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BMC Public Health

, 15:914

First Online: 18 September 2015Received: 25 January 2015Accepted: 04 September 2015DOI: 10.1186-s12889-015-2227-y

Cite this article as: Sommer, I., Griebler, U., Mahlknecht, P. et al. BMC Public Health 2015 15: 914. doi:10.1186-s12889-015-2227-y


BackgroundNon-communicable diseases NCDs are the largest cause of premature death worldwide. Socioeconomic inequalities contribute to a disparity in the burden of NCDs among disadvantaged and advantaged populations in low LIC, middle MIC, and high income countries HIC. We conducted an overview of systematic reviews to systematically and objectively assess the available evidence on socioeconomic inequalities in relation to morbidity and mortality of NCDs and their risk factors.

MethodsWe searched PubMed, The Cochrane Library, EMBASE, SCOPUS, Global Health, and Business Source Complete for relevant systematic reviews published between 2003 and December 2013. Two authors independently screened abstracts and full-text publications and determined the risk of bias of the included systematic reviews.

ResultsWe screened 3302 abstracts, 173 full-text publications and ultimately included 22 systematic reviews. Most reviews had major methodological shortcomings; however, our synthesis showed that having low socioeconomic status SES and-or living in low and middle income countries LMIC increased the risk of developing cardiovascular diseases CVD, lung and gastric cancer, type 2 diabetes, and chronic obstructive pulmonary disease COPD. Furthermore, low SES increased the risk of mortality from lung cancer, COPD, and reduced breast cancer survival in HIC. Reviews included here indicated that lower SES is a risk factor for obesity in HIC, but this association varied by SES measure. Early case fatalities of stroke were lower and survival of retinoblastoma was higher in MIC compared to LIC.

ConclusionsThe current evidence supports an association between socioeconomic inequalities and NCDs and risk factors for NCDs. However, this evidence is incomplete and limited by the fairly low methodological quality of the systematic reviews, including shortcomings in the study selection and quality assessment process.

Electronic supplementary materialThe online version of this article doi:10.1186-s12889-015-2227-y contains supplementary material, which is available to authorized users.

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Autor: Isolde Sommer - Ursula Griebler - Peter Mahlknecht - Kylie Thaler - Kathryn Bouskill - Gerald Gartlehner - Shanti Mendis


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