Objective: To examine trends in educational inequalities in smoking and physical activity using Canadian population-based surveys from 1974 through to 2005.
Design, setting and participants: A secondary analysis of Canadian population based surveys from 1974 through to 2005. We estimated the prevalence of both smoking and physical activity across educational groups for both men and women, as well as relative and absolute measures of inequality.
Main results: We found differences in both smoking and physical activity across educational groups in all surveys examined between 1974 and 2005, with lower educational groups more likely to be heavy smokers and inactive in each survey. Both relative and absolute educational inequalities in smoking widened between 1974 and 2005 (RCI for smoking 10 plus cigarettes per day changed from -7.9 to -26.9 among men; and -4.8 to -27.4 among women), with inequalities in physical activity narrowing between 1981 and 1996, then widening between 1996 and 2005 (RCI for inactivity -4.34 to -6.75 among men; -3.57 to -5.54 among women). In general results among men and women did not differ substantially.
Conclusions: It is unlikely that the widening educational inequalities in smoking and physical activity documented here reflect lower knowledge of the consequences of smoking and physical inactivity among lower educated groups. Our results suggest more work needs to be done in both designing population health approaches that focus on equity and the creation of supportive environments that provide equal opportunities for behaviour change for all educational groups in Canada.
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