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Trends of socioeconomic equality in mortality amenable to healthcare and health policy in 1992–2013 in Finland: a population-based register study
  1. Sonja Lumme1,
  2. Kristiina Manderbacka1,
  3. Sakari Karvonen2,
  4. Ilmo Keskimäki1,3
  1. 1 Social and Health Systems Research Unit, Department of Health and Social Care Systems, National Institute for Health and Welfare, Helsinki, Finland
  2. 2 Social Policy Research Unit, Department of Health and Social Care Systems, National Institute for Health and Welfare, Helsinki, Finland
  3. 3 University of Tampere, Faculty of Social Sciences, Tampere, Finland
  1. Correspondence to Dr Sonja Lumme; sonja.lumme{at}thl.fi

Abstract

Objective To study trends in socioeconomic equality in mortality amenable to healthcare and health policy interventions.

Design A population-based register study.

Setting Nationwide data on mortality from the Causes of Death statistics for the years 1992–2013.

Participants All deaths of Finnish inhabitants aged 25–74.

Outcome measures Yearly age-standardised rates of mortality amenable to healthcare interventions, alcohol-related mortality, ischaemic heart disease mortality and mortality due to all the other causes by income. Concentration index (C) was used to evaluate the magnitude and changes in income group differences.

Results Significant socioeconomic inequalities favouring the better-off were observed in each mortality category among younger (25–64) and older (65–74) age groups. Inequality was highest in alcohol-related mortality, C was −0.58 (95% CI −0.62 to −0.54) among younger men in 2008 and −0.62 (−0.72 to −0.53) among younger women in 2013. Socioeconomic inequality increased significantly during the study period except for alcohol-related mortality among older women.

Conclusions The increase in socioeconomic inequality in mortality amenable to healthcare and health policy interventions between 1992 and 2013 suggests that either the means or the implementation of the health policies have been inadequate.

  • health care
  • health policy
  • socioeconomic equality
  • mortality
  • register study

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Footnotes

  • Patient consent for publication Not required.

  • Contributors SL participated in the conception and planning of the study, designed the study, analysed and interpreted the data and was a major contributor in writing the manuscript. KM, SK, and IK participated in the conception and planning of the study and the interpretation of the results for important intellectual content and writing the manuscript. All authors read and approved the final manuscript.

  • Funding This work was supported by the Academy of Finland (project numbers 277939 and 312708), but the Academy had no involvement in its design, data collection, analysis, findings or decision to publish.

  • Competing interests None declared.

  • Ethics approval Ethics Committee of National Institution for Health and Welfare.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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