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11-06-2022 | Obesity | Original Article

Social differentials in the impact of risk factor exposures on life expectancy and health expectancy

Authors: Henrik Brønnum-Hansen, Michael Davidsen

Published in: Journal of Public Health | Issue 9/2023

Abstract

Aim

The study estimates the impact of exposure to smoking, high alcohol consumption and obesity on life expectancy and three health expectancy indicators by educational level and gender.

Subject and methods

Gender-, educational- and risk factor-specific life tables were constructed using nationwide register data and the Danish National Health Survey in 2017. Health expectancies were estimated by Sullivan’s method.

Results

Heavy smoking (15+ cigarettes daily) reduced life expectancy by 11.7 and 8.2 years among men with low and high education, respectively. The corresponding loss of life years for heavy smoking women was 10.7 and 7.3 years. No significant educational differences in the loss of 10–11 disease-free life expectancy was seen for male heavy smokers, in contrast to the loss of 13.7 and 9.1 years among female heavy smokers with low and high education. A social gradient in the loss of life expectancy was seen for the impact of high alcohol consumption for both genders and for loss of disease-free life expectancy for men. High alcohol consumption did not reduce disease-free life expectancy among women with medium and high education. There was no significantly different impact of obesity on disease-free life expectancy between educational groups. Educational differentials were seen for the impact of smoking and high alcohol consumption on loss of disability-free life expectancy and years in self-rated good health.

Conclusion

Prevention targeted at people with low education can reduce social inequality in life and health expectancy. Particular attention should be paid to women with a low education.

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Bender AM, Sørensen J, Diderichsen F, Brønnum-Hansen H (2020) A health inequality impact assessment from reduction in overweight and obesity. BMC Public Health 20:1823. https://doi.org/10.1186/s12889-020-09831-xCrossRefPubMedPubMedCentral

Brønnum-Hansen H (2020) Assessing the impact of risk factors on health expectancy, Chapt. 8. In: Jagger C, Crimmins EM, Saito Y, Yokota RTC, Van Oyen H, Robine JM (eds.) International Handbook of Health Expectancies. Springer, Cham

Brønnum-Hansen H, Jeune B (2015) Gender-specific modifying effect on the educational disparities in the impact of smoking on health expectancy. Eur J Public Health 25:477–481. https://doi.org/10.1093/eurpub/cku185CrossRefPubMed

Brønnum-Hansen H, Juel K (2004a) Impact of smoking on the social gradient in health expectancy in Denmark. J Epidemiol Commun Health 58:604–610. https://doi.org/10.1136/jech.2003.012955CrossRef

Brønnum-Hansen H, Juel K (2004b) Smoking expands expected lifetime with musculoskeletal disease regardless of educational level. Eur J Epidemiol 19:195–196. https://doi.org/10.1023/b:ejep.0000017829.62827.a2CrossRefPubMed

Cambois E, Brønnum-Hansen H, Hayward M, Nusselder WJ (2020) Monitoring social differentials in health expectancies, Chapt. 4. In: Jagger C, Crimmins EM, Saito Y, Yokota RTC, Van Oyen H, Robine JM (eds.) International handbook of health expectancies. Springer, Cham

Christensen AI, Lau CJ, Kristensen PL, Johnsen SB, Wingstrand A, Friis K, Davidsen M, Andreasen AH (2021) The Danish National Health Survey: study design, response rate and respondent characteristics in 2010, 2013 and 2017. Scand J Public Health. https://doi.org/10.1177/1403494820966534

Danish Health Authority (2018) The Danes’ smoking habits. Developments from 1994 to 2017 (2018) [Danskernes rygevaner. Udviklingen fra 1994 til 2017]. Copenhagen, Danish Health Authority (in Danish)

Danish Health Authority (2020a) Social inequality in health and disease (2020) [Social ulighed i sundhed og sygdom]. Danish Health Authority (in Danish), Copenhagen

Danish Health Authority (2020b) Efforts against inequality in health (2020) [Indsatser mod ulighed i sundhed]. Danish Health Authority (in Danish), Copenhagen

Diderichsen F, Andersen I, Manuel C et al (2012) Health inequality - determinants and policies. Scand J Public Health 40(Suppl 8):1–105. https://doi.org/10.1177/1403494812457734CrossRef

Diderichsen F, Hallqvist J, Whitehead M (2019) Differential vulnerability and susceptibility: how to make use of recent development in our understanding of mediation and interaction to tackle health inequalities. Int J Epidemiol 48:268–274. https://doi.org/10.1093/ije/dyy167CrossRefPubMed

Eriksen L, Davidsen M, Jensen HAR, Ryd JT, Strøbæk L, White ED, Sørensen J, Juel K (2016) Statens Institut for Folkesundhed, Syddansk Universitet for Sundhedsstyrelsen. Sygdomsbyrden i Danmark – risikofaktorer

Iversen L (2017) The fight for life. Five Danish prevention successes [Kampen for liv. Fem danske forebyggelsessucceser]. National Institute for Public Health (in Danish)

Jagger C, Van Oyen H, Robine J-M (2014) Health expectancy calculation by the Sullivan method: a practical guide. Technical report, 4th edition

Jensen VM, Rasmussen AW (2011) Danish education registers. Scand J Public Health 39:91–94. https://doi.org/10.1177/1403494810394715CrossRefPubMed

Majer IM, Nusselder WJ, Mackenbach JP, Kunst AE (2011) Life expectancy and life expectancy with disability of normal weight, overweight, and obese smokers and nonsmokers in Europe. Obesity 19:1451–1459. https://doi.org/10.1038/oby.2011.46CrossRefPubMed

Marteau TM, White M, Rutter H, Petticrew M, Mytton OT, McGowan JG, Aldridge RW (2019) Increasing healthy life expectancy equitably in England by 5 years by 2035: could it be achieved? Lancet 393:2571–2573. https://doi.org/10.1016/S0140-6736(19)31510-7CrossRefPubMed

Sullivan DF (1971) A single index of mortality and morbidity. Health Serv Ment Health Adm Health Rep 86:347–354. https://doi.org/10.2307/4594169CrossRef

Valverde JR, MackenBach J, Bopp M, Brønnum-Hansen H, Deboosere P, Kalediene R, Kovács K, Leinsalu M, Martikainen P, Regidor E, Strand BH, Nusselder W (2021) Determinants of educational inequalities in disability-free life expectancy between ages 35 and 80 in Europe. SSM – Population. Health 13:100740. https://doi.org/10.1016/j.ssmph.2021.100740CrossRef

Van Oyen H, Bogaert P, Yokota RTC, Berger N (2018) Measuring disability: a systematic review of the validity and reliability of the global activity limitations indicator (GALI). Arch Public Health 76:25. https://doi.org/10.1186/s13690-018-0270-8CrossRefPubMedPubMedCentral

Title: Social differentials in the impact of risk factor exposures on life expectancy and health expectancy
Authors: Henrik Brønnum-Hansen
Michael Davidsen
Publication date: 11-06-2022
Publisher: Springer Berlin Heidelberg
Keywords: Obesity
Obesity
Published in: Journal of Public Health / Issue 9/2023
Print ISSN: 2198-1833
Electronic ISSN: 1613-2238
DOI: https://doi.org/10.1007/s10389-022-01724-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Social differentials in the impact of risk factor exposures on life expectancy and health expectancy

Abstract

Aim

Subject and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aim

Subject and methods

Results

Conclusion

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