Four indicators of socioeconomic position: relative ranking across causes of death

Abstract

Objective: A study was undertaken to examine the relative ability of occupational class, education, household income, and housing conditions to discriminate all cause and cause-specific mortality-risk in Oslo, and to see if this relative ability is consistent across the 12 most common causes of death. Design and setting: Census records of inhabitants in Oslo 1990 aged 45 to 64 were linked to death records 1990—98 (n=88,159). All inhabitants were included except those who lacked census data on the independent variables. The relative index of inequality (RII) for each indicator was calculated. Main results: Education, occupation, and housing conditions had similar RIIs for all-cause mortality in both sexes. Household income had low RIIs, particularly in men. For the 12 most common causes of death some heterogeneity in the relative ranking between the four indicators was observed, with causes of death known to be related to early-life social circumstances (stomach cancer, cardiovascular disease, chronic obstructive pulmonary disease) being particularly strongly related to education, and causes of death which were likely to be determined by adult social circumstances (violence, sudden unexpected death) being particularly strongly related to occupation and housing conditions. Conclusions: Education, occupational class, and housing conditions all seemed to discriminate all-cause mortality to a similar degree. However, the cause-specific analysis revealed a heterogeneous pattern.