Trends in risk factors for lifestyle-related diseases by socioeconomic position in Geneva, Switzerland, 1993-2000: health inequalities persist

Abstract

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.

FIGURE 1—

Age-adjusted annual trends in obesity and hypertension prevalence amidst seasonal and sampling background fluctuations, by occupation groups: Geneva, Switzerland, 1993–2000.^a Note. Obesity is defined as body mass index of 30 or more. Hypertension is defined as systolic blood pressure or 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher or treatment. ^aObesity in men. Low: slope = −0.003, P = .995; medium: slope = −0.72, P = .15; high: slope = 0.79, P = .023; interaction P = .039 ^bObesity in women. Low: slope = 0.69, P = .21; medium: slope = 0.03, P = .93; high: slope = −0.02, P = .97; interaction P = .53 ^cHypertension in men. Low: slope = −0.82, P = .19; medium: slope = −2.30, P = .0009; high: slope = −1.89, P = .0001; interaction P = .24 ^dHypertension in women. Low: slope = −1.34, P = .091; medium: slope = −1.08, P = .015; high: slope = −1.46, P = .013; interaction P = .87