Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

Socioeconomic inequalities in cause specific mortality among older people in France

Authors: Gwenn Menvielle, Annette Leclerc, Jean-François Chastang, Danièle Luce

Published in: BMC Public Health | Issue 1/2010

Login to get access

Abstract

Background

European comparative studies documented a clear North-South divide in socioeconomic inequalities with cancer being the most important contributor to inequalities in total mortality among middle aged men in Latin Europe (France, Spain, Portugal, Italy). The aim of this paper is to investigate educational inequalities in mortality by gender, age and causes of death in France, with a special emphasis on people aged 75 years and more.

Methods

We used data from a longitudinal population sample that includes 1% of the French population. Risk of death (total and cause specific) in the period 1990-1999 according to education was analysed using Cox regression models by age group (45-59, 60-74, and 75+). Inequalities were quantified using both relative (ratio) and absolute (difference) measures.

Results

Relative inequalities decreased with age but were still observed in the oldest age group. Absolute inequalities increased with age. This increase was particularly pronounced for cardiovascular diseases. The contribution of different causes of death to absolute inequalities in total mortality differed between age groups. In particular, the contribution of cancer deaths decreased substantially between the age groups 60-74 years and 75 years and more, both in men and in women.

Conclusions

This study suggests that the large contribution of cancer deaths to the excess mortality among low educated people that was observed among middle aged men in Latin Europe is not observed among French people aged 75 years and more. This should be confirmed among other Latin Europe countries.
Appendix
Available only for authorised users
Literature
1.
Mackenbach JP, Stirbu I, Roskam AJ, Schaap MM, Menvielle G, Leinsalu M, Kunst AE: Socioeconomic inequalities in health in 22 European countries. N Engl J Med. 2008, 358 (23): 2468-2481. 10.1056/NEJMsa0707519.CrossRefPubMed
2.
Mackenbach JP, Kunst AE, Cavelaars AE, Groenhof F, Geurts JJ: Socioeconomic inequalities in morbidity and mortality in western Europe. The EU Working Group on Socioeconomic Inequalities in Health. Lancet. 1997, 349 (9066): 1655-1659. 10.1016/S0140-6736(96)07226-1.CrossRefPubMed
3.
Kunst AE, Groenhof F, Mackenbach JP, Health EW: Occupational class and cause specific mortality in middle aged men in 11 European countries: comparison of population based studies. EU Working Group on Socioeconomic Inequalities in Health. BMJ. 1998, 316 (7145): 1636-1642.CrossRefPubMedPubMedCentral
4.
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 (5): 1012-1019. 10.1038/sj.bjc.6604274.CrossRefPubMedPubMedCentral
5.
Manor O, Matthews S, Power C: Comparing measures of health inequality. Soc Sci Med. 1997, 45 (5): 761-771. 10.1016/S0277-9536(96)00412-1.CrossRefPubMed
6.
Marmot MG, Shipley MJ: Do socioeconomic differences in mortality persist after retirement? 25 year follow up of civil servants from the first Whitehall study. Bmj. 1996, 313 (7066): 1177-1180.CrossRefPubMedPubMedCentral
7.
Huisman M, Kunst AE, Bopp M, Borgan JK, Borrell C, Costa G, Deboosere P, Gadeyne S, Glickman M, Marinacci C, Minder C, Regidor E, Valkonen T, Mackenbach JP: 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.CrossRefPubMed
8.
Rosvall M, Chaix B, Lynch J, Lindstrom M, Merlo J: Contribution of main causes of death to social inequalities in mortality in the whole population of Scania, Sweden. BMC Public Health. 2006, 6: 79-10.1186/1471-2458-6-79.CrossRefPubMedPubMedCentral
9.
Rostad B, Schei B, Lund Nilsen TI: Social inequalities in mortality in older women cannot be explained by biological and health behavioural factors - results from a Norwegian health survey (the HUNT Study). Scand J Public Health. 2009, 37 (4): 401-408. 10.1177/1403494809102777.CrossRefPubMed
10.
Scanlan J: Can we actually measure health disparities?. Chance. 2006, 19 (2):
11.
Vagero D, Erikson R: Socioeconomic inequalities in morbidity and mortality in western Europe. Lancet. 1997, 350 (9076): 516-10.1016/S0140-6736(97)26033-2. author reply 517-518.CrossRefPubMed
12.
Rouault D: The Echantillon Démograhique Permanent: a French equivalent to the Longitudinal Study. Update - News from the LS User Group. 1994, 5-13. 7
13.
World Health Organisation: International Classification of Diseases. Ninth revision. Geneva. 1977
14.
Mackenbach JP, Kunst AE: Measuring the magnitude of socio-economic inequalities in health: an overview of available measures illustrated with two examples from Europe. Soc Sci Med. 1997, 44 (6): 757-771. 10.1016/S0277-9536(96)00073-1.CrossRefPubMed
15.
Pamuk E: Social class inequality in mortality from 1921 to 1972 in England and Wales. Popul Stud. 1985, 39: 17-31. 10.1080/0032472031000141256.CrossRef
16.
Efron B, Tibshirani RJ: An introduction to the bootstrap. 1993, New York: Chapman & Hall, 57:CrossRef
17.
Galobardes B, Shaw M, Lawlor DA, Lynch JW, Davey Smith G: Indicators of socioeconomic position (part 1). J Epidemiol Community Health. 2006, 60 (1): 7-12. 10.1136/jech.2004.023531.CrossRefPubMedPubMedCentral
18.
Berkman LF, Macintyre S: The measurement of social class in health studies:old measures and new formulations. IARC Sci Publ. 1997, 138: 51-64.PubMed
19.
Krieger N, Williams DR, Moss NE: Measuring social class in US public health research: concepts, methodologies, and guidelines. Annu Rev Public Health. 1997, 18: 341-378. 10.1146/annurev.publhealth.18.1.341.CrossRefPubMed
20.
Ross CE, Mirowsky J: Refining the association between education and health: the effects of quantity, credential, and selectivity. Demography. 1999, 36 (4): 445-460. 10.2307/2648083.CrossRefPubMed
21.
Huisman M, Kunst AE, Andersen O, Bopp M, Borgan JK, Borrell C, Costa G, Deboosere P, Desplanques G, Donkin A, Gadeyne S, Minder C, Regidor E, Spadea T, Valkonen T, Mackenbach JP: Socioeconomic inequalities in mortality among elderly people in 11 European populations. J Epidemiol Community Health. 2004, 58 (6): 468-475. 10.1136/jech.2003.010496.CrossRefPubMedPubMedCentral
22.
Robert-Bobee I, Cadot O: Mortalité aux grands âges: encore des écarts selon le diplôme et la catégorie sociale. INSEE Première. 2007, 1122:
23.
Lewington S, Clarke R, Qizilbash N, Peto R, Collins R: Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002, 360 (9349): 1903-1913. 10.1016/S0140-6736(02)11911-8.CrossRefPubMed
24.
Huisman M, Kunst AE, Mackenbach JP: Educational inequalities in smoking among men and women aged 16 years and older in 11 European countries. Tob Control. 2005, 14 (2): 106-113. 10.1136/tc.2004.008573.CrossRefPubMedPubMedCentral
25.
Sasco AJ, Grizeau D, Pobel D, Chatard O, Danzon M: Smoking and social class in France 1974-1991 (en français). Bull Cancer. 1994, 81 (5): 355-359.PubMed
26.
Menvielle G, Leclerc A, Chastang JF, Luce D, Edisc group: Social inequalities in breast cancer mortality among French women: disappearing educational disparities from 1968 to 1996. Br J Cancer. 2006, 94 (1): 152-155. 10.1038/sj.bjc.6602907.
27.
Strand BH, Kunst A, Huisman M, Menvielle G, Glickman M, Bopp M, Borell C, Borgan JK, Costa G, Deboosere P, Regidor E, Valkonen T, Mackenbach JP: The reversed social gradient: higher breast cancer mortality in the higher educated compared to lower educated. A comparison of 11 European populations during the 1990s. Eur J Cancer. 2007, 43 (7): 1200-1207. 10.1016/j.ejca.2007.01.021.CrossRefPubMed
28.
Strand BH, Tverdal A, Claussen B, Zahl PH: Is birth history the key to highly educated women's higher breast cancer mortality? A follow-up study of 500,000 women aged 35-54. Int J Cancer. 2005, 117 (6): 1002-1006. 10.1002/ijc.21239.CrossRefPubMed
29.
Menvielle G, Chastang JF, Luce D, Leclerc A: [Changing social disparities and mortality in France (1968-1996): cause of death analysis by educational level]. Rev Epidemiol Sante Publique. 2007, 55 (2): 97-105.CrossRefPubMed
30.
Percy C, Ries LG, Van Holten VD: The accuracy of liver cancer as the underlying cause of death on death certificates. Public Health Rep. 1990, 105 (4): 361-367.PubMedPubMedCentral
31.
Leclerc A, Lert F, Fabien C: Differential mortality: some comparisons between England and Wales, Finland and France, based on inequality measures. Int J Epidemiol. 1990, 19 (4): 1001-1010. 10.1093/ije/19.4.1001.CrossRefPubMed
32.
Menvielle G, Kunst AE, Stirbu I, Borrell C, Bopp M, Regidor E, Heine Strand B, Deboosere P, Lundberg O, Leclerc A, Costa G, Chastang JF, Esnaola S, Martikainen P, Mackenbach JP: Socioeconomic inequalities in alcohol related cancer mortality among men: to what extent do they differ between Western European populations?. Int J Cancer. 2007, 121 (3): 649-655. 10.1002/ijc.22721.CrossRefPubMedPubMedCentral
33.
Singh-Manoux A, Gourmelen J, Lajnef M, Sabia S, Sitta R, Menvielle G, Melchior M, Nabi H, Lanoe JL, Gueguen A, Lert F: Prevalence of educational inequalities in obesity between 1970 and 2003 in France. Obes Rev. 2009, 10 (5): 511-518. 10.1111/j.1467-789X.2009.00596.x.CrossRefPubMed
Metadata
Title
Socioeconomic inequalities in cause specific mortality among older people in France
Authors
Gwenn Menvielle
Annette Leclerc
Jean-François Chastang
Danièle Luce
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-260

Other articles of this Issue 1/2010

BMC Public Health 1/2010 Go to the issue

Study protocol

Make Better Choices (MBC): Study design of a randomized controlled trial testing optimal technology-supported change in multiple diet and physical activity risk behaviors

Research article

Comparing two service delivery models for the prevention of mother-to-child transmission (PMTCT) of HIV during transition from single-dose nevirapine to multi-drug antiretroviral regimens

Research article

Utilization of delivery care among rural women in china: does the health insurance make a difference? a cross-sectional study

Research article

Knowledge and perception of pulmonary tuberculosis in pastoral communities in the middle and Lower Awash Valley of Afar region, Ethiopia

Research article

'I guess my own fancy screwed me over': transitions in drug use and the context of choice among young people entrenched in an open drug scene

Research article

Abdominal obesity and other risk factors largely explain the high CRP in Indigenous Australians relative to the general population, but not gender differences: a cross-sectional study