Disease aetiology and materialist explanations of socioeconomic mortality differentials: a research note

Abstract

Sir, Olsen et al. have recently published some very interesting results about infertility and correlates for seeking medical advice in five European countries. The authors expected that infertility treatment and advice were more frequently used by couples with a high social status. However, this was not the case for the data from Denmark, Germany and Italy. In these countries the educational level was lower among the infertile couples who sought medical help. This result is in contrast to results from our similar population-based study from Denmark. In this study, which was carried out in 1989,3,743 15 to 44 yearold women, selected at random, were asked to fill in a mailed questionnaire about infertility. The response rate was 78% (n=2,865). Among the 25 to 44 year-old women 1,596 had tried to become pregnant. 418 (26.2%) had experienced infertility. A total of 224 women (47.4%) had sought infertility treatment. As in the study by Olsen et al., nulliparity was the strongest predictor for seeking medical help (age-adjusted odds ratio (AOR) = 3.46; 95% CI: 2.18-5.50; p nine years compared to < nine years. There was a non-significant tendency towards vocational education lasting more than three years and high social class being predictors (AOR =1.61; 95% CI: 0.992.62; p=0.06 and AOR = 1.58; 95% CI: 0.99-2.54; p=0.06). Our results are in accordance with Gunnell and Ewing's population-based study from Somerset, UK where 1,061 women between 36 and 50 years were surveyed. In this study, 26.4% were infertile. Of these 44% of the housewives, 59% in the higher social occupational grouping and 38% in the lower social grouping, contacted their GP (chi