Changes in socioeconomic inequalities in mortality during an economic boom and recession among middle-aged men and women in Finland

Abstract

Background: Socioeconomic inequalities in mortality increased in several countries in the 1980s, but little is known about more recent trends. This study looks at how social class differences in mortality changed in Finland during 1981–1995, a period which saw drastic economic fluctuations. Methods: The study is based on the person records of the Finnish censuses of 1980, 1985 and 1990, to which the death records for 1981–1985, 1986–1990 and 1991–1995 respectively were linked. Men and women aged 35–64 years were classified into manual and non-manual classes on the basis of current or former occupation or the occupation of head of household. Results: Class differences in mortality Increased during the 1980s among both men and women due to a more rapid decrease in cardiovascular mortality in the non-manual class and to a more rapid increase in mortality from alcohol-related causes of death, accidents and suicide in the manual class. In the 1990s, a period of severe economic recession, the increase in the relative mortality gap was clearly smaller than in the 1980s. This was due to the convergence between classes of trends for cardiovascular mortality and for mortality from alcohol-related causes, accidents and suicide. Conclusion: In Finland, economic recession slowed down rather than sped up the growth of relative inequalities among middle-aged men and women. Changes in mortality and socioeconomic inequalities in mortality result from a complex combination of different and even opposite trends in mortality from various causes of death. In the light of this complexity it seems unlikely that there exists any major single explanation for changes in inequalities in mortality.