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Socio-economic differences in mortality are among the most pervasive characteristics of Western societies. While the mortality gradient by income is well established for the period after 1970, knowledge about the origins of this gradient is still rudimentary. We analyse the association between income and cause-specific adult mortality during the period 1905-2014 in an area of southern Sweden, using competing-risk hazard models with individual-level longitudinal data for over 2.2 million person-years and over 35,000 deaths. We find that the present-day income gradient in adult mortality emerged only in the period after the Second World War and did so for the leading causes of death and for men and women largely simultaneously.

Higher socioeconomic status (SES) is associated with lower mortality, and this correlation has been confirmed using different indicators across several geographical settings. Nevertheless, the timing of the emergence of the SES gradient remains unclear. We used individual-level longitudinal data for a regional population in southern Sweden covering the period between 1813 and 2014, and we applied a cause-specific proportional hazard model. We estimated SES differences in all-cause, nonpreventable, preventable, and cause-specific adult mortality in four subperiods (1813-1921, 1922-1967, 1968-1989, 1990-2014) by gender adjusting for birth year, place of residence, marital status, and migration status. The SES gradient in mortality present today for both genders emerged only around 1970, and with few exceptions, it emerged at approximately the same time for all causes of death. It emerged earlier for women than for men, particularly in infectious diseases. In the nineteenth and early twentieth centuries, we found a positive association between SES and mortality from circulatory diseases for men. SES has not always been a fundamental cause of mortality; it only emerged as such in the second half of the twentieth century. We argue that habits and behaviors embedded in the different social strata played a major role in the emergence of the SES gradient.

Across today's developed world, there is a clear mortality gradient by socioeconomic status for all ages. It is often taken for granted that this gradient was as strong-or even stronger-in the past when social transfers were rudimentary and health care systems were less developed. Some studies based on cross-sectional data have supported this view, but others based on longitudinal data found that this was not the case. If there was no gradient in the past, when did it emerge? To answer this question, we examine social class differences in adult mortality for men and women in southern Sweden over a 200-year period, using unique individual-level register data. We find a systematic class gradient in adult mortality emerging at ages 30-59 only after 1950 for women and after 1970 for men, and in subsequent periods also observable for ages 60-89. Given that the mortality gradient emerged when Sweden transitioned into a modern welfare state with substantial social transfers and a universal health care system, this finding points to lifestyle and psychosocial factors as likely determinants.

This paper presents an analysis of the impact of childbearing history on later-life mortality for ever-married men and women using historical micro-level data of high quality for southern Sweden. The analysis uses a Cox proportional hazards model, estimating the effects on old-age mortality of number of births and timing of first and last births. By studying the effects of previous childbearing on mortality by sex and social status, we also gain important insights into the mechanisms relating childbearing to mortality in old age. The results show that number of children ever born had a statistically significant negative impact on longevity after age 50 for females but not for males. Analysis by social group shows that only landless women experienced higher mortality from having more children, which seems to indicate that the main explanations are to be found in social or economic conditions specific to females, rather than in the strictly biological or physiological effects of childbearing.

Consensus is lacking in the literature about the role of socioeconomic factors on influenza-associated deaths during the 1918 pandemic. Although some scholars have found that social factors were important, others have not. In this study, we analyzed differences in excess mortality by social class in Sweden during the 1918 pandemic. We analyzed individual-level mortality of the entire population aged 30–59 years by combining information from death records with census data on occupation. Social class was measured by an occupation-based class scheme. Excess mortality during the pandemic was measured as the number of deaths relative to the number occurring in the same month the year before. Social class differences in numbers of deaths were modeled using a complementary log-log model that was adjusted for potential confounding at the family, the residential (urban/rural), and the county levels. We found notable class differences in excess mortality but no perfect class gradient. Class differences were somewhat larger for men than for women. [ABSTRACT FROM AUTHOR]

This paper deals with socioeconomic differences in adult mortality in southern Sweden 1815-1968, a period of transformation from an agricultural to a modern industrial society and increasing life expectancy. We use longitudinal micro-level data with information on demographic events, household structure and socioeconomic status. The main finding is that the socioeconomic gradient is a very recent phenomenon. While mortality fell in all socioeconomic groups it was not until the 1950s that a socioeconomic gradient appeared, and then only among adults in working ages. For the elderly, we find no significant mortality differentials between various social groups at any time. These results are consistent with the divergence hypothesis, although this process started much later than previously thought, and was not an immediate consequence of industrialization. [ABSTRACT FROM AUTHOR]