Observational studyBMC public health2023
Inequality in quality-adjusted life expectancy by educational attainment in Norway: an observational study.
Observational study in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 13 citations in OpenAlex.
- Multimorbidity and health related quality of life in midlife - a longitudinal study from Northern Finland Birth Cohort 1966.Scandinavian journal of primary health care · 2026Article
- Parenthood and mental health throughout the life course: A total population study.Social psychiatry and psychiatric epidemiology · 2026Article
- Functional Dentition Life Expectancy (FDLE): a novel indicator for monitoring oral health in ageing populations.Clinical oral investigations · 2026Article
- Inequalities in Quality-Adjusted Life Expectancy in Australia by Educational Attainment.PharmacoEconomics · 2025Article
- Quality-Adjusted Life Expectancy Norms Based on the EQ-5D-5L and SF-6Dv2 for China.Applied health economics and health policy · 2025Article
- Quality-adjusted life expectancy norms for the Iranian population.Population health metrics · 2025Article
- Educational disparities in cancer incidence, stage, and survival in Oslo.Research in health services & regions · 2024Article
- Impact of education and income inequalities on life expectancy: insights from the new EU members.Frontiers in public health · 2024Article
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHealth inequalities are often assessed in terms of life expectancy or health-related quality of life (HRQoL). Few studies combine both aspects into quality-adjusted life expectancy (QALE) to derive comprehensive estimates of lifetime health inequality. Furthermore, little is known about the sensitivity of estimated inequalities in QALE to different sources of HRQoL information. This study assesses inequalities in QALE by educational attainment in Norway using two different measures of HRQoL.
methodsWe combine full population life tables from Statistics Norway with survey data from the Tromsø study, a representative sample of the Norwegian population aged ≥ 40. HRQoL is measured using the EQ-5D-5L and EQ-VAS instruments. Life expectancy and QALE at 40 years of age are calculated using the Sullivan-Chiang method and are stratified by educational attainment. Inequality is measured as the absolute and relative gap between individuals with lowest (i.e. primary school) and highest (university degree 4 + years) educational attainment.
resultsPeople with the highest educational attainment can expect to live longer lives (men: + 17.9% (95%CI: 16.4 to 19.5%), women: + 13.0% (95%CI: 10.6 to 15.5%)) and have higher QALE (men: + 22.4% (95%CI: 20.4 to 24.4%), women: + 18.3% (95%CI: 15.2 to 21.6%); measured using EQ-5D-5L) than individuals with primary school education. Relative inequality is larger when HRQoL is measured using EQ-VAS.
conclusionHealth inequalities by educational attainment become wider when measured in QALE rather than LE, and the degree of this widening is larger when measuring HRQoL by EQ-VAS than by EQ-5D-5L. We find a sizable educational gradient in lifetime health in Norway, one of the most developed and egalitarian societies in the world. Our estimates provide a benchmark against which other countries can be compared.
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