| 1. |
- Agardh, Emilie E., et al.
(author)
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Alcohol-attributed disease burden in four Nordic countries between 2000 and 2017 : Are the gender gaps narrowing? A comparison using the Global Burden of Disease, Injury and Risk Factor 2017 study
- 2021
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In: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 40:3, s. 431-442
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Journal article (peer-reviewed)abstract
- Introduction and Aims. The gender difference in alcohol use seems to have narrowed in the Nordic countries, but it is not clear to what extent this may have affected differences in levels of harm. We compared gender differences in all-cause and cause-specific alcohol-attributed disease burden, as measured by disability-adjusted life-years (DALY), in four Nordic countries in 2000-2017, to find out if gender gaps in DALYs had narrowed. Design and Methods. Alcohol-attributed disease burden by DALYs per 100 000 population with 95% uncertainty intervals were extracted from the Global Burden of Disease database. Results. In 2017, all-cause DALYs in males varied between 2531 in Finland and 976 in Norway, and in females between 620 in Denmark and 270 in Norway. Finland had the largest gender differences and Norway the smallest, closely followed by Sweden. During 2000-2017, absolute gender differences in all-cause DALYs declined by 31% in Denmark, 26% in Finland, 19% in Sweden and 18% in Norway. In Finland, this was driven by a larger relative decline in males than females; in Norway, it was due to increased burden in females. In Denmark, the burden in females declined slightly more than in males, in relative terms, while in Sweden the relative decline was similar in males and females. Discussion and Conclusions. The gender gaps in harm narrowed to a different extent in the Nordic countries, with the differences driven by different conditions. Findings are informative about how inequality, policy and sociocultural differences affect levels of harm by gender.
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| 2. |
- Agardh, Emilie E., et al.
(author)
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Disease Burden Attributed to Drug use in the Nordic Countries : a Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2019
- 2023
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In: International Journal of Mental Health and Addiction. - 1557-1874 .- 1557-1882.
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Journal article (peer-reviewed)abstract
- The Nordic countries share similarities in many social and welfare domains, but drug policies have varied over time and between countries. We wanted to compare differences in mortality and disease burden attributed to drug use over time. Using results from the Global Burden of Disease (GBD) study, we extracted age-standardized estimates of deaths, DALYs, YLLs and YLDs per 100 000 population for Denmark, Finland, Iceland, Norway, and Sweden during the years 1990 to 2019. Among males, DALY rates in 2019 were highest in Finland and lowest in Iceland. Among females, DALY rates in 2019 were highest in Iceland and lowest in Sweden. Sweden have had the highest increase in burden since 1990, from 252 DALYs to 694 among males, and from 111 to 193 among females. Norway had a peak with highest level of all countries in 2001-2004 and thereafter a strong decline. Denmark have had the most constant burden over time, 566-600 DALYs among males from 1990 to 2010 and 210-240 DALYs among females. Strict drug policies in Nordic countries have not prevented an increase in some countries, so policies need to be reviewed.
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| 3. |
- Charara, Raghid, et al.
(author)
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The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013
- 2017
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 12:1
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Journal article (peer-reviewed)abstract
- The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost-YLLs) and nonfatal outcomes (years lived with disability-YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of the total disease burden in the EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years of age. The highest proportion of DALYs occurred in the 25-49 age group, with a peak in the 35-39 years age group (5344 DALYs/100,000). The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Within the mental disorders group in EMR, depressive disorders accounted for most DALYs, followed by anxiety disorders. Among EMR countries, Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to the global level. Our findings call for EMR ministries of health to increase provision of mental health services and to address the stigma of mental illness. Moreover, our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability. Indeed, mental health problems, if not properly addressed, will lead to an increased burden of diseases in the region.
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| 4. |
- Haukenes, Inger, et al.
(author)
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Inequity in disability pension: an intersectional analysis of the co-constitution of gender, education and age. The Hordaland Health Study
- 2019
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In: Critical Public Health. - : Informa UK Limited. - 0958-1596 .- 1469-3682. ; 29:3, s. 302-313
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Journal article (peer-reviewed)abstract
- © 2018 Informa UK Limited, trading as Taylor & Francis Group Social position, education, gender and increasing age are all identified as important risk factors for disability pension. This study takes an intersectionality approach and examines their co-constitution, in relation to inequity in disability pension. The population included 22,203 middle-aged men and women participating in the community-based Hordaland Health Study, Western Norway (1997–1999). The participants were categorised in four exposure groups: higher educated men, higher educated women, lower educated men and lower educated women. The outcome was disability pension from 1992 to end of 2007, from a national registry. Using recommendations for intersectionality-informed quantitative research, we estimated the main effects of gender and educational attainment on disability pension, and potential statistical multiplicative interactions between gender and education in relation to cause-specific and all-cause disability pension. For all-cause disability pension, men with higher education had the lowest risk for disability pension (rate per 1000 person-years: 2.01) during the course of working life (from age 35 to 57), followed by higher educated women (rate 3.56), and lower educated men (rate 4.59). Finally, women with lower education had a substantially increased risk already in early middle age (rate 8.39). We found a statistical multiplicative effect of lower education and female gender on all-cause disability pension and disability pension with musculoskeletal disorders compared with men with higher education. The discussion highlights that inequity in disability pension is not only about defining vulnerable groups, but also about understanding how privileges and disadvantages are unequally distributed.
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| 5. |
- Kassebaum, Nicholas J., et al.
(author)
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Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015
- 2016
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In: The Lancet. - 0140-6736 .- 1474-547X. ; 388:10053, s. 1603-1658
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Journal article (peer-reviewed)abstract
- Background Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate. Findings Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs off set by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2.9 years (95% uncertainty interval 2.9-3.0) for men and 3.5 years (3.4-3.7) for women, while HALE at age 65 years improved by 0.85 years (0.78-0.92) and 1.2 years (1.1-1.3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs. Interpretation Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum.
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| 6. |
- Moradi-Lakeh, Maziar, et al.
(author)
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Burden of musculoskeletal disorders in the Eastern Mediterranean Region, 1990-2013 : findings from the Global Burden of Disease Study 2013
- 2017
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In: Annals of the Rheumatic Diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 76, s. 1365-1373
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Journal article (peer-reviewed)abstract
- OBJECTIVES: We used findings from the Global Burden of Disease Study 2013 to report the burden of musculoskeletal disorders in the Eastern Mediterranean Region (EMR).METHODS: The burden of musculoskeletal disorders was calculated for the EMR's 22 countries between 1990 and 2013. A systematic analysis was performed on mortality and morbidity data to estimate prevalence, death, years of live lost, years lived with disability and disability-adjusted life years (DALYs).RESULTS: For musculoskeletal disorders, the crude DALYs rate per 100 000 increased from 1297.1 (95% uncertainty interval (UI) 924.3-1703.4) in 1990 to 1606.0 (95% UI 1141.2-2130.4) in 2013. During 1990-2013, the total DALYs of musculoskeletal disorders increased by 105.2% in the EMR compared with a 58.0% increase in the rest of the world. The burden of musculoskeletal disorders as a proportion of total DALYs increased from 2.4% (95% UI 1.7-3.0) in 1990 to 4.7% (95% UI 3.6-5.8) in 2013. The range of point prevalence (per 1000) among the EMR countries was 28.2-136.0 for low back pain, 27.3-49.7 for neck pain, 9.7-37.3 for osteoarthritis (OA), 0.6-2.2 for rheumatoid arthritis and 0.1-0.8 for gout. Low back pain and neck pain had the highest burden in EMR countries.CONCLUSIONS: This study shows a high burden of musculoskeletal disorders, with a faster increase in EMR compared with the rest of the world. The reasons for this faster increase need to be explored. Our findings call for incorporating prevention and control programmes that should include improving health data, addressing risk factors, providing evidence-based care and community programmes to increase awareness.
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| 7. |
- Skogen, Jens Christoffer, et al.
(author)
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The gender gap in accrued pension rights – an indicator of women’s accumulated disadvantage over the course of working life. The Hordaland Health Study (HUSK)
- 2018
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 46:3, s. 417-424
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Journal article (peer-reviewed)abstract
- Aims: Economic gender equality is one of the goals of the Nordic Welfare states. Despite this, there is a considerable gender gap in pensionable income in the European Union, and an unmet need for measures that absorb more of the complexity associated with accumulated (dis)advantages across gender and population groups. The aims of the present study were to examine the gender difference in association between average earned pension points and 1) education and 2) current occupational prestige, and to discuss pension points as a possible indicator of accumulated disadvantages. Methods: We linked a community-based survey, the Hordaland Health study (HUSK), to the national register of insurance benefits (FD-trygd). This made it possible to trace gendered patterns of economic (dis)advantages associated with educational level, career development and gainful work over the life course for 17,275 individuals. Results: We found profound differences in earned accrued pension rights between men and women across socioeconomic strata, and a significant interaction between pension rights and gender in the association with education and occupational prestige. Our findings indicate that men, as a group, may have lower educational attainment and occupational prestige than women, and still earn more pension points throughout their career. These differences place women at risk for future economic strain and deprivation over and above their similarly educated and positioned male counterparts. Conclusions: We suggest that accrued pension rights may be a relevant measure of accumulated (dis)advantages over the course of working life, and a useful indicator when gender equa lity is measured and discussed.
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