Introduction: The study of social differences in health is today focused on determinants. The knowledge of determinants is useful for the definition of policies to tackle inequities. The aim of this paper is to analyse the social distribution of cancer incidence, fatality and mortality in the city of Turin during the 80's and to estimate the amount of inequality produced within the health system.
Sources of data: The social distribution of the risk of death in Turin during 1981-1989, estimated from the Turin Longitudinal Study, is compared with incidence and fatality during approximately the same time period.
Results: Among men, the relative risks for all cancer sites, among social classes, appear to confirm the hypothesis of a multiplicative model of incidence and fatality. In particular, colo-rectal, prostatic, bladder cancers and lymphoma and leukaemia show relative risks similar to the expected ones. Cancers of larynx, lung and stomach seem to be less coherent. Among women, colon-rectum, lung, breast and lymphoma and leukaemia show coherent results, whereas relative risks for uterus are far from the expected.
Discussion: The coherence with the expected values of the social distribution of mortality suggests the adequacy of the multiplicative model for the provision of mortality from incidence and fatality. Therefore it is possible to state that the portion of inequality in health originated within the health system is big enough to suggest the need to put the equity in the access to health services in the agenda of interventions.