Socioeconomic inequalities in health and disability.: Social epidemiology in the Nord-Trøndelag health study (HUNT), Norway
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Socioeconomic inequalities in health and disability are found in all countries where social gradients have been studied. Despite rapid economic growth and expanding health care systems, aiming at providing services to people according to need rather than according to wealth, persistent and even widening health inequalities are found in Europe after the second World War. In this research project we wanted to establish a method for measuring socioeconomic status based on occupational groups and education in the HUNT Study, thereby providing tools for research in social medicine. A social gradient scale based on the occupational grouping from the HUNT study questionnaires had not been established. When this study was planned however, educational level, which might serve as a proxy for socioeconomic status, had been monitored in both HUNT I and HUNT II. Disability pension has been a central element in social security legislation in Norway, established as a universal right for all citizens in 1967. This public income-maintenance program protects workers in case of disability, and comprises both universal and earningrelated programs. The main eligibility criterion has been permanent impaired earning ability by at least 50 % for reasons of illness or disease, injury or disability. Despite objective health improvement in the population the last decades, incidence of disability pension has increased. In epidemiology, socioeconomic status is not only an important variable in itself. It is also a confounder that should be taken into consideration in discussing almost all causal relationships. Thus, in population based health studies, measures of socio-economic status are essential. Occupation, education and income together determine the socioeconomic status of a person. However, these factors are sufficiently distinct to require that they should also be studied separately in relation to health. To study them separately is often preferable since this can suggest hypotheses on causal relationships between exposure and disease.
Has partsKrokstad, S; Westin, S. Health inequalities by socioeconomic status among men in the Nord-Trøndelag Health Study, Norway.. Scand J Publ Health. 30(2): 113-24, 2002.
Krokstad, S; Ringdal, K; Westin, S. Classifying people by social class in population based health surveys.. Norsk Epidemiologi. 12(1): 19-25, 2002.
Krokstad, S; Kunst, AE; Westin, S. Trends in health inequalities by educational level in a Norwegian total population study.. J Epidemiol Community Health. 56(5): 375-80, 2002.
Elstad, JI; Krokstad, S. Social causation, health-selective mobility, and the reproduction of socioeconomic health inequalities over time: panel study of adult men.. Social Science & Medicine. 57(8): 1475-89, 2003.
Krokstad, S; Westin, S. Disability in society − medical and non-medical determinants for disability pension in a Norwegian total county population study.. Social Science & Medicine. 58(10): 1837-1848, 2004.
Krokstad, S; Johnsen, R; Westin, S. Social determinants of disability pension: a 10-year follow-up of 62 000 people in a Norwegian county population.. International Journal of Epidemiology. 31: 1183-91, 2002.
Krokstad, S; Magnus, P; Skrondal, A; Westin, S. The importance of social characteristics of communities for the medically based disability pension.. Eur J Public Health. 14(4): 406-12, 2004.
PublisherDet medisinske fakultet
SeriesDissertations at the Faculty of Medicine, 0805-7680; 239
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