The Richer the Better? SES Inequalities In Cause-Specific Adult Mortality In a Long-Term Perspective: Evidence from Sweden 1813-2014

Higher socioeconomic status (SES) is associated with lower mortality. This has been confirmed
using different indicators across several geographical settings. Nevertheless, the mechanisms
behind this association are still under debate. In particular, the timing of the emergence of the
SES gradient remains an open question. In this paper, we study the development of SES
inequalities in cause-specific mortality for a regional population in southern Sweden from the
early nineteenth century until 2014. We apply a cause-specific hazard model to estimate mortality
differentials by SES. Our results confirm that the SES differences we see today emerged only
around 1970. More importantly, our study demonstrates that, with few exceptions, SES
differences emerged about the same time for all causes of death. For women it started earlier than
for men, particularly in infectious diseases. In the nineteenth and early twentieth century we find
a positive association between SES and mortality from circulatory diseases for men. We argue
that habits and behaviors embedded in the different social strata played a major role behind the
SES differences in mortality that we observe throughout the analyzed period.