The European Journal of Public Health Advance Access originally published online on December 6, 2008
The European Journal of Public Health 2009 19(1):38-45; doi:10.1093/eurpub/ckn123
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Social inequalities |
Associations of multiple socio-economic circumstances with physical functioning among Finnish and British employees
Elina Laaksonen1, Pekka Martikainen2, Jenny Head3, Ossi Rahkonen1, Michael G. Marmot3 and Eero Lahelma1
1 Department of Public Health, University of Helsinki, Finland
2 Department of Sociology, University of Helsinki, Finland
3 Department of Epidemiology and Public Health, University College London, UK
Correspondence: Elina Laaksonen, Researcher, Department of Public Health, PO Box 41, 00014 University of Helsinki, Finland, tel: + 358 (0)9 191 27553, fax:+358 (0)9 191 27540, e-mail: elina.laaksonen{at}helsinki.fi
Received February 18, 2008 , accepted November 10, 2008
Background: To further increase our understanding of socio-economic health inequalities, we need studies considering multiple socio-economic circumstances and comparing different cultural contexts. This study compared the associations of past and present socio-economic circumstances with physical functioning between employees from Finland and Britain.
Methods: Cross-sectional survey data from the Helsinki Health Study (n = 5866) and the Whitehall II Study (n = 3052) were used. Participants were white-collar public sector employees aged 45–60 years. Physical functioning was measured with the SF-36 physical component summary. The socio-economic indicators were parental and own education, childhood and current economic difficulties, occupational class, income, housing tenure.
Results: Childhood and current economic difficulties were independently associated with physical functioning in both cohorts, although in London women childhood difficulties did not reach statistical significance. Own education was independently associated with physical functioning in Helsinki. Occupational class showed associations with physical functioning in both cohorts. These were mainly attenuated by education and income, but in London women there was a strong independent association. The association of income with physical functioning was attenuated by education (Helsinki) and occupational class (London). Parental education and housing tenure showed no consistent associations.
Conclusions: Past and present economic difficulties were independently associated with physical functioning. The conventional socio-economic indicators showed less consistent associations which were partly mediated through other indicators and modified by the national context. The associations that varied according to the indicators and between the cohorts highlight the importance of considering the multiplicity of socio-economic circumstances and comparing different cultural contexts in further studies.
Keywords: comparisons, employees, physical functioning, socio-economic position
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