Socioeconomic inequalities show remarkably poor association with health and disease in Southern Croatia

Abstract

Objectives: This study aimed at investigating the association of socioeconomic status and health outcomes in populations of the two remote Croatian islands and one coastal city.

Methods: Medical history and survey information were used to create 33 variables that were analysed using logistic regression. The population from the island of Vis was followed up and mortality data were used to calculate hazard ratios using Cox regression.

Results: Socioeconomic inequalities were poorly associated with health and disease indices. In the matrix of 33 outcome variables and 13 socioeconomic predictor classes, only 10 associations were significant at the level of P < 0.001. None of the associations was replicated across samples. We did not detect the association of any socioeconomic estimate with mortality data for the island of Vis.

Conclusions: Homogenous island populations were expected to have greater levels of social homogeneity and consequently less expressed inequalities in health. The lack of stronger association in the urban population of Split is likely the result of the mechanisms that persisted from the former communist regime and high level of retained formal and informal social support.