The potential for reducing differences in life expectancy between educational groups in five European countries: the effects of obesity, physical inactivity and smoking.
BACKGROUND
This study assesses the effects of obesity, physical inactivity and smoking on life expectancy (LE) differences between educational groups in five European countries in the early 2000s.


METHODS
We estimate the contribution of risk factors on LE differences between educational groups using the observed risk factor distributions and under a hypothetically more optimal risk factor distribution. Data on risk factor prevalence were obtained from the Survey of Health, Ageing and Retirement in Europe study, and data on mortality from census-linked data sets for the age between 50 and 79 according to sex and education.


RESULTS
Substantial differences in LE of up to 2.8 years emerged between men with a low and a high level of education in Denmark, Austria and France, and smaller differences among men in Italy and Spain. The educational differences in LE were not as large among women. The largest potential for reducing educational differences was in Denmark (25% among men and 41% among women) and Italy (14% among men).


CONCLUSIONS
The magnitude of the effect of unhealthy behaviours on educational differences in LE varied between countries. LE among those with a low or medium level of education could increase in some European countries if the behavioural risk factor distributions were similar to those observed among the highly educated.
Department of Social Research, University of Helsinki, Finland.
Netta E
NE
Mäki
Department of Social Research, University of Helsinki, Finland.
Pekka T
PT
Martikainen
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Terje
T
Eikemo
Department of Social Epidemiology, INSERM, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France Department of Social Epidemiology, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France.
Gwenn
G
Menvielle
CHESS, Centre for Health Equity Studies, Sweden Department of Health Sciences, Mid Sweden University, Sweden.
Olle
O
Lundberg
CHESS, Centre for Health Equity Studies, Sweden.
Olof
O
Ostergren
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.
Johan P
JP
Mackenbach
D000368:Aged; D019352:Censuses; D004522:Educational Status; D005060:Europe / Q000453:epidemiology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009765:Obesity; D057185:Sedentary Behavior; D012907:Smoking / Q000009:adverse effects*
Health Behaviour; Inequalities; Public Health