The association between unhealthy behaviors and socioeconomic status differs between countries

February 22, 2011

According to a study by Silvia Stringhini and colleagues from INSERM, (U1018 Centre for Research in Epidemiology and Population Health) and University College London, (Department of Epidemiology and Public Health), published in this week's PLoS Medicine, although socioeconomic status and health behaviors are strong predictors of mortality, there are major differences in the social patterning of unhealthy behaviors in different countries.

The authors investigated whether health behaviours are equally important mediators of the association between socio-economic status and health in different cultural settings. They compared recent findings of the British Whitehall II study with those of another European cohort, the French GAZEL study. Both large cohort studies have comparable designs and have a similar age range and follow-up period. The Whitehall II study started in 1985, with the aim of examining the socioeconomic gradient in health among 10308 London-based civil servants (6895 men and 3413 women) aged 35-55. The GAZEL study started in 1989 among employees of the French national gas and electricity company totalling 20625 employees (15011 men and 5614 women), aged 35-50.

The authors found that the socioeconomic gradient in smoking and unhealthy diet was greater in Whitehall II than in GAZEL. Socioeconomic differences in mortality were similar in the two cohorts, a hazard ratio of 1.62 in Whitehall II and 1.94 in GAZEL for lowest versus highest occupational position. Health behaviours weakened the association between socio-economic status and mortality substantially in Whitehall II (by 75%) but only by 19% in GAZEL. The supplementary analysis the researchers conducted using education and income as socio-economic markers gave similar results.

These findings are important as they show that health behaviours are only likely to be major contributors towards socioeconomic differences in health in settings with a marked social characterisation of those behaviours. The authors conclude that in order to identify the common and unique determinants of social inequalities in health in different populations, "there needs to be further comparative research on the relative importance of different pathways linking socioeconomic status to health."
-end-
Funding: The Whitehall II study was supported by grants from the British Medical Research Council (grant number: G0902037); the British Heart Foundation (grant number: RG/07/008/23674); the British Health and Safety Executive; the British Department of Health; the National Heart, Lung, and Blood Institute, NIH (grant number: R01HL036310); the National Institute on Aging, NIH (grant numbers: R01AG013196 and R01AG034454). The GAZEL Cohort Study was funded by EDF-GDF and INSERM, and received grants from the Cohortes Sante TGIR Program, Agence nationale de la recherche (ANR) and Agence francaise de securite sanitaire de l'environnement et du travail (AFSSET). This work was supported by a ''European Young Investigator Award'' from the European Science Foundation to AS-M, a grant from the British Heart Foundation to MS, grants from the BUPA Foundation, UK; EU OSH ERA research program and the Academy of Finland to MK. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: The authors have declared that no competing interests exist.

Citation: Stringhini S, Dugravot A, Shipley M, Goldberg M, Zins M, et al. (2011) Health Behaviours, Socioeconomic Status, and Mortality: Further Analyses of the British Whitehall II and the French GAZEL Prospective Cohorts. PLoS Med 8(2): e1000419. doi:10.1371/journal.pmed.1000419

IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000419

CONTACT:

Silvia Stringhini

INSERM
U1018- Centre for Research in Epidemiology and Population Health
Hopital Paul Brousse
16 avenue Paul Vaillant Couturier, Bâtiment 15/16
Villejuif Cedex, Val de Marne 94807
France
+33 (0)1 77747425
silvia.stringhini@inserm.fr

PLOS

Related Public Health Articles from Brightsurf:

COVID-19 and the decolonization of Indigenous public health
Indigenous self-determination, leadership and knowledge have helped protect Indigenous communities in Canada during the coronavirus disease 2019 (COVID-19) pandemic, and these principles should be incorporated into public health in future, argue the authors of a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200852.

Public health consequences of policing homelessness
In a new study examining homelessness, researchers find that policy such a lifestyle has massive public health implications, making sleeping on the street even MORE unhealthy.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.

The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.

The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.

BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.

Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.

Read More: Public Health News and Public Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.