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Background: Several studies have revealed widening of inequalities in life expectancy, but little is known about the recent changes in health expectancy nationally and between socioeconomic groups. This study examines dynamics of national and education-specific life expectancy and health expectancies at age 50 years in Denmark from 2004/2007 to 2015. Methods: Nationwide register data on education and mortality were linked and combined with Danish health data from the Survey of Health, Ageing and Retirement in Europe and changes in life expectancy and three health expectancy indicators were estimated by Sullivan's method. Results: From 2004 to 2015, national life expectancy at age 50 years increased by 2.4 years for men and 2.1 years for women. Simultaneously, after an initial rapid improvement from 2004 to 2007, the pace of progress in health expectancy decreased. From 2007 to 2015, the difference in life expectancy at age 50 years between men with long and short education increased from 4.3 to 5.0 years. For women, the corresponding increase in the life expectancy gap was less pronounced from 3.5 to 3.8 years. The educational gap in lifetime without long-term illness decreased from 4.6 years to 3.1 years for men and from 6.1 years to 4.6 years for women. On the contrary, the educational gap increased for lifetime without activity limitations and in self-rated good health. Conclusions: Previously observed improvements in health expectancy in Denmark slowed down despite continuing progress in life expectancy. This worrying change coincides with persistent educational inequalities in life expectancy and health expectancy and is a challenge to a sustainable social and health development in the future. [ABSTRACT FROM AUTHOR]

Background: The pension age in Denmark is adjusted in line with projected increasing life expectancy without taking health differentials between occupational groups into account. The purpose was to study occupational disparities in partial life expectancy and health expectancy between the ages of 50 and 75. Methods : Register data on occupation and mortality were combined with data from the Danish part of Survey of Health, Ageing and Retirement in Europe in 2010–2014 (N =3179). Expected lifetime without and with activity limitations and without and with long-term illness was estimated by Sullivan's method and comparisons made between four occupational groups. Results : We found clear differences between occupational groups. Expected lifetime without activity limitations between the ages of 50 and 75 was about 4.5 years longer for men and women in high skilled white-collar occupations than for men and women in low skilled blue-collar occupations. Men in high skilled blue-collar and low skilled white-collar occupations could expect 2.3 and 3.8 years shorter lifetimes without activity limitations, respectively, than men in high skilled white-collar occupations. For women in low skilled white-collar occupations, lifetime without activity limitations was 2.6 years shorter than for women in high skilled white-collar occupations. Due to few observations, no results were obtained for women in the high skilled blue-collar group. The social gradient was also significant when health was measured by years without long-term illness. Conclusions : The results support implementation of a flexible pension scheme to take into account the health differentials between occupational groups. [ABSTRACT FROM AUTHOR]

Aims: The state old-age pension in Denmark increases to keep pace with the projected increase in average life expectancy (LE) without any regard to the social gap in LE and expected lifetime in good health. The purpose of this study was to compare changes in LE and disability-free life expectancy (DFLE) between groups of Danes with high, medium and low levels of education. Methods: Nationwide register data on education and mortality were combined with data from the Surveys of Health, Ageing and Retirement in Europe (SHARE) surveys in 2006–2007, 2010–2011 and 2013–2014 and the DFLE by educational level was estimated by Sullivan’s method for each of these three time points. Results: Between 2006–2007 and 2013–2014, LE among 65-year-old men and women with a low educational level increased by 1.3 and 1.0 years, respectively, and by 1.4 and 1.3 years for highly educated men and women. The gap in LE between people with high and low levels of education remained more than 2 years. In 2006–2007, 65-year-old men with a high level of education could expect 3.2 more years without disability than men of the same age with a low level of education. In 2013–2014, the difference was 2.9 years. For women, the results were 3.7 and 3.4 years, respectively. Conclusions: With the persistent social inequality in LE of more than 2 years and the continuous gap between high and low educational groups in DFLE of about 3 years, a differential pension age is recommended. [ABSTRACT FROM AUTHOR]

Aims: Tobacco smoking is among the leading risk factors for chronic disease and early death in developed countries, including Denmark, where smoking causes 14% of the disease burden. In Denmark, many public health interventions, including smoking prevention, are undertaken by the municipalities, but models to estimate potential health effects of local interventions are lacking. The aim of the current study was to model the effects of decreased smoking prevalence in Copenhagen, Denmark. Methods: The DYNAMO-HIA model was applied to the population of Copenhagen, by using health survey data and data from Danish population registers. We modelled the effects of four intervention scenarios aimed at different target groups, compared to a reference scenario. The potential effects of each scenario were modelled until 2040. Results: A combined scenario affecting both initiation rates among youth, and cessation and re-initiation rates among adults, which reduced the smoking prevalence to 4% by 2025, would have large beneficial effects on incidence and prevalence of smoking-related diseases and mortality. Health benefits could also be obtained through interventions targeting only cessation or re-initiation rates, whereas an intervention targeting only initiation among youth had marginal effects on morbidity and mortality within the modelled time frame. Conclusions: By modifying the DYNAMO-HIA model, we were able to estimate the potential health effects of four interventions to reduce smoking prevalence in the population of Copenhagen. The effect of the interventions on future public health depended on population subgroup(s) targeted, duration of implementation and intervention reach. [ABSTRACT FROM PUBLISHER]

Aims: The construct quality-adjusted life years (QALYs) combines mortality and overall health status and can be used to quantify the impact of risk factors on population health. The purpose of the study was to estimate the impact of tobacco smoking, high alcohol consumption, physical inactivity, and overweight on QALYs. Methods: Life tables for each level of exposure to the risk factor were constructed mainly on the basis of the Danish National Cohort Study. QALYs were estimated for exposed and unexposed by Sullivan's method, by combining life tables, EQ-5D self-classified health status from the Danish Health Survey 2000, and Danish EQ-5D values. Results: The quality-adjusted life expectancy of 25-year-olds was 10-11 QALYs shorter for heavy smokers than for those who never smoke. The difference in life expectancy was 9-10 years. Men and women with high alcohol consumption could expect to lose about 5 and 3 QALYs, respectively. Sedentary persons could expect to have about 7 fewer QALYs than physically active persons. Obesity shortened QALYs by almost 3 for men and 6 for women. Conclusions: Smoking, high alcohol consumption, physical inactivity, and obesity strongly reduce life expectancy and health-related quality of life. These results could be used by health policy-makers to evaluate the potential gains in public health due to interventions against these risk factors, when the prevalence of exposure to the risk factor is available. [ABSTRACT FROM AUTHOR]

Background: Priority setting in public health policy must be based on information on the effectiveness of alternative preventive and therapeutic interventions. The purpose of this study is to predict the effect on mortality from ischaemic heart disease (IHD) in Denmark of reduced exposure to the risk factors hypertension, hypercholesterolaemia, cigarette smoking, and physical inactivity. Methods: The simulation model, "Prevent", was used. The input data for the model were population size, death rates, prevalence of cardiovascular risk factors, and relative risks. Scenarios of the impact of reduced exposure to risk factors on mortality from IHD were studied, including the health benefits of successful implementation of some of the targets in the Danish Government programme for public health and health promotion, 1999-2008. Results: The greatest reduction in mortality from IHD would be achieved by interventions against cigarette smoking. If the proportion of cigarette smokers could be reduced by one-third within 10 years, the number of deaths due to IHD among people under 65 would be 10% lower for men and 15% lower for women. If the proportion of heavy smokers or the proportion of people with hypertension were reduced by 25%, the rate of mortality from IHD would be 5% lower for men and 6-7% lower for women. Reducing the number of cases of severe hypercholesterolaemia by 25% would lower the IHD mortality rate before age 65 by 3% for men and 6% for women after 15 years, similar to the effect of easy exercise for at least 4 hours a week among physically inactive people. [ABSTRACT FROM AUTHOR]

Background: Mortality and disease patterns in Greenland have greatly changed since the 1950s. Infectious diseases have decreased markedly; chronic diseases, suicides and violent deaths have increased. Methods: Life tables for the period 1991-95 were used and health status was derived from the 1993/94 Greenland Health Interview Survey. Health expectancy for the Inuit population of Greenland was calculated by an index suggested by Sullivan. Results: Greenland Inuit women live longer than men, but the expected lifetime in self-rated good health was shorter for women than for men. Chronic disease rates are high in Greenland, and consequently many healthy life years are lost, especially because of musculoskeletal diseases. Health expectancy decreases with age, but for this Inuit population the proportion of healthy life years increases after the age of 60, especially among men. Conclusion: The many healthy life years lost in Greenland according to self-rated poor health and chronic diseases should be a cause for concern in public health planning in Greenland. Special attention should also be paid to future investigations of regional patterns of health in Greenland, since there is great population heterogeneity according to geography and urbanization. [ABSTRACT FROM AUTHOR]

Background: Social differences in mortality rates reported in Denmark gave rise to the present study of health expectancy in different socioeconomic groups. Methods: Data on health status and occupation were derived from Health Interview Surveys. Information on occupation and deaths is register data. Health expectancy in each socioeconomic group was calculated using Sullivan's method. Results: Among 30-year-old men, high-level salaried employees had the longest expected lifetime in perceived good health, 41 years, which amounts to 89% of life expectancy, compared to 34 years (73%) for farmers, 32 years (73%) for unskilled workers, and 19 years (56%) for economically inactive men. Expected lifetime in perceived good health for high-level salaried female employees from age 30 was 46 years (91% of life expectancy). The lowest was found for assisting spouses, 36 years (71%) and economically inactive women, 25 years (56%). Large differences were also found when data on long-standing illness were used. Conclusion: The differences between socioeconomic groups are greater for health expectancy than for life expectancy. [ABSTRACT FROM AUTHOR]

Cross-national comparisons and ranking of summary measures of population health sometimes give rise to inconsistent and diverging conclusions. In order to minimise confusion, international comparative studies ought to be based on well-harmonised data with common standards of definitions and documentation. Calculation methods and results should be communicated clearly and exactly. [ABSTRACT FROM PUBLISHER]

Introduction: The Danish Multiple Sclerosis (MS) Registry was established in 1956. Content: The register comprises data on all Danes who had MS in 1949 or who have been diagnosed since. Data on new cases and updated information on persons with an MS diagnosis already notified are continuously collected and classified according to standardized diagnostic criteria. Validity and coverage: The completeness and validity is high (91% and 94%, respectively). Conclusion: In January 2005 the register included data on 20,652 persons with a valid MS diagnosis, of whom 9,377 were alive. The register is the only existing nationwide MS register and covers a period of more than 50 years. [ABSTRACT FROM PUBLISHER]

Aims: A newly published study showed that the life expectancy for Danes was below the European Union (EU) average. Furthermore, the study showed that healthy life years (HLYs) at 50 years of age were much higher in Denmark than in the other EU countries in 2005. However, the results of this study should be interpreted with caution. Methods: The analyses regarding HLYs were based on the global long-term activity limitation index as a measure of disability and were included in the EU Survey on Income and Living Condition (EU-SILC). In Denmark two response categories were used to asses longterm activity limitation (yes; no) compared to three levels in all other countries (severely limited; limited but not severely; none). In addition, the wording of the question in Denmark makes cross-national comparisons even more inadequate. The questions and the response categories were revised in the Danish SILC-2008. Results: A comparison of the previous and the revised indicator shows that the estimated number of HLYs at 50 years of age is approximately three years lower for both men and women in 2008 than in 2005. Furthermore, in Denmark data was collected via telephone interviews or postal questionnaires. However, in almost all other countries data was collected via face-to-face interviews. It is well known that the mode of data collection may affect response distributions. Conclusions: Results based on non-harmonized indicators should always be interpreted cautiously to avoid policy-makers and others reaching erroneous conclusions. [ABSTRACT FROM AUTHOR]

The article presents the author's viewpoint on the use of Health Impact Assessments (HIA), as a tool for policy and decision making. He claims that HIA is helpful in predicting the future health consequences of implementing any policy related to public health. He also talks about some models for health assessment. He informs that health models related to coronary heart diseases are popular. While another successful model is the "Prevent model," used in estimating the healthcare cost of smoking.

Responds to comments made on the authors' article concerning the importance of selecting risk factor prevalence data and relative risk estimates relating risk factors to ischemical heart disease mortality. Prevalence of hypertension and hypercholesterol-anemia; Trends of smoking prevalence; Comparison of the health benefits of selected preventive interventions.

Aims: Health expectancy represents the average lifetime in various states of health and differs among social groups. The purpose of the study was to determine trends in social inequality in health expectancy since 1994 between groups with high, medium and low educational levels in Denmark. Methods: The study was based on data from nationwide registers on educational level and mortality during the period 1994—2005 and data on health status derived from the Danish Health Interview Surveys carried out in 1994, 2000 and 2005. Expected lifetime in self-rated good and poor health, lifetime without and with longstanding illness and expected lifetime without and with long-lasting difficulties or restrictions were estimated by Sullivan's method. Results: Between 1994 and 2005, life expectancy at age 30 years increased by 1.9 years for men and 1.5 years for women with a low educational level. For people with a high educational level, the increase was 2.7 years for men and 2.2 years for women. The difference between people with low and high educational level in expected lifetime in self-rated good health increased by 2.0 and 1.3 years for 30-year-old men and women, respectively. The social gap also increased for other indicators. Conclusions: During the past 12 years, social inequality in life expectancy and health expectancy has increased in Denmark, but the proportion of the population with a low educational level has decreased. [ABSTRACT FROM AUTHOR]

Background: The population of Greenland comprises almost 31 000 Inuit Greenlanders aged 20-65. The purpose of this study was to estimate trends in expected life years between age 20 and 65 in good and poor health, and to compare changes between men and women since the mid-1990s. Methods: Partial life expectancy was calculated and combined with prevalence data on self-rated health, longstanding illness and musculoskeletal diseases derived from health surveys carried out in 1993-94, 1999-2001 and 2005-10. Trends for men and women were compared and changes were decomposed into contributions from changes in mortality and disability. Results: Partial life expectancy increased by 2.2 years for men and 0.8 years for women during the entire period. However, expected lifetime in self-rated good health decreased by 3.3 years for men and by 4.6 years for women (p<0.01). For men, life expectancy without longstanding illness increased by 4.7 years (p<0.001). The increase for women by 1.4 years was non-significant (p=0.29). Expected lifetime without musculoskeletal diseases increased significantly by 4.5 years for men and by 1.9 years for women. Conclusions: The development of expected lifetime without longstanding illness supports the theory of compression of morbidity, but as the trend direction differs according to which measure for health is used, a definite conclusion cannot be drawn. The different rate of development of partial life expectancy and expected lifetime in good health between men and women is remarkable, and has reduced the gender gap. The results call for special concern about the women’s health in Greenland. [ABSTRACT FROM PUBLISHER]

Background:This study aimed to review Danish register-studies on seafarers’ and fishermen’s health and safety. Methods: Register-based or register-linked studies from 1970 until 2012 were identified and reviewed. Four categories of studies were included: mortality, hospitalization, specific diagnosesand conditions and accidents. Standardized risks estimates were typically calculated by comparison with the total Danish working population. Results: Elevated rates were found in all four categories. For mortality male seafarers had excess rates of accidents, cirrhosis of the liver, cancer, and suicides, and fishermen of accidents and cardiovascular disorders. Female seafarers in male-dominated occupations also had increased mortality rates. Elevated hospitalization rates for male seafarers were particularly prominent for endocrine/nutritional conditions, cervical discopathy, gastrointestinal and cardiovascular diseases, cancers, hearing impairment, and injuries, and for female seafarers cancers, circulatory and genitourinary diseases and injuries. Fishermen had increased hospitalization rates for cardiovascular diseases, bronchitis, emphysema, lung cancer, gonarthrosis, thoracolumbar discopathy, rotator cuff syndrome, carpal tunnel syndrome, injuries and hearing impairment. Specific diagnosesand conditions: There was an elevated risk of tuberculosis, hepatitis B and certain cancers for male seafarers, and of obesity and occupational accidents for both fishermen and seafarers. Conclusions: In spite of safety measures and significant structural changes in the Danish merchant and fishing fleet, the spectrum of health indicators continues to indicate considerable risk factors in the maritime environment and/or the lifestyle of seafarers and fishermen. Future monitoring of fishermen’s and seafarers’ health will remain essential for implementing appropriate preventive measures. [ABSTRACT FROM PUBLISHER]

Introduction: This paper reviews the most important articles using data from the Danish Multiple Sclerosis Registry (DMSR) published in the past 25 years. Research topics: These articles include: descriptive epidemiological studies, indicating that the female incidence of multiple sclerosis (MS) in Denmark has increased considerably; follow-up studies on social events, showing that patients at a high rate lose their working ability and their spouses/partners; mortality studies, demonstrating a considerable excess mortality; cause-of-death studies; comorbidity studies; and, most importantly, historical prospective studies identifying some risk factors (e.g. infectious mononucleosis) and refuting others (head trauma and a number of occupational exposures e.g. nurses, utility workers, people exposed to solvents). The most important results are briefly presented. Conclusion: The Danish MS register has proven to be a valuable tool for MS epidemiology and has provided knowledge that could not otherwise be achieved. [ABSTRACT FROM PUBLISHER]

Aims: To describe the characteristics of men and women exposed to physical violence, to identify risk factors for violence exposure and to quantify the attributable healthcare costs of violence. Methods: The Danish national health interview surveys of 2000 and 2005 included data on exposure to defined forms of physical violence over the last 12 months. Respondents who reported exposure to violence during the past year were compared with a reference group of non-exposed respondents, and data were merged with the National Health Registers. We identified risk factors for violence by logistic regression models and used OLS regression for quantification of attributable healthcare costs of violence, including somatic and psychiatric admissions, outpatient contacts, prescriptions and primary health services; and analyzed intimate partner violence separately. Results: Young age, being divorced and drinking more than the recommended amount of alcohol per week were risk factors for violence both for men and women. Total annual healthcare costs, adjusted for age and deliveries, were 787 euros higher on average for women exposed to violence than for non-exposed women, mainly related to psychiatric treatment. For women, no significant cost differences existed between victims of partner violence and non-victims. The total healthcare costs were not higher for exposed men than for non-exposed men, but male victims of partner violence incurred significantly higher costs. Conclusions: Primarily due to costs of psychiatric treatment, male and female victims of violence had higher total healthcare costs than non-exposed people. Whether mental health problems increase the risk of violence exposure or violence is a particular risk factor for health problems cannot be assessed by cross-sectional data alone. [ABSTRACT FROM PUBLISHER]

Aims: The aim of this study was twofold. Firstly we identified victims of violence in national registers and discussed strengths and weaknesses of this approach. Secondly we assessed the magnitude of violence and the characteristics of the victims using register-based data. Methods: We used three nationwide registers to identify victims of violence: The National Patient Register, the Victim Statistics, and the Causes of Death Register. We merged these data and assessed the degree of overlap between data sources. We identified a reference population by selecting all individuals in Denmark over 15 years of age that had not been exposed to violence. For the study population and the reference population, socioeconomic and demographic information were retrieved from Statistics Denmark. We used logistic regression models in a cross-sectional analysis to identify characteristics of victims of violence. Results: In 2006, 22,000 individuals were registered as having been exposed to violence. About 70% of these victims were men. Most victims were identified from emergency room contacts and police records, and few from the Causes of Death Register. There was some overlap between the two large data sources. We found significant differences between victims and non-victims according to socio-economic status, education, marital status, and ethnic origin, and also between victims by source of identification. Conclusions: We have identified a study population consisting of individual victims of violence that opens for further studies on violence. The use of different data sources is a strength but also a potential weakness to epidemiological, health economic, and other analyses using these data. [ABSTRACT FROM AUTHOR]

Population-based studies with information from registers can take place in Denmark due to linkage between registers at the individual level by means of a unique personal identification number (CPR-number), which all persons with residence in Denmark have. Registers with information on health can be linked to other population registers containing information on, for example, transfer payments, education, housing, income, and socioeconomic position. This article introduces a database and search engine, which is available for public health and welfare researchers as an aid to seek information on the content of important Danish registers. [ABSTRACT FROM PUBLISHER]

Aims: Cross-country comparisons of mortality and longevity patterns of Nordic populations could contribute with novel insights into the compositional changes of these populations. We investigated three metrics of population ageing: the proportion of the population aged 75+ and 90+ years, the proportion of birth cohorts reaching 75 and 90 years, and life expectancy (LE) at age 75 and 90 years in Sweden, Norway, Iceland, Denmark and Finland, in the period 1990–2014. Methods: Demographic information was collected from national statistical databases and the Human Mortality Database. Results: All metrics on population ageing increased during the study period, but there were some cross-country variations. Finland experienced a notably steep increase in the proportion of 75+ and 90+ year olds compared to the other countries. Regarding the proportion reaching old ages, the Finnish lagged behind from the beginning, but females decreased this difference. The Danes were more similar to the other countries at the beginning, but did not experience the same increase over time. Gender-specific LE at age 75 and 90 years was similar overall in the five countries. Conclusions: Developments in cross-country variation suggest that survival until old age has become more similar for Finnish females and more different for Danish males and females compared with the other countries in recent decades. This provides perspectives on the potential to improve longevity in Denmark and Finland. Similarities in LE in old age suggest that expected mortality in old age has been more similar throughout the study period. [ABSTRACT FROM AUTHOR]

Aims: In Denmark life expectancy (LE) has increased since 1995 after a long period of stagnation. Healthy life expectancy (HLE) at age 65 increased more than LE during the period 1987-2005. The aim of the study was to determine the trend in HLE in Denmark at ages 50 and 65 during the period 2004-2011. Methods: The study was based on nationwide register data on mortality and data on health status from the SHARE surveys carried out in 2004/2005, 2006/2007 and 2010/2011. Expected lifetime in various health states was estimated by Sullivan’s method. Changes from 2004 to 2011 were decomposed into contributions from changes in mortality and prevalence of activity limitations. Results: During the period 2004-2011 LE increased by about 1 year at both age 50 and age 65. However, the increase in expected lifetime in self-rated good health, without long-term health problems and without activity limitations was even longer in both genders and it increased by 1.5-4.0 years depending on age, gender and health indicator. Consequently, expected lifetime in an unhealthy state decreased and the proportions of lifetime in a healthy state increased. The disability effect of the health gain was stronger than the mortality effect. Conclusions:In Denmark HLE increased substantially more than LE during the period 2004-2011 for all three health indicators at both age 50 and age 65, and for both genders. Thus, the improvement in health expectancy continued in Denmark in recent years. [ABSTRACT FROM PUBLISHER]

Danish registers contain information on many important health and social issues. Because all Danish citizens have a unique personal identification number, linkage at the individual level between these nationwide registers and other data sources is possible and feasible. In this paper we briefly introduce selected Danish registers and the data structure and requirements for getting access to data at Statistics Denmark, which is the main provider of register data. We introduce the Danish Data Archive and briefly present the Act on Processing of Personal Data, which is the legal foundation for analyses of register-based data in Denmark. [ABSTRACT FROM PUBLISHER]

Background: The EQ-5D is a widely used generic health-related quality of life instrument that has been used to describe population health and health outcomes in clinical trials and health economic evaluations. Aims: To generate Danish population norms for the EQ-5D index score, stratified by age and gender. Methods: The EQ-5D data from three population health surveys were pooled, thus providing EQ-5D profile data for 15,700 individuals aged 20-79 years. The Danish TTO scoring algorithm was used to weight each respondent's profile data to derive a single index score. Mean values were computed by gender and 10-year age groups, and educational groups. Results: In a random sample from the general Danish population, the mean EQ-5D index score ranged between 0.93 for 20-29 year-olds and 0.83 for 70-79 year-olds. Men had a significantly higher score than women in all age groups. Longer education was associated with higher EQ-5D index score in most age groups. Conclusions: The calculated mean values for the EQ-5D index score may be used as reference values for comparative purposes in future Danish population health and evaluative studies. [ABSTRACT FROM AUTHOR]

Aims : A study was undertaken on implementing medical data collection as a tool to assess the relative number and character of intentional injuries before and during an armed conflict. Methods : Data on hospital contacts due to intentional injury were collected retrospectively at two hospitals in West Bank, Palestine, and classified by ICD10 and the new International Classification of External Causes of Injuries (ICECI). A three-month period prior to the current Intifada, June-August 2000 and two three-month periods of the Intifada, September-December 2000 and June-August 2001 were chosen. Results : The number of contacts increased from 23 in the period prior to the Intifada to 740 during the first and 199 during the second period of the Intifada. During the period before the Intifada the victims were men, and no one was younger than 10 years. During the Intifada 9% were women, 3% below 10 years, and 9% aged 10-14 years. Prior to the Intifada all injuries were caused by blunt force. During the Intifada 65% of the injuries were caused by firearms or explosives, 19% by beating and 6% by gaseous substances. Among children most lesions were localized to the head, including eye and brain damage, and were mostly caused by firearms. Conclusions : Injury registration by ICD10 combined with ICECI codes facilitates analyses of correlations between characteristics of armed conflicts and injuries. Medical data collection is an important instrument in documentation of the effects of weapons and in surveillance of violations of humanitarian law, particularly as to the worrying magnitude of young children being seriously victimized. [ABSTRACT FROM AUTHOR]

Aim: Myocardial infarction incidence declined by 3-5% per year from 1982-92 in the Danish study population of the WHO MONICA project. This study examined whether psychosocial coronary risk factors changed in the population during this period. Methods: Cross-sectional data from 6,695 Danish men and women aged 30, 40, 50, and 60 years, were examined in 1982-84, 1986-87, and 1991-92. Data from Social Registers were used to analyse trends in community social structure. Results: From 1982 to 1992 an increase in individuals' school education and social class followed an increase in the general welfare of the study area. At the same time type A behaviours increased in both men and women, while there were no changes in reported personal problems. The proportion of women living alone increased, while the proportion of emotionally distressed decreased. In men there were no changes in cohabitation status or emotional distress. The changes in the psychosocial factors were the same in different educational groups. Conclusion: The socioeconomic position of the population improved at the individual and the community level during the study period. This was concurrent with the declining incidence of myocardial infarction. [ABSTRACT FROM AUTHOR]

Aims: To examine trends in alcohol drinking in different educational groups. Methods: Data from three cross-sectional WHO MONICA surveys conducted in 1982-84, 1987, and 1991-92 were analysed to estimate trends in abstention, moderate, heavy, and sporadic heavy alcohol use in relation to level of education, age and smoking. In total, 6,695 Danish men and women aged 30, 40, 50, and 60 years were included. Results: Alcohol drinking decreased in both men and women during the study period, but changes were only significant among the highest educated. In the highest educated men the prevalence of moderate alcohol use increased from 77 to 82%, while heavy alcohol use declined from 19 to 12%. In the highest educated women the prevalence of abstention increased from 15 to 22%, while moderate alcohol use declined from 78 to 68%. Conclusion: During the 1980s, alcohol drinking decreased among the highest educated men and women and an educational gradient in alcohol drinking widened in men and attenuated in women. [ABSTRACT FROM AUTHOR]