The contribution of specific diseases to educational disparities in disability-free life expectancy.
OBJECTIVE
We examined the contribution that specific diseases, as causes of both death and disability, make to educational disparities in disability-free life expectancy (DFLE).


METHODS
We used disability data from the Belgian Health Interview Survey (1997) and mortality data from the National Mortality Follow-Up Study (1991-1996) to assess education-related disparities in DFLE and to partition these differences into additive contributions of specific diseases.


RESULTS
The DFLE advantage of higher-educated compared with lower-educated persons was 8.0 years for men and 5.9 years for women. Arthritis (men, 1.3 years; women, 2.2 years), back complaints (men, 2.1 years), heart disease/stroke (men, 1.5 years; women, 1.6 years), asthma/chronic obstructive pulmonary disease (COPD) (men, 1.2 years; women, 1.5 years), and "other diseases" (men, 2.4 years) contributed the most to this difference.


CONCLUSIONS
Disabling diseases, such as arthritis, back complaints, and asthma/COPD, contribute substantially to differences in DFLE by education. Public health policy aiming to reduce existing disparities in the DFLE and to improve population health should not only focus on fatal diseases but also on these nonfatal diseases.
Nusselder
Wilma J
WJ
Department of Public Health, Erasmus MC, Rotterdam, The Netherlands. w.nusselder@erasmusmc.nl
Looman
Caspar W N
CW
Mackenbach
Johan P
JP
Huisman
Martijn
M
van Oyen
Herman
H
Deboosere
Patrick
P
Gadeyne
Sylvie
S
Kunst
Anton E
AE
D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000191:economics* / Q000401:mortality*; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D004522:Educational Status; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged