Journal Article

Trends in Socioeconomic Disparities in Stroke Mortality in Six European Countries between 1981–1985 and 1991–1995

M. Avendaño, A. E. Kunst, F. van Lenthe, V. Bos, G. Costa, T. Valkonen, M. Cardano, S. Harding, J-K. Borgan, M. Glickman, A. Reid and J. P. Mackenbach

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 161, issue 1, pages 52-61
Published in print January 2005 | ISSN: 0002-9262
Published online January 2005 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwi011
Trends in Socioeconomic Disparities in Stroke Mortality in Six European Countries between 1981–1985 and 1991–1995

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This study assesses whether stroke mortality trends have been less favorable among lower than among higher socioeconomic groups. Longitudinal data on mortality by socioeconomic status were obtained for Finland, Norway, Denmark, Sweden, England/Wales, and Turin, Italy. Data covered the entire population or a representative sample. Stroke mortality rates were calculated for the period 1981–1995. Changes in stroke mortality rate ratios were analyzed using Poisson regression and compared with rate ratios in ischemic heat disease mortality. Trends in stroke mortality were generally as favorable among lower as among higher socioeconomic groups, such that socioeconomic disparities in stroke mortality persisted and remained of a similar magnitude in the 1990s as in the 1980s. In Norway, however, occupational disparities in stroke mortality significantly widened, and a nonsignificant increase was observed in some countries. In contrast, disparities in ischemic heart disease mortality widened throughout this period in most populations. Improvements in hypertension prevalence and treatment may have contributed to similar stroke mortality declines in all socioeconomic groups in most countries. Socioeconomic disparities in stroke mortality generally persisted and may have widened in some populations, which fact underlines the need to improve preventive and secondary care for stroke among the lower socioeconomic groups.

Keywords: cerebrovascular accident; Europe; mortality; social class; ICD-9, International Classification of Diseases, Ninth Revision (ICD-8 and ICD-10 defined analogously).

Journal Article.  6226 words.  Illustrated.

Subjects: Public Health and Epidemiology

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