Laboratory

MaxHel Center

At a Glance Projects Publications Team

Research Area

Comparisons

An important part in demonstrating causation is the validation of findings in different populations and contexts. Comparative studies – with harmonized instrumentation – are ideally placed at achieving this. Such studies also help to situate analyses of health inequalities within the wider sociopolitical context and are an important way to assess how macro-level social conditions and policies may affect health inequalities. In addition, comparative studies of populations in different countries may help us to understand the limits of explanations of social inequalities in health obtained in particular settings. Too often, extrapolations of causal social epidemiological findings from one setting are made to different countries and time periods. As an example, in high-impact studies the relationships found in selected high-income countries between mortality and socially patterned risk factors, such as smoking prevalence and fruit and vegetable intake, are used to model and forecast causes of death across all regions of the world. Whether it is at all appropriate to extrapolate these patterns to different settings and time periods has not been critically scrutinized.

Most of the comparative studies to date are based on routinely collected survey data (self-reported morbidity) or register data (mortality) typically aggregated at the macro-level. Comparative studies that can longitudinally assess the individual-level social, behavioral, and biological pathways that underlie health inequalities are rare. We are in a unique position to fill this gap by placing findings obtained in the Finnish context in an international perspective, using high-quality data from other countries. This research theme addresses the role of contextual factors, using cross-national, cross-regional, and cross-cohort and multigenerational variation.