Determinants of inequalities in life expectancy: an international comparative study of eight risk factors

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Determinants of inequalities in life expectancy : an international comparative study of eight risk factors. / Mackenbach, Johan P; Valverde, José Rubio; Bopp, Matthias; Brønnum-Hansen, Henrik; Deboosere, Patrick; Kalediene, Ramune; Kovács, Katalin; Leinsalu, Mall; Martikainen, Pekka; Menvielle, Gwenn; Regidor, Enrique; Nusselder, Wilma J.

I: The Lancet Public Health, Bind 4, Nr. 10, 10.2019, s. e529-e537.

Publikation: Bidrag til tidsskriftTidsskriftartikelfagfællebedømt

Harvard

Mackenbach, JP, Valverde, JR, Bopp, M, Brønnum-Hansen, H, Deboosere, P, Kalediene, R, Kovács, K, Leinsalu, M, Martikainen, P, Menvielle, G, Regidor, E & Nusselder, WJ 2019, 'Determinants of inequalities in life expectancy: an international comparative study of eight risk factors', The Lancet Public Health, bind 4, nr. 10, s. e529-e537. https://doi.org/10.1016/S2468-2667(19)30147-1

APA

Mackenbach, J. P., Valverde, J. R., Bopp, M., Brønnum-Hansen, H., Deboosere, P., Kalediene, R., Kovács, K., Leinsalu, M., Martikainen, P., Menvielle, G., Regidor, E., & Nusselder, W. J. (2019). Determinants of inequalities in life expectancy: an international comparative study of eight risk factors. The Lancet Public Health, 4(10), e529-e537. https://doi.org/10.1016/S2468-2667(19)30147-1

Vancouver

Mackenbach JP, Valverde JR, Bopp M, Brønnum-Hansen H, Deboosere P, Kalediene R o.a. Determinants of inequalities in life expectancy: an international comparative study of eight risk factors. The Lancet Public Health. 2019 okt.;4(10):e529-e537. https://doi.org/10.1016/S2468-2667(19)30147-1

Author

Mackenbach, Johan P ; Valverde, José Rubio ; Bopp, Matthias ; Brønnum-Hansen, Henrik ; Deboosere, Patrick ; Kalediene, Ramune ; Kovács, Katalin ; Leinsalu, Mall ; Martikainen, Pekka ; Menvielle, Gwenn ; Regidor, Enrique ; Nusselder, Wilma J. / Determinants of inequalities in life expectancy : an international comparative study of eight risk factors. I: The Lancet Public Health. 2019 ; Bind 4, Nr. 10. s. e529-e537.

Bibtex

@article{cdeef80c13954116b86ff20a5250206c,
title = "Determinants of inequalities in life expectancy: an international comparative study of eight risk factors",
abstract = "BACKGROUND: Socioeconomic inequalities in longevity have been found in all European countries. We aimed to assess which determinants make the largest contribution to these inequalities.METHODS: We did an international comparative study of inequalities in risk factors for shorter life expectancy in Europe. We collected register-based mortality data and survey-based risk factor data from 15 European countries. We calculated partial life expectancies between the ages of 35 years and 80 years by education and gender and determined the effect on mortality of changing the prevalence of eight risk factors-father with a manual occupation, low income, few social contacts, smoking, high alcohol consumption, high bodyweight, low physical exercise, and low fruit and vegetable consumption-among people with a low level of education to that among people with a high level of education (upward levelling scenario), using population attributable fractions.FINDINGS: In all countries, a substantial gap existed in partial life expectancy between people with low and high levels of education, of 2·3-8·2 years among men and 0·6-4·5 years among women. The risk factors contributing most to the gap in life expectancy were smoking (19·8% among men and 18·9% among women), low income (9·7% and 13·4%), and high bodyweight (7·7% and 11·7%), but large differences existed between countries in the contribution of risk factors. Sensitivity analyses using the prevalence of risk factors in the most favourable country (best practice scenario) showed that the potential for reducing the gap might be considerably smaller. The results were also sensitive to varying assumptions about the mortality risks associated with each risk factor.INTERPRETATION: Smoking, low income, and high bodyweight are quantitatively important entry points for policies to reduce educational inequalities in life expectancy in most European countries, but priorities differ between countries. A substantial reduction of inequalities in life expectancy requires policy actions on a broad range of health determinants.FUNDING: European Commission and Network for Studies on Pensions, Aging, and Retirement.",
author = "Mackenbach, {Johan P} and Valverde, {Jos{\'e} Rubio} and Matthias Bopp and Henrik Br{\o}nnum-Hansen and Patrick Deboosere and Ramune Kalediene and Katalin Kov{\'a}cs and Mall Leinsalu and Pekka Martikainen and Gwenn Menvielle and Enrique Regidor and Nusselder, {Wilma J}",
note = "Copyright {\textcopyright} 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.",
year = "2019",
month = oct,
doi = "10.1016/S2468-2667(19)30147-1",
language = "English",
volume = "4",
pages = "e529--e537",
journal = "The Lancet Public Health",
issn = "2468-2667",
publisher = "Elsevier",
number = "10",

}

RIS

TY - JOUR

T1 - Determinants of inequalities in life expectancy

T2 - an international comparative study of eight risk factors

AU - Mackenbach, Johan P

AU - Valverde, José Rubio

AU - Bopp, Matthias

AU - Brønnum-Hansen, Henrik

AU - Deboosere, Patrick

AU - Kalediene, Ramune

AU - Kovács, Katalin

AU - Leinsalu, Mall

AU - Martikainen, Pekka

AU - Menvielle, Gwenn

AU - Regidor, Enrique

AU - Nusselder, Wilma J

N1 - Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

PY - 2019/10

Y1 - 2019/10

N2 - BACKGROUND: Socioeconomic inequalities in longevity have been found in all European countries. We aimed to assess which determinants make the largest contribution to these inequalities.METHODS: We did an international comparative study of inequalities in risk factors for shorter life expectancy in Europe. We collected register-based mortality data and survey-based risk factor data from 15 European countries. We calculated partial life expectancies between the ages of 35 years and 80 years by education and gender and determined the effect on mortality of changing the prevalence of eight risk factors-father with a manual occupation, low income, few social contacts, smoking, high alcohol consumption, high bodyweight, low physical exercise, and low fruit and vegetable consumption-among people with a low level of education to that among people with a high level of education (upward levelling scenario), using population attributable fractions.FINDINGS: In all countries, a substantial gap existed in partial life expectancy between people with low and high levels of education, of 2·3-8·2 years among men and 0·6-4·5 years among women. The risk factors contributing most to the gap in life expectancy were smoking (19·8% among men and 18·9% among women), low income (9·7% and 13·4%), and high bodyweight (7·7% and 11·7%), but large differences existed between countries in the contribution of risk factors. Sensitivity analyses using the prevalence of risk factors in the most favourable country (best practice scenario) showed that the potential for reducing the gap might be considerably smaller. The results were also sensitive to varying assumptions about the mortality risks associated with each risk factor.INTERPRETATION: Smoking, low income, and high bodyweight are quantitatively important entry points for policies to reduce educational inequalities in life expectancy in most European countries, but priorities differ between countries. A substantial reduction of inequalities in life expectancy requires policy actions on a broad range of health determinants.FUNDING: European Commission and Network for Studies on Pensions, Aging, and Retirement.

AB - BACKGROUND: Socioeconomic inequalities in longevity have been found in all European countries. We aimed to assess which determinants make the largest contribution to these inequalities.METHODS: We did an international comparative study of inequalities in risk factors for shorter life expectancy in Europe. We collected register-based mortality data and survey-based risk factor data from 15 European countries. We calculated partial life expectancies between the ages of 35 years and 80 years by education and gender and determined the effect on mortality of changing the prevalence of eight risk factors-father with a manual occupation, low income, few social contacts, smoking, high alcohol consumption, high bodyweight, low physical exercise, and low fruit and vegetable consumption-among people with a low level of education to that among people with a high level of education (upward levelling scenario), using population attributable fractions.FINDINGS: In all countries, a substantial gap existed in partial life expectancy between people with low and high levels of education, of 2·3-8·2 years among men and 0·6-4·5 years among women. The risk factors contributing most to the gap in life expectancy were smoking (19·8% among men and 18·9% among women), low income (9·7% and 13·4%), and high bodyweight (7·7% and 11·7%), but large differences existed between countries in the contribution of risk factors. Sensitivity analyses using the prevalence of risk factors in the most favourable country (best practice scenario) showed that the potential for reducing the gap might be considerably smaller. The results were also sensitive to varying assumptions about the mortality risks associated with each risk factor.INTERPRETATION: Smoking, low income, and high bodyweight are quantitatively important entry points for policies to reduce educational inequalities in life expectancy in most European countries, but priorities differ between countries. A substantial reduction of inequalities in life expectancy requires policy actions on a broad range of health determinants.FUNDING: European Commission and Network for Studies on Pensions, Aging, and Retirement.

U2 - 10.1016/S2468-2667(19)30147-1

DO - 10.1016/S2468-2667(19)30147-1

M3 - Journal article

C2 - 31578987

VL - 4

SP - e529-e537

JO - The Lancet Public Health

JF - The Lancet Public Health

SN - 2468-2667

IS - 10

ER -

ID: 228365509