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Exploring trends in and determinants of educational inequalities in self-rated health
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Uppsala University, Sweden.
Vastmanland County Council, Sweden.
Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
Örebro County Council, Sweden.
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2015 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 7, 677-686 p.Article in journal (Refereed) Published
Abstract [en]

Aims: Educational inequalities in self-rated health (SRH) in European welfare countries are documented, but recent trends in these inequalities are less well understood. We examined educational inequalities in SRH in different age groups, and the contribution of selected material, behavioural and psychosocial determinants from 2000 to 2008. Methods: Data were derived from cross-sectional surveys conducted in 2000, 2004 and 2008 including 37,478, 34,876 and 32,982 respondents, respectively, aged 25-75 in mid-Sweden. Inequalities were analysed by age-standardized and age-stratified rate ratios of poor SRH and age-standardized prevalence of determinants, and contribution of determinants by age-adjusted logistic regression. Results: Relative educational inequalities in SRH increased among women from 2000 (rate ratio (RR) 1.70, 95% CI 1.55-1.85) to 2008 (RR 2.07, 95% CI 1.90-2.26), but were unchanged among men (RR 1.91-2.01). The increase among women was mainly due to growing inequalities in the age group 25-34 years. In 2008, significant age differences emerged with larger inequalities in the youngest compared with the oldest age group in both genders. All determinants were more prevalent in low educational groups; the most prominent were lack of a financial buffer, smoking and low optimism. Educational differences were unchanged over the years for most determinants. In all three surveys, examined determinants together explained a substantial part of the educational inequalities in SRH. Conclusions: Increased relative educational health inequalities among women, and persisting inequalities among men, were paralleled by unchanged, large differences in material/structural, behavioural and psychosocial factors. Interventions to reduce these inequalities need to focus on early mid-life.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD , 2015. Vol. 43, no 7, 677-686 p.
Keyword [en]
Health status disparities; social medicine; socioeconomic factors; educational status
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:liu:diva-122099DOI: 10.1177/1403494815592271ISI: 000361768900002PubMedID: 26138729OAI: oai:DiVA.org:liu-122099DiVA: diva2:861909
Note

Funding Agencies|Centre for Clinical Research Sormland, Uppsala University; Sormland County Council, Sweden; County Council of Vastmanland; County Council of Uppsala; County Council of Sormland; County Council of Orebro; County Council of Varmland

Available from: 2015-10-19 Created: 2015-10-19 Last updated: 2016-04-11

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Garvin, PeterKristenson, Margareta
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Division of Community MedicineFaculty of Medicine and Health SciencesResearch & Development Unit in Local Health Care
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Public Health, Global Health, Social Medicine and Epidemiology

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