TRENDS IN SOCIOECONOMIC MORTALITY DIFFERENTIALS IN POSTWAR NORWAY - EVIDENCE AND INTERPRETATIONS

The aim of the study was to describe changes in socioeconomic mortalit y differentials among adults in post-war Norway and to examine some se lected interpretations. Three separate data sets were obtained. In eac h set, census information on occupational class was linked to subseque nt mortality during three five-year periods, 1960-65, 1970-75 and 1980 -85. The analysis showed a general decline in mortality but an increas e in the socioeconomic mortality differentials among men, as measured by standardised mortality ratios (SMR). Women, however, displayed inco nsistent SMR patterns and no clear trends. It is argued that this is d ue to an artefact, ie classification by women's own occupational class , and to health-related exits from the labour market. Women were thus excluded from the analysis that followed. Over the years covered, soci oeconomic age-specific mortality differentials decreased among younger men and increased among older men. To mirror these changes, 'potentia l years of life lost' (PYLL) were calculated. Essentially, PYLL render ed the same picture as SMR did. The size of the increase in mortality differentials, as measured by SMR and PYLL, among men was somewhat und erestimated due to health-related exits from the work force, especiall y among unskilled workers, ie a 'healthy worker effect'. A distinct ch ange took place in the balance between the occupational groups at the extremes in the occupational structure over the years in question. Thi s led to fewer deaths occurring among unskilled workers. Still, howeve r, it seemed justified to state that social inequality in mortality re mains a severe health problem. Little evidence was found of the hypoth esised cohort effects.