Structural changes and social inequalities in health in Finland, 1986-1994

Background: This paper seeks to examine changes in health inequalities in F inland from the mid-1980s to the mid-1990s. To improve our understanding of the contribution of employment status changes to class and educational dif ferences in health within the context of changing labour market conditions. we examined the differences in ill health among social classes, educationa l groups, and employment status groups. Methods: The data was derived from nation-wide Finnish Surveys on Living Co nditions from 1986 and 1994. Analyses included the age range 25-64 years. H ealth was measured using limiting long-standing illness and perceived healt h as below good. Results are presented as age-standardized prevalence perce ntages and odds ratios from logistic regression analyses. Results: The pattern and size of relative social inequalities in ill health have remained generally stable during the eight-year study period in Finla nd. Differences between social classes have changed only slightly. Differen ces between educational groups have declined somewhat among men, but have r emained stable among women. Compared with the employed, health among the un employed, housewives, and pensioners has improved for both men and women. A nalysing social class differences within both the employed and the non-empl oyed showed only negligible changes. Conclusions: Changes in social inequalities in health as indicated by class and educational differentials among Finnish men and women have mostly been negligible. The observed changes are likely to have been affected by the 1 990s' labour market crisis in Finland. The rapidly increasing mass unemploy ment is unlikely to have been very individually selective in the short run. However, in the longer run, to the extent that unemployment remains high, this trend can be expected to change as re-entry to paid employment is like ly to be more individually selective.