Skip to main content
PMC home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1996 Dec;50(6):653–660. doi: 10.1136/jech.50.6.653

Total and occupationally active life expectancies in relation to social class and marital status in men classified as healthy at 20 in Finland.

J Kaprio 1, S Sarna 1, M Fogelholm 1, M Koskenvuo 1
PMCID: PMC1060383  PMID: 9039385

Abstract

STUDY OBJECTIVE: To study differences in total life expectancy and in occupationally active life expectancy in relation to social class and marital status in men classified as healthy as young adults. DESIGN: Historical cohort study. SETTING: Finland. PARTICIPANTS: Altogether 1662 men classified as completely healthy at the time of induction to military service (mean birth year 1923), who had been selected as referents for a study of former athletes. Mean follow up time was 46 years. MEASUREMENTS: Vital status was determined by follow up through local parish data up to 1990. Mortality data were obtained from the Cause of Death bureau of the Central Statistical Office of Finland. Occurrence of work disability was assessed from nationwide disability pension register data. Mean total life expectancy and mean occupationally active life expectancy (end points disability pension or death before age 65 years) were estimated. Social class was based on the major lifetime occupation, while marital status was classified as "never married" or "ever married" at the end of follow up. MAIN RESULTS: Mean total life expectancy was highest among executives and managers (73.2 (95% confidence interval (CI): 70.3, 76.1) years), next highest in clerical (white collar) workers (72.0 (70.0, 74.1) years), and lowest in unskilled blue collar workers (63.65 (61.1, 66.2) years). Skilled workers and farmers were intermediate. For the occupationally active life expectancy estimates, a similar gradient was observed: highest for executives (61.9 (60.7, 63.1) years) and lowest for the unskilled (52.2 (50.2, 54.2) years). The ratio of occupationally active life expectancy to total life expectancy was highest for executives (85%) and lowest for farmers (81%) and unskilled workers (82%). CONCLUSIONS: The social class gradient known to exist for mortality is also present for occupational disability. Social class and marital status differences in mortality are already evident in early adulthood and continue into old age. Those with the highest life expectancy also have the largest proportion of their life span free of occupationally incapacitating disability.

Full text

PDF
656

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Antonovsky A. Social class, life expectancy and overall mortality. Milbank Mem Fund Q. 1967 Apr;45(2):31–73. [PubMed] [Google Scholar]
  2. Barker D. J., Hales C. N., Fall C. H., Osmond C., Phipps K., Clark P. M. Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth. Diabetologia. 1993 Jan;36(1):62–67. doi: 10.1007/BF00399095. [DOI] [PubMed] [Google Scholar]
  3. Barker D. J., Martyn C. N. The maternal and fetal origins of cardiovascular disease. J Epidemiol Community Health. 1992 Feb;46(1):8–11. doi: 10.1136/jech.46.1.8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Barker D. J., Osmond C., Simmonds S. J., Wield G. A. The relation of small head circumference and thinness at birth to death from cardiovascular disease in adult life. BMJ. 1993 Feb 13;306(6875):422–426. doi: 10.1136/bmj.306.6875.422. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Ben-Shlomo Y., Smith G. D. Deprivation in infancy or in adult life: which is more important for mortality risk? Lancet. 1991 Mar 2;337(8740):530–534. doi: 10.1016/0140-6736(91)91307-g. [DOI] [PubMed] [Google Scholar]
  6. Ben-Shlomo Y., Smith G. D., Shipley M., Marmot M. G. Magnitude and causes of mortality differences between married and unmarried men. J Epidemiol Community Health. 1993 Jun;47(3):200–205. doi: 10.1136/jech.47.3.200. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Doornbos G., Kromhout D. Educational level and mortality in a 32-year follow-up study of 18-year-old men in The Netherlands. Int J Epidemiol. 1990 Jun;19(2):374–379. doi: 10.1093/ije/19.2.374. [DOI] [PubMed] [Google Scholar]
  8. Eaker E. D., Pinsky J., Castelli W. P. Myocardial infarction and coronary death among women: psychosocial predictors from a 20-year follow-up of women in the Framingham Study. Am J Epidemiol. 1992 Apr 15;135(8):854–864. doi: 10.1093/oxfordjournals.aje.a116381. [DOI] [PubMed] [Google Scholar]
  9. Elford J., Whincup P., Shaper A. G. Early life experience and adult cardiovascular disease: longitudinal and case-control studies. Int J Epidemiol. 1991 Dec;20(4):833–844. doi: 10.1093/ije/20.4.833. [DOI] [PubMed] [Google Scholar]
  10. Feinstein J. S. The relationship between socioeconomic status and health: a review of the literature. Milbank Q. 1993;71(2):279–322. [PubMed] [Google Scholar]
  11. Forsdahl A. Living conditions in childhood and subsequent development of risk factors for arteriosclerotic heart disease. The cardiovascular survey in Finnmark 1974-75. J Epidemiol Community Health. 1978 Mar;32(1):34–37. doi: 10.1136/jech.32.1.34. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Garrison R. J., Gold R. S., Wilson P. W., Kannel W. B. Educational attainment and coronary heart disease risk: the Framingham Offspring Study. Prev Med. 1993 Jan;22(1):54–64. doi: 10.1006/pmed.1993.1004. [DOI] [PubMed] [Google Scholar]
  13. Guralnik J. M., Land K. C., Blazer D., Fillenbaum G. G., Branch L. G. Educational status and active life expectancy among older blacks and whites. N Engl J Med. 1993 Jul 8;329(2):110–116. doi: 10.1056/NEJM199307083290208. [DOI] [PubMed] [Google Scholar]
  14. Haynes S. G., Feinleib M., Kannel W. B. The relationship of psychosocial factors to coronary heart disease in the Framingham Study. III. Eight-year incidence of coronary heart disease. Am J Epidemiol. 1980 Jan;111(1):37–58. doi: 10.1093/oxfordjournals.aje.a112873. [DOI] [PubMed] [Google Scholar]
  15. Hein H. O., Suadicani P., Gyntelberg F. Ischaemic heart disease incidence by social class and form of smoking: the Copenhagen Male Study--17 years' follow-up. J Intern Med. 1992 May;231(5):477–483. doi: 10.1111/j.1365-2796.1992.tb00963.x. [DOI] [PubMed] [Google Scholar]
  16. Helsing K. J., Comstock G. W., Szklo M. Causes of death in a widowed population. Am J Epidemiol. 1982 Sep;116(3):524–532. doi: 10.1093/oxfordjournals.aje.a113436. [DOI] [PubMed] [Google Scholar]
  17. House J. S., Kessler R. C., Herzog A. R. Age, socioeconomic status, and health. Milbank Q. 1990;68(3):383–411. [PubMed] [Google Scholar]
  18. Illsley R., Baker D. Contextual variations in the meaning of health inequality. Soc Sci Med. 1991;32(4):359–365. doi: 10.1016/0277-9536(91)90336-b. [DOI] [PubMed] [Google Scholar]
  19. Isohanni M., Oja H., Moilanen I., Rantakallio P., Koiranen M. The relation between teenage smoking and drinking, with special reference to non-standard family background. Scand J Soc Med. 1993 Mar;21(1):24–30. doi: 10.1177/140349489302100105. [DOI] [PubMed] [Google Scholar]
  20. Kaplan G. A., Salonen J. T. Socioeconomic conditions in childhood and ischaemic heart disease during middle age. BMJ. 1990 Nov 17;301(6761):1121–1123. doi: 10.1136/bmj.301.6761.1121. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Kaprio J., Koskenvuo M., Rita H. Mortality after bereavement: a prospective study of 95,647 widowed persons. Am J Public Health. 1987 Mar;77(3):283–287. doi: 10.2105/ajph.77.3.283. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Koskenvuo M., Kaprio J., Romo M., Langinvainio H. Incidence and prognosis of ischaemic heart disease with respect to marital status and social class. A national record linkage study. J Epidemiol Community Health. 1981 Sep;35(3):192–196. doi: 10.1136/jech.35.3.192. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Koskenvuo M., Sarna S., Kaprio J., Lönnqvist J. Cause-specific mortality by marital status and social class in Finland during 1969--1971. Soc Sci Med Med Psychol Med Sociol. 1979 Nov;13A(6):691–697. doi: 10.1016/0271-7123(79)90114-7. [DOI] [PubMed] [Google Scholar]
  24. Koskenvuo M., Sarna S., Kaprio J. Mortality by marital status and social class in Finland during 1969--1971. Mortality from natural and violent causes. Scand J Soc Med. 1978;6(3):137–143. doi: 10.1177/140349487800600307. [DOI] [PubMed] [Google Scholar]
  25. Leclerc A., Pietri F., Boitel L., Chastang J. F., Carval P., Blondet M. Level of education, lifestyle, and morbidity in two groups of white collar workers. J Epidemiol Community Health. 1992 Aug;46(4):403–408. doi: 10.1136/jech.46.4.403. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Malcolm J. A., Dobson A. J. Marriage is associated with a lower risk of ischaemic heart disease in men. Med J Aust. 1989 Aug 21;151(4):185–188. doi: 10.5694/j.1326-5377.1989.tb115986.x. [DOI] [PubMed] [Google Scholar]
  27. Marmot M. G., Kogevinas M., Elston M. A. Social/economic status and disease. Annu Rev Public Health. 1987;8:111–135. doi: 10.1146/annurev.pu.08.050187.000551. [DOI] [PubMed] [Google Scholar]
  28. Marmot M. G., Smith G. D., Stansfeld S., Patel C., North F., Head J., White I., Brunner E., Feeney A. Health inequalities among British civil servants: the Whitehall II study. Lancet. 1991 Jun 8;337(8754):1387–1393. doi: 10.1016/0140-6736(91)93068-k. [DOI] [PubMed] [Google Scholar]
  29. Mendes de Leon C. F., Appels A. W., Otten F. W., Schouten E. G. Risk of mortality and coronary heart disease by marital status in middle-aged men in The Netherlands. Int J Epidemiol. 1992 Jun;21(3):460–466. doi: 10.1093/ije/21.3.460. [DOI] [PubMed] [Google Scholar]
  30. Morris J. N. Inequalities in health: ten years and little further on. Lancet. 1990 Aug 25;336(8713):491–493. doi: 10.1016/0140-6736(90)92026-e. [DOI] [PubMed] [Google Scholar]
  31. Notkola V. J., Martikainen P., Leino P. I. Time trends in mortality in forestry and construction workers in Finland 1970-85 and impact of adjustment for socioeconomic variables. J Epidemiol Community Health. 1993 Jun;47(3):186–191. doi: 10.1136/jech.47.3.186. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Nyboe J., Jensen G., Appleyard M., Schnohr P. Risk factors for acute myocardial infarction in Copenhagen. I: Hereditary, educational and socioeconomic factors. Copenhagen City Heart Study. Eur Heart J. 1989 Oct;10(10):910–916. doi: 10.1093/oxfordjournals.eurheartj.a059401. [DOI] [PubMed] [Google Scholar]
  33. Näyhä S. Social group and mortality in Finland. Br J Prev Soc Med. 1977 Dec;31(4):231–237. [PMC free article] [PubMed] [Google Scholar]
  34. Rissanen A., Heliövaara M., Knekt P., Reunanen A., Aromaa A., Maatela J. Risk of disability and mortality due to overweight in a Finnish population. BMJ. 1990 Oct 13;301(6756):835–837. doi: 10.1136/bmj.301.6756.835. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Rosengren A., Wedel H., Wilhelmsen L. Coronary heart disease and mortality in middle aged men from different occupational classes in Sweden. BMJ. 1988 Dec 10;297(6662):1497–1500. doi: 10.1136/bmj.297.6662.1497. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Sarna S., Sahi T., Koskenvuo M., Kaprio J. Increased life expectancy of world class male athletes. Med Sci Sports Exerc. 1993 Feb;25(2):237–244. [PubMed] [Google Scholar]
  37. Syme S. L., Berkman L. F. Social class, susceptibility and sickness. Am J Epidemiol. 1976 Jul;104(1):1–8. doi: 10.1093/oxfordjournals.aje.a112268. [DOI] [PubMed] [Google Scholar]
  38. Valkonen T. Problems in the measurement and international comparisons of socio-economic differences in mortality. Soc Sci Med. 1993 Feb;36(4):409–418. doi: 10.1016/0277-9536(93)90403-q. [DOI] [PubMed] [Google Scholar]
  39. Wilkins R., Adams O. B. Health expectancy in Canada, late 1970s: demographic, regional, and social dimensions. Am J Public Health. 1983 Sep;73(9):1073–1080. doi: 10.2105/ajph.73.9.1073. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Woodward M., Shewry M. C., Smith W. C., Tunstall-Pedoe H. Social status and coronary heart disease: results from the Scottish Heart Health Study. Prev Med. 1992 Jan;21(1):136–148. doi: 10.1016/0091-7435(92)90013-8. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES