Socioeconomic status and mortality in Swedish women: Opposing trends for cardiovascular disease and cancer

We examined relations between socioeconomic status and cardiovascular disea se, cancer, and diabetes mellitus in a 24-year prospective study of 1,462 S wedish women. Two socioeconomic indicators were used: the husband's occupat ional category for married women and a composite indicator combining women' s educational level with household income for all women. The husband's occu pational category was strongly associated with cardiovascular disease and c ancer mortality in opposite directions, independent of age and other potent ial confounders. Women with husbands of lower occupational categories had a n increased risk of cardiovascular disease mortality [relative risk (RR) = 1.60, 95% confidence interval (95% CI) = 1.09-2.33] while experiencing lowe r rates of all-site cancer mortality (RR = 0.69; 95% CI = 0.50-0.96). A sim ilar relation was seen with the composite variable: women with low socioeco nomic status had an increased risk of cardiovascular disease (RR = 1.37; 95 % CI = 1.01-1.84) but a somewhat lower risk for cancer of all sites (RR = 0 .86; 95% CI = 0.66-1.11). Finally, morbidity data (diabetes mellitus, strok e, and breast cancer) yielded results that were consistent with the mortali ty trends, and breast cancer appeared to account for a major part of the as sociation between total cancer and high socioeconomic status. In summary, h igher socioeconomic status was associated with decreased cardiovascular dis ease mortality and excess cancer mortality, in such a way that only a weak association was seen for all-cause mortality.