APH 2003, 61, 33-51:
Do regional differences in psychosocial variables contribute to regional differences in cardiovascular mortality in Belgium ?
P. De Smet, M. Moreau, E. Pelfrene, E. Clays, F. Leynen, F. Kittel, G. De Backer, M. Kornitzer
Keywords: Belgium, coronary heart disease mortality, psychosocial variables, work environment
Since the end of the sixties the southern French speaking part of
Belgium has shown an excess coronary and cardiovascular mortality
as compared to the northern Dutch speaking region. The main hypothesis
formulated 25 years ago related this excess mortality to less favourable
nutritional patterns. In this paper we look in this paper at regional
differences in psychosocial variables related to coronary heart disease
as reported in the epidemiological literature. The hypothesis is that
French speaking working subjects present a less favourable psychosocial
profile as compared to Dutch speaking subjects.
Study 1 concerns 3092 working subjects of both genders from the BIRNH
study who answered the Jenkins Activity Survey; a self administered
questionnaire related to the Type A behaviour pattern and the JobStress
Questionnaire wich is a home made questionnaire. Study 2 concerns
21,419 subjects of the BELSTRESS study who answered self administered
questionnaires concerning the Karasek model on Demand/ Control/Social
Support at work, depression, self-perceived health, exhaustion, social
support outside work, aggression, sleep disturbances and anxiety.
Univariate results in both genders stratified by level of education
are presented in this paper.
Results: Study 1: French speaking subjects present
the type A behaviour pattern more frequently and score significantly
higher on the home made job-stress questionnaire. Study 2: French
speaking subjects present higher average ratios of Demand/Control
(job strain direction) as well as higher scores on depression, anxiety,
agressivity, current health index (self-perceived health), vital exhaustion
and lower prevalences of a high social support network outside work
as well as higher prevalences of sleep problems.
Conclusions: Besides less favourable nutritional
patterns French speaking subjects present less favourable profiles
on a host of psycho-social variables related to coronary heart disease.
Hence part of the excess coronary heart disease mortality, incidence
and prevalence observed in the southern part of Belgium could be related
to these psy-chosocial variables. This hypothesis should be tested
in a large prospective study concerning both Belgian linguistic communities.