Abstract

BackgroundOver the decades, global public health efforts have sought to reduce socio-economic health differences, including differences in mental health. Only a few studies have examined changes in socio-economic differences in psychological symptoms over time. The aim of this study was to assess trends in socio-economic differences in self-reported insomnia and stress over a 24-year time period in Finland.MethodsThe data source is a repeated cross-sectional survey “Health Behaviour and Health among the Finnish Adult Population” (AVTK), from the years 1979 to 2002, divided into five study periods. Indicators for socio-economic status included employment status from the survey, and educational level and household income from the Statistics Finland register data. We studied the age group of 25–64 years (N = 70115; average annual response rate 75%). Outcome measures were single questions of self-reported insomnia and stress.ResultsThe overall prevalence of insomnia was 18-19% and that of stress 16-19%. Compared to the first study period, 1979–1982, the prevalence of stress increased until study period 1993–1997. The prevalence of insomnia increased during the last study period, 1998–2002. Respondents who were unemployed or had retired early reported more insomnia and stress over time among both men and women. Lower education was associated with more insomnia especially among men; and conversely, with less stress among both sexes. Compared to the highest household income level, those in the intermediate levels of income had less stress whereas those in the lowest income levels had more stress among both sexes. Income level differences in insomnia were less consistent. In general, socio-economic differences in self-reported insomnia and stress fluctuated some, but did not change substantially over the study period 1979–2002.ConclusionsSelf-reported insomnia and stress were more common during later study periods. The socio-economic differences in insomnia and stress have remained fairly stable over a 24-year time period. However, some of the associations in socio-economic differences were curvilinear and converse. Future studies are needed to explore the complex socio-economic gradients, especially in stress.

Highlights

  • Over the decades, global public health efforts have sought to reduce socio-economic health differences, including differences in mental health

  • Self-reported insomnia and stress were more common during later study periods

  • The socio-economic differences in insomnia and stress have remained fairly stable over a 24-year time period

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Summary

Introduction

Global public health efforts have sought to reduce socio-economic health differences, including differences in mental health. A few studies have examined changes in socio-economic differences in psychological symptoms over time. The aim of this study was to assess trends in socio-economic differences in self-reported insomnia and stress over a 24-year time period in Finland. The aim of WHO’s ‘Global strategy for health for all by the year 2000’ was to reduce socio-economic health differences, including those in mental health, and this strategy was launched in Finland in 1985. Various health indicators show improvement in the health of the population, but socio-economic differences in general health have remained stable or even widened in Finland [1] and other western countries [2,3,4]. Non-specific psychological symptoms, such as selfreported insomnia and stress, are commonly used to monitor the subjective dimension of mental well-being at the general population level [7]. Insomnia has been defined as difficulty falling asleep or staying asleep despite adequate opportunity for sleep [8]

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