dc.contributor.author | Gutacker, Nils | |
dc.contributor.author | Kinge, Jonas Minet | |
dc.contributor.author | Olsen, Jan Abel | |
dc.date.accessioned | 2023-05-19T08:25:24Z | |
dc.date.available | 2023-05-19T08:25:24Z | |
dc.date.issued | 2023-05-03 | |
dc.description.abstract | Background Health inequalities are often assessed in terms of life expectancy or health-related quality of life
(HRQoL). Few studies combine both aspects into quality-adjusted life expectancy (QALE) to derive comprehensive
estimates of lifetime health inequality. Furthermore, little is known about the sensitivity of estimated inequalities in
QALE to diferent sources of HRQoL information. This study assesses inequalities in QALE by educational attainment in
Norway using two diferent measures of HRQoL.<p>
<p>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.
<p>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.
<p>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. | en_US |
dc.identifier.citation | Gutacker, Kinge, Olsen. Inequality in quality-adjusted life expectancy by educational attainment in Norway: an observational study. BMC Public Health. 2023:1-9 | en_US |
dc.identifier.cristinID | FRIDAID 2147752 | |
dc.identifier.doi | 10.1186/s12889-023-15663-2 | |
dc.identifier.issn | 1471-2458 | |
dc.identifier.uri | https://hdl.handle.net/10037/29239 | |
dc.language.iso | eng | en_US |
dc.publisher | BMC | en_US |
dc.relation.journal | BMC Public Health | |
dc.rights.accessRights | openAccess | en_US |
dc.rights.holder | Copyright 2023 The Author(s) | en_US |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0 | en_US |
dc.rights | Attribution 4.0 International (CC BY 4.0) | en_US |
dc.title | Inequality in quality-adjusted life expectancy by educational attainment in Norway: an observational study | en_US |
dc.type.version | publishedVersion | en_US |
dc.type | Journal article | en_US |
dc.type | Tidsskriftartikkel | en_US |
dc.type | Peer reviewed | en_US |