Documents Valkonen, Tapani 3 results

"Background Less attention has been paid to mortality trends across income groups than those measured by other socioeconomic indicators. This study assessed the change in life expectancy by income over 20?years in the Finnish general population. Methods Life expectancy among 35-year-olds by household income quintiles was studied. Change in life expectancy from 1988–92 to 2003–7 was decomposed by age and cause of death. The dataset contained 754?087 deaths by oversample of 80% of all deaths during the period. Results The gap in life expectancy between the highest and the lowest income quintiles widened during the study period by 5.1?years among men and 2.9?years among women, and in 2007 it stood at 12.5?years and 6.8?years, respectively. Stagnation in the lowest income group was the main reason for the increased disparity for both sexes. Increasing mortality attributable to alcohol-related diseases and increasing or stagnating mortality for many cancers, as well as a slower decline in mortality due to ischaemic heart disease among men in the lowest income quintile, were the most significant factors increasing the gap. Conclusions The increasing gap in life expectancy was mostly due to the stagnation of mortality in the lowest income quintile and especially because of the increasing mortality in alcohol-related diseases. The increase in disparity may be more extreme when using income instead of occupational class or education, possibly because income identifies a lower and economically more deprived segment on a social hierarchy more clearly. The results identify a clear need to tackle the specific health problems of the poorest."

"Background and objectives Studies on socioeconomic health disparities often suffer from a lack of uniform data and methodology. Using high quality, census-linked data and sensible inequality measures, this study documents the changes in absolute and relative mortality differences by education in Finland, Norway and Sweden over the period 1971 to 2000. Methods The age-standardised mortality rates and the population exposures for three educational categories were computed from detailed data provided by the national statistical offices. Mortality disparities by education were assessed using two range measures (rate differences and rate ratios), and two Gini-like measures (the average inter-group difference (AID) and the Gini coefficient (G)). The formulae for the decomposition of the change in the AID into (1) the contribution of change in population composition by education, and (2) the contribution of mortality change were introduced. Results Mortality decreases were often greater for high than for medium and low education. Both relative and absolute mortality disparities tend to increase over time. The magnitude and timing of the increases in absolute disparities vary by country. Both the rate differences and the AIDs have increased since the 1970s in Norway and Sweden, and since the 1980s in Finland. The contributions of the changes in population composition to the total AID increase were substantial in all countries, and for both sexes. The mortality contributions were substantial for males in Norway and Sweden. Conclusions The study reports increases in absolute mortality disparity, and its components. This trend needs to be further studied and addressed by policies."

"Background Knowledge on health inequalities in early life is less complete and less consistent than with the well-documented differentials in the adult population. This study examines the presence and strength of the association between parental education and mortality during different periods of childhood and young adulthood, and changes in the association over time. Methods Longitudinal individual level data were used in a register follow-up of 15 years. The data include an 11% sample of the Finnish population with an oversample of 80% of all deaths between the ages of 1 and 24. Mortalities and relative indices of inequality (RII) were calculated by parental education, sex, age group and cause of death. Results Lower parental education was associated with a higher risk of mortality during the whole period of 1990–2004. The differentials were largest among 1–4-year-old children (RII=2.4, 95% CI 1.57 to 3.56 for males and RII=4.5, 2.71 to 7.32 for females) and among young men aged 15–19 (RII=2.4, 2.00 to 2.98). The educational gradient was sharper in accidental and violent causes of death, but deaths from diseases contributed to differentials for both sexes among the youngest and the oldest. Conclusion The association between parental education and mortality in young age was consistent, although distinctively patterned by sex, age and cause of death. The results provide some support for the idea of equalisation of health inequalities during the child–youth transition. The convergence of differences in late childhood, and re-emergence in early adulthood, particularly among men, was, however, related to changes in the cause composition of deaths."