Inequality in quality-adjusted life expectancy by educational attainment in Norway: an observational study
Permanent lenke
https://hdl.handle.net/10037/29239Dato
2023-05-03Type
Journal articleTidsskriftartikkel
Peer reviewed
Sammendrag
Methods We combine full population life tables from Statistics Norway with survey data from the Tromsø study, a representative sample of the Norwegian population aged ≥40. HRQoL is measured using the EQ-5D-5L and EQ-VAS instruments. Life expectancy and QALE at 40 years of age are calculated using the Sullivan-Chiang method and are stratifed by educational attainment. Inequality is measured as the absolute and relative gap between individuals with lowest (i.e. primary school) and highest (university degree 4+years) educational attainment.
Results People with the highest educational attainment can expect to live longer lives (men: +17.9% (95%CI: 16.4 to 19.5%), women: +13.0% (95%CI: 10.6 to 15.5%)) and have higher QALE (men: +22.4% (95%CI: 20.4 to 24.4%), women: +18.3% (95%CI: 15.2 to 21.6%); measured using EQ-5D-5L) than individuals with primary school education. Relative inequality is larger when HRQoL is measured using EQ-VAS.
Conclusion Health inequalities by educational attainment become wider when measured in QALE rather than LE, and the degree of this widening is larger when measuring HRQoL by EQ-VAS than by EQ-5D-5L. We fnd a sizable educational gradient in lifetime health in Norway, one of the most developed and egalitarian societies in the world. Our estimates provide a benchmark against which other countries can be compared.