Trends in health inequalities by educational level in a Norwegian total population study

• Published in: Journal of epidemiology and community health (1979) 2002-05, Vol.56 (5), p.375-380
• Main Authors: Krokstad, S, Kunst, A E, Westin, S
• Format: Article
• Language: English
• Subjects: Academic achievement; Adult; Age groups; Aged; Analysis. Health state; Biological and medical sciences; Cross-Sectional Studies; Education; Educational levels; Educational Status; Egalitarianism; Epidemiology; Equal education; Female; General aspects; Health aspects; Health care inequality; Health disparities; Health problems; Health Status; Humans; Income inequality; inequalities; International comparisons; Male; Medical care; Medical conditions; Medical sciences; Men; Middle Aged; Missing data; Morbidity; Norway; Norway - epidemiology; Odds Ratio; Population; Population education; Population studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Research Report; Social aspects; Social change; Social Class; Socioeconomic factors; socioeconomic status; Socioeconomics; Trends; Womens health
• ISSN: 0143-005X; 1470-2738
• DOI: 10.1136/jech.56.5.375

Objective: To describe levels of inequality and trends in self reported morbidity by educational level in a total Norwegian county population in the mid-1980s and mid-1990s. Design: Two cross sectional health surveys at an interval of 10 years in the Nord-Trøndelag Health Study, HUNT I (1984–86) and HUNT II (1995–97). Setting: Primary health care, total county population study. Participants: Men and women, 25–69 years. Main results: There was a consistent pattern of increasing self reported health problems with decreasing educational level for three health variables: perceived health, any longstanding health problem, and having a chronic condition. A stable or slight decrease in inequalities over time was found. The prevalence odds ratio for perceived health less than good were 2.71 for men (95% confidence intervals (CI): 2.39 to 3.09) and 2.13 for women (95% CI: 1.85 to 2.46) in the first survey, 2.51 for men (95% CI: 2.27 to 2.78) and 2.06 for women (95% CI: 1.88 to 2.26) 10 years later. Conclusions: The magnitude of the socioeconomic gradients in health in this population seemed somewhat lower than in Norway as a whole and close to the average in studies from other European countries. There was a slight trend towards smaller differences despite rapid structural changes in working life, turbulence in economy, and more people experiencing unemployment.