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García-Castrillo P, González-Álvarez MA. Inequality in the Face of Death: The Income Gradient in Mortality of the Spanish Pre-Recession Working-Age Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312379. [PMID: 34886105 PMCID: PMC8657191 DOI: 10.3390/ijerph182312379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this paper is to evaluate the association between socioeconomic status (SES) and mortality over a three-year period for working-age Spaniards (2007-2009), paying particular attention to the effect of income level. The analysis is relatively new in Spain, and the studies are limited. Neither income nor wealth are included in existing Spanish mortality studies. The main reason for this limitation is the nature of the data sets used, mainly Census Records. We overcome this problem by using data on 693,994 individuals taken from a Social Security sampling and used to estimate the probabilities of death for each income decile and the mortality rate ratios in three different models: (1) using only income, controlled by age and sex, (2) adding socio-economic and geographical variables, and (3) adding level of education. However, the data used here also have some limitations. They do not include government employees, the military or the Department of Justice personnel, whose exclusion we believe causes an under-representation of highly educated people in our sample. The results confirm that there is a non-linear relationship between mortality and income. This non-linear relationship implies that income redistribution resulting from progressive taxation systems could lead to higher reductions in mortality for low-income groups than the reductions induced in the mortality of the high-income population, thus reducing overall mortality.
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Vanthomme K, Van den Borre L, Vandenheede H, Hagedoorn P, Gadeyne S. Site-specific cancer mortality inequalities by employment and occupational groups: a cohort study among Belgian adults, 2001-2011. BMJ Open 2017; 7:e015216. [PMID: 29133313 PMCID: PMC5695485 DOI: 10.1136/bmjopen-2016-015216] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This study probes into site-specific cancer mortality inequalities by employment and occupational group among Belgians, adjusted for other indicators of socioeconomic (SE) position. DESIGN This cohort study is based on record linkage between the Belgian censuses of 1991 and 2001 and register data on emigration and mortality for 01/10/2001 to 31/12/2011. SETTING Belgium. PARTICIPANTS The study population contains all Belgians within the economically active age (25-65 years) at the census of 1991. OUTCOME MEASURES Both absolute and relative measures were calculated. First, age-standardised mortality rates have been calculated, directly standardised to the Belgian population. Second, mortality rate ratios were calculated using Poisson's regression, adjusted for education, housing conditions, attained age, region and migrant background. RESULTS This study highlights inequalities in site-specific cancer mortality, both related to being employed or not and to the occupational group of the employed population. Unemployed men and women show consistently higher overall and site-specific cancer mortality compared with the employed group. Also within the employed group, inequalities are observed by occupational group. Generally manual workers and service and sales workers have higher site-specific cancer mortality rates compared with white-collar workers and agricultural and fishery workers. These inequalities are manifest for almost all preventable cancer sites, especially those cancer sites related to alcohol and smoking such as cancers of the lung, oesophagus and head and neck. Overall, occupational inequalities were less pronounced among women compared with men. CONCLUSIONS Important SE inequalities in site-specific cancer mortality were observed by employment and occupational group. Ensuring financial security for the unemployed is a key issue in this regard. Future studies could also take a look at other working regimes, for instance temporary employment or part-time employment and their relation to health.
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Affiliation(s)
- Katrien Vanthomme
- Department of Sociology - Interface Demography, Economic and Social Sciences and Solvay Business School - Vrije Universiteit Brussel, Brussels, Belgium
| | - Laura Van den Borre
- Department of Sociology - Interface Demography, Economic and Social Sciences and Solvay Business School - Vrije Universiteit Brussel, Brussels, Belgium
| | - Hadewijch Vandenheede
- Department of Sociology - Interface Demography, Economic and Social Sciences and Solvay Business School - Vrije Universiteit Brussel, Brussels, Belgium
| | - Paulien Hagedoorn
- Department of Sociology - Interface Demography, Economic and Social Sciences and Solvay Business School - Vrije Universiteit Brussel, Brussels, Belgium
| | - Sylvie Gadeyne
- Department of Sociology - Interface Demography, Economic and Social Sciences and Solvay Business School - Vrije Universiteit Brussel, Brussels, Belgium
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Wirth M, Vena JE, Smith EK, Bauer SE, Violanti J, Burch J. The epidemiology of cancer among police officers. Am J Ind Med 2013; 56:439-53. [PMID: 23255299 PMCID: PMC3655699 DOI: 10.1002/ajim.22145] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND This review summarizes peer-reviewed studies examining cancer risks among police officers. It provides an overview of existing research limitations and uncertainties and the plausible etiologic risk factors associated with cancer in this understudied occupation. METHODS Previous cancer studies among police officers were obtained via a systematic review of the MEDLINE, CABDirect, and Web of Science bibliographic databases. RESULTS Quality observational studies of cancer among police officers are sparse and subject to limitations in exposure assessment and other methods. Results from three studies suggested possible increased mortality risks for all cancers, and cancers of the colon, kidney, digestive system, esophagus, male breast, and testis, as well as Hodgkin's disease. Few incidence studies have been performed, and results have been mixed, although some associations with police work have been observed for thyroid, skin, and male breast cancer. CONCLUSIONS Police are exposed to a mix of known or suspected agents or activities that increase cancer risk. Epidemiologic evidence to date is sparse and inconsistent. There is a critical need for more research to understand the biological and social processes underlying exposures and the suggested disproportionate risks and to identify effective prevention strategies.
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Affiliation(s)
- Michael Wirth
- South Carolina Statewide Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
| | - John E. Vena
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
- Department of Social and Preventive Medicine, State University of New York at Buffalo, Buffalo, New York
| | - Emily K. Smith
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
| | - Sarah E. Bauer
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
| | - John Violanti
- Department of Social and Preventive Medicine, State University of New York at Buffalo, Buffalo, New York
| | - James Burch
- South Carolina Statewide Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
- Dorn Department of Veteran’s Affairs Medical Center, Columbia, South Carolina
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Muntaner C, Borrell C, Solà J, Marí-Dell'Olmo M, Chung H, Rodríguez-Sanz M, Benach J, Rocha KB, Ng E. Class Relations and All-Cause Mortality: A Test of Wright's Social Class Scheme Using the Barcelona 2000 Health Interview Survey. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2011; 41:431-58. [DOI: 10.2190/hs.41.3.c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study is to test the effects of neo-Marxian social class and potential mediators such as labor market position, work organization, material deprivation, and health behaviors on all-cause mortality. The authors use longitudinal data from the Barcelona 2000 Health Interview Survey (N = 7,526), with follow-up interviews through the municipal census in 2008 (95.97% response rate). Using data on relations of property, organizational power, and education, the study groups social classes according to Wright's scheme: capitalists, petit bourgeoisie, managers, supervisors, and skilled, semi-skilled, and unskilled workers. Findings indicate that social class, measured as relations of control over productive assets, is an important predictor of mortality among working-class men but not women. Workers (hazard ratio = 1.60; 95% confidence interval, 1.10–2.35) but also managers and small employers had a higher risk of death compared with capitalists. The extensive use of conventional gradient measures of social stratification has neglected sociological measures of social class conceptualized as relations of control over productive assets. This concept is capable of explaining how social inequalities are generated. To confirm the protective effect of the capitalist class position and the “contradictory class location hypothesis,” additional efforts are needed to properly measure class among low-level supervisors, capitalists, managers, and small employers.
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Muntaner C, Borrell C, Solà J, Marì-Dell'Olmo M, Chung H, Rodríguez-Sanz M, Benach J, Noh S. Capitalists, managers, professionals and mortality: Findings from the Barcelona Social Class and All Cause Mortality Longitudinal Study. Scand J Public Health 2009; 37:826-38. [DOI: 10.1177/1403494809346870] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: To examine the effects of Neo-Marxian social class (i.e. measured as relations of control over productive assets) and potential mediators such as labour-market position, work organization, material deprivation and health behaviours upon mortality in Barcelona, Spain. Methods: Longitudinal data from the Barcelona 2000 Health Interview Survey (n = 7526) with follow-up interviews through the municipal census in 2008 (95.97% response rate) were used. Using data on relations of property, organizational power, and education, social classes were grouped according to Wright’s scheme: capitalists, petit bourgeoisie, managers, supervisors, and skilled, semi-skilled and unskilled workers. Results: Social class, measured as relations of control over productive assets, is an important predictor of mortality among working-class positions for men but not for women. Workers (hazard ratio 1.60, 95% confidence interval 1.10—2.35), managers and small employers had a higher risk of death than capitalists. Conclusions: The extensive use of conventional gradient measures of social stratification has neglected sociological measurements of social class conceptualized as relations of control over productive assets. This concept is capable of explaining how social inequalities are generated. To confirm the protective effect of the capitalist class position and the ‘‘contradictory class location hypothesis’’, additional efforts are needed to properly measure class among low-level supervisors, capitalists, managers, and small employers.
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Affiliation(s)
- Carles Muntaner
- Center for Addictions and Mental Health, University of Toronto, Toronto, Canada, Institute for Work and Health, Toronto, Canada
| | - Carme Borrell
- Agència de Salut Pública de Barcelona, Barcelona, Spain, , CIBER Epidemiología y Salud Pública (CIBERESP), Spain, Universitat Pompeu Fabra, Barcelona, Spain
| | - Judit Solà
- Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Marc Marì-Dell'Olmo
- Agència de Salut Pública de Barcelona, Barcelona, Spain, CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Haejoo Chung
- Center for Addictions and Mental Health, University of Toronto, Toronto, Canada
| | - Maica Rodríguez-Sanz
- Agència de Salut Pública de Barcelona, Barcelona, Spain, Center for Addictions and Mental Health, University of Toronto, Toronto, Canada
| | - Joan Benach
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain, Health Inequalities Research Group, Employment Conditions Knowledge Network Research Unit, Universitat Pompeu Fabra, Barcelona, Spain
| | - Samuel Noh
- Institute for Work and Health, Toronto, Canada
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Saurel-Cubizolles MJ, Chastang JF, Menvielle G, Leclerc A, Luce D. Social inequalities in mortality by cause among men and women in France. J Epidemiol Community Health 2008; 63:197-202. [PMID: 19088115 DOI: 10.1136/jech.2008.078923] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The aim of this study was to compare inequalities in mortality (all causes and by cause) by occupational group and educational level between men and women living in France in the 1990s. METHODS Data were analysed from a permanent demographic sample currently including about one million people. The French Institute of Statistics (INSEE) follows the subjects and collects demographic, social and occupational information from the census schedules and vital status forms. Causes of death were obtained from the national file of the French Institute of Health and Medical Research (INSERM). A relative index of inequality (RII) was calculated to quantify inequalities as a function of educational level and occupational group. Overall all-cause mortality, mortality due to cancer, mortality due to cardiovascular disease and mortality due to external causes (accident, suicide, violence) were considered. RESULTS Overall, social inequalities were found to be wider among men than among women, for all-cause mortality, cancer mortality and external-cause mortality. However, this trend was not observed for cardiovascular mortality, for which the social inequalities were greater for women than for men, particularly for mortality due to ischaemic cardiac diseases. CONCLUSIONS This study provides evidence for persistent social inequalities in mortality in France, in both men and women. These findings highlight the need for greater attention to social determinants of health. The reduction of cardiovascular disease mortality in low educational level groups should be treated as a major public health priority.
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Affiliation(s)
- M-J Saurel-Cubizolles
- INSERM U149-IFR 69, 16 avenue Paul Vaillant Couturier, 94807 Villejuif cedex, France.
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Menvielle G, Kunst A. Social inequalities in cancer incidence and cancer survival: Lessons from Danish studies. Eur J Cancer 2008; 44:1933-7. [DOI: 10.1016/j.ejca.2008.06.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2008] [Accepted: 06/20/2008] [Indexed: 11/25/2022]
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Menvielle G, Kunst AE, Stirbu I, Strand BH, Borrell C, Regidor E, Leclerc A, Esnaola S, Bopp M, Lundberg O, Artnik B, Costa G, Deboosere P, Martikainen P, Mackenbach JP. Educational differences in cancer mortality among women and men: a gender pattern that differs across Europe. Br J Cancer 2008; 98:1012-9. [PMID: 18283307 PMCID: PMC2266850 DOI: 10.1038/sj.bjc.6604274] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
We used longitudinal mortality data sets for the 1990s to compare socioeconomic inequalities in total cancer mortality between women and men aged 30–74 in 12 different European populations (Madrid, Basque region, Barcelona, Slovenia, Turin, Switzerland, France, Belgium, Denmark, Norway, Sweden, Finland) and to investigate which cancer sites explain the differences found. We measured socioeconomic status using educational level and computed relative indices of inequality (RII). We observed large variations within Europe for educational differences in total cancer mortality among men and women. Three patterns were observed: Denmark, Norway and Sweden (significant RII around 1.3–1.4 among both men and women); France, Switzerland, Belgium and Finland (significant RII around 1.7–1.8 among men and around 1.2 among women); Spanish populations, Slovenia and Turin (significant RII from 1.29 to 1.88 among men; no differences among women except in the Basque region, where RII is significantly lower than 1). Lung, upper aerodigestive tract and breast cancers explained most of the variations between gender and populations in the magnitude of inequalities in total cancer mortality. Given time trends in cancer mortality, the gap in the magnitude of socioeconomic inequalities in cancer mortality between gender and between European populations will probably decrease in the future.
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Affiliation(s)
- G Menvielle
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
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Menvielle G, Luce D, Geoffroy-Perez B, Chastang JF, Leclerc A. Social inequalities and cancer mortality in France, 1975-1990. Cancer Causes Control 2005; 16:501-13. [PMID: 15986105 DOI: 10.1007/s10552-004-7114-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2004] [Accepted: 12/02/2004] [Indexed: 11/24/2022]
Abstract
OBJECTIVE to investigate social inequalities in cancer mortality from 1975 through 1990 among men and women in France. METHODS A sample, that included census data for approximately 1% of the French population, has been followed for mortality from 1975 to 1990. Causes of death were obtained through a record-linkage with the French national cause-of-death file. The analysis was restricted to those aged 35:59 in 1975 and included 61,876 men and 65,291 women. Occupational class, coded according to the social class scheme of Erikson, Goldthorpe and Portecarero in 7 categories, and educational level (in 4 categories) in 1975 have been studied. The analysis has been conducted for 15 cancer sites among men and 13 among women. Analysis used a Cox proportional hazards model. RESULTS For educational level, inequalities among men were more pronounced for cancers of the pharynx Relative Risk (RR) lowest versus highest educational level=9.2, 95% Confidence Interval (CI) 2.9-29.1, larynx (RR=6.2, CI=3.0:12.6), oral cavity (RR=2.7, CI=1.3-5.3), lung (RR=3.5, CI=2.5-4.8), esophagus (RR=3.1, CI=1.9-5.2), stomach (RR=2.5, CI=1.2-5.3) and rectum (RR=3.4, CI=1.2-9.6). No association between educational level and cancer mortality was observed for cancers of either the colon or lymphatic and hematopoietic tissue. Social inequalities were less pronounced among women but nevertheless observed for cancer of the uterus (RR=1.9, CI=1.0-3.6), stomach (RR=4.1, CI=1.0-17.1) and lung (RR=1.6, CI=0.7-3.7). No associations were found for mortality from breast or ovarian cancers. Results were similar when socioeconomic status was measured by occupational class. CONCLUSION The analysis showed substantial inequalities in cancer mortality in France, with large differences according to cancer site.
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Affiliation(s)
- Gwenn Menvielle
- INSERM U88-IFR69, HNSM, 14 rue du Val d'Osne, 94415, Saint-Maurice Cedex, France.
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Smith GD. Infection, medical care and inequalities. Int J Epidemiol 2005; 34:507-8. [PMID: 16003828 DOI: 10.1093/ije/dyi111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shaw M, Tunstall H, Smith GD. Seeing social position: visualizing class in life and death. Int J Epidemiol 2003; 32:332-5. [PMID: 12777412 DOI: 10.1093/ije/dyg176] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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