Socioeconomic differences in the use of ill-defined causes of death in 16 European countries

Ivana Kulhánová (1) , Gwenn Menvielle (2) , Matthias Bopp (3) , Carme Borrell (4) , Patrick Deboosere (5) , Terje A Eikemo (6, 1) , Rasmus Hoffmann (1) , Mall Leinsalu (7, 8) , Pekka Martikainen (9) , Enrique Regidor (10) , Maica Rodríguez-Sanz (4) , Jitka Rychtaříková (11) , Bogdan Wojtyniak (12) , Johan P Mackenbach (1)

1 Department of public health
2 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
3 UZH - Universität Zürich [Zürich] = University of Zurich
4 ASPB - Agència de Salut Pública de Barcelona
5 VUB - Vrije Universiteit Brussel
6 NTNU - Norwegian University of Science and Technology [Trondheim]
7 Sodertorn University
8 National institute for health development Talinn
9 Helsingin yliopisto = Helsingfors universitet = University of Helsinki
10 UCM - Universidad Complutense de Madrid = Complutense University of Madrid [Madrid]
11 UK - Univerzita Karlova [Praha, Česká republika] = Charles University [Prague, Czech Republic]
12 National Institute of Public Health - National Institute of Hygiene [Poland]

Background: Cause-of-death data linked to information on socioeconomic position form one of the most important sources of information about health inequalities in many countries. The proportion of deaths from ill-defined conditions is one of the indicators of the quality of cause-of-death data. We investigated educational differences in the use of ill-defined causes of death in official mortality statistics. Methods: Using age-standardized mortality rates from 16 European countries, we calculated the proportion of all deaths in each educational group that were classified as due to " Symptoms, signs and ill-defined conditions ". We tested if this proportion differed across educational groups using Chi-square tests. Results: The proportion of ill-defined causes of death was lower than 6.5% among men and 4.5% among women in all European countries, without any clear geographical pattern. This proportion statistically significantly differed by educational groups in several countries with in most cases a higher proportion among less than secondary educated people compared with tertiary educated people. Conclusions: We found evidence for educational differences in the distribution of ill-defined causes of death. However, the differences between educational groups were small suggesting that socioeconomic inequalities in cause-specific mortality in Europe are not likely to be biased.

Mots clés: Mortality; Education; Ill-defined causes of death; Data quality; Europe

Domaines: Santé publique et épidémiologie

Ivana Kulhánová, Gwenn Menvielle, Matthias Bopp, Carme Borrell, Patrick Deboosere, et al.. Socioeconomic differences in the use of ill-defined causes of death in 16 European countries. BMC Public Health, 2014, 14, pp.1295. ⟨10.1186/1471-2458-14-1295⟩. ⟨hal-01311292⟩