19 June 2015

Social inequalities in health – determinants and mechanisms

Several studies at the section of social medicine are dealing with the social inequalities in mortality morbidity and consequences of morbidity. The research is focused on understanding the mechanisms driving the comparatively large growing inequalities in Denmark and identifying modifiable determinants and developing methods to estimate the quantitative role of these determinants.

Studies are primarily done with a life course perspective analyzing the clustering and interaction between causes in different age intervals. Studies include both the impact of genetic and  early exposures in life on later health outcomes but also mid-life exposures and biomarkers and their differential impact on functional decline and ageing.

Four mechanisms are identified: Indirect health selection in early years, differential exposure to major health hazards, differential vulnerability due to clustering and interaction between risk factors, and differential consequences of disease in terms of survival, disability and participation on the labour market.

In order to make the very power demanding longitudinal survival studies possible specific register data are generated, and several large cohort studies from the Copenhagen area is merged into the SIC-database.

Contact: Ingelise Andersen, Henrik Brønnum-Hansen, Finn Diderichsen

Selected Publications

Diderichsen F, Andersen I, Manuel CL, Andersen A-MN, Bach E, Baadsgaard M et al. Health Inequality - determinants and policies. Scandinavian Journal of Public Health. 2012 nov;40(8):1-105.

Nordahl H, Lange T, Osler M, Diderichsen F, Andersen I, Prescott E et al. Education and Cause-specific Mortality: The Mediating Role of Differential Exposure and Vulnerability to Behavioral Risk Factors. Epidemiology. 2014;25(3):389-396.

Rod NH, Lange T, Andersen I, Marott JL, Diderichsen F. Additive interaction in survival analysis: use of the additive hazards model. Epidemiology. 2012 sep;23(5):733-7.

Nordahl H, Hvidtfeldt UA, Diderichsen F, Rod NH, Osler M, Frederiksen BL et al. Cohort Profile: The Social Inequality in Cancer (SIC) cohort study. International Journal of Epidemiology. 2014 dec;43(6):1750-1758.

Søndergaard G, Mortensen LH, Andersen AN: Does shared family background influence the impact of educational differences on early mortality?  Am J Epidemiol. 2012 Oct 15;176(8):675-83.