Trends in Risk Factors for Lifestyle-Related Diseases by Socioeconomic Position in Geneva, Switzerland, 19932000: Health Inequalities Persist
Bruna Galobardes, MD, MPH,
Michael C. Costanza, PhD,
Martine S. Bernstein, MD,
Cecile Delhumeau, MPH and
Alfredo Morabia, MD, PhD
At the time of the study, all of the authors were with the Division of Clinical Epidemiology, Geneva University Hospitals, Switzerland.
Correspondence: Requests for reprints should be sent to Alfredo Morabia, MD, PhD, Division of Clinical Epidemiology, Geneva University Hospitals, 25, rue Micheli-du-Crest, CH-1211 Geneva 14, Switzerland (e-mail: alfredo.morabia{at}hcuge.ch).
Objectives. We report on trends in risk factors for lifestyle-relateddiseases among socioeconomic position (SEP) groups.
Methods. We continuously surveyed the adult population of Geneva,Switzerland, for 8 years (19932000) with independent,cross-sectional surveys of representative samples (4207 menand 3987 women aged 3574 years). Age-adjusted linearregression slopes estimated annual risk factor trends. Interactionterms were tested for trend differences between SEP groups.
Results. Overall, low-SEP persons had the worst risk factorprofiles. Eight-year trends indicate that (1) number of pack-yearssmoked decreased by half a pack-year among high-SEP female currentsmokers only; (2) obesity prevalence more than doubled from5% to 11% among high-SEP men only; (3) systolic and diastolicblood pressures decreased similarly in all SEP groups; (4) unsaturated-to-saturateddietary fat ratio declined in the low-SEP group only; and (5)physical inactivity and current/former cigarette smoking prevalencesremained unchanged in all SEP groups.
Conclusions. Smoking, obesity, high blood pressure, and physicalinactivity are more prevalent among low-SEP persons. Most socioeconomicrisk factor differences remained stable in the 1990s. Thus,social inequalities in chronic disease morbidity and mortalitywill persist in the next decades.
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