The contribution of specific diseases to educational disparities in disability-free life expectancy

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

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review


Objectives. We examined the contribution that specific diseases, as causes of both death and disability, make to educational disparities in disability-free life expectancy (DFLE). Methods. We used disability data from the Belgian Health Interview Survey (1997) and mortality data from the National Mortality Follow-Up Study (1991-1996) to assess education-related disparities in DFLE and to partition these differences into additive contributions of specific diseases. Results. The DFLE advantage of higher-educated compared with lower-educated persons was 8.0 years for men and 5.9 years for women. Arthritis (men, 1.3 years; women, 2.2 years), back complaints (men, 2.1 years), heart disease/stroke (men, 1.5 years; women, 1.6 years), asthma/chronic obstructive pulmonary disease (COPD) (men, 1.2 years; women, 1.5 years), and "other diseases" (men, 2.4 years) contributed the most to this difference. Conclusions. Disabling diseases, such as arthritis, back complaints, and asthma/COPD, contribute substantially to differences in DFLE by education. Public health policy aiming to reduce existing disparities in the DFLE and to improve population health should not only focus on fatal diseases but also on these nonfatal diseases.

Original languageEnglish
Pages (from-to)2035-2041
Number of pages7
JournalAmerican Journal of Public Health
Issue number11
Publication statusPublished - Nov 2005

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