Addi van Bergen

Chapter 6 132 Table 6. Prevalence and proportion of ill health and personal control by population segment (%’s, weighted #). SE segment SE+low labour market segment Prevalence Proportion Prevalence Proportion CVD risk factors Diabetes 13.8 20.2 12.3 35.0 High blood pressure 21.4 15.5 20.3 28.4 Current smoking 38.2 15.3 35.5 26.9 Obesity (BMI 30 or higher) 23.5 17.6 23.0 33.0 Inactivity 24.3 26.6 20.3 43.8 Cancer 3.6 12.8 3.7 26.1 Self-rated health fair or poor 64.4 24.4 59.3 43.3 Anxiety and depression symptoms 42.4 47.5 31.5 67.2 Low personal control 48.6 41.7 35.5 60.4 # Sampling weights were calculated by Statistics Netherlands based on a linear model with 9 sociodemographic variables and their interaction terms [28]. @ The proportion of the population with the condition in question, that falls within this segment. For example row 1 Diabetes: of the 174,134 socially excluded adults 24,030 or 13.8% reported diabetes. The socially excluded population segment thus accounted for 20.2% of all 118,965 diabetes cases (24,030/118,965). DISCUSSION Our first hypothesis, i.e., that SE is a stronger social stratifier than the commonly used social factors of education, income, labour market position and migration background, was confirmed for all four stratifiers in relation to anxiety and depression symptoms and for low household income and non-Western migration background in relation to the other health indicators. The second hypothesis, i.e., that SE is more strongly associated with low agency than the four social factors was also confirmed. The differences found for low personal control (as an indicator of low agency) were substantial. The third hypothesis, i.e., that combining SE with one of the social factors would not improve its stratifying ability, was confirmed in terms of RRs but not in terms of PAFs. The study showed a remarkable 7.9-fold higher chance of experiencing anxiety and depression symptoms in socially excluded persons in urban areas of the Netherlands compared to individuals who were not socially excluded, which was significantly higher than that found for low education, low income, low labour market position and non-Western migration background. One might suspect overlapping symptoms between SE and anxiety and depression symptoms, but this was not found to be the case. SE and anxiety and depression are theoretically distinct concepts. Both