Perlman, FJA; (2006) Socioeconomic position, self-rated health and mortality in Russia. Doctoral thesis , UCL (University College London).

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Abstract

Background: In Russia, the educational gradient in mortality increased during the 1990s. However, there have been few comparisons of gradients using different socioeconomic indicators. Aims: These were to study the association of different measures of socioeconomic position with each other and with health, together with possible explanations. Data: The Russia Longitudinal Monitoring Survey is a large, nationally representative panel study. Data from 7 rounds (1994-2001) were used to study 11,482 adults aged over 18. Social and economic measures, self-rated health and deaths (reported by a household member) were recorded. Methods: Correlations between income, education, occupation and subjective social status were measured. Their associations with self-rated health and mortality were studied using logistic regression and Cox proportional hazards analysis respectively, including multivariate analyses. Results: Education and occupation were strongly correlated (R=0.52). Both were weakly associated with income (R=0.08 and 0.13 respectively). Education (3 categories) was strongly protective against mortality 0.66 (0.59-0.74) men, 0.66 (0.59-0.74) women , and education explained the weaker associations between income, occupation and mortality. Although alcohol consumption and smoking predicted mortality, they did not explain its association with socioeconomic position. Income, occupation and education were all moderately associated with self-rated health. Subjective social status strongly predicted self-rated health, but not mortality. Ownership of consumer goods, satisfaction and optimism predicted self-rated health, but did not fully explain its association with socioeconomic position. Unemployment and insecure employment were associated with health, although inconsistently. Discussion: Income was weakly associated with education and occupation compared to the West. Socioeconomic gradients in self-rated health and mortality were demonstrated, and were not fully explained by alcohol, smoking, material and psychosocial measures. The strong association between education and mortality could perhaps be because it reflects lifetime socioeconomic position. Associations between education, smoking and mortality were comparable to other studies, supporting the reliability of the data.

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