Mortality and Social Class in Sweden — Exploring a New Epidemiological Tool

Abstract

Total mortality, mortality from coronary heart disease (CHD), cerebrovascular disease, and other causes of death, were examined for three social groups and ten socio-economic groups in Sweden. The study included all subjects born in the country between 1896 and 1940 who were economically active in 1960—1.9 million men and 0.7 million women. Information on social and socio-economic status, and other social and demographic characteristics, was obtained from the 1960 Census. Information on cause-specific mortality during the period 1961-68 was obtained from a record linkage with the Cause of Death Registry. The analyses were based on 112469 deaths and 21 million person years at risk. Information on smoking habits was obtained from a sample of 55000 from the Census population. CHD mortality for women was high among manual workers, SMR=110 (95% confidence limits 104-117), and low among non-manual workers, SMR=84 (78-91). CNS-vascular mortality for women was also high among manual workers, SMR=107 (110-115), and low among non-manual workers, SMR=89 (82-97). Heavy smoking was more common among non-manual workers in both sexes, which may have contributed to a reverse social class gradient among men, with non-manual male workers being at higher risk for CHD than manual male workers. Farmers (and agricultural workers) generally had a low mortality. Other self-employed men and women had a high total mortality, a high mortality from CHD and CNS-vascular disease—and a high proportion of heavy smokers. There remain differences in mortality between social and socio-economic groups which cannot be explained by smoking habits, age, gender, urbanization, region of residence and marital status.