Social Disparities in the Evolution of an Epidemiological Profile: Transition Processes in Mortality Between 1971 and 2008 in an Industrialized Middle Income Country: The Case of Hungary

摘要

The present paper seeks to understand the transformation of mortality patterns in Hungary, by which mortality inequalities by education began to appear in the early 1980s, continued to grow in the following 25 years, and now seem to be stabilising. The first part of this paper overviews the theoretical innovations of the last decades regarding the interpretation of cause-specific mortality dynamics, often referred to as epidemiological transition theories, and their relevance for the analysis of mortality inequalities. The paper then analyses the cause-specific trends of mortality for two educational classes between 1971 and 2008. The trends were corrected for changes in the coding system and divided into linear (stagnating, increasing or decreasing) periods. Causes of death were grouped according to the relationship between the sequences of these periods for the two educational classes. The 57 causes of death were finally clustered into six groups. One group, which is dominated by nutrition-related and cardiovascular diseases, is largely responsible for the onset of mortality inequalities in 1980. The results imply that the quality of nutrition has diverged for the educational classes since 1980, and this fact has left its footprint on the pattern of mortality. The history of food production and availability seems to be in line with nutrition-related mortality, and it is argued that nutrition transition theory provides a very plausible explanatory framework for the growth of mortality inequalities.