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

Autor: José Rubio Valverde, Gwenn Menvielle, Pekka Martikainen, Johan P. Mackenbach, Katalin Kovács, Henrik Brønnum-Hansen, Ramune Kalediene, Mall Leinsalu, Wilma J. Nusselder, Matthias Bopp, Enrique Regidor, Patrick Deboosere
Přispěvatelé: Gestionnaire, Hal Sorbonne Université, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Universität Zürich [Zürich] = University of Zurich (UZH), IT University of Copenhagen (ITU), Vrije Universiteit Brussel (VUB), Lithuanian University of Health Sciences [Kaunas, Lithuania], Hungarian Demographic Research Institute [Budapest, Hungary], Stockholm Centre for Health and Social Change [Stockholm, Sweden], Södertörn University College, Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), CIBER de Epidemiología y Salud Pública (CIBERESP), University of Zurich, Mackenbach, Johan P, Brussels Interdisciplinary Research centre on Migration and Minorities, Vriendenkring VUB, Sociology, Interface Demography, IT University of Copenhagen, University of Helsinki, Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Helsinki Inequality Initiative (INEQ), Population Research Unit (PRU), Center for Population, Health and Society, Public Health
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Health Behavior
01 natural sciences
0302 clinical medicine
Risk Factors
Medicine
SOCIOECONOMIC-STATUS
030212 general & internal medicine
media_common
Aged
80 and over
education.field_of_study
lcsh:Public aspects of medicine
Smoking
1. No poverty
Longevity
Public Health
Global Health
Social Medicine and Epidemiology
Middle Aged
3142 Public health care science
environmental and occupational health
3. Good health
Europe
614.2 [udc]
8. Economic growth
Female
HEALTH
Adult
Inequality
Alcohol Drinking
media_common.quotation_subject
Population
610 Medicine & health
03 medical and health sciences
Life Expectancy
SDG 3 - Good Health and Well-being
MILLION MEN
Humans
Social determinants of health
0101 mathematics
Risk factor
Life expectancy
Health Status
Health services accessibility
Socioeconomic factors
education
Socioeconomic status
EDUCATIONAL INEQUALITIES
Exercise
Aged
Consumption (economics)
business.industry
MORTALITY
010102 general mathematics
Body Weight
Public Health
Environmental and Occupational Health
lcsh:RA1-1270
CONSUMPTION
Health Status Disparities
10060 Epidemiology
Biostatistics and Prevention Institute (EBPI)
2739 Public Health
Environmental and Occupational Health
Diet
SOCIAL DETERMINANTS
Folkhälsovetenskap
global hälsa
socialmedicin och epidemiologi
2014 SPECIAL MODULE
Socioeconomic Factors
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
business
EUROPEAN COUNTRIES
Demography
Zdroj: Lancet Public Health
Lancet Public Health, Elsevier, 2019, 4 (10), pp.e529-e537. ⟨10.1016/S2468-2667(19)30147-1⟩
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, vol. 4, no. 10, pp. e529-e537 . https://doi.org/10.1016/S2468-2667(19)30147-1
LANCET PUBLIC HEALTH, 4(10), E529-E537. Elsevier Ltd.
The Lancet Public Health, Vol 4, Iss 10, Pp e529-e537 (2019)
The Lancet Public Health, Oxon : Elsevier Ltd., 2019, vol. 4, no. 10, p. 529-537
ISSN: 2468-2667
DOI: 10.1016/S2468-2667(19)30147-1⟩
Popis: 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.
Databáze: OpenAIRE
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