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Social mobility, marital status, and mortality risk in an adult life course perspective: The Malmo preventive project

Nilsson, Peter M; Nilsson, Jan-Åke LU ; Östergren, Per-Olof LU and Berglund, Göran LU (2005) In Scandinavian Journal of Public Health 33(6). p.412-423
Abstract
Aims: Adverse social factors predict increased mortality. This study aimed to assess the influence of social class and marital status on mortality, adding an adult life course perspective. Methods: In total, 32,907 males and 20,204 females were evaluated based on census data in Malmo, Sweden. Of these subjects, 22,444 males and 10,902 females also took part in health screening. The main outcomes were all-cause and cause-specific mortality rates in subgroups based on social class and marital status, either measured once or repeatedly in adult life. Results were based on a total of 522,807 years of follow-up in men ( 5,761 deaths) and 239,815 in women ( 1,354 deaths). Results: Total and cardiovascular mortality were significantly higher in... (More)
Aims: Adverse social factors predict increased mortality. This study aimed to assess the influence of social class and marital status on mortality, adding an adult life course perspective. Methods: In total, 32,907 males and 20,204 females were evaluated based on census data in Malmo, Sweden. Of these subjects, 22,444 males and 10,902 females also took part in health screening. The main outcomes were all-cause and cause-specific mortality rates in subgroups based on social class and marital status, either measured once or repeatedly in adult life. Results were based on a total of 522,807 years of follow-up in men ( 5,761 deaths) and 239,815 in women ( 1,354 deaths). Results: Total and cardiovascular mortality were significantly higher in manual male employees with age-adjusted risk ratios (RR) of 1.7 (95% CI 1.5-1.9) and 1.6 (1.3-2.0) in skilled manual workers, and 2.0 (1.7-2.2) and 1.9 (1.6-2.3) in unskilled manual workers, compared with high-level non-manual employees. The differences remained after adjustment for baseline risk factors and prevalent cardiovascular disease, and were similar for women. Increased mortality risk was also documented for subjects who were divorced or unmarried ( adjusted for social class), as well as being downward socially mobile or in a permanent low social class ( manual) position. Conclusions: Social class based on occupation, either measured once or repeatedly in adult life, is associated with marked differences in mortality risk in middle-aged subjects. People who remain married/cohabiting or remarry are at lower risk of early death than people who remain unmarried or divorced. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
census, life course, marital status, social class, mortality, population-based
in
Scandinavian Journal of Public Health
volume
33
issue
6
pages
412 - 423
publisher
Taylor & Francis
external identifiers
  • wos:000233856100002
  • pmid:16332606
  • scopus:30944455479
ISSN
1651-1905
DOI
10.1080/14034940510005905
language
English
LU publication?
yes
id
0c4c5387-07fb-45fd-9237-377119122cf8 (old id 894327)
date added to LUP
2008-01-16 15:33:08
date last changed
2017-07-23 04:33:38
@article{0c4c5387-07fb-45fd-9237-377119122cf8,
  abstract     = {Aims: Adverse social factors predict increased mortality. This study aimed to assess the influence of social class and marital status on mortality, adding an adult life course perspective. Methods: In total, 32,907 males and 20,204 females were evaluated based on census data in Malmo, Sweden. Of these subjects, 22,444 males and 10,902 females also took part in health screening. The main outcomes were all-cause and cause-specific mortality rates in subgroups based on social class and marital status, either measured once or repeatedly in adult life. Results were based on a total of 522,807 years of follow-up in men ( 5,761 deaths) and 239,815 in women ( 1,354 deaths). Results: Total and cardiovascular mortality were significantly higher in manual male employees with age-adjusted risk ratios (RR) of 1.7 (95% CI 1.5-1.9) and 1.6 (1.3-2.0) in skilled manual workers, and 2.0 (1.7-2.2) and 1.9 (1.6-2.3) in unskilled manual workers, compared with high-level non-manual employees. The differences remained after adjustment for baseline risk factors and prevalent cardiovascular disease, and were similar for women. Increased mortality risk was also documented for subjects who were divorced or unmarried ( adjusted for social class), as well as being downward socially mobile or in a permanent low social class ( manual) position. Conclusions: Social class based on occupation, either measured once or repeatedly in adult life, is associated with marked differences in mortality risk in middle-aged subjects. People who remain married/cohabiting or remarry are at lower risk of early death than people who remain unmarried or divorced.},
  author       = {Nilsson, Peter M and Nilsson, Jan-Åke and Östergren, Per-Olof and Berglund, Göran},
  issn         = {1651-1905},
  keyword      = {census,life course,marital status,social class,mortality,population-based},
  language     = {eng},
  number       = {6},
  pages        = {412--423},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Public Health},
  title        = {Social mobility, marital status, and mortality risk in an adult life course perspective: The Malmo preventive project},
  url          = {http://dx.doi.org/10.1080/14034940510005905},
  volume       = {33},
  year         = {2005},
}