@article{ref1,
title="The contribution of psychological distress to socio-economic differences in cause-specific mortality: a population-based follow-up of 28 years",
journal="BMC public health",
year="2011",
author="Talala, Kirsi M. and Huurre, Taina M. and Laatikainen, Tiina K. M. and Martelin, Tuija P. and Ostamo, Aini I. and Prättälä, Ritva S.",
volume="11",
number="",
pages="e138-e138",
abstract="BACKGROUND: Psychological factors associated with low social status have been proposed as one possible explanation for the socio-economic gradient in health. The aim of this study is to explore whether different indicators of psychological distress contribute to socio-economic differences in cause-specific mortality. METHODS: The data source is a nationally representative, repeated cross-sectional survey, &quot;Health Behaviour and Health among the Finnish Adult Population&quot; (AVTK). The survey results were linked with socio-economic register data from Statistics Finland (from the years 1979-2002) and mortality follow-up data up to 2006 from the Finnish National Cause of Death Register. The data included 32,451 men and 35,420 women (response rate 73.5%). Self-reported measures of depression, insomnia and stress were used as indicators of psychological distress. Socio-economic factors included education, employment status and household income. Mortality data consisted of unnatural causes of death (suicide, accidents and violence, and alcohol-related mortality) and coronary heart disease (CHD) mortality. Adjusted hazard ratios were calculated using the Cox regression model. RESULTS: In unnatural mortality, psychological distress accounted for some of the employment status (11-31%) and income level (4-16%) differences among both men and women, and for the differences related to the educational level (5-12%) among men; the educational level was associated statistically significantly with unnatural mortality only among men. Psychological distress had minor or no contribution to socio-economic differences in CHD mortality. CONCLUSIONS: Psychological distress partly accounted for socio-economic disparities in unnatural mortality. Further studies are needed to explore the role and mechanisms of psychological distress associated with socio-economic differences in cause-specific mortality.<p /><p>Language: en</p>",
language="en",
issn="1471-2458",
doi="10.1186/1471-2458-11-138",
url="http://dx.doi.org/10.1186/1471-2458-11-138"
}