Skip to main content
Top
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Socioeconomic disparities in lung cancer mortality in Belgian men and women (2001-2011): does it matter who you live with?

Authors: Katrien Vanthomme, Hadewijch Vandenheede, Paulien Hagedoorn, Sylvie Gadeyne

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

Ample studies have observed an adverse association between individual socioeconomic position (SEP) and lung cancer mortality. Moreover, the presence of a partner has shown to be a crucial determinant of health. Yet, few studies have assessed whether partner’s SEP affects health in addition to individual SEP. This paper will study whether own SEP (education), partner’s SEP (partner’s education) and own and partner’s SEP combined (housing conditions), are associated with lung cancer mortality in Belgium.

Methods

Data consist of the Belgian 2001 census linked to register data on cause-specific mortality for 2001–2011. The study population includes all married or cohabiting Belgian inhabitants aged 40–84 years. Age-standardized lung cancer mortality rates (direct standardization) and mortality rate ratios (Poisson regression) were computed for the different SEP groups.

Results

In men, we observed a clear inverse association between all SEP indicators (own and partner’s education, and housing conditions) and lung cancer mortality. Men benefit from having a higher educated partner in terms of lower lung cancer mortality rates. These observations hold for both middle-aged and older men.
For women, the picture is less uniform. In middle-aged and older women, housing conditions is inversely associated with lung cancer mortality. As for partner’s education, for middle-aged women, the association is rather weak whereas for older women, there is no such association. Whereas the educational level of middle-aged women is inversely associated with lung cancer mortality, in older women this association disappears in the fully adjusted model.

Conclusions

Both men and women benefit from being in a relationship with a high-educated partner. It seems that for men, the educational level of their partner is of great importance while for women the housing conditions is more substantial. Both research and policy interventions should allow for the family level as well.
Literature
1.
go back to reference Vanthomme K, Vandenheede H, Hagedoorn P, Deboosere P, Gadeyne S. Trends in site- and sex-specific cancer mortality between 1979 and 2010 in Belgium compared with Europe using WHO data. J Public Health. 2015 Jun 11. doi:10.1093/pubmed/fdv078. [Epub ahead of print] Vanthomme K, Vandenheede H, Hagedoorn P, Deboosere P, Gadeyne S. Trends in site- and sex-specific cancer mortality between 1979 and 2010 in Belgium compared with Europe using WHO data. J Public Health. 2015 Jun 11. doi:10.​1093/​pubmed/​fdv078. [Epub ahead of print]
2.
go back to reference Phelan JC, Link BG. Controlling disease and creating disparities: a fundamental cause perspective. Journals Gerontol Ser B. 2005;60B Special(II):27–33.CrossRef Phelan JC, Link BG. Controlling disease and creating disparities: a fundamental cause perspective. Journals Gerontol Ser B. 2005;60B Special(II):27–33.CrossRef
3.
go back to reference Phelan JC, Link BG, Diez-roux A, Kawachi I, Levin B. “Fundamental causes” of social inequalities in mortality: a test of the theory *. J Health Soc Behav. 2004;45(3):265–85.CrossRefPubMed Phelan JC, Link BG, Diez-roux A, Kawachi I, Levin B. “Fundamental causes” of social inequalities in mortality: a test of the theory *. J Health Soc Behav. 2004;45(3):265–85.CrossRefPubMed
4.
go back to reference Schmidlin K, Spoerri A, Egger M, Zwahlen M, Stuck A, Clough-Gorr KM. Cancer, a disease of aging (part 2)–risk factors for older adult cancer mortality in Switzerland 1991–2008. Swiss Med Wkly. 2012;142(August):w13607.PubMed Schmidlin K, Spoerri A, Egger M, Zwahlen M, Stuck A, Clough-Gorr KM. Cancer, a disease of aging (part 2)–risk factors for older adult cancer mortality in Switzerland 1991–2008. Swiss Med Wkly. 2012;142(August):w13607.PubMed
5.
go back to reference Kohler IV, Martikainen P, Smith KP, Elo IT. Educational differences in All-cause mortality by marital status–EVidence from Bulgaria, Finland and the united states. Demogr Res. 2008;19(10):2011–42.CrossRefPubMedPubMedCentral Kohler IV, Martikainen P, Smith KP, Elo IT. Educational differences in All-cause mortality by marital status–EVidence from Bulgaria, Finland and the united states. Demogr Res. 2008;19(10):2011–42.CrossRefPubMedPubMedCentral
6.
go back to reference Huijts T, Monden CWS, Kraaykamp G. Education, educational heterogamy, and self-assessed health in Europe: a multilevel study of spousal effects in 29 European countries. Eur Sociol Rev. 2009;26(3):261–76.CrossRef Huijts T, Monden CWS, Kraaykamp G. Education, educational heterogamy, and self-assessed health in Europe: a multilevel study of spousal effects in 29 European countries. Eur Sociol Rev. 2009;26(3):261–76.CrossRef
7.
8.
go back to reference Martelin T. Mortality by indicators of socioeconomic status among the Finnish elderly. Soc Sci Med. 1994;38(9):1257–78.CrossRefPubMed Martelin T. Mortality by indicators of socioeconomic status among the Finnish elderly. Soc Sci Med. 1994;38(9):1257–78.CrossRefPubMed
9.
go back to reference NÆss Ø, Claussen B, Thelle DS, Smith GD. Four indicators of socioeconomic position : relative ranking across causes of death. Scand J Public Health. 2005;33:215–21.CrossRefPubMed NÆss Ø, Claussen B, Thelle DS, Smith GD. Four indicators of socioeconomic position : relative ranking across causes of death. Scand J Public Health. 2005;33:215–21.CrossRefPubMed
10.
go back to reference Kravdal Ø. A broader perspective on education and mortality: are we influenced by other people’s education? Soc Sci Med. 2008;66(3):620–36.CrossRefPubMed Kravdal Ø. A broader perspective on education and mortality: are we influenced by other people’s education? Soc Sci Med. 2008;66(3):620–36.CrossRefPubMed
11.
go back to reference Monden CW, van Lenthe F, De Graaf ND, Kraaykamp G. Partner’s and own education: does who you live with matter for self-assessed health, smoking and excessive alcohol consumption? Soc Sci Med. 2003;57(10):1901–12.CrossRefPubMed Monden CW, van Lenthe F, De Graaf ND, Kraaykamp G. Partner’s and own education: does who you live with matter for self-assessed health, smoking and excessive alcohol consumption? Soc Sci Med. 2003;57(10):1901–12.CrossRefPubMed
12.
go back to reference Harvei S, Kravdal Ø. The importance of marital and socioeconomic status in incidence and survival of prostate cancer. Prev Med (Baltim). 1997;26:623–32.CrossRef Harvei S, Kravdal Ø. The importance of marital and socioeconomic status in incidence and survival of prostate cancer. Prev Med (Baltim). 1997;26:623–32.CrossRef
13.
go back to reference Vandenheede H, Vanroelen C, Gadeyne S, De Grande H, Deboosere P. Household-based socioeconomic position and diabetes-related mortality among married and cohabiting persons: findings from a census-based cohort study (Flanders, 2001–2010). J Epidemiol Community Health. 2013;0:1–7. Vandenheede H, Vanroelen C, Gadeyne S, De Grande H, Deboosere P. Household-based socioeconomic position and diabetes-related mortality among married and cohabiting persons: findings from a census-based cohort study (Flanders, 2001–2010). J Epidemiol Community Health. 2013;0:1–7.
14.
go back to reference Hart CL, Hole DJ, Gillis CR, Smith GD, Watt CM, Hawtorne VM. Social class differences in lung cancer mortality : risk factor explanations using two Scottish cohort studies. Int J Epidemiol. 2001;30:268–74.CrossRefPubMed Hart CL, Hole DJ, Gillis CR, Smith GD, Watt CM, Hawtorne VM. Social class differences in lung cancer mortality : risk factor explanations using two Scottish cohort studies. Int J Epidemiol. 2001;30:268–74.CrossRefPubMed
15.
go back to reference Soerjomataram I, Barendregt JJ, Gartner C, Kunst A, Møller H, Avendano M. Reducing inequalities in lung cancer incidence through smoking policies. Lung Cancer. 2011;73(3):268–73.CrossRefPubMed Soerjomataram I, Barendregt JJ, Gartner C, Kunst A, Møller H, Avendano M. Reducing inequalities in lung cancer incidence through smoking policies. Lung Cancer. 2011;73(3):268–73.CrossRefPubMed
16.
go back to reference Wagenaar KP, de Boer MR, Luce D, Menvielle G. Time trends in educational differences in lung and upper aero digestive tract cancer mortality in France between 1990 and 2007. Cancer Epidemiol. 2012;36(4):329–34.CrossRefPubMed Wagenaar KP, de Boer MR, Luce D, Menvielle G. Time trends in educational differences in lung and upper aero digestive tract cancer mortality in France between 1990 and 2007. Cancer Epidemiol. 2012;36(4):329–34.CrossRefPubMed
17.
go back to reference Rubin MS, Clouston S, Link BG. A fundamental cause approach to the study of disparities in lung cancer and pancreatic cancer mortality in the United States. Soc Sci Med. 2014;100:54–61.CrossRefPubMed Rubin MS, Clouston S, Link BG. A fundamental cause approach to the study of disparities in lung cancer and pancreatic cancer mortality in the United States. Soc Sci Med. 2014;100:54–61.CrossRefPubMed
18.
go back to reference Mackenbach JP, Huisman M, Andersen O, Bopp M, Borgan J-K, Borrell C, et al. Inequalities in lung cancer mortality by the educational level in 10 European populations. Eur J Cancer. 2004;40:126–35.CrossRefPubMed Mackenbach JP, Huisman M, Andersen O, Bopp M, Borgan J-K, Borrell C, et al. Inequalities in lung cancer mortality by the educational level in 10 European populations. Eur J Cancer. 2004;40:126–35.CrossRefPubMed
19.
go back to reference Lopez AD, Collishaw NE, Piha T. A descriptive model of the cigarette epidemic in developed countries. Tob Control. 1994;3:242–7.CrossRefPubMedCentral Lopez AD, Collishaw NE, Piha T. A descriptive model of the cigarette epidemic in developed countries. Tob Control. 1994;3:242–7.CrossRefPubMedCentral
20.
go back to reference Jaffe DH, Eisenbach Z, Neumark YD, Manor O. Effects of husbands’ and wives’ education on each other’s mortality. Soc Sci Med. 2006;62(8):2014–23.CrossRefPubMed Jaffe DH, Eisenbach Z, Neumark YD, Manor O. Effects of husbands’ and wives’ education on each other’s mortality. Soc Sci Med. 2006;62(8):2014–23.CrossRefPubMed
21.
go back to reference Floud S, Balkwill A, Canoy D, Wright FL, Reeves GK, Green J, et al. Marital status and ischemic heart disease incidence and mortality in women : a large prospective study. BMC Med. 2014;12(42):1–9. Floud S, Balkwill A, Canoy D, Wright FL, Reeves GK, Green J, et al. Marital status and ischemic heart disease incidence and mortality in women : a large prospective study. BMC Med. 2014;12(42):1–9.
22.
go back to reference Kravdal Ø. The poorer cancer survival among the unmarried in Norway: is much explained by comorbidities? Soc Sci Med. 2013;81:42–52.CrossRefPubMed Kravdal Ø. The poorer cancer survival among the unmarried in Norway: is much explained by comorbidities? Soc Sci Med. 2013;81:42–52.CrossRefPubMed
23.
24.
go back to reference Johnson NJ, Backlund E, Sorlie PD, Loveless CA. Marital status and mortality: the national longitudinal mortality study. Ann Epidemiol. 2000;10:224–38.CrossRefPubMed Johnson NJ, Backlund E, Sorlie PD, Loveless CA. Marital status and mortality: the national longitudinal mortality study. Ann Epidemiol. 2000;10:224–38.CrossRefPubMed
25.
go back to reference Manzoli L, Villari P, Pirone GM, Boccia A. Marital status and mortality in the elderly: a systematic review and meta-analysis. Soc Sci Med. 2007;64(1):77–94.CrossRefPubMed Manzoli L, Villari P, Pirone GM, Boccia A. Marital status and mortality in the elderly: a systematic review and meta-analysis. Soc Sci Med. 2007;64(1):77–94.CrossRefPubMed
26.
go back to reference Goldman N, Korenman S, Weinstein R. Marital status and health among the elderly. Soc Sci Med. 1995;40(12):1717–30.CrossRefPubMed Goldman N, Korenman S, Weinstein R. Marital status and health among the elderly. Soc Sci Med. 1995;40(12):1717–30.CrossRefPubMed
27.
go back to reference Lund R, Due P, Modvig J, Holstein BE, Damsgaard MT, Andersen PK. Cohabitation and marital status as predictors of mortality–an eight year follow-up study. Soc Sci Med. 2002;55:673–9.CrossRefPubMed Lund R, Due P, Modvig J, Holstein BE, Damsgaard MT, Andersen PK. Cohabitation and marital status as predictors of mortality–an eight year follow-up study. Soc Sci Med. 2002;55:673–9.CrossRefPubMed
28.
go back to reference Waldron I, Hughes ME, Brooks TL. Marriage protection and marriage selection–prospective evidence for reciprocal effects of marital status and health. Soc Sci Med. 1996;43(I):113–23.CrossRefPubMed Waldron I, Hughes ME, Brooks TL. Marriage protection and marriage selection–prospective evidence for reciprocal effects of marital status and health. Soc Sci Med. 1996;43(I):113–23.CrossRefPubMed
29.
30.
go back to reference Pinquart M, Duberstein PR. Associations of social networks with cancer mortality: a meta-analysis. Crit Rev Oncol Hematol. 2010;75(2):122–37.CrossRefPubMed Pinquart M, Duberstein PR. Associations of social networks with cancer mortality: a meta-analysis. Crit Rev Oncol Hematol. 2010;75(2):122–37.CrossRefPubMed
31.
go back to reference Skalická V, Kunst AE. Effects of spouses’ socioeconomic characteristics on mortality among men and women in a Norwegian longitudinal study. Soc Sci Med. 2008;66(9):2035–47.CrossRefPubMed Skalická V, Kunst AE. Effects of spouses’ socioeconomic characteristics on mortality among men and women in a Norwegian longitudinal study. Soc Sci Med. 2008;66(9):2035–47.CrossRefPubMed
32.
go back to reference Brown DC, Hummer RA, Hayward MD. The importance of spousal education for the self-rated health of married adults in the United States. Popul Res Policy Rev. 2014;33(1):127–51.CrossRefPubMed Brown DC, Hummer RA, Hayward MD. The importance of spousal education for the self-rated health of married adults in the United States. Popul Res Policy Rev. 2014;33(1):127–51.CrossRefPubMed
33.
go back to reference Lyssens-Danneboom V, Mortelmans D. Living apart together and money: new partnerships, traditional gender roles. J Marriage Fam. 2014;76(5):949–66.CrossRef Lyssens-Danneboom V, Mortelmans D. Living apart together and money: new partnerships, traditional gender roles. J Marriage Fam. 2014;76(5):949–66.CrossRef
34.
go back to reference Van Imhoff E, Keilman N. Lipro 2.0: an application of a dynamic demographic projection model to household structure in the Netherlands. vol. 23. Amsterdam: NIDI, CBGS; 1991. p. 255. Van Imhoff E, Keilman N. Lipro 2.0: an application of a dynamic demographic projection model to household structure in the Netherlands. vol. 23. Amsterdam: NIDI, CBGS; 1991. p. 255.
35.
go back to reference Deboosere P, Willaert D. Codebook Algemene Socio-economische enquête 2001. Brussel; 2004. Report No.: Working Paper 2004–1 Deboosere P, Willaert D. Codebook Algemene Socio-economische enquête 2001. Brussel; 2004. Report No.: Working Paper 2004–1
36.
go back to reference Belgian Cancer Registry. Cancer survival in Belgium. Brussels; 2012 Belgian Cancer Registry. Cancer survival in Belgium. Brussels; 2012
37.
go back to reference Gisle L, Hesse E, Drieskens S, Demarest S, Van der Heyden J, Tafforeau J. Gezondheidsenquête België, 2008. Rapport II - Leefstijl en preventie. Brussel; 2010 Gisle L, Hesse E, Drieskens S, Demarest S, Van der Heyden J, Tafforeau J. Gezondheidsenquête België, 2008. Rapport II - Leefstijl en preventie. Brussel; 2010
38.
go back to reference Gisle L. Het gebruik van tabak. In: Gisle L, Demarest S, editors. Gezondheidsenquête 2013 Rapport 2: Gezondheidsgedrag en leefstijl. Brussel: WIV-ISP; 2014. Gisle L. Het gebruik van tabak. In: Gisle L, Demarest S, editors. Gezondheidsenquête 2013 Rapport 2: Gezondheidsgedrag en leefstijl. Brussel: WIV-ISP; 2014.
39.
go back to reference IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. IARC monographs on the evaluation of carcinogenic risks to humans. Volume 83. Tobacco smoke and involuntary smoking. Lyon: World Health Organization; 2004. p. 1452. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. IARC monographs on the evaluation of carcinogenic risks to humans. Volume 83. Tobacco smoke and involuntary smoking. Lyon: World Health Organization; 2004. p. 1452.
40.
go back to reference Bossuyt N, Gadeyne S, Deboosere P, Van Oyen H. Socio-economic inequalities in health expectancy in Belgium. Public Health. 2004;118(1):3–10.CrossRefPubMed Bossuyt N, Gadeyne S, Deboosere P, Van Oyen H. Socio-economic inequalities in health expectancy in Belgium. Public Health. 2004;118(1):3–10.CrossRefPubMed
41.
go back to reference Koskinen S, Martelin T. Why are socioeconomic mortality differences smaller among women than among men? Soc Sci Med. 1994;38(10):1385–96.CrossRefPubMed Koskinen S, Martelin T. Why are socioeconomic mortality differences smaller among women than among men? Soc Sci Med. 1994;38(10):1385–96.CrossRefPubMed
42.
go back to reference Jaffe DH, Eisenbach Z, Neumark YD, Manor O. Does one’s own and one’s spouse’s education affect overall and cause-specific mortality in the elderly? Int J Epidemiol. 2005;34(6):1409–16.CrossRefPubMed Jaffe DH, Eisenbach Z, Neumark YD, Manor O. Does one’s own and one’s spouse’s education affect overall and cause-specific mortality in the elderly? Int J Epidemiol. 2005;34(6):1409–16.CrossRefPubMed
43.
Metadata
Title
Socioeconomic disparities in lung cancer mortality in Belgian men and women (2001-2011): does it matter who you live with?
Authors
Katrien Vanthomme
Hadewijch Vandenheede
Paulien Hagedoorn
Sylvie Gadeyne
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3139-1

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue