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Contribution of smoking and alcohol consumption to income differences in life expectancy: evidence using Danish, Finnish, Norwegian and Swedish register data
Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).ORCID iD: 0000-0002-7156-3260
Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS). University of Helsinki, Finland; The Max Planck Institute for Demographic Research, Germany.ORCID iD: 0000-0001-9374-1438
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2019 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 73, no 4, p. 334-339Article in journal (Refereed) Published
Abstract [en]

Background Despite being comparatively egalitarian welfare states, the Nordic countries have not been successful in reducing health inequalities. Previous studies have suggested that smoking and alcohol contribute to this pattern. Few studies have focused on variations in alcohol-related and smoking-related mortality within the Nordic countries. We assess the contribution of smoking and alcohol to differences in life expectancy between countries and between income quintiles within countries.

Methods We collected data from registers in Denmark, Finland, Norway and Sweden comprising men and women aged 25–79 years during 1995–2007. Estimations of alcohol-related mortality were based on underlying and contributory causes of death on individual death certificates, and smoking-related mortality was based on an indirect method that used lung cancer mortality as an indicator for the population-level impact of smoking on mortality.

Results About 40%–70% of the between-country differences in life expectancy in the Nordic countries can be attributed to smoking and alcohol. Alcohol-related and smoking-related mortality also made substantial contributions to income differences in life expectancy within countries. The magnitude of the contributions were about 30% in Norway, Sweden and among Finnish women to around 50% among Finnish men and in Denmark.

Conclusions Smoking and alcohol consumption make substantial contributions to both between-country differences in mortality among the Nordic countries and within-country differences in mortality by income. The size of these contributions vary by country and sex.

Place, publisher, year, edition, pages
2019. Vol. 73, no 4, p. 334-339
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Sciences
Identifiers
URN: urn:nbn:se:su:diva-165332DOI: 10.1136/jech-2018-211640ISI: 000471848000008OAI: oai:DiVA.org:su-165332DiVA, id: diva2:1282308
Projects
C-LifeTITA
Funder
NordForsk, 75970Academy of Finland, 293103EU, Horizon 2020, 667661Available from: 2019-01-24 Created: 2019-01-24 Last updated: 2019-12-03Bibliographically approved

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Östergren, OlofMartikainen, Pekka
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