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Published Online First: 15 April 2008. doi:10.1136/jech.2007.071001
Journal of Epidemiology and Community Health 2008;62:1057-1063
Copyright © 2008 by the BMJ Publishing Group Ltd.

RESEARCH REPORTS

Socioeconomic position and hysterectomy: a cross-cohort comparison of women in Australia and Great Britain

R Cooper1, J Lucke2, D A Lawlor3, G Mishra1, J-H Chang2, S Ebrahim4, D Kuh1 and A Dobson2

1 MRC National Survey of Health and Development, Department of Epidemiology and Public Health, University College London, London, UK
2 School of Population Health, University of Queensland, Australia
3 Department of Social Medicine, University of Bristol, UK
4 Non-communicable Disease Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK

Correspondence to:
Dr R Cooper, MRC Unit for Lifelong Health and Ageing, 33 Bedford Place, London WC1B 5JU; r.cooper{at}nshd.mrc.ac.uk

Objectives: To examine the associations between indicators of socioeconomic position (SEP) and hysterectomy in two Australian and two British cohorts.

Study population: Women participating in the Australian Longitudinal Study on Women’s Health (ALSWH), born 1921–1926 and 1946–1951, and two cohorts of British women, the British Women’s Heart and Health Study and the MRC National Survey of Health and Development, born at similar times (1920 to 1939 and 1946, respectively) and surveyed at similar ages to the ALSWH cohorts.

Methods: Relative indices of inequality were derived for own and head of household occupational class, educational level attained and age at leaving school. Logistic regression was used to test the associations between these indicators of SEP and self-reported hysterectomy and/or oophorectomy.

Results: Inverse associations between indicators of SEP and hysterectomy were found in both the Australian and British cohorts of women born in 1946 or later. There was also evidence of an inverse association between education and hysterectomy in the older Australian cohort. However, the associations in this older cohort were weaker than those found in the mid-aged Australian cohort. In the older British cohort, born in the 1920s and 1930s, little evidence of association between SEP in adulthood and hysterectomy was found.

Conclusions: These results suggest that inverse associations between indicators of SEP and hysterectomy are stronger in younger than in older cohorts in both Australia and Great Britain. They provide further evidence of the dynamic nature of the association between indicators of SEP and hysterectomy.


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