Trends in health inequalities by educational level in a Norwegian total population study

OBJECTIVE: To describe levels of inequality and trends in self reported morbidity by educational level in a total Norwegian county population in the mid-1980s and mid-1990s. DESIGN: Two cross sectional health surveys at an interval of 10 years in the Nord-Trøndelag Health Study, HUNT I (1984-86) and HUNT II (1995-97). SETTING: Primary health care, total county population study. PARTICIPANTS: Men and women, 25-69 years. MAIN RESULTS: There was a consistent pattern of increasing self reported health problems with decreasing educational level for three health variables: perceived health, any longstanding health problem, and having a chronic condition. A stable or slight decrease in inequalities over time was found. The prevalence odds ratio for perceived health less than good were 2.71 for men (95% confidence intervals (CI): 2.39 to 3.09) and 2.13 for women (95% CI: 1.85 to 2.46) in the first survey, 2.51 for men (95% CI: 2.27 to 2.78) and 2.06 for women (95% CI: 1.88 to 2.26) 10 years later. CONCLUSIONS: The magnitude of the socioeconomic gradients in health in this population seemed somewhat lower than in Norway as a whole and close to the average in studies from other European countries. There was a slight trend towards smaller differences despite rapid structural changes in working life, turbulence in economy, and more people experiencing unemployment