Demographic trends and differences in development among the geographic areas are discussed.^ieng