STUDY OBJECTIVE--The aim was to investigate the health effects of economic changes in a rural and industrial community. DESIGN--This was a historical cohort study with retrospective information on exposure and information on health outcome from a mailed questionnaire (response rate 82.5%). SETTING--An industrial and a rural community in northern Sweden. PARTICIPANTS--Participants included all men born in a rural community and a random sample of men born in a neighbouring industrial community 1915-1924 and alive in 1984 (N = 1989). MAIN RESULTS--Morbidity was higher in the cohort born in the rural municipality in which more profound changes in the socioeconomic structure had occurred. Even when taking such factors as childhood deprivation, migration, socioeconomic status, early retirement, unemployment, and single living into consideration, most of the differences in morbidity in the two municipalities still remained. However, the changes in employment conditions alone do not appear to explain the differences in morbidity that were found. CONCLUSION--The higher morbidity in the rural community indicates a health effect of the profound economic changes in that community but this difference cannot be explained by crude indicators of exposure to migration, unemployment, and other indicators of economic change.
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