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ABOUT HEALTH INEQUALITIES

Great health differences occur between socio-economic groups in Finland. White-collar workers are healthier than blue-collar workers, and people in employment are healthier than unemployed people. High-income people with the highest educational level are healthier than low-income people with only a basic education.

Socio-economic status generally refers to both material dimensions of welfare and the prerequisites for acquiring such material resources. While material resources include income, property and housing standards, the prerequisites for acquiring them include education, profession and employment status. All socio-economic factors are consistently and clearly associated with key health indicators and health risks.

Among best ways of increasing the level of health among Finns is to reduce health differences between population groups so that the health of the more disadvantaged groups approaches that of the more advantaged groups. The reduction of health differences between population groups is among the key targets of the national Health 2015 public health programme.

According to the eight main target of the Health 2015 public health programme, the health status of the population is to be improved by reducing inequality and increasing the welfare and relative status of the most disadvantaged population groups. The objective is to reduce mortality differences between different vocational groups and groups of different educational backgrounds by a fifth by 2015.

The overall status of health in Finland has improved over the past decades, and Finns live longer than earlier. However, not all population groups have benefited from the development equally. So far, the efforts made to reduce health differences have been inadequate and the differences have partly increased.

In 2003, male life expectancy was 75.1 and female life expectancy 81.8 years in Finland. By international standards, the difference between male and female life expectancies (6.7 years) is large in Finland, despite some decline over the past decades. By contrast, differences between socio-economic groups have grown. At the turn of the millennium, the life expectancy of 35-year-old male upper white-collar workers was some six years longer than that of male blue-collar workers of the same age, while two decades earlier the difference was nearly one and a half years smaller. The corresponding difference for female white- and blue-collar workers was 3.2 years at the turn of the millennium.

Differences occur between population groups even in many health risks. For instance, 18 % of males in the highest educational groups are daily smokers, compared with 38 % in the lowest educational group.

The causes of health differences between population groups are multi-dimensional. They are linked with differences in the living and workplace conditions, physical and psychosocial burden and culture-bound behavioural patterns of different vocational groups and groups with different educational backgrounds.

Factors that contribute to and maintain health differences can be affected by public policy. For instance, it is at least in principle possible to interfere with excessive levels of alcohol consumption and related harm by national policy (price and tax policies), regional policy (intensified control) and local action (e.g. developing leisure time activities for young people). The general health-care system and occupational health care can also contribute to preventing and levelling out health differences. However, few practical action models have been available so far. The reduction of health differences requires sustained co-operation between many different actors.

Health differences between population groups have been found to exist in all countries where reliable research information is available. Health policy programmes is Sweden, Great Britain and the Netherlands, in particular, have paid significant attention to reducing such differences. In Sweden, for instance, efforts have been made to take health differences into account in welfare reports. In Great Britain, partnership structures based on multi-sector collaboration have been developed, and extensive regional projects have been implemented to reduce poverty and health differences. The impact of various interventions on health differences has been examined systematically in the Netherlands. As far as possible, experiences gained in other countries are made use of in identifying optimal methods for reducing health differences in the Finnish context.


Updated 25.9.2006