Abstract
Background: Smoking, physical inactivity and obesity are modifiable risk factors for morbidity and mortality. The aim of this study was to examine the extent to which the co-occurrence of these behaviour-related risk factors predict healthy life expectancy and chronic disease-free life expectancy in four European cohort studies. Methods: Data were drawn from repeated waves of four cohort studies in England, Finland, France and Sweden. Smoking status, physical inactivity and obesity (body mass index ≥30 kg/m2) were examined separately and in combination. Health expectancy was estimated by using two health indicators: suboptimal self-rated health and having a chronic disease (cardiovascular disease, cancer, respiratory disease and diabetes). Multistate life table models were used to estimate sex-specific healthy life expectancy and chronic disease-free life expectancy from ages 50 to 75 years. Results: Compared with men and women with at least two behaviour-related risk factors, those with no behaviour-related risk factors could expect to live on average8 years longer in good health and 6 years longer free of chronic diseases between ages 50 and 75. Having any single risk factor was also associated with reduction in healthy years. No consistent differences between cohorts were observed. Conclusions: Data from four European countries show that persons with individual and co-occurring behaviour-related risk factors have shorter healthy life expectancy and shorter chronic disease-free life expectancy. Population level reductions in smoking, physical inactivity and obesity could increase life-years lived in good health.
Highlights
The world’s population is ageing at a rapid pace
Prevalence of suboptimal self-rated health varied across cohorts and ranged among men from 19% (GAZEL) to 37% (FPS); among women this prevalence varied between 21% (SLOSH) and 34% (FPS)
At the first observation point, about half of the English Longitudinal Study of Ageing (ELSA), Finnish Public Sector study (FPS) and GAZEL participants and 60% of Swedish Longitudinal Occupational Survey of Health (SLOSH) participants were free of all three behaviourrelated risk factors
Summary
The world’s population is ageing at a rapid pace. Rising life expectancy (LE) represents one of the major human success stories,[1] but not all the increased years of life are being spent in optimal health. A study based on data from 11 European countries estimated that 60% of deaths from all causes could be attributed to behaviour-related risk factors.[5] the importance of health behaviours for the prevention of chronic diseases, such as type 2 diabetes, coronary heart disease and cancer, is widely acknowledged. Physical inactivity and obesity are among the top 10 behaviour-related risk factors for burden of diseases in developed countries,[6] and they have been shown to be associated with shorter health expectancy and LE.7––9. The aim of this study was to examine the extent to which the cooccurrence of these behaviour-related risk factors predict healthy life expectancy and chronic disease-free life expectancy in four European cohort studies. Results: Compared with men and women with at least two behaviour-related risk factors, those with no behaviour-related risk factors could expect to live on average[8] years longer in good health and 6 years longer free of chronic diseases between ages 50 and 75
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