J Epidemiol Community Health 2000;54:437-443 ( June )

Research report

Changes in social inequalities in health in the Basque Country Cecilia Anitua, Santiago Esnaola

Research Unit, Department of Health, Basque Government

Correspondence to: Dr Anitua, Departamento de Sanidad, Gobierno Vasco, Donostia-San Sebastián 1, 01010 Vitoria-Gasteiz, Spain (escav-san{at}ej-gv.es)

Accepted for publication 30 November 1999

STUDY OBJECTIVETo determine the extent of the inequalities in self reported health between socioeconomic groups and its changes over time in the Basque Country (Spain).
DESIGNCross sectional data on the association between occupation, education and income and three health indicators was obtained from the Basque Health Surveys of 1986 and 1992. Representative population samples were analysed. In 1986 the number of respondents was 24 657 and in 1992, 13 277.
SETTINGBasque Country, Spain.
MAIN OUTCOME MEASURESThe effect of socioeconomic position on health and the magnitude of social inequalities in health were quantified using the odds ratios based on logistic regression analysis, and the Relative Index of Inequality.
RESULTSAs was expected, social inequalities in self reported health existed in both surveys, but the social gradient was greater in 1992. Social differences varied according to gender and health indicator. According to education an increase in social inequalities was observed consistently in all the health indicators except long term conditions in women. A consistent increase in inequalities in limiting longstanding illness was also observed according to all socioeconomic indicators.
CONCLUSIONSThese results agree to a large extent with those of previous studies in other countries. In this context the unequal distribution of material circumstances and working conditions between socioeconomic groups seem to play a major part in health inequalities. The worsening of the labour market during this period and the onset of a new economic recession may explain the increase in social inequalities over time.


Keywords: health inequalities; trends; social class; Spain

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© 2000 by Journal of Epidemiology and Community Health
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