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Socioeconomic indicators in epidemiologic research: A practical example from the LIFEPATH study

Identifieur interne : 002831 ( Pmc/Curation ); précédent : 002830; suivant : 002832

Socioeconomic indicators in epidemiologic research: A practical example from the LIFEPATH study

Auteurs : Angelo D Rrico [Italie] ; Fulvio Ricceri [Italie] ; Silvia Stringhini [Suisse] ; Cristian Carmeli [Suisse] ; Mika Kivimaki [Royaume-Uni, Finlande] ; Mel Bartley [Royaume-Uni] ; Cathal Mccrory [Irlande (pays)] ; Murielle Bochud [Suisse] ; Peter Vollenweider [Suisse] ; Rosario Tumino [Italie] ; Marcel Goldberg [France] ; Marie Zins [France] ; Henrique Barros [Portugal] ; Graham Giles [Australie] ; Gianluca Severi [France, Italie] ; Giuseppe Costa [Italie] ; Paolo Vineis [Royaume-Uni]

Source :

RBID : PMC:5448763

Abstract

Background

Several social indicators have been used in epidemiological research to describe socioeconomic position (SEP) of people in societies. Among SEP indicators, those more frequently used are education, occupational class and income. Differences in the incidence of several health outcomes have been reported consistently, independently from the indicator employed. Main objectives of the study were to present the socioeconomic classifications of the social indicators which will be employed throughout the LIFEPATH project and to compare social gradients in all-cause mortality observed in the participating adult cohorts using the different SEP indicators.

Methods

Information on the available social indicators (education, own and father’s occupational class, income) from eleven adult cohorts participating in LIFEPATH was collected and harmonized. Mortality by SEP for each indicator was estimated by Poisson regression on each cohort and then evaluated using a meta-analytical approach.

Results

In the meta-analysis, among men mortality was significantly inversely associated with both occupational class and education, but not with father’s occupational class; among women, the increase in mortality in lower social strata was smaller than among men and, except for a slight increase in the lowest education category, no significant differences were found.

Conclusions

Among men, the proposed three-level classifications of occupational class and education were found to predict differences in mortality which is consistent with previous research. Results on women suggest that classifying them through their sole SEP, without considering that of their partners, may imply a misclassification of their social position leading to attenuation of mortality differences.


Url:
DOI: 10.1371/journal.pone.0178071
PubMed: 28557991
PubMed Central: 5448763

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<title xml:lang="en" level="a" type="main">Socioeconomic indicators in epidemiologic research: A practical example from the LIFEPATH study</title>
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<name sortKey="D Rrico, Angelo" sort="D Rrico, Angelo" uniqKey="D Rrico A" first="Angelo" last="D Rrico">Angelo D Rrico</name>
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<addr-line>Epidemiology Unit, ASL TO3, Piedmont Region, Grugliasco, Torino, Italy</addr-line>
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<name sortKey="Ricceri, Fulvio" sort="Ricceri, Fulvio" uniqKey="Ricceri F" first="Fulvio" last="Ricceri">Fulvio Ricceri</name>
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<addr-line>Epidemiology Unit, ASL TO3, Piedmont Region, Grugliasco, Torino, Italy</addr-line>
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<addr-line>Department of Clinical and Biological Science, University of Turin, Turin, Italy</addr-line>
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<name sortKey="Stringhini, Silvia" sort="Stringhini, Silvia" uniqKey="Stringhini S" first="Silvia" last="Stringhini">Silvia Stringhini</name>
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<name sortKey="Carmeli, Cristian" sort="Carmeli, Cristian" uniqKey="Carmeli C" first="Cristian" last="Carmeli">Cristian Carmeli</name>
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<wicri:regionArea>University College London, Department of Epidemiology and Public Health, London</wicri:regionArea>
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<addr-line>The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland</addr-line>
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<name sortKey="Bochud, Murielle" sort="Bochud, Murielle" uniqKey="Bochud M" first="Murielle" last="Bochud">Murielle Bochud</name>
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<name sortKey="Vollenweider, Peter" sort="Vollenweider, Peter" uniqKey="Vollenweider P" first="Peter" last="Vollenweider">Peter Vollenweider</name>
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<name sortKey="Tumino, Rosario" sort="Tumino, Rosario" uniqKey="Tumino R" first="Rosario" last="Tumino">Rosario Tumino</name>
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<name sortKey="Goldberg, Marcel" sort="Goldberg, Marcel" uniqKey="Goldberg M" first="Marcel" last="Goldberg">Marcel Goldberg</name>
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<addr-line>Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France</addr-line>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif</wicri:regionArea>
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<nlm:aff id="aff009">
<addr-line>Paris Descartes University, Paris, France</addr-line>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Paris Descartes University, Paris</wicri:regionArea>
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<name sortKey="Zins, Marie" sort="Zins, Marie" uniqKey="Zins M" first="Marie" last="Zins">Marie Zins</name>
<affiliation wicri:level="1">
<nlm:aff id="aff008">
<addr-line>Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France</addr-line>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1">
<nlm:aff id="aff009">
<addr-line>Paris Descartes University, Paris, France</addr-line>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Paris Descartes University, Paris</wicri:regionArea>
</affiliation>
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<name sortKey="Barros, Henrique" sort="Barros, Henrique" uniqKey="Barros H" first="Henrique" last="Barros">Henrique Barros</name>
<affiliation wicri:level="1">
<nlm:aff id="aff010">
<addr-line>EPIUnit- Institute of Public Health, University of Porto, Porto, Portugal</addr-line>
</nlm:aff>
<country xml:lang="fr">Portugal</country>
<wicri:regionArea>EPIUnit- Institute of Public Health, University of Porto, Porto</wicri:regionArea>
</affiliation>
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<author>
<name sortKey="Giles, Graham" sort="Giles, Graham" uniqKey="Giles G" first="Graham" last="Giles">Graham Giles</name>
<affiliation wicri:level="1">
<nlm:aff id="aff011">
<addr-line>Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia</addr-line>
</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Severi, Gianluca" sort="Severi, Gianluca" uniqKey="Severi G" first="Gianluca" last="Severi">Gianluca Severi</name>
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<nlm:aff id="aff012">
<addr-line>Centre de Recherche en Épidémiologie et Santé des Populations (CESP, Inserm U1018), Université Paris-Saclay, UPS, USQ, Gustave Roussy, Villejuif, France</addr-line>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Centre de Recherche en Épidémiologie et Santé des Populations (CESP, Inserm U1018), Université Paris-Saclay, UPS, USQ, Gustave Roussy, Villejuif</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1">
<nlm:aff id="aff013">
<addr-line>Human Genetics Foundation (HuGeF), Turin, Italy</addr-line>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Human Genetics Foundation (HuGeF), Turin</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Costa, Giuseppe" sort="Costa, Giuseppe" uniqKey="Costa G" first="Giuseppe" last="Costa">Giuseppe Costa</name>
<affiliation wicri:level="1">
<nlm:aff id="aff001">
<addr-line>Epidemiology Unit, ASL TO3, Piedmont Region, Grugliasco, Torino, Italy</addr-line>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Epidemiology Unit, ASL TO3, Piedmont Region, Grugliasco, Torino</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1">
<nlm:aff id="aff002">
<addr-line>Department of Clinical and Biological Science, University of Turin, Turin, Italy</addr-line>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Clinical and Biological Science, University of Turin, Turin</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Vineis, Paolo" sort="Vineis, Paolo" uniqKey="Vineis P" first="Paolo" last="Vineis">Paolo Vineis</name>
<affiliation wicri:level="1">
<nlm:aff id="aff014">
<addr-line>MRC-PHE Centre for Environment and Health, School of Public Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom</addr-line>
</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>MRC-PHE Centre for Environment and Health, School of Public Health, Department of Epidemiology and Biostatistics, Imperial College London, London</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series>
<title level="j">PLoS ONE</title>
<idno type="eISSN">1932-6203</idno>
<imprint>
<date when="2017">2017</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<sec id="sec001">
<title>Background</title>
<p>Several social indicators have been used in epidemiological research to describe socioeconomic position (SEP) of people in societies. Among SEP indicators, those more frequently used are education, occupational class and income. Differences in the incidence of several health outcomes have been reported consistently, independently from the indicator employed. Main objectives of the study were to present the socioeconomic classifications of the social indicators which will be employed throughout the LIFEPATH project and to compare social gradients in all-cause mortality observed in the participating adult cohorts using the different SEP indicators.</p>
</sec>
<sec id="sec002">
<title>Methods</title>
<p>Information on the available social indicators (education, own and father’s occupational class, income) from eleven adult cohorts participating in LIFEPATH was collected and harmonized. Mortality by SEP for each indicator was estimated by Poisson regression on each cohort and then evaluated using a meta-analytical approach.</p>
</sec>
<sec id="sec003">
<title>Results</title>
<p>In the meta-analysis, among men mortality was significantly inversely associated with both occupational class and education, but not with father’s occupational class; among women, the increase in mortality in lower social strata was smaller than among men and, except for a slight increase in the lowest education category, no significant differences were found.</p>
</sec>
<sec id="sec004">
<title>Conclusions</title>
<p>Among men, the proposed three-level classifications of occupational class and education were found to predict differences in mortality which is consistent with previous research. Results on women suggest that classifying them through their sole SEP, without considering that of their partners, may imply a misclassification of their social position leading to attenuation of mortality differences.</p>
</sec>
</div>
</front>
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<journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
<journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
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<issn pub-type="epub">1932-6203</issn>
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<publisher-loc>San Francisco, CA USA</publisher-loc>
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<article-id pub-id-type="pmid">28557991</article-id>
<article-id pub-id-type="pmc">5448763</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0178071</article-id>
<article-id pub-id-type="publisher-id">PONE-D-16-45168</article-id>
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<subject>Medicine and Health Sciences</subject>
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<subj-group>
<subject>Socioeconomic Aspects of Health</subject>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>People and Places</subject>
<subj-group>
<subject>Population Groupings</subject>
<subj-group>
<subject>Professions</subject>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Social Sciences</subject>
<subj-group>
<subject>Sociology</subject>
<subj-group>
<subject>Education</subject>
<subj-group>
<subject>Schools</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>People and Places</subject>
<subj-group>
<subject>Population Groupings</subject>
<subj-group>
<subject>Families</subject>
<subj-group>
<subject>Fathers</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Social Sciences</subject>
<subj-group>
<subject>Economics</subject>
<subj-group>
<subject>Labor Economics</subject>
<subj-group>
<subject>Employment</subject>
<subj-group>
<subject>Jobs</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Research and Analysis Methods</subject>
<subj-group>
<subject>Mathematical and Statistical Techniques</subject>
<subj-group>
<subject>Statistical Methods</subject>
<subj-group>
<subject>Meta-Analysis</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Physical Sciences</subject>
<subj-group>
<subject>Mathematics</subject>
<subj-group>
<subject>Statistics (Mathematics)</subject>
<subj-group>
<subject>Statistical Methods</subject>
<subj-group>
<subject>Meta-Analysis</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Social Sciences</subject>
<subj-group>
<subject>Sociology</subject>
<subj-group>
<subject>Social Stratification</subject>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Social Sciences</subject>
<subj-group>
<subject>Sociology</subject>
<subj-group>
<subject>Education</subject>
<subj-group>
<subject>Educational Attainment</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Socioeconomic indicators in epidemiologic research: A practical example from the LIFEPATH study</article-title>
<alt-title alt-title-type="running-head">Socioeconomic indicators in epidemiologic research: The LIFEPATH study</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>d’Errico</surname>
<given-names>Angelo</given-names>
</name>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor001">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ricceri</surname>
<given-names>Fulvio</given-names>
</name>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff002">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Stringhini</surname>
<given-names>Silvia</given-names>
</name>
<xref ref-type="aff" rid="aff003">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Carmeli</surname>
<given-names>Cristian</given-names>
</name>
<xref ref-type="aff" rid="aff003">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kivimaki</surname>
<given-names>Mika</given-names>
</name>
<xref ref-type="aff" rid="aff004">
<sup>4</sup>
</xref>
<xref ref-type="aff" rid="aff005">
<sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bartley</surname>
<given-names>Mel</given-names>
</name>
<xref ref-type="aff" rid="aff004">
<sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>McCrory</surname>
<given-names>Cathal</given-names>
</name>
<xref ref-type="aff" rid="aff006">
<sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bochud</surname>
<given-names>Murielle</given-names>
</name>
<xref ref-type="aff" rid="aff003">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Vollenweider</surname>
<given-names>Peter</given-names>
</name>
<xref ref-type="aff" rid="aff003">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tumino</surname>
<given-names>Rosario</given-names>
</name>
<xref ref-type="aff" rid="aff007">
<sup>7</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Goldberg</surname>
<given-names>Marcel</given-names>
</name>
<xref ref-type="aff" rid="aff008">
<sup>8</sup>
</xref>
<xref ref-type="aff" rid="aff009">
<sup>9</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zins</surname>
<given-names>Marie</given-names>
</name>
<xref ref-type="aff" rid="aff008">
<sup>8</sup>
</xref>
<xref ref-type="aff" rid="aff009">
<sup>9</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Barros</surname>
<given-names>Henrique</given-names>
</name>
<xref ref-type="aff" rid="aff010">
<sup>10</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Giles</surname>
<given-names>Graham</given-names>
</name>
<xref ref-type="aff" rid="aff011">
<sup>11</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Severi</surname>
<given-names>Gianluca</given-names>
</name>
<xref ref-type="aff" rid="aff012">
<sup>12</sup>
</xref>
<xref ref-type="aff" rid="aff013">
<sup>13</sup>
</xref>
</contrib>
<contrib contrib-type="author" equal-contrib="yes">
<name>
<surname>Costa</surname>
<given-names>Giuseppe</given-names>
</name>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff002">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author" equal-contrib="yes">
<name>
<surname>Vineis</surname>
<given-names>Paolo</given-names>
</name>
<xref ref-type="aff" rid="aff014">
<sup>14</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<collab>LIFEPATH Consortium</collab>
<xref ref-type="author-notes" rid="fn001">
<sup></sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff001">
<label>1</label>
<addr-line>Epidemiology Unit, ASL TO3, Piedmont Region, Grugliasco, Torino, Italy</addr-line>
</aff>
<aff id="aff002">
<label>2</label>
<addr-line>Department of Clinical and Biological Science, University of Turin, Turin, Italy</addr-line>
</aff>
<aff id="aff003">
<label>3</label>
<addr-line>Institute of Social and Preventive Medicine and Department of Psychiatry and Department of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland</addr-line>
</aff>
<aff id="aff004">
<label>4</label>
<addr-line>University College London, Department of Epidemiology and Public Health, London, United Kingdom</addr-line>
</aff>
<aff id="aff005">
<label>5</label>
<addr-line>Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland</addr-line>
</aff>
<aff id="aff006">
<label>6</label>
<addr-line>The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland</addr-line>
</aff>
<aff id="aff007">
<label>7</label>
<addr-line>Cancer Registry, Department of Prevention, ASP, Ragusa, Italy</addr-line>
</aff>
<aff id="aff008">
<label>8</label>
<addr-line>Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France</addr-line>
</aff>
<aff id="aff009">
<label>9</label>
<addr-line>Paris Descartes University, Paris, France</addr-line>
</aff>
<aff id="aff010">
<label>10</label>
<addr-line>EPIUnit- Institute of Public Health, University of Porto, Porto, Portugal</addr-line>
</aff>
<aff id="aff011">
<label>11</label>
<addr-line>Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia</addr-line>
</aff>
<aff id="aff012">
<label>12</label>
<addr-line>Centre de Recherche en Épidémiologie et Santé des Populations (CESP, Inserm U1018), Université Paris-Saclay, UPS, USQ, Gustave Roussy, Villejuif, France</addr-line>
</aff>
<aff id="aff013">
<label>13</label>
<addr-line>Human Genetics Foundation (HuGeF), Turin, Italy</addr-line>
</aff>
<aff id="aff014">
<label>14</label>
<addr-line>MRC-PHE Centre for Environment and Health, School of Public Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom</addr-line>
</aff>
<contrib-group>
<contrib contrib-type="editor">
<name>
<surname>Ciccozzi</surname>
<given-names>Massimo</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1">
<addr-line>National Institute of Health, ITALY</addr-line>
</aff>
<author-notes>
<fn fn-type="COI-statement" id="coi001">
<p>
<bold>Competing Interests: </bold>
The authors have declared that no competing interests exist.</p>
</fn>
<fn fn-type="con">
<p>
<list list-type="simple">
<list-item>
<p>
<bold>Conceptualization:</bold>
P. Vineis AD FR SS GC.</p>
</list-item>
<list-item>
<p>
<bold>Data curation:</bold>
AD FR SS CC.</p>
</list-item>
<list-item>
<p>
<bold>Formal analysis:</bold>
FR CC.</p>
</list-item>
<list-item>
<p>
<bold>Funding acquisition:</bold>
P. Vineis SS.</p>
</list-item>
<list-item>
<p>
<bold>Investigation:</bold>
P. Vineis SS MK CM.</p>
</list-item>
<list-item>
<p>
<bold>Methodology:</bold>
AD FR SS MK.</p>
</list-item>
<list-item>
<p>
<bold>Resources:</bold>
AD FR SS CC MK M. Bartley CM M. Bochud P. Vollenweider RT MG MZ HB GG GS GC P. Vineis.</p>
</list-item>
<list-item>
<p>
<bold>Software:</bold>
FR.</p>
</list-item>
<list-item>
<p>
<bold>Supervision:</bold>
GC P. Vineis.</p>
</list-item>
<list-item>
<p>
<bold>Writing – original draft:</bold>
AD FR GC.</p>
</list-item>
<list-item>
<p>
<bold>Writing – review & editing:</bold>
AD FR SS CC MK M. Bartley CM M. Bochud P. Vollenweider RT MG MZ HB GG GS GC P. Vineis.</p>
</list-item>
</list>
</p>
</fn>
<fn fn-type="other" id="fn001">
<p>¶ Complete membership of the LIFEPATH consortium is provided in the Acknowledgments</p>
</fn>
<corresp id="cor001">* E-mail:
<email>angelo.derrico@epi.piemonte.it</email>
</corresp>
</author-notes>
<pub-date pub-type="epub">
<day>30</day>
<month>5</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="collection">
<year>2017</year>
</pub-date>
<volume>12</volume>
<issue>5</issue>
<elocation-id>e0178071</elocation-id>
<history>
<date date-type="received">
<day>14</day>
<month>11</month>
<year>2016</year>
</date>
<date date-type="accepted">
<day>8</day>
<month>5</month>
<year>2017</year>
</date>
</history>
<permissions>
<copyright-statement>© 2017 d’Errico et al</copyright-statement>
<copyright-year>2017</copyright-year>
<copyright-holder>d’Errico et al</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<license-p>This is an open access article distributed under the terms of the
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:href="pone.0178071.pdf"></self-uri>
<abstract>
<sec id="sec001">
<title>Background</title>
<p>Several social indicators have been used in epidemiological research to describe socioeconomic position (SEP) of people in societies. Among SEP indicators, those more frequently used are education, occupational class and income. Differences in the incidence of several health outcomes have been reported consistently, independently from the indicator employed. Main objectives of the study were to present the socioeconomic classifications of the social indicators which will be employed throughout the LIFEPATH project and to compare social gradients in all-cause mortality observed in the participating adult cohorts using the different SEP indicators.</p>
</sec>
<sec id="sec002">
<title>Methods</title>
<p>Information on the available social indicators (education, own and father’s occupational class, income) from eleven adult cohorts participating in LIFEPATH was collected and harmonized. Mortality by SEP for each indicator was estimated by Poisson regression on each cohort and then evaluated using a meta-analytical approach.</p>
</sec>
<sec id="sec003">
<title>Results</title>
<p>In the meta-analysis, among men mortality was significantly inversely associated with both occupational class and education, but not with father’s occupational class; among women, the increase in mortality in lower social strata was smaller than among men and, except for a slight increase in the lowest education category, no significant differences were found.</p>
</sec>
<sec id="sec004">
<title>Conclusions</title>
<p>Among men, the proposed three-level classifications of occupational class and education were found to predict differences in mortality which is consistent with previous research. Results on women suggest that classifying them through their sole SEP, without considering that of their partners, may imply a misclassification of their social position leading to attenuation of mortality differences.</p>
</sec>
</abstract>
<funding-group>
<award-group id="award001">
<funding-source>
<institution-wrap>
<institution-id institution-id-type="funder-id">http://dx.doi.org/10.13039/501100007601</institution-id>
<institution>Horizon 2020</institution>
</institution-wrap>
</funding-source>
<award-id>633666</award-id>
<principal-award-recipient>
<name>
<surname>Vineis</surname>
<given-names>Paolo</given-names>
</name>
</principal-award-recipient>
</award-group>
<award-group id="award002">
<funding-source>
<institution-wrap>
<institution-id institution-id-type="funder-id">http://dx.doi.org/10.13039/501100001711</institution-id>
<institution>Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung</institution>
</institution-wrap>
</funding-source>
<award-id>PZ00P3_167732</award-id>
<principal-award-recipient>
<name>
<surname>Stringhini</surname>
<given-names>Silvia</given-names>
</name>
</principal-award-recipient>
</award-group>
<funding-statement>This study is supported by the European Commission (Horizon 2020 grant n° 633666) and the Swiss State Secretariat for Education, Research and Innovation SERI. Silvia Stringhini is supported by an Ambizione Grant (PZ00P3_167732) from the Swiss National Science Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement>
</funding-group>
<counts>
<fig-count count="8"></fig-count>
<table-count count="6"></table-count>
<page-count count="32"></page-count>
</counts>
<custom-meta-group>
<custom-meta id="data-availability">
<meta-name>Data Availability</meta-name>
<meta-value>Data cannot be made freely available because of restrictions imposed by the Project Steering Board of the LIFEPATH project, as written in the ethical document provided to the European Commission. However, aggregate data are available for other researchers, on request. Requests should be sent to the PI of the LIFEPATH Project, Paolo Vineis (e-mail
<email>p.vineis@imperial.ac.uk</email>
).</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes>
<title>Data Availability</title>
<p>Data cannot be made freely available because of restrictions imposed by the Project Steering Board of the LIFEPATH project, as written in the ethical document provided to the European Commission. However, aggregate data are available for other researchers, on request. Requests should be sent to the PI of the LIFEPATH Project, Paolo Vineis (e-mail
<email>p.vineis@imperial.ac.uk</email>
).</p>
</notes>
</front>
</pmc>
</record>

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