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AJPH First Look, published online ahead of print Sep 29, 2005
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American Journal of Public Health, 10.2105/AJPH.2004.054700

Research and Practice

The Contribution of Specific Diseases to Educational Disparities in Disability-Free Life Expectancy

Wilma J. Nusselder 1*, Caspar W.N. Looman 1, Johan P. Mackenbach 1, Martijn Huisman 1, Herman van Oyen 2, Patrick Deboosere 3, Sylvie Gadeyne 3, Anton E. Kunst 1

1 Erasmus MC Rotterdam, the Netherlands
2 Scienfic Institute for Public Health, University Brussels, Belgium
3 Interface Demography, Centrum voor Sociologie, VUB Brussel, Belgium

* To whom correspondence should be addressed. E-mail: w.nusselder{at}erasmusmc.nl.


  Abstract

Objectives: We examined the contribution of specific diseases as causes of both death and disability to educational differences in disability-free life expectancy (DFLE). Methods: Disability data from the Belgium Health Interview Survey (1997) and mortality data from the National mortality follow-up study (1991-1996) were used to assess educational differences in DFLE, and to partition these differences into additive contributions of specific diseases. Results: DFLE advantage of higher educated as compared to lower educated persons was 8.0 (men) and 5.9 (women) years. Arthritis (men: 1.3, women 2.2 years), back complaints (men: 2.1 years), heart disease/stroke (men: 1.5, women: 1.6 years), asthma/COPD (men: 1.2 women 1.5 years) and 'other diseases' (men: 2.4 years) contributed most to this difference. Conclusions: Disabling diseases, such as arthritis, back complaints and asthma/COPD contribute largely to educational differences in DFLE. Public health policy aiming to reduce existing disparities in the DFLE and to improve population health should not only focus on fatal diseases, but on these non-fatal diseases as well.

Key Words: Disability, Socioeconomic Factors, Mortality, Surveys




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