Supplement: Risk factors and public health in Denmark

Abstract

A large number of indicators of mortality, morbidity and social economic costs have been calculated for up to 19 risk factors. This is the first attempt in Denmark to present an overall description of the impact of these risk factors on public health. The analyses should contribute to the planning foundation for disease prevention and health promotion. The risk factors have been selected on the basis of data availability, importance and public interest. ∗ Behavioural factors such as smoking, physical inactivity and unhealthy dietary habits have a great impact on the health of both men and women, while the effects of alcohol and drug abuse are mainly seen among men and those of unsafe sex are mainly seen among women. ∗ Biological risk factors such as overweight and hypertension have a great impact on the health of both men and women. ∗ Among employed persons, occupational diseases and ill-health caused by psychosocial job strain are more frequent among men. With regard to accidents, traffic accidents involving young men and accidental falls among elderly women entail the greatest burden. ∗ There is a marked excess of premature deaths and disease among persons with a low educational level. ∗ The causes of disease are complex and multifactorial, and in order to relate the indicators of health and social economic costs to the risk factors it is necessary to make a number of simple and crude assumptions. Nevertheless, the method can provide a greater insight into the impact of a number of risk factors on public health, and can thus prove useful in prevention planning, both nationally and regionally. ∗ The importance or rank order of the various risk factors varies depending on the health indicator in question. In addition, the behavioural and biological factors are influenced by living conditions, for example education and occupation, which are in turn affected by the way in which society is organised. The rank order does not take into account the mutual interdependence of the risk factors or the fact that they are located at different levels in a causal network. Comparison of the importance of smoking and educational level requires careful interpretation as smoking habits differ between population groups having different educational levels. Similarly, comparison of physical inactivity, overweight and an unhealthy diet requires careful interpretation. ∗ It is nevertheless evident that smoking, educational level, physical inactivity, alcohol and overweight play a major role with most of the indicators of health and social economic costs. With certain indicators, e.g. emergency department contacts, accidents play an important role. ∗ The importance of the selected risk factors has changed dramatically over the past 50 years, and it is likely that the rank order will change again within some years.