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The potential for reducing differences in life expectancy between educational groups in five European countries: the effects of obesity, physical inactivity and smoking
  1. Netta E Mäki1,
  2. Pekka T Martikainen1,
  3. Terje Eikemo2,3,
  4. Gwenn Menvielle4,5,
  5. Olle Lundberg6,7,
  6. Olof Östergren6,
  7. Johan P Mackenbach2,
  8. the EURO-GBD-SE consortium members
  1. 1Department of Social Research, University of Helsinki, Finland
  2. 2Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
  3. 3Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
  4. 4Department of Social Epidemiology, INSERM, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
  5. 5Department of Social Epidemiology, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
  6. 6CHESS, Centre for Health Equity Studies, Sweden
  7. 7Department of Health Sciences, Mid Sweden University, Sweden
  1. Correspondence to Dr Netta E Mäki, Department of Social Research, Faculty of Social Sciences, P.O.Box 59, University of Helsinki, Helsinki, FIN-00014, Finland; netta.maki{at}


Introduction 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.

  • Inequalities
  • Health Behaviour
  • Public Health

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