BACKGROUND: Psychological factors associated with low social status have been proposed as one possible explanation for the socio-economic gradient in health. The aim of this study is to explore whether different indicators of psychological distress contribute to socio-economic differences in cause-specific mortality. METHODS: The data source is a nationally representative, repeated cross-sectional survey, "Health Behaviour and Health among the Finnish Adult Population" (AVTK). The survey results were linked with socio-economic register data from Statistics Finland (from the years 1979-2002) and mortality follow-up data up to 2006 from the Finnish National Cause of Death Register. The data included 32,451 men and 35,420 women (response rate 73.5%). Self-reported measures of depression, insomnia and stress were used as indicators of psychological distress. Socio-economic factors included education, employment status and household income. Mortality data consisted of unnatural causes of death (suicide, accidents and violence, and alcohol-related mortality) and coronary heart disease (CHD) mortality. Adjusted hazard ratios were calculated using the Cox regression model. RESULTS: In unnatural mortality, psychological distress accounted for some of the employment status (11-31%) and income level (4-16%) differences among both men and women, and for the differences related to the educational level (5-12%) among men; the educational level was associated statistically significantly with unnatural mortality only among men. Psychological distress had minor or no contribution to socio-economic differences in CHD mortality. CONCLUSIONS: Psychological distress partly accounted for socio-economic disparities in unnatural mortality. Further studies are needed to explore the role and mechanisms of psychological distress associated with socio-economic differences in cause-specific mortality.
BACKGROUND: Psychological factors associated with low social status have been proposed as one possible explanation for the socio-economic gradient in health. The aim of this study is to explore whether different indicators of psychological distress contribute to socio-economic differences in cause-specific mortality. METHODS: The data source is a nationally representative, repeated cross-sectional survey, "Health Behaviour and Health among the Finnish Adult Population" (AVTK). The survey results were linked with socio-economic register data from Statistics Finland (from the years 1979-2002) and mortality follow-up data up to 2006 from the Finnish National Cause of Death Register. The data included 32,451 men and 35,420 women (response rate 73.5%). Self-reported measures of depression, insomnia and stress were used as indicators of psychological distress. Socio-economic factors included education, employment status and household income. Mortality data consisted of unnatural causes of death (suicide, accidents and violence, and alcohol-related mortality) and coronary heart disease (CHD) mortality. Adjusted hazard ratios were calculated using the Cox regression model. RESULTS: In unnatural mortality, psychological distress accounted for some of the employment status (11-31%) and income level (4-16%) differences among both men and women, and for the differences related to the educational level (5-12%) among men; the educational level was associated statistically significantly with unnatural mortality only among men. Psychological distress had minor or no contribution to socio-economic differences in CHD mortality. CONCLUSIONS: Psychological distress partly accounted for socio-economic disparities in unnatural mortality. Further studies are needed to explore the role and mechanisms of psychological distress associated with socio-economic differences in cause-specific mortality.
Authors: Mika Kivimäki; David Gunnell; Debbie A Lawlor; George Davey Smith; Jaana Pentti; Marianna Virtanen; Marko Elovainio; Timo Klaukka; Jussi Vahtera Journal: Psychol Med Date: 2006-11-23 Impact factor: 7.723
Authors: Johan P Mackenbach; Vivian Bos; Otto Andersen; Mario Cardano; Giuseppe Costa; Seeromanie Harding; Alison Reid; Orjan Hemström; Tapani Valkonen; Anton E Kunst Journal: Int J Epidemiol Date: 2003-10 Impact factor: 7.196
Authors: Mikko Laaksonen; Kirsi Talala; Tuija Martelin; Ossi Rahkonen; Eva Roos; Satu Helakorpi; Tiina Laatikainen; Ritva Prättälä Journal: Eur J Public Health Date: 2007-06-14 Impact factor: 3.367
Authors: Kirsi M Talala; Tuija P Martelin; Ari H Haukkala; Tommi T Härkänen; Ritva S Prättälä Journal: BMC Public Health Date: 2012-08-13 Impact factor: 3.295