Socioeconomic inequalities in health in 22 European countries

European Union Working Group on Socioeconomic Inequalities in Health, A. Villerusa

    Research output: Contribution to journalArticlepeer-review

    2365 Citations (Scopus)

    Abstract

    Background: Comparisons among countries can help to identify opportunities for the reduction of inequalities in health. We compared the magnitude of inequalities in mortality and self-assessed health among 22 countries in all parts of Europe. Methods: We obtained data on mortality according to education level and occupational class from census-based mortality studies. Deaths were classified according to cause, including common causes, such as cardiovascular disease and cancer; causes related to smoking; causes related to alcohol use; and causes amenable to medical intervention, such as tuberculosis and hypertension. Data on self-assessed health, smoking, and obesity according to education and income were obtained from health or multipurpose surveys. For each country, the association between socioeconomic status and health outcomes was measured with the use of regression-based inequality indexes. Results: In almost all countries, the rates of death and poorer self-assessments of health were substantially higher in groups of lower socioeconomic status, but the magnitude of the inequalities between groups of higher and lower socioeconomic status was much larger in some countries than in others. Inequalities in mortality were small in some southern European countries and very large in most countries in the eastern and Baltic regions. These variations among countries appeared to be attributable in part to causes of death related to smoking or alcohol use or amenable to medical intervention. The magnitude of inequalities in self-assessed health also varied substantially among countries, but in a different pattern. Conclusions: We observed variation across Europe in the magnitude of inequalities in health associated with socioeconomic status. These inequalities might be reduced by improving educational opportunities, income distribution, health-related behavior, or access to health care.

    Original languageEnglish
    Pages (from-to)2468-2481
    Number of pages14
    JournalNew England Journal of Medicine
    Volume358
    Issue number23
    DOIs
    Publication statusPublished - 5 Jun 2008

    Field of Science*

    • 3.3 Health sciences

    Publication Type*

    • 1.1. Scientific article indexed in Web of Science and/or Scopus database

    Fingerprint

    Dive into the research topics of 'Socioeconomic inequalities in health in 22 European countries'. Together they form a unique fingerprint.

    Cite this