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E Lahelma, O Pentala, A Helldán, S Helakorpi, O Rahkonen, 36-year trends in socioeconomic differences in self-rated health among Finnish adults: Eero Lahelma, European Journal of Public Health, Volume 27, Issue suppl_3, November 2017, ckx187.289, https://doi.org/10.1093/eurpub/ckx187.289
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Background
Socioeconomic inequalities in health are a scourge much tougher than thought some decades ago. Nevertheless, long-term trends in health inequalities at the population level have been little studied and are poorly understood, although such evidence would be helpful for efficient reduction of health inequalities. We examined educational differences in self-rated health among Finnish adults in 1979-2014.
Methods
Annual mail surveys representing adult Finns were made in 1979-2014 (n = 2183-4089) by the National Institute for Health and Welfare. We included 25-64 year-olds and measured self-rated health less than good. Socioeconomic position was measured by relative education, i.e. years of education divided annually into thirds. We calculated 5-year moving averages and 95% confidence intervals (CI) for age-adjusted prevalence percentages.
Results
Over the 36 years, the prevalence of less than good self-rated health declined somewhat. Among men, in 1979-1983, the prevalence in the lowest educational third was 56% (CI 52.3-60.2) and in the highest third 24% (20.1-27.6); in 2009-2014 the figures were 49% (42.1-55.4) and 27% (19.6-28.6). Among women, in 1979-1983, the prevalence in the lowest educational third was 57% (52.8-61.2) and in the highest third 22% (18.3-25.7); in 2009-2014 the figures were 47% (39.9-53.8) and 24% (19.9-27.0). Educational differences in health narrowed somewhat from the 1980s to the 1990s, but remained large and unchanged after that.
Conclusions
Among Finnish men and women, in 1979-2014, large health inequalities persisted, with relatively minor changes over time. Still in the mid 2010s, health inequalities remain a major challenge for egalitarian health policies despite a series of national programmes aimed at reducing the inequalities. Our study suggests that those lowest on the social ladder are in a particular need for measures promoting health and preventing ill health. Successful measures would benefit the health in the whole population.
Key messages:
Large educational inequalities in self-rated health remained among Finnish men and women over a 36-year long period.
Reducing health inequalities has not been successful despite national programmes.
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