Socioeconomic inequalities in mortality among women and among men: an international study

During the past 2 decades, socioeco-nomic inequalities in mortality have been studied extensively in countries around the world. Inequalities in mortality have been documented from the United States ' to the former Soviet Union,2 from the Netherlands3 to New Zealand,4 and from Bangladesh5 to Brazil.6 Many studies, however, have been confined to men, partly because the most fre-quently used socioeconomic classification, that based on occupation, can less easily be applied to women. Women who are not in paid employment cannot be classified accord-ing to their own occupational class, and even ifthey can be classified, their own occupation may not be an adequate indicator of the socioeconomic status of the household they are part of.7'8 From studies that have included women, it has become clear that inequalities in mortal-ity exist among women as they do among men, but they tend to be smaller among women.9-3 This finding may be an artifact in studies that used occupational class as an indi-cator of socioeconomic status, but similar findings were reported from a few studies that used education level or material living stan-dards as socioeconomic indicators.8 14-17 Finnish data suggest that the inequalities in mortality between women and men may partly be the result of differences between women and men in cause-of-death pattem.15"16 We report here on a study of differences by sex in the magnitude of socioeconomic inequalities in total and cause-specific mor