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Strong regional links between socio-economic background factors and disability and mortality in Oslo, Norway
M A Rognerud1, O Krüger, F Gjertsen
1Centre for Preventive Medicine, Ullevaal Hospital, Oslo, Norway.
Study Objective:
To study geographical differences in mortality and disability and socio-economic status in Oslo, Norway.
Setting:
A total of 25 local authority districts within the city of Oslo.
Design:
Analysis of age adjusted mortality rates aged 0-74 in the period 1991-1994, and cross sectional data on disability pensioners aged 50-66 and socio-economic indicators (low education, single parenthood, unemployment, high income) in 1994.
Main Outcome Measures:
The levels of correlation between the health outcomes (mortality and disability) and socio-economic exposure variables.
Main Results:
The geographical patterns of mortality and disability display substantial similarities and show strong linear correlation with area measures of socio-economic deprivation. The ratios between the highest and lowest area mortality rates were 3.3 for men and 2.1 for women, while the high-low ratios of disability were 7.0 for men and 3.8 for women. For women deprivation measures are better correlated with disability than mortality. While disability and mortality display similar correlations with deprivation measures for men.
Conclusions:
The social gradients in health are substantial in Oslo. Further ecological analysis of cause specific morbidity and mortality and the distribution of risk factors ought to be done to identify problem areas suitable for interventions. However, to understand the mechanisms and the relative importance of each etiological factor, studies based on individual data have to be performed.