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Life expectancy and disease burden in the Nordic countries: results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017
Ctr Dis Burden, Bergen, Norway.;Univ Bergen, Dept Psychosocial Sci, Bergen, Norway..
Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden.;Swedish Res Council Hlth Working Life & Welf, Stockholm, Sweden..
Norwegian Inst Publ Hlth, N-5808 Bergen, Norway.;Ctr Dis Burden, Bergen, Norway.;Norwegian Qual Improvement Lab Examinat, Bergen, Norway..
Dept Hlth Promot, Bergen, Norway.;Stavanger Univ Hosp, Alcohol & Drug Res Western Norway, Stavanger, Norway..
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Number of Authors: 462019 (English)In: The Lancet Public Health, ISSN 2468-2667, Vol. 4, no 12, p. E658-E669Article in journal (Refereed) Published
Abstract [en]

Background

The Nordic countries have commonalities in gender equality, economy, welfare, and health care, but differ in culture and lifestyle, which might create country-wise health differences. This study compared life expectancy, disease burden, and risk factors in the Nordic region.

Methods

Life expectancy in years and age-standardised rates of overall, cause-specific, and risk factor-specific estimates of disability-adjusted life-years (DALYs) were analysed in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. Data were extracted for Denmark, Finland, Iceland, Norway, and Sweden (ie, the Nordic countries), and Greenland, an autonomous area of Denmark. Estimates were compared with global, high-income region, and Nordic regional estimates, including Greenland.

Findings

All Nordic countries exceeded the global life expectancy; in 2017, the highest life expectancy was in Iceland among females (85.9 years [95% uncertainty interval [UI] 85.5-86.4] vs 75.6 years [75.3-75.9] globally) and Sweden among males (80.8 years [80.2-81.4] vs 70.5 years [70.1-70.8] globally). Females (82.7 years [81.9-83.4]) and males (78.8 years [78.1-79.5]) in Denmark and males in Finland (78.6 years [77.8-79.2]) had lower life expectancy than in the other Nordic countries. The lowest life expectancy in the Nordic region was in Greenland (females 77.2 years [76.2-78.0], males 70.8 years [70.3-71.4]). Overall disease burden was lower in the Nordic countries than globally, with the lowest age-standardised DALY rates among Swedish males (18 555.7 DALYs [95% UI 15 968.6-21 426.8] per 100 000 population vs 35 834.3 DALYs [33 218.2-38 740.7] globally) and Icelandic females (16 074.1 DALYs [13 216.4-19 240.8] vs 29 934.6 DALYs [26 981.9-33 211.2] globally). Greenland had substantially higher DALY rates (26 666.6 DALYs [23 478.4-30 218.8] among females, 33 101.3 DALYs [30 182.3-36 218.6] among males) than the Nordic countries. Country variation was primarily due to differences in causes that largely contributed to DALYs through mortality, such as ischaemic heart disease. These causes dominated male disease burden, whereas non-fatal causes such as low back pain were important for female disease burden. Smoking and metabolic risk factors were high-ranking risk factors across all countries. DALYs attributable to alcohol use and smoking were particularly high among the Danes, as was alcohol use among Finnish males.

Interpretation

Risk factor differences might drive differences in life expectancy and disease burden that merit attention also in high-income settings such as the Nordic countries. Special attention should be given to the high disease burden in Greenland.

Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 4, no 12, p. E658-E669
National Category
Clinical Medicine
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-31508DOI: 10.1016/S2468-2667(19)30224-5ISI: 000500947300014PubMedID: 31759894OAI: oai:DiVA.org:du-31508DiVA, id: diva2:1382053
Available from: 2020-01-01 Created: 2020-01-01 Last updated: 2020-01-01Bibliographically approved

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