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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1999 May;53(5):288–293. doi: 10.1136/jech.53.5.288

The magnitude of differences in perceived general health associated with educational level in the regions of Spain

E Regidor, V Dominguez, P Navarro, C Rodriguez
PMCID: PMC1756877  PMID: 10396535

Abstract

STUDY OBJECTIVE: To examine and compare the relation between inequalities in perceived general health and education in the 17 regions of Spain. DESIGN AND METHODS: Data were taken from the 1993 Spanish Health Interview Survey. For each region we calculated the magnitude of inequality in perceived general health in association with educational level by a measure of association or effect and by a relative index of inequality. Both measures are odds ratios and were estimated by logistic regression. The first is an odds ratio associated with one year less education, while the second represents the inequality in perceived general health between those at the bottom and those at the top of the educational hierarchy. MAIN RESULTS: The six regions with the highest relative indices of inequality also have the highest odds ratios associated with one year less education, and five of the six regions with the lowest relative indices of inequality have the lowest odds ratios associated with one year less education. Pearson's correlation coefficient between the odds ratio and the relative index of inequality is 0.94. CONCLUSIONS: Regional differences in levels of inequality in perceived general health are attributable exclusively to the effect of education on health and not to the distribution of the population among the different educational levels. It is not known why the magnitude of this effect of education on health varies from one area to another.

 

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Selected References

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

  1. Bakke P. S., Hanoa R., Gulsvik A. Educational level and obstructive lung disease given smoking habits and occupational airborne exposure: a Norwegian community study. Am J Epidemiol. 1995 Jun 1;141(11):1080–1088. doi: 10.1093/oxfordjournals.aje.a117373. [DOI] [PubMed] [Google Scholar]
  2. Cavelaars A. E., Kunst A. E., Geurts J. J., Crialesi R., Grötvedt L., Helmert U., Lahelma E., Lundberg O., Matheson J., Mielck A. Differences in self reported morbidity by educational level: a comparison of 11 western European countries. J Epidemiol Community Health. 1998 Apr;52(4):219–227. doi: 10.1136/jech.52.4.219. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Diez-Roux A. V., Nieto F. J., Tyroler H. A., Crum L. D., Szklo M. Social inequalities and atherosclerosis. The atherosclerosis risk in communities study. Am J Epidemiol. 1995 May 15;141(10):960–972. doi: 10.1093/oxfordjournals.aje.a117363. [DOI] [PubMed] [Google Scholar]
  4. 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]
  5. Feldman J. J., Makuc D. M., Kleinman J. C., Cornoni-Huntley J. National trends in educational differentials in mortality. Am J Epidemiol. 1989 May;129(5):919–933. doi: 10.1093/oxfordjournals.aje.a115225. [DOI] [PubMed] [Google Scholar]
  6. Gutíerrez-Fisac J. L., Regidor E., Rodríguez C. Trends in obesity differences by educational level in Spain. J Clin Epidemiol. 1996 Mar;49(3):351–354. doi: 10.1016/0895-4356(95)00535-8. [DOI] [PubMed] [Google Scholar]
  7. House J. S., Kessler R. C., Herzog A. R. Age, socioeconomic status, and health. Milbank Q. 1990;68(3):383–411. [PubMed] [Google Scholar]
  8. Kunst A. E., Mackenbach J. P. The size of mortality differences associated with educational level in nine industrialized countries. Am J Public Health. 1994 Jun;84(6):932–937. doi: 10.2105/ajph.84.6.932. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. La Vecchia C., Negri E., Pagano R., Decarli A. Education, prevalence of disease, and frequency of health care utilisation. The 1983 Italian National Health Survey. J Epidemiol Community Health. 1987 Jun;41(2):161–165. doi: 10.1136/jech.41.2.161. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Lahelma E., Manderbacka K., Rahkonen O., Karisto A. Comparisons of inequalities in health: evidence from national surveys in Finland, Norway and Sweden. Soc Sci Med. 1994 Feb;38(4):517–524. doi: 10.1016/0277-9536(94)90248-8. [DOI] [PubMed] [Google Scholar]
  11. Lahelma E., Valkonen T. Health and social inequities in Finland and elsewhere. Soc Sci Med. 1990;31(3):257–265. doi: 10.1016/0277-9536(90)90272-t. [DOI] [PubMed] [Google Scholar]
  12. Mackenbach J. P., Kunst A. E., Cavelaars A. E., Groenhof F., Geurts J. J. Socioeconomic inequalities in morbidity and mortality in western Europe. The EU Working Group on Socioeconomic Inequalities in Health. Lancet. 1997 Jun 7;349(9066):1655–1659. doi: 10.1016/s0140-6736(96)07226-1. [DOI] [PubMed] [Google Scholar]
  13. Pamuk E. R. Social class inequality in mortality from 1921 to 1972 in England and Wales. Popul Stud (Camb) 1985 Mar;39(1):17–31. doi: 10.1080/0032472031000141256. [DOI] [PubMed] [Google Scholar]
  14. Pappas G., Queen S., Hadden W., Fisher G. The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. N Engl J Med. 1993 Jul 8;329(2):103–109. doi: 10.1056/NEJM199307083290207. [DOI] [PubMed] [Google Scholar]
  15. Regidor E., Navarro P., Dominguez V., Rodriguez C. Inequalities in income and long-term disability in Spain: analysis of recent hypotheses using cross sectional study based on individual data. BMJ. 1997 Nov 1;315(7116):1130–1135. doi: 10.1136/bmj.315.7116.1130. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Sorlie P. D., Backlund E., Keller J. B. US mortality by economic, demographic, and social characteristics: the National Longitudinal Mortality Study. Am J Public Health. 1995 Jul;85(7):949–956. doi: 10.2105/ajph.85.7.949. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. West P. Rethinking the health selection explanation for health inequalities. Soc Sci Med. 1991;32(4):373–384. doi: 10.1016/0277-9536(91)90338-d. [DOI] [PubMed] [Google Scholar]
  18. Wilkinson R. G. Divided we fall. BMJ. 1994 Apr 30;308(6937):1113–1114. doi: 10.1136/bmj.308.6937.1113. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Wilkinson R. G. National mortality rates: the impact of inequality? Am J Public Health. 1992 Aug;82(8):1082–1084. doi: 10.2105/ajph.82.8.1082. [DOI] [PMC free article] [PubMed] [Google Scholar]

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