[Social inequality in the burden of disease].
BACKGROUND
Social inequality in health status is apparent in different life expectancy as well as expected lifetime with illness. The purpose of the study was to estimate the difference in expected lifetime with cancer, cardiovascular diseases and diseases of the musculoskeletal system between Danes with high and low educational levels.


METHODS
The study was based on data from the Danish Health Interview Survey in 2000 and registered data on education and mortality in the period 1995-1999. Expected lifetime with and without long-standing, limiting illness based on observed data was compared with expected lifetime with and without long-standing, limiting illness after elimination of specific diseases and causes of death. The expected lifetime for persons with high and low educational levels between the age of 30 and 75 with and without illness was compared.


RESULTS
Cancer contributes by 0.3 years to the difference in partial life expectancy (age 30-75) between persons with high and low educational levels. Cardiovascular diseases cause men with low educational levels a loss of 0.6 life years and women 0.4 life years compared to men and women with high educational levels. Because of co-morbidity elimination of cancer would increase social inequality in expected lifetime with illness. The same was seen for women if cardiovascular diseases were eliminated. If diseases of the musculoskeletal system were eliminated, the difference in expected lifetime without long-standing, limiting illness from age 30 to 75 between persons with high and low educational levels would be reduced by 1.2 years.


CONCLUSIONS
Social inequality in life expectancy would be reduced by the elimination of cancer and cardiovascular diseases. Socially disadvantaged suffer from the largest burden of disease.
Brønnum-Hansen
Henrik
H
Statens Institut for Folkesundhed, København K. hbh@niph.dk
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality / Q000523:psychology; D002423:Cause of Death; D017281:Cost of Illness; D003718:Denmark / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000401:mortality / Q000523:psychology; D009369:Neoplasms / Q000401:mortality / Q000523:psychology; D012959:Socioeconomic Factors