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Socioeconomic differences in 'avoidable' mortality in Sweden 1986-1990

R Westerling1, A Gullberg, M Rosén

  • 1Department of Social Medicine, Uppsala University, Akademiska Sjukhuset, S-751 85 Uppsala, Sweden.

International Journal of Epidemiology
|June 1, 1996
PubMed
Summary

Socioeconomic status significantly impacts avoidable mortality in Sweden. Individuals outside the labor force face substantially higher death risks, suggesting potential disparities in healthcare access or outcomes.

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Area of Science:

  • Public Health
  • Epidemiology
  • Health Services Research

Background:

  • Avoidable mortality serves as a key indicator for healthcare system performance.
  • Socioeconomic disparities in health outcomes are a critical public health concern.

Purpose of the Study:

  • To analyze socioeconomic differences in avoidable mortality in Sweden between 1986 and 1990.
  • To discuss methodological considerations in studying socioeconomic factors and mortality.

Main Methods:

  • Linked Swedish Population and Housing Census (1985) data with the National Cause of Death Register (1986-1990).
  • Analyzed mortality from potentially avoidable causes for individuals aged 21-64.
  • Calculated Standardized Mortality Ratios (SMRs) by age and sex for different socioeconomic groups, including those outside the labor market.

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Main Results:

  • Individuals not in the workforce exhibited higher death rates across all studied indicators compared to those employed.
  • Significantly elevated risks (3.1 to 7.5 times greater) were observed in the non-working population for conditions like chronic bronchitis, diabetes, and cerebrovascular disease.
  • Smaller differences in avoidable mortality were found between blue-collar, white-collar, and self-employed workers, though blue-collar workers had a higher risk for peptic ulcers.

Conclusions:

  • The similar mortality outcomes among employed socioeconomic groups suggest equitable healthcare quality within the workforce.
  • The markedly higher mortality risk in the non-working population warrants attention and may reflect a 'healthy worker' effect or other socioeconomic determinants.
  • The time lag between occupational exposure and mortality outcome can influence the measurement of socioeconomic differences in mortality.