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Table 1 Description of main results of eligible publications, according to SES variable and health outcome used

From: Connecting the dots on health inequalities – a systematic review on the social determinants of health in Portugal

   Health outcome
   Medical indicators Functional indicators Subjective health
Socioeconomic determinants Place of residence Physical health tended to be better among rural adolescents (Machado-Rodrigues, 2012, Machado-Rodrigues, 2011) and less deprived neighborhoods (Bastos, 2013). Parental perceptions of better neighborhood environments also tended to show an association with better physical (Nogueira, 2013a, Machado-Rodrigues, 2014) but worse mental health (Carvalho, 2014) among children. The only study (Nunes, 2010) showed no association between place of residence and cognitive ability. One study (Humboldt, 2014) showed that life satisfaction was better in rural areas.
Race/ethnicity/culture/language Migrants showed higher mortality (Harding, 2008, Williamson, 2009), worse oral health (Pereira, 2013) and a higher percentage of small preterm births (Harding, 2006b). On the other hand, migrant adolescents had less mental health problems (Neto, 2009 and Neto, 2010) and better cardiorespiratory fitness (Santos, 2011).   There were differences in SRH among nationalities in one study (Dias, 2013), but all other studies showed no association between migration, ethnicity or nationality and subjective health (Malmusi, 2014 and Humboldt, 2014).
Occupation Most studies showed a strong association between unemployment or less differentiated occupations and worse health (see, for example, Fraga, 2014 or Santos, 2008), although some found no association (for example Alves, 2012 or Bastos, 2013). None found an opposite result. One study (Azevedo, 2012) found people who were unemployed or retired were more likely to suffer from chronic pain. Silva (2014) showed strong associations between employment and more differentiated occupations with SRH. On the other hand, Humboldt (2014) found no association between employment and life satisfaction.
Gender/sex Almost all studies showed an association between being female and worse health (see, for example, Santos, 2011 or Bulhões, 2013). Some studies found no gender differences (see, for example, Bastos, 2013 or Neto, 2010) and two found the opposite association (Perelman, 2012 and Stewart-Knox, 2012). Women were more likely to take sickness absence (Masterkaasa, 2014 and Perelman, 2012) and report chronic pain (Azevedo, 2012 and Perelman, 2012), and one study showed men reported more bed days (Perelman, 2012). Cognitive abilities differed between genders, depending on the test used (Martins, 2012, Santos, 2014a). Almost every study showed women had worse subjective health outcomes (see, for example, Bambra, 2009, Dias, 2013 or Pereira, 2011).
Religion One study showed no association between religion or spirituality and the onset of major depression (Leurent, 2013).   One study showed religious people showed higher life satisfaction (Humboldt, 2014), and another showed no association between religion or spirituality and quality of life or well-being (Vilhena, 2014).
Education Lower education tended to show a strong association with worse health in almost all studies (see, for example, Bastos, 2013 or Santos, 2010). There were two exceptions: Lawlor, 2005, who showed that insulin resistance was more common in children of more educated parents and Costa, 2008, who showed girls whose parents were more educated had more eating disorder symptomatology. Education was strongly associated with cognitive ability (Martins, 2012, Nunes, 2010 and Santos, 2014a), chronic pain (Azevedo, 2012) and functional limitations (Eikemo, 2008, Knesebeck, 2006). Better SRH was associated with higher education in all studies (see, for example, Knesebeck, 2006 or Silva, 2014) except one, that showed the opposite (Humboldt, 2014).
Socioeconomic status Married individuals tended to show better health outcomes (see, for example, Harding, 2008 or Williamson, 2009), but had higher odds of being obese (Alves, 2012 and Goulão, 2015). Income, deprivation and financial difficulties showed conflicting results: while most studies tended to show worse health outcomes for more deprived people (see, for example, Pereira, 2013 or Alves, 2012) or no association at all (see, for example, Correia, 2014 or Pimenta, 2011), there were some exceptions that showed, for example, lower prevalence of obesity among homeless people (Oliveira, 2012) or more insulin resistance among children with richer parents (Lawlor, 2005). One study (Azevedo, 2012) found no association between marital status and chronic pain. Early life SES, as measured by height, was strongly associated with chronic pain in women (Perelman, 2014). Objective income (Humboldt, 2014, Silva, 2014) and perceived income (Dias, 2013) were found to be associated with subjective health, but not marital status (Humboldt, 2014) or height, as a measure of early life SES (Perelman, 2014).
Social capital One study (Ferreira-Valente, 2014) showed that social support was associated with better psychological functioning. One study (Ferreira-Valente, 2014) showed that social support had a strong association with physical functioning, but not pain intensity. Number of activities outside the home was the only social capital indicator that showed an association with SRH (Silva, 2014). Other analyses showed no association (Vilhena, 2014, Silva, 2014).
  1. Note: no eligible publication explored the relationship between ‘race/ethnicity/culture/language’ or ‘religion’ and functional indicators
  2. Legend: SRH Self Rated Health. SES Socioeconomic Status