Regional and Social Class Variation in the Relative Risk of Death from Amenable Causes in the City of Helsinki, 1980–1986

BACKGROUND: Relative risk of death from causes amenable to health services' intervention was studied in a case-control design to ascertain regional and social class differences. METHODS: The data were 2091 deaths from amenable causes and 8364 randomly drawn living controls in 1980-1986 in the seven health districts in Helsinki, Finland. Logistic regression was used to adjust relative risk estimates for age, sex and marital status. RESULTS: Adjustments decreased the risk ratios. Compared with the Southern District, the Middle District had significantly higher adjusted relative risk (RR = 1.4; 95% confidence interval [CI]: 1.1-1.7). People with no address had even higher relative risk (RR = 3.1; 95% CI: 2.3-4.2). Compared with social group I, increased relative risks were found in social group II (RR = 1.3; 95% CI: 1.1-1.6), group III (RR = 2.0; 95% CI: 1.6-2.4), group IV (RR = 1.9; 95% CI: 1.5-2.5) and group VI (RR = 8.5; 95% CI: 6.9-10.6). Males had higher relative risk than females (RR = 2.4; 95% CI: 2.1-2.8). Of the dead with no address, 29% were pensioners and 41% had been registered unemployed or occupation was unknown; 48% were single and 17% divorced. CONCLUSIONS: Our results suggest that regional inequalities in health care between various districts in Helsinki are small. However, to a large extent two overlapping groups, social group VI and people with no address, seem to delineate a deprived group likely to need special help from health care.