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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]

Abstract: Objective : To estimate the impacts of tobacco smoking, high alcohol consumption, physical inactivity and overweight on expected lifetime with and without long-standing, limiting illness. Methods : Life tables for each level of exposure to the risk factors were constructed, mainly on the basis of the Danish National Cohort Study. Expected lifetime without long-standing, limiting illness was estimated for exposed and unexposed persons by combining life tables and prevalence data from the Danish Health Interview Survey 2000 (14,503 participants aged 25+). Results : The life expectancy of 25-year-olds was 9–10 years shorter for heavy smokers than for those who never smoke, and all the lifetime lost would have been without long-standing, limiting illness. Similarly, all 5 years of expected lifetime lost by men with high alcohol consumption would have been without illness. The expected lifetime without long-standing, limiting illness was 8–10 years shorter among sedentary than physically active people. Obesity shortened lifetime without illness by 5 years for men and ten years for women. Conclusion : The results of this study could be used in health policy-making, as the potential gains in public health due to interventions against these risk factors could be evaluated, when the prevalence of exposure to the risk factor is available. [Copyright &y& Elsevier]

Objective: The study evaluated the health impact of specific diseases. Method: Life tables and health survey data are combined to estimate expected lifetime with and without long-standing illness. We compared estimates based on observed rates of mortality and prevalence of illness with those based on hypothetical rates from which a specific disease has been eliminated. Results: Life expectancy would increase by 4.0 years for 65-year-olds if circulatory diseases are eliminated, and the proportion of expected Ill, time without long-standing, limiting illness would increase from 59.2% to 66.5% for men and to 52.2% to 55.6% for women. Elimination of musculoskeletal diseases would not change life expectancy but would increase the proportion of expected lifetime without long-standing illness. Conclusions: Because of comorbidity, more years of illness are to be expected if lethal diseases are to be eliminated. Elimination of nonfatal diseases would mainly transfer years with long-standing illness to years without illness. [ABSTRACT FROM AUTHOR]

We compared the rate of fatal accidents among Danes with multiple sclerosis (MS) with that of the general population. The study was based on linkage of the Danish Multiple Sclerosis Registry to the Cause of Death Registry and covered all 10174 persons in whom MS was diagnosed during the period 1953–1996. The end of follow-up was 1 January 1999. We calculated standardized mortality ratios (SMRs) for various types of fatal accidents. A total of 76 persons (48 men and 28 women) died from accidents, whereas the expected number of fatalities from such causes was 55.7 (31.4 men and 24.3 women). Thus, the risk for death from accidents among persons with MS was 37% higher than that of the general population (SMR = 1.37). We found no significant excess risk for fatal road accidents (SMR = 0.80). The risk for falls was elevated (SMR = 1.29) but not statistically significantly so. The risks were particularly high for deaths from burns (SMR = 8.90) and suffocation (SMR = 5.57). We conclude that persons with MS are more prone to fatal accidents than the general population. The excess risk is due not to traffic accidents but to burns and suffocation. [ABSTRACT FROM AUTHOR]

Background: While life expectancy quantifies average length of life, health expectancy represents the average lifetime in different health states and offers the possibility to evaluate quality of life with respect to health. The purpose of the study was to estimate changes in health expectancy in Denmark from 1987 to 2000 and to assess theories about the relation between increased total lifetime and lifetime in various health states. Methods: Data on health status derived from the Danish Health Interview Surveys carried out in 1987, 1991, 1994 and 2000 were combined with life-table data. Expected lifetime in selfrated good health, life expectancy without longstanding illness and disabilityfree life expectancy were estimated by Sullivan's method. Results: In 1987, the life expectancy of a 65-year-old man was 14.1 years, 8.9 years of which were expected to be disabilityfree. In 2000, life expectancy had increased to 15.0 years, 11.3 years of which were disabilityfree. Thus, life expectancy had increased by 0.9 years, whereas disabilityfree life expectancy had increased by 2.4 years. Among 65-year-old women, life expectancy had increased by 0.2 years and disabilityfree life expectancy by 1.1 years. Expected lifetime in selfrated good health had also improved, but the trend in life expectancy without longstanding illness went in the opposite direction, and expected lifetime with longstanding illness had increased. Conclusion: The recent rise in life expectancy in Denmark after many years of stagnation appears to be accompanied by generally improved health status among the elderly, but health expectancy trends depend on the health indicator chosen. [ABSTRACT FROM AUTHOR]

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]

Background: The purpose of the study was to determine trends in social inequality in mortality and life expectancy in Denmark. Methods: The study was based on register data on educational level and mortality during the period 1981-2005 and comprised all deaths among Danes aged 30-60. Sex- and age-specific death rates for each of three levels of education were calculated and age-standardized to allow comparisons over time and between groups. As data obtained since 1996 included ages up to 74, partial life expectancy (i.e. expected lifetime of 30-year-olds before the age of 75) was calculated for the period 1996-2005. Results: Between 1981 and 2005, the difference in death rates between people aged 30-60 with low and high educational level increased by two-thirds for men and was doubled for women. During the period 1996-2005, the gap in partial life expectancy from age 30 to 75 between people with low and high educational level increased by 0.3 years. Conclusion: During the past 25 years, the social gap in mortality has widened in Denmark. In particular, women with a low educational level have been left behind. [ABSTRACT FROM AUTHOR]

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]

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: 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]

Background: The aim of this study was to evaluate the association between experienced physical violence and health-related quality of life (HRQoL) by comparing self-reported health status for individuals with and without experience of physical violence. Our hypothesis was that individuals exposed to violence would experience worse HRQoL than non-exposed individuals. We tested whether men and women and different age groups experience similar reductions in HRQoL, and the extent to which such differences might be associated with social circumstances and lifestyle conditions. Finally, we explored the HRQoL consequences of exposure to violence in a longer time perspective. Methods: We used data from self-completed questionnaires in two Danish nationally representative, cross-sectional health interview surveys. Exposure to violence was indicated through specific survey questions (Straus' conflict tactics scale) enquiring about different types of violence during the last 12 months. Health status of respondents was elicited by the EQ-5D and SF-36 questionnaires. The health status profiles were converted to health score indexes using the Danish algorithm for EQ-5D and the revised Brazier algorithm for SF-6D. Differences in score indexes between the exposed and non-exposed individuals were explored separately for men and women using ordinary least square regression with four age categories as explanatory variables. Results: In the 2000 and 2005 surveys, respectively, 4.9% and 5.7% of respondents indicated that they had been exposed to physical violence within the last 12 months. Exposure to violence was more prevalent in the younger age groups and more prevalent for men than women. Respondents exposed to violence had lower score indexes on both the EQ-5D and the SF-6D compared with the non-exposed. Respondents who reported exposure to violence in both 2000 and 2005 reported lower HRQoL than individuals who only reported exposure in one of the surveys. Conclusions: The results of this study provide evidence for an association between exposure to physical violence and reduction in health-related quality of life. [ABSTRACT FROM AUTHOR]

Multiple sclerosis is an inflammatory disease of the central nervous system of unknown aetiology. Its prevalence varies by ethnicity and place: persons of northern European descent are at increased risk while persons living at lower latitudes appear to be protected against the disease. The Danish Multiple Sclerosis Registry is a national registry established in 1956 after a population-based survey which receives information from numerous sources. It is considered to be more than 90% complete, with a validity of 94%. Using data from the Registry, we calculated prevalences per 100,000 inhabitants. The standardized prevalence of multiple sclerosis increased from 58.8 (95% confidence interval: 54.9-62.7) in 1950 to 154.5 per 100,000 (95% confidence interval: 148.8-160.2) in 2005, and the female to male ratio increased from 1.31 in 1950 to 2.02 in 2005. The increase in prevalence is due to both increased survival of multiple sclerosis patients and an increased incidence rate. The rise in prevalence in the past 50 years is probably due more to environmental factors than to genetic changes in the Danish population. Among women, environmental changes could include older age at first birth, use of oral contraceptives, or changes in sun behaviour and/or vitamin D status. [ABSTRACT FROM AUTHOR]

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]