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August 2003, Vol 93, No. 8 | American Journal of Public Health 1302-1309
© 2003 American Public Health Association


RESEARCH AND PRACTICE

Trends in Risk Factors for Lifestyle-Related Diseases by Socioeconomic Position in Geneva, Switzerland, 1993–2000: 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-related diseases among socioeconomic position (SEP) groups.

Methods. We continuously surveyed the adult population of Geneva, Switzerland, for 8 years (1993–2000) with independent, cross-sectional surveys of representative samples (4207 men and 3987 women aged 35–74 years). Age-adjusted linear regression slopes estimated annual risk factor trends. Interaction terms were tested for trend differences between SEP groups.

Results. Overall, low-SEP persons had the worst risk factor profiles. Eight-year trends indicate that (1) number of pack-years smoked decreased by half a pack-year among high-SEP female current smokers only; (2) obesity prevalence more than doubled from 5% to 11% among high-SEP men only; (3) systolic and diastolic blood pressures decreased similarly in all SEP groups; (4) unsaturated-to-saturated dietary fat ratio declined in the low-SEP group only; and (5) physical inactivity and current/former cigarette smoking prevalences remained unchanged in all SEP groups.

Conclusions. Smoking, obesity, high blood pressure, and physical inactivity are more prevalent among low-SEP persons. Most socioeconomic risk factor differences remained stable in the 1990s. Thus, social inequalities in chronic disease morbidity and mortality will persist in the next decades.




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