Health inequalities in the Netherlands: a cross-sectional study of the role of Type D (distressed) personality

• Published in: BMC public health Vol. 12; no. 1; p. 46
• Main Authors: van Bon-Martens, Marja JH, Denollet, Johan, Kiemeney, Lambertus ALM, Droomers, Mariël, de Beer, Monique JA, van de Goor, Ien AM, van Oers, Hans AM
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 18.01.2012; BioMed Central; BMC
• Subjects: Adult; Alcohol use; Behavior; Cross-Sectional Studies; Education; Female; Health services; Health Status Disparities; Human subjects; Humans; Life expectancy; Life Style; Lifestyles; Male; Medical research; Methods; Middle Aged; Netherlands; Observational studies; Personality; Personality - classification; Personality assessment; Public health; Risk factors; Risk-Taking; Social Class; Socioeconomics; Stress, Psychological; Studies; Womens health; Young Adult; Netherlands
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/1471-2458-12-46

In the Netherlands, as in many European countries, inequalities in health exist between people with a high and a low socioeconomic status (SES). From the perspective of the 'indirect selection hypothesis', this study was designed to expand our understanding of the role of Type D personality as an explanation of health inequalities. Data came from two cross-sectional Dutch surveys among the general population (aged between 19 and 64 years, response 53.7%, n = 12,090). We analyzed the relative risks of low SES, assessed using education and income, and Type D personality, assessed using the Type D Scale-14 (DS14), for different outcomes regarding lifestyle-related risk factors and health, using multivariate Generalized Linear Models. Results showed that Type D personality was significantly associated with low SES (OR = 1.7 for both low education and low income). Moreover, the relative risks of Type D personality and low SES were significantly elevated for most adverse health outcomes, unconditionally as well as conditionally. The cross-sectional design hinders the making of definite etiological inferences. Nevertheless, our findings suggest that Type D personality does not explain the socioeconomic health inequalities, but is a risk factor in addition to low SES. Prevention of adverse health outcomes in low SES populations may have more effect when it takes into account that persons with a low SES in combination with a Type D personality are at highest risk.