Poor childhood living conditions are associated with short stature. Before the Second World War Finland had much lower living standards than Sweden, but this gap had largely disappeared by the 1970s. Body height differences were examined by birth cohort, economic difficulties in childhood and adult socioeconomic position in Finland and Sweden.
Two nationally representative data sets were used (n = 7,300 in Finland and n = 4,551 in Sweden). Three indicators of social background were included, i.e. economic difficulties in childhood, education and occupational class. The methods used were direct age-standardisation, index of dissimilarity and regression analysis.
In the cohort born in 1920-1929 body height was taller in Sweden (175.8 cm among men and 163.7 cm among women) than in Finland (173.9 and 161.2 cm respectively). Body height by birth cohort increased faster in Finland, with the result that, in the cohort born in 1960-1969, the gap between the countries had narrowed to 0.8 cm among men and 0.3 cm among women. Body height differences by social background were larger in Finland than in Sweden. Socioeconomic body height differences have remained largely stable over the birth cohorts in both countries.
The results suggest that differential economic development is partly seen in the narrowing of body height differences between Finland and Sweden. However, socioeconomic differences in body height have remained largely similar over the birth cohorts studied and between Finland and Sweden.
STUDY OBJECTIVE: To assess whether there are variations between 11 Western European countries with respect to the size of differences in self reported morbidity between people with high and low educational levels. DESIGN AND METHODS: National representative data on morbidity by educational level were obtained from health interview surveys, level of living surveys or other similar surveys carried out between 1985 and 1993. Four morbidity indicators were included and a considerable effort was made to maximise the comparability of these indicators. A standardised scheme of educational levels was applied to each survey. The study included men and women aged 25 to 69 years. The size of morbidity differences was measured by means of the regression based Relative Index of Inequality. MAIN RESULTS: The size of inequalities in health was found to vary between countries. In general, there was a tendency for inequalities to be relatively large in Sweden, Norway, and Denmark and to be relatively small in Spain, Switzerland, and West Germany. Intermediate positions were observed for Finland, Great Britain, France, and Italy. The position of the Netherlands strongly varied according to sex: relatively large inequalities were found for men whereas relatively small inequalities were found for women. The relative position of some countries, for example, West Germany, varied according to the morbidity indicator. CONCLUSIONS: Because of a number of unresolved problems with the precision and the international comparability of the data, the margins of uncertainty for the inequality estimates are somewhat wide. However, these problems are unlikely to explain the overall pattern. It is remarkable that health inequalities are not necessarily smaller in countries with more egalitarian policies such as the Netherlands and the Scandinavian countries. Possible explanations are discussed.
To assess the extent of lung cancer mortality differentials by education while adjusting for exposure to tobacco smoke and asbestos based on survey questions.
Alpha-Tocopherol, Beta Carotene Cancer Prevention (ATBC) Study of 50-69-year-old Finnish male smokers enrolled 1985-1988. These analyses are based on the placebo group and the alpha-tocopherol supplementation group, altogether 14 011 men, with full information on tobacco smoking. Mortality follow-up was to the end of April 1993 and it was based on the complete death certificate register of the Statistics Finland.
Lung cancer mortality of basic-educated men was 32% (rate ratio [RR] = 1.32; 95% CI : 0.93-1.87) higher than that of better-educated men in the ATBC Study. The excess is practically unchanged when additional adjustment was made for age at initiation, duration of smoking, current smoking at baseline and at first follow-up, smoke inhalation, occupational exposure to asbestos and interactions between asbestos exposure and all smoking variables. This excess mortality was about 40% of the similar excess observed in the general population of men of similar age.
Educational differences in lung cancer mortality in the total Finnish population are likely to be mainly caused by differences in exposure, particularly to active smoking. Further understanding of the determinants and consequences of socioeconomic differences in smoking behaviour are of major scientific and public health importance.
STUDY OBJECTIVE: To compare the age pattern of educational health inequalities in four Nordic countries in the mid-1980s and the mid-1990s. DESIGN: Cross sectional interview surveys at two points of time. SETTING: Data on self reported limiting longstanding illness, and perceived health were collected from Denmark, Finland, Norway, and Sweden in 1986/87 and in 1994/95. PARTICIPANTS: Representative samples of the non-institutionalised population at 15 years or older. Analyses were restricted to respondents aged between 25 and 75 (n= 23 325 men and 24 184 women). Response rates varied from 73% to 87%. MAIN RESULTS: The age adjusted prevalence of limiting longstanding illness in Finland was 10% higher in men and 6% higher in women than in other Nordic countries in 1986/87 but the gap narrowed by 1994/95. Educational health inequalities were largest in Norway. In 1986/87 the odds ratio (OR) for limiting longstanding illness was 11.25 (95% CI 8.66 to 14.62) among men and 8.23 (95% CI 6.60 to 10.27) among women in the oldest age group (65-74 years old) in Finland when the youngest age group (25-34 years old) was used as the reference category (OR=1.00). The age pattern in Finland was steeper than in Sweden (OR=5.02, 95% CI 3.97 to 6.34 in men and 5.29, 95% CI 4.18 to 6.71 in women) or Norway (OR=6.32, 95% CI 4.06 to 9.84 and 5.45, 95% CI 3.81 to 7.82, respectively). In 1994/95 relative health improved in the oldest age group in Finland (OR=5.80, 95% CI 4.33 to 7.78 in men and 5.94, 95% CI 4.52 to 7.79 in women) and in Norway (OR=4.55, 95% CI 3.01 to 6.88 and 3.96, 95% CI 2.70 to 5.81, respectively) but remained stable in Sweden. The study compared health differences by age in different educational categories and found that in Finland in 1986/87 the health in the oldest age group was poorer for secondary (OR=10.59, 95% CI 5.96 to 18.82) or basic educated (OR=9.76, 95% CI 6.66 to 14.30) men than for men with higher education (OR=5.15, 95% CI 2.59 to 10.22). The difference was not found among women or in other Nordic countries and it diminished among men in Finland in 1994/95. The results of perceived health were broadly similar to the above results of limiting longstanding illness. CONCLUSION: The results suggest that compared with other Nordic countries the comparatively poorer health in Finland is partly attributable to a cohort effect. This may be associated with the lower standard of living in Finland that lasted until the mid-1950s. The cohort effect is also likely to contribute to educational health inequalities among older Finnish men. The results suggest that not only current social policies but also past economic circumstances are likely to affect the overall health status as well as health inequalities.
To study the socio-demographic determinants of body-height and the bearing of these determinants on the association between body-height and health among Finnish adults.
Cross-sectional population survey including questions on social background, body-height and health, and retrospective questions on childhood living conditions. The data derive from a representative Survey on Living Conditions collected by Statistics Finland in 1994. The response rate was 73%. Male and female respondents > or =20 years were included in the analysis (N = 8212). Statistical methods include regression analysis and logistic regression analysis.
Body-height was strongly associated with year of birth, region, childhood living conditions and education among adult men and women. Body-height was also associated with limiting long-standing illness and perceived health as below good. Tall men had the best health and short men the poorest health. Among women the association of body-height with health differed from men, as tall women showed high levels of limiting long-standing illness, notably musculo-skeletal diseases. Adjusting for the background variables weakened but did not abolish the association between poor health and short stature among men and women.
Short stature is associated with poor health among Finnish men and women. A non-linear association among women was found for musculo-skeletal diseases. The studied social background factors explained only little of the association between body-height and health.
Studies on health inequalities have usually focused either on mortality or on morbidity. This concerns national studies as well as international comparisons of health inequalities. This paper seeks to bridge the gap by applying health expectancy as a synthetic overall measure of health. The purpose of the study is to compare socioeconomic inequalities in health expectancy in Finland and Norway in the late 1980s. Additionally, the major methodological issues in the use of health expectancy in the study of health inequalities are identified. Data on mortality by level of education derive from linked national follow-up studies (1986-1990) of population censuses. Data on the prevalence of morbidity by level of education derive from nationally representative surveys of the noninstitutionalised adult population in 1985/87. Persons aged 25-74 years were included. Four measures of morbidity were used: limiting long-standing illness, extremely limiting long-standing illness, functional disabilities and perceived less than good health. The association between mortality/morbidity and level of education in each 5-year age/sex group was determined by a regression-based method. Partial life expectancies and partial health expectancies for ages 25-74 were then calculated by using the mortality quotients and morbidity prevalences predicted by the regression model for those at the top and the bottom of the educational hierarchy in each 5-year age group, using an application of the method first presented by Sullivan. Although various measures of health expectancy were used, the result were consistent. In absolute terms the size of socioeconomic inequalities in health expectancy in Finland and Norway is on the same level. In relative terms, however, the size of inequalities in health expectancy is greater in Norway. If one considers premature mortality to be more severe than any indicator of morbidity, the mortality morbidity mix of the health inequalities is less favourable to Finland, since the size of absolute inequalities in mortality is greater in Finland. Health expectancy measures provide a promising measure for assessing and comparing the pattern and the size of health inequalities.