Educational expansion and inequalities in mortality-A fixed-effects analysis using longitudinal data from 18 European populations.

Objective: The aim of this paper is to empirically evaluate whether widening educational inequalities in mortality are related to the substantive shifts that have occurred in the educational distribution.

Materials And Methods: Data on education and mortality from 18 European populations across several decades were collected and harmonized as part of the Demetriq project. Using a fixed-effects approach to account for time trends and national variation in mortality, we formally test whether the magnitude of relative inequalities in mortality by education is associated with the gender and age-group specific proportion of high and low educated respectively.

Determinants of the magnitude of socioeconomic inequalities in mortality: A study of 17 European countries.

The magnitude of socioeconomic inequalities in mortality differs importantly between countries, but these variations have not been satisfactorily explained. We explored the role of behavioral and structural determinants of these variations, by using a dataset covering 17 European countries in the period 1970-2010, and by conducting multilevel multivariate regression analyses. Our results suggest that between-country variations in inequalities in current mortality can partly be understood from variations in inequalities in smoking, excessive alcohol consumption, and poverty.

Trends in educational inequalities in obesity in 15 European countries between 1990 and 2010.

Background: The prevalence of obesity increased dramatically in many European countries in the past decades. Whether the increase occurred to the same extent in all socioeconomic groups is less known. We systematically assessed and compared the trends in educational inequalities in obesity in 15 different European countries between 1990 and 2010.

'Fundamental causes' of inequalities in mortality: an empirical test of the theory in 20 European populations.

The 'fundamental causes' theory stipulates that when new opportunities for lowering mortality arise, higher socioeconomic groups will benefit more because of their greater material and non-material resources. We tested this theory using harmonised mortality data by educational level for 22 causes of death and 20 European populations from the period 1980-2010. Across all causes and populations, mortality on average declined by 2.

Long-term trends of inequalities in mortality in 6 European countries.

Objectives: We aimed to assess whether trends in inequalities in mortality during the period 1970-2010 differed between Finland, Norway, England and Wales, France, Italy (Turin) and Hungary.

Methods: Total and cause-specific mortality data by educational level and, if available, occupational class were collected and harmonized. Both relative and absolute measures of inequality in mortality were calculated.

The Impact of Tobacco Control Policies on Smoking Among Socioeconomic Groups in Nine European Countries, 1990-2007.

Background: It is uncertain whether tobacco control policies have contributed to a narrowing or widening of socioeconomic inequalities in smoking in European countries during the past two decades. This paper aims to investigate the impact of price and non-price related population-wide tobacco control policies on smoking by socioeconomic group in nine European countries between 1990 and 2007.

Methods: Individual-level education, occupation and smoking status were obtained from nationally representative surveys.

Did the English strategy reduce inequalities in health? A difference-in-difference analysis comparing England with three other European countries.

Background: Between 1997 and 2010, the English government pursued an ambitious programme to reduce health inequalities, the explicit and sustained commitment of which was historically and internationally unique. Previous evaluations have produced mixed results. None of these evaluations have, however, compared the trends in health inequalities within England with those in other European countries.

The impact of increasing income inequalities on educational inequalities in mortality - An analysis of six European countries.

Background: Over the past decades, both health inequalities and income inequalities have been increasing in many European countries, but it is unknown whether and how these trends are related. We test the hypothesis that trends in health inequalities and trends in income inequalities are related, i.e.

Changes in mortality inequalities over two decades: register based study of European countries.

Objective: To determine whether government efforts in reducing inequalities in health in European countries have actually made a difference to mortality inequalities by socioeconomic group.

Design: Register based study.

Data Source: Mortality data by level of education and occupational class in the period 1990-2010, usually collected in a census linked longitudinal study design.

The arithmetic of reducing relative and absolute inequalities in health: a theoretical analysis illustrated with European mortality data.

Background: Reducing inequalities in health is a great challenge for public health, but how relative and absolute inequalities in mortality respond to changes in mortality by socioeconomic group is not well understood.

Methods: We derived arithmetically what combinations of changes and starting levels of mortality by socioeconomic group produce narrowing, and what combinations produce widening of relative and absolute inequalities in mortality. We then determined empirically how often these scenarios actually occur with data on inequalities in cause-specific mortality in five European countries spanning four decades (1970-2010).

Trends in socioeconomic inequalities in self-assessed health in 17 European countries between 1990 and 2010.

Background: Between the 1990s and 2000s, relative inequalities in all-cause mortality increased, whereas absolute inequalities decreased in many European countries. Whether similar trends can be observed for inequalities in other health outcomes is unknown. This paper aims to provide a comprehensive overview of trends in socioeconomic inequalities in self-assessed health (SAH) in Europe between 1990 and 2010.

Differences in adults' health and health behaviour between 16 European urban areas and the associations with socio-economic status and physical and social environment.

With a growing proportion of the European population living in urban areas (UAs), exploring health in urban areas becomes increasingly important. The objective of this study is to assess the magnitude of differences in health and health behaviour between adults living in urban areas (UAs) across Europe. We also explored whether and to what extent such differences can be explained by socio-economic status (SES) and physical or social environment.

Inequalities in Alcohol-Related Mortality in 17 European Countries: A Retrospective Analysis of Mortality Registers.

Background: Socioeconomic inequalities in alcohol-related mortality have been documented in several European countries, but it is unknown whether the magnitude of these inequalities differs between countries and whether these inequalities increase or decrease over time.

Methods And Findings: We collected and harmonized data on mortality from four alcohol-related causes (alcoholic psychosis, dependence, and abuse; alcoholic cardiomyopathy; alcoholic liver cirrhosis; and accidental poisoning by alcohol) by age, sex, education level, and occupational class in 20 European populations from 17 different countries, both for a recent period and for previous points in time, using data from mortality registers. Mortality was age-standardized using the European Standard Population, and measures for both relative and absolute inequality between low and high socioeconomic groups (as measured by educational level and occupational class) were calculated.

The effects of population-based mammography screening starting between age 40 and 50 in the presence of adjuvant systemic therapy.

Adjuvant systemic therapy has been shown to be effective in reducing breast cancer mortality. The additional effect of mammography screening remains uncertain, in particular for women aged 40-49 years. We therefore assessed the effects of screening starting between age 40 and 50, as compared to the effects of adjuvant systemic therapy.

Digital mammography screening: weighing reduced mortality against increased overdiagnosis.

Objective: Digital mammography has been shown to increase the detection of ductal carcinoma in situ (DCIS) compared to screen-film mammography. The benefits and risks of such an increase were assessed.

Methods: Breast cancer detection rates were compared between 502,574 screen-film and 83,976 digital mammograms performed between 2004 and 2006 among Dutch screening participants.

Interpreting overdiagnosis estimates in population-based mammography screening.

Estimates of overdiagnosis in mammography screening range from 1% to 54%. This review explains such variations using gradual implementation of mammography screening in the Netherlands as an example. Breast cancer incidence without screening was predicted with a micro-simulation model.

Methodological reflections on body-mind intervention studies with cancer patients.

Objective: Methodological reflection on the content, results and limitations of three body-mind intervention studies with cancer patients (CPs) in order to improve the quality of studies on body-mind interventions and to raise the potential value for CPs.

Methods: A secondary analysis of a study on haptotherapy and two studies applying relaxing face massage, using a variety of well-being effect measures. Six methodological themes are discussed: (1) drop-out; (2) characteristics of participating patients, (3) participation of patients in other complementary interventions; (4) satisfaction of participants; (5) effects of the three interventions, and (6) role of response shift.

Cost-effectiveness of opportunistic versus organised mammography screening in Switzerland.

Background: Various centralised mammography screening programmes have shown to reduce breast cancer mortality at reasonable costs. However, mammography screening is not necessarily cost-effective in every situation. Opportunistic screening, the predominant screening modality in several European countries, may under certain circumstances be a cost-effective alternative.

Breast cancer screening: evidence for false reassurance?

Tumour stage distribution at repeated mammography screening is, unexpectedly, often not more favourable than stage distribution at first screenings. False reassurance, i.e.

The integration of a woman's perspective in hysterectomy decisions.

It has been argued, based on a limited amount of research data, that patient participation in decision-making regarding surgery, results not only in more patient satisfaction, but also in better surgery outcomes. Especially in a procedure such as hysterectomy, with far-reaching consequences and many potential side effects, it may therefore be relevant to promote an active role of the patient in the decision-making process. The article identifies contextual elements that might promote this active role.