Addi van Bergen

Chapter 6 128 to show somewhat higher RRs than those for the political and cultural dimensions, especially for anxiety and depression symptoms and low personal control. The RRs and PAFs are shown in Table A1 (Additional file 1). Overlap SE and social factors and combined effect To test the third hypothesis, we examined the overlap between the social factors and SE and the added value of combining SE with one of the social factors. Over one- third of adults with a low labour market position were socially excluded (34.1%). Moderate to strong social exclusion was also found in at least one in five adults with low education (25.7%), low household income (21.5%) or non-Western migration background (20.7%). Therefore, the overlap with SE was considerable, yet the social factors identified mainly non-excluded population groups (66-79%) (Table A2, Additional file 1). Figure 3 (and Table A3 Additional file 1) shows that for many health indicators, the RRs were lower in the non-excluded group than in the excluded group. The reference category here consisted of those who were not socially excluded and had no SF present (SE-SF- group). The reference value was set to 1. Figures 3a-d show that, especially for anxiety and depression symptoms and low personal control, the differences between the RRs were high. Respondents with low education and SE had an RR of 10.53 for anxiety and depression symptoms, while respondents with low education who were not socially excluded had an RR of 2.58, all of whom were compared to the non-exposed group (SE-SF- group) (Figure 3a). For low labour market positions, the RRs of anxiety and depression symptoms were 15.02 when combined with SE and 5.17 when not (Figure 3c). A large part of the stratifying power of low education and low labour market position is thus associated with SE. The same pattern can be seen for other health indicators and social factors, with a few exceptions; the ∆ RRs of cancer, obesity and high blood pressure by low education and low labour market position and the ∆ RR of diabetes by low education were not significantly higher with SE than without SE (Table A3 Additional file 1). In all other combinations, the RRs were significantly higher for the SF+SE+ group than for the SF+SE-group. It should be noted, however, that although the RRs in the SF+SE-group were generally lower, most of the RRs were significantly higher than 1 (31 out of 36) and would in other studies, with less pronounced results, be seen as relevant (Table A3 Additional file 1). As shown in Table 5 and Figures 1b and 2b, we investigated the potential contribution of the social factors to the stratifying power of SE. The panels show for each combination of SE and the social factors the RRs (1b) and PAFs (2b) for ill health and low personal control. The blue diamonds represent the RRs and PAFs of SE alone. In only three cases did the combination of SE with one of the social actors yield a higher RR than that of SE alone. The RRs for diabetes and high blood pressure increased when SE was combined with of low education. This was to be expected, as we saw in Figure 1a that the RRs of low education were significantly higher for diabetes and