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Evolution of socioeconomic inequalities in site-specific cancer mortality among Belgian women between 1991 and 2008 using a fundamental cause approach

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Abstract

Purpose

According to the “fundamental cause theory”, emerging knowledge on health-enhancing behaviours and technologies results in persisting and even widening health disparities, favouring the higher socioeconomic groups. This study aims to assess (trends in) socioeconomic inequalities in site-specific cancer mortality in Belgian women.

Methods

Data were derived from record linkage between the Belgian census and register data on mortality for 1991–1997 and 2001–2008 for all Belgian female inhabitants aged 50–79 years. Both absolute and relative inequalities by education and housing conditions were calculated.

Results

The results revealed persisting socioeconomic inequalities in total and site-specific cancer mortality. As expected, these inequalities were larger for the more preventable cancer sites. Generally, socioeconomic inequalities remained quite stable between the 1990s and the 2000s, although for some preventable cancer sites (e.g., uterus and oesophagus) a significant increase in inequality was observed.

Conclusions

These persisting socioeconomic inequalities are likely due to differences in exposure to risk factors and unhealthy behaviours, and access and utilization of healthcare across the social strata. Since equality in health should be a priority for a fair public health policy, efforts to reduce inequalities in risk behaviours and access and use of health care should remain high on the agenda.

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Acknowledgments

The authors would like to thank Didier Willaert for his indispensable data support. This research was funded by the Research Foundation Flanders (Grant Number G025813N).

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Authors and Affiliations

  1. Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium

    Katrien Vanthomme, Hadewijch Vandenheede, Paulien Hagedoorn & Sylvie Gadeyne

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  1. Katrien Vanthomme
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  2. Hadewijch Vandenheede
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Corresponding author

Correspondence to Katrien Vanthomme.

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Conflict of interest

The authors declare that they have no conflict of interest. This research as well as the data adheres to the ethical code of scientific research in Belgium: http://www.belspo.be/belspo/organisation/publ/pub_ostc/Eth_code/ethcode_nl.pdf. All authors have signed the ethical code.

Appendix

Appendix

See Table 5.

Table 5 Sensivity analysis
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Vanthomme, K., Vandenheede, H., Hagedoorn, P. et al. Evolution of socioeconomic inequalities in site-specific cancer mortality among Belgian women between 1991 and 2008 using a fundamental cause approach. Cancer Causes Control 28, 829–840 (2017). https://doi.org/10.1007/s10552-017-0921-z

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