Occupational health. Occupational status and all-cause mortality. A study with health insurance data from Nordrhein-Westfalen, Germany

Abstract

Background: Differences in all-cause mortality between occupational status groups in men and women between 30 and 70 years of age were examined for a West German population. Methods: Health insurance data collected between January 1987 and December 1996 were used. Age, age at death and occupational status were the main variables considered. All insured men (N=80, 172) and women (N=32, 166) who were employed or employed before retirement were classified by their last occupational status (semi skilled/unskilled, skilled manual, skilled non manual, intermediate occupations/professionals). Relative hazards (odds ratios) of all-cause mortality in relation to the highest occupational group were computed by means of logistic regression. Results: After controlling for age and period of insurance, odds ratios for unskilled/semi-skilled men, in relation to intermediate occupations/professionals, were 4.3, for skilled manuals 4.2 and for skilled non-manuals 2.1. For women the respective figures were 3.8, 4.9 and 1.7. Conclusions: For a large group of males and females it was shown that marked social gradients in terms of all-cause mortality also exist in Germany. The main dividing line can be drawn between the lowest status group (unskilled and semi-skilled) and skilled manuals on the one hand and non-manuals on the other, although differences also exist between the non-manual groups.