Top

Published in:

01-01-2011 | MORTALITY

Occupational and behavioural factors in the explanation of social inequalities in premature and total mortality: a 12.5-year follow-up in the Lorhandicap study

Authors: Isabelle Niedhammer, Eve Bourgkard, Nearkasen Chau, The Lorhandicap Study Group

Published in: European Journal of Epidemiology | Issue 1/2011

Abstract

The respective contribution of occupational and behavioural factors to social disparities in all-cause mortality has been studied very seldom. The objective of this study was to evaluate the role of occupational and behavioural factors in explaining social inequalities in premature and total mortality in the French working population. The study population consisted of a sample of 2,189 and 1,929 French working men and women, who responded to a self-administered questionnaire in mid-1996, and were followed up until the end of 2008. Mortality was derived from register-based information and linked to the baseline data. Socioeconomic status was measured using occupation. Occupational factors included biomechanical and physical exposures, temporary contract, psychological demands, and social support, and behavioural factors, smoking, alcohol abuse, and body mass index. Significant social differences were observed for premature and total mortality. Occupational factors reduced the hazard ratios of mortality for manual workers compared to managers/professionals by 72 and 41%, from 1.88 (95% CI: 1.17–3.01) to 1.25 (95% CI: 0.74–2.12) for premature mortality, and from 1.71 (95% CI: 1.18–2.47) to 1.42 (95% CI: 0.95–2.13) for total mortality. The biggest contributions were found for biomechanical and physical exposures, and job insecurity. The role of behavioural factors was very low. Occupational factors played a substantial role in explaining social disparities in mortality, especially for premature mortality and men. Improving working conditions amongst the lowest social groups may help to reduce social inequalities in mortality.

Available only for authorised users

Dalstra JA, Kunst AE, Borrell C, Breeze E, Cambois E, Costa G, et al. Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries. Int J Epidemiol. 2005;34(2):316–26.CrossRefPubMed

Huisman M, Kunst AE, Bopp M, Borgan JK, Borrell C, Costa G, et al. Educational inequalities in cause-specific mortality in middle-aged and older men and women in eight western European populations. Lancet. 2005;365(9458):493–500.PubMed

Mackenbach JP, Stirbu I, Roskam AJ, Schaap MM, Menvielle G, Leinsalu M, et al. Socioeconomic inequalities in health in 22 European countries. N Engl J Med. 2008;358(23):2468–81.CrossRefPubMed

van Lenthe FJ, Gevers E, Joung IM, Bosma H, Mackenbach JP. Material and behavioral factors in the explanation of educational differences in incidence of acute myocardial infarction: the Globe study. Ann Epidemiol. 2002;12(8):535–42.CrossRefPubMed

Galobardes B, Shaw M, Lawlor DA, Lynch JW, Davey SG. Indicators of socioeconomic position (part 1). J Epidemiol Community Health. 2006;60(1):7–12.CrossRefPubMed

Galobardes B, Shaw M, Lawlor DA, Lynch JW, Davey SG. Indicators of socioeconomic position (part 2). J Epidemiol Community Health. 2006;60(2):95–101.CrossRefPubMed

Goldman N. Social inequalities in health disentangling the underlying mechanisms. Ann N Y Acad Sci. 2001;954:118–39.CrossRefPubMed

Mackenbach J-P. Health inequalities: Europe in profile. In: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4121584.pdf. European Commission; 2006.

Wilkinson R, Marmot M. Social determinants of health: the solid facts. 2nd ed. In: World Health Organization; 2003.

10.

Skalicka V, Van Lenthe F, Bambra C, Krokstad S, Mackenbach J. Material, psychosocial, behavioural and biomedical factors in the explanation of relative socio-economic inequalities in mortality: evidence from the HUNT study. Int J Epidemiol. 2009;38(5):1272–84.CrossRefPubMed

11.

van Oort FV, van Lenthe FJ, Mackenbach JP. Material, psychosocial, and behavioural factors in the explanation of educational inequalities in mortality in The Netherlands. J Epidemiol Community Health. 2005;59(3):214–20.CrossRefPubMed

12.

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. 2009;63(3):197–202.CrossRefPubMed

13.

Mackenbach JP, Bos V, Andersen O, Cardano M, Costa G, Harding S, et al. Widening socioeconomic inequalities in mortality in six Western European countries. Int J Epidemiol. 2003;32(5):830–7.CrossRefPubMed

14.

Laaksonen M, Talala K, Martelin T, Rahkonen O, Roos E, Helakorpi S, et al. Health behaviours as explanations for educational level differences in cardiovascular and all-cause mortality: a follow-up of 60,000 men and women over 23 years. Eur J Public Health. 2008;18(1):38–43.CrossRefPubMed

15.

Lantz PM, House JS, Lepkowski JM, Williams DR, Mero RP, Chen J. Socioeconomic factors, health behaviors, and mortality: results from a nationally representative prospective study of US adults. JAMA. 1998;279(21):1703–8.CrossRefPubMed

16.

Lynch JW, Kaplan GA, Cohen RD, Tuomilehto J, Salonen JT. Do cardiovascular risk factors explain the relation between socioeconomic status, risk of all-cause mortality, cardiovascular mortality, and acute myocardial infarction? Am J Epidemiol. 1996;144(10):934–42.PubMed

17.

Pekkanen J, Tuomilehto J, Uutela A, Vartiainen E, Nissinen A. Social class, health behaviour, and mortality among men and women in eastern Finland. BMJ. 1995;311(7005):589–93.PubMed

18.

Siahpush M, English D, Powles J. The contribution of smoking to socioeconomic differentials in mortality: results from the Melbourne Collaborative Cohort Study, Australia. J Epidemiol Community Health. 2006;60(12):1077–9.CrossRefPubMed

19.

Woodward M, Oliphant J, Lowe G, Tunstall-Pedoe H. Contribution of contemporaneous risk factors to social inequality in coronary heart disease and all causes mortality. Prev Med. 2003;36(5):561–8.CrossRefPubMed

20.

Landsbergis PA. Assessing the contribution of working conditions to socioeconomic disparities in health: a commentary. Am J Ind Med. 2010;53(2):95–103.CrossRefPubMed

21.

Aldabe B, Anderson R, Lyly-Yrjanainen M, Parent-Thirion A, Vermeylen G, Kelleher CC, et al. Contribution of material, occupational, and psychosocial factors in the explanation of social inequalities in health in 28 countries in Europe. J Epidemiol Community Health. 2010.

22.

Borg V, Kristensen TS. Social class and self-rated health: can the gradient be explained by differences in life style or work environment? Soc Sci Med. 2000;51(7):1019–30.CrossRefPubMed

23.

Borrell C, Muntaner C, Benach J, Artazcoz L. Social class and self-reported health status among men and women: what is the role of work organisation, household material standards and household labour? Soc Sci Med. 2004;58(10):1869–87.CrossRefPubMed

24.

Hemstrom O. Health inequalities by wage income in Sweden: the role of work environment. Soc Sci Med. 2005;61(3):637–47.CrossRefPubMed

25.

Niedhammer I, Chastang JF, David S, Kelleher C. The contribution of occupational factors to social inequalities in health: findings from the national French SUMER survey. Soc Sci Med. 2008;67(11):1870–81.CrossRefPubMed

26.

Schrijvers CT, van de Mheen HD, Stronks K, Mackenbach JP. Socioeconomic inequalities in health in the working population: the contribution of working conditions. Int J Epidemiol. 1998;27(6):1011–8.CrossRefPubMed

27.

Sekine M, Chandola T, Martikainen P, Marmot M, Kagamimori S. Socioeconomic inequalities in physical and mental functioning of Japanese civil servants: explanations from work and family characteristics. Soc Sci Med. 2006;63(2):430–45.CrossRefPubMed

28.

Warren JR, Hoonakker P, Carayon P, Brand J. Job characteristics as mediators in SES-health relationships. Soc Sci Med. 2004;59(7):1367–78.CrossRefPubMed

29.

Chau N, Khlat M. Strong association of physical job demands with functional limitations among active people: a population-based study in North-eastern France. Int Arch Occup Environ Health. 2009;82(7):857–66.CrossRefPubMed

30.

Gauchard GC, Deviterne D, Guillemin F, Sanchez J, Perrin PP, Mur JM, et al. Prevalence of sensory and cognitive disabilities and falls, and their relationships: a community-based study. Neuroepidemiology. 2006;26(2):108–18.CrossRefPubMed

31.

Loos-Ayav C, Chau N, Riani C, Guillemin F. Functional disability in France and its relationship with health-related quality of life—a population-based prevalence study. Clin Exp Rheumatol. 2007;25(5):701–8.PubMed

32.

Beresford TP, Blow FC, Hill E, Singer K, Lucey MR. Comparison of CAGE questionnaire and computer-assisted laboratory profiles in screening for covert alcoholism. Lancet. 1990;336(8713):482–5.CrossRefPubMed

33.

Krieger N, Rehkopf DH, Chen JT, Waterman PD, Marcelli E, Kennedy M. The fall and rise of US inequities in premature mortality: 1960–2002. PLoS Med. 2008;5(2):e46.CrossRefPubMed

34.

Goldberg M, Chastang JF, LeClerc A, Zins M, Bonenfant S, Bugel I, et al. Socioeconomic, demographic, occupational, and health factors associated with participation in a long-term epidemiologic survey: a prospective study of the French GAZEL cohort and its target population. Am J Epidemiol. 2001;154(4):373–84.CrossRefPubMed

35.

Monden CW. Current or lifetime smoking? Consequences for explaining educational inequalities in self-reported health. Prev Med. 2004;39(1):19–26.CrossRefPubMed

36.

Monden CW. Current and lifetime exposure to working conditions. Do they explain educational differences in subjective health? Soc Sci Med. 2005;60(11):2465–76.CrossRefPubMed

37.

Niedhammer I, Saurel-Cubizolles MJ, Piciotti M, Bonenfant S. How is sex considered in recent epidemiological publications on occupational risks? Occup Environ Med. 2000;57(8):521–7.CrossRefPubMed

Title: Occupational and behavioural factors in the explanation of social inequalities in premature and total mortality: a 12.5-year follow-up in the Lorhandicap study
Authors: Isabelle Niedhammer
Eve Bourgkard
Nearkasen Chau
The Lorhandicap Study Group
Publication date: 01-01-2011
Publisher: Springer Netherlands
Published in: European Journal of Epidemiology / Issue 1/2011
Print ISSN: 0393-2990
Electronic ISSN: 1573-7284
DOI: https://doi.org/10.1007/s10654-010-9506-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Occupational and behavioural factors in the explanation of social inequalities in premature and total mortality: a 12.5-year follow-up in the Lorhandicap study

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2011

The decline in stomach cancer mortality: exploration of future trends in seven European countries

LifeGene—a large prospective population-based study of global relevance

Depression in Swedish women: relationship to factors at birth

Volunteer effect and compromised randomization in the Mayo Project of screening for lung cancer

Estimation of the contribution of biomarkers of different metabolic pathways to risk of type 2 diabetes

Adult height and the risk of cardiovascular disease among middle aged men and women in Japan