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Occupational and behavioural factors in the explanation of social inequalities in premature and total mortality: a 12.5-year follow-up in the Lorhandicap study

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Abstract

The respective contribution of occupational and behavioural factors to social disparities in all-cause mortality has been studied very seldom. The objective of this study was to evaluate the role of occupational and behavioural factors in explaining social inequalities in premature and total mortality in the French working population. The study population consisted of a sample of 2,189 and 1,929 French working men and women, who responded to a self-administered questionnaire in mid-1996, and were followed up until the end of 2008. Mortality was derived from register-based information and linked to the baseline data. Socioeconomic status was measured using occupation. Occupational factors included biomechanical and physical exposures, temporary contract, psychological demands, and social support, and behavioural factors, smoking, alcohol abuse, and body mass index. Significant social differences were observed for premature and total mortality. Occupational factors reduced the hazard ratios of mortality for manual workers compared to managers/professionals by 72 and 41%, from 1.88 (95% CI: 1.17–3.01) to 1.25 (95% CI: 0.74–2.12) for premature mortality, and from 1.71 (95% CI: 1.18–2.47) to 1.42 (95% CI: 0.95–2.13) for total mortality. The biggest contributions were found for biomechanical and physical exposures, and job insecurity. The role of behavioural factors was very low. Occupational factors played a substantial role in explaining social disparities in mortality, especially for premature mortality and men. Improving working conditions amongst the lowest social groups may help to reduce social inequalities in mortality.

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Acknowledgments

Lorhandicap study group: N Chau, F Guillemin, JF Ravaud, J Sanchez, S Guillaume, JP Michaely, C Otero Sierra, B Legras, A Dazord, M Choquet, L Méjean, N Tubiana-Rufi, JP Meyer, Y Schléret, and JM Mur. The authors would like to thank D Saouag, M Weiss, M Depesme-Cuny, and B Phélut for their help during the survey. The work was granted by the Pôle Européen de Santé.

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Authors and Affiliations

  1. INSERM, U1018, CESP Centre for Research in Epidemiology and Population Health, Epidemiology of Occupational and Social Determinants of Health Team, Villejuif, France

    Isabelle Niedhammer

  2. Univ Paris-Sud, UMRS 1018, Villejuif, France

    Isabelle Niedhammer

  3. Université de Versailles St-Quentin, UMRS 1018, Villejuif, France

    Isabelle Niedhammer

  4. UCD School of Public Health, University College Dublin, Woodview House, Belfield, Dublin 4, Ireland

    Isabelle Niedhammer

  5. Institut National de Recherche et de Sécurité (INRS), WHO Collaborative Centre, Département Epidémiologie en Entreprise, Vandœuvre-lès-Nancy, France

    Eve Bourgkard

  6. INSERM, U669, Paris, France

    Nearkasen Chau

  7. Univ Paris-Sud, UMRS 669, Paris, France

    Nearkasen Chau

  8. Univ Paris Descartes, UMRS 669, Paris, France

    Nearkasen Chau

Authors
  1. Isabelle Niedhammer
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  2. Eve Bourgkard
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  3. Nearkasen Chau
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The Lorhandicap Study Group

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Correspondence to Isabelle Niedhammer.

Appendix

Appendix

See Table 4.

Table 4 Description and prevalence (No. of exposed, % exposed) of occupational exposures among the population studied (N = 4,118)
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Niedhammer, I., Bourgkard, E., Chau, N. et al. Occupational and behavioural factors in the explanation of social inequalities in premature and total mortality: a 12.5-year follow-up in the Lorhandicap study. Eur J Epidemiol 26, 1–12 (2011). https://doi.org/10.1007/s10654-010-9506-9

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  • DOI: https://doi.org/10.1007/s10654-010-9506-9

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