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Background A greater understanding of the factors that are associated with favourable health may help increase longevity and healthy life expectancy. We examined sociodemographic, psychosocial, lifestyle and environmental exposures associated with multiple health indicators. Methods UK Biobank recruited > 500,000 participants, aged 37–73, between 2006 and 2010. Health indicators examined were 81 cancer and 443 non-cancer illnesses used to classify participants' health status; long-standing illness; and self-rated health. Exposures were sociodemographic (age, sex, ethnicity, education, income and deprivation), psychosocial (loneliness and social isolation), lifestyle (smoking, alcohol intake, sleep duration, BMI, physical activity and stair climbing) and environmental (air pollution, noise and residential greenspace) factors. Associations were estimated using logistic and ordinal logistic regression. Results In total, 307,378 participants (mean age = 56.1 years [SD = 8.07], 51.9% female) were selected for cross-sectional analyses. Low income, being male, neighbourhood deprivation, loneliness, social isolation, short or long sleep duration, low or high BMI and smoking were associated with poor health. Walking, vigorous-intensity physical activity and more frequent alcohol intake were associated with good health. There was some evidence that airborne pollutants (PM 2.5 , PM 10 and NO 2 ) and noise (L den ) were associated with poor health, though findings were not consistent across all models. Conclusions Our findings highlight the multifactorial nature of health, the importance of non-medical factors, such as loneliness, healthy lifestyle behaviours and weight management, and the need to examine efforts to improve the health outcomes of individuals on low incomes.

Background Disability pension has increased in recent decades and is seen as a public health and socioeconomic problem in Western Europe. In the Nordic countries, the increase has been particularly steep among young women. Purpose The aim was to analyze the influence of low social integration, socioeconomic risk conditions and different measures of self-reported ill health on the risk of receiving disability pension in young women. Method The study comprised all Swedish women born in 1960 to 1979, who had been interviewed in any of the annual Swedish Surveys of Living Conditions (1990–2002). The assumed predictors were related to disability pension by Cox proportional hazard regression. The mean number of years of follow-up for the 10,936 women was 7 years (SD 3.8), and the study base was restricted to the ages 16 to 43 years of age. Results An increased risk of receiving a disability pension was found among lone women, those who had sparse contacts with others, job-seeking women, homemakers, as well as women with low education, and poor private financial situations. A tenfold increase in the risk of receiving a disability pension was found among women reporting a long-standing illness and poor self-rated health, compared to women without a long-standing illness and good self-rated health. Psychiatric diagnoses and symptoms/unspecified illness were the strongest predictors of disability pension, particularly before 30 years of age. Conclusion The study suggests that weak social relations and weak connections to working life contribute to increase the risk of disability pension in young women, also after control for socioeconomic conditions and self-reported ill health. Self-rated health was the strongest predictor, followed by long-standing illness and not having a job (job seekers and homemakers).

Background: Hypotheses concerning compression of morbidity have gained support, particularly due to improved lifestyles from 1950 to date, but now the increase is largely due to improvements in healthcare. Methods: Survey data from Sweden were used to test whether the older population aged 65-84 years during 1995-2002 had more longstanding illnesses than the older population of 1980-87 or 1988-94. Results: There was an increased prevalence of many longstanding illnesses among the elderly in Sweden between 1988-94 and 1995-2002. The increase was especially pronounced among those with at least three longstanding illnesses. For diabetes, heart disease, and hypertension, the prevalence among elderly men increased by over 20%. However, those reporting these kinds of longstanding illnesses perceive improved health and are less restricted in their daily activities. Conclusions: Results from Sweden indicate that many countries approaching Sweden's life expectancy will have an increased need for care for the oldest population in the future. The compression-of-morbidity hypothesis is being challenged, probably due to improvements in healthcare.

Despite a number of studies focusing on the health of immigrants, our knowledge of the risk of limiting long-standing illness (LLSI)) in migrant women of reproductive age is restricted. A simple random sample of 5037 Swedish-born and 629 foreign-born women (aged 20-41 at the first occasion) were interviewed over the periods 1983-1990 and 1991-1998. The risk of LLSI was estimated by applying logistic regression for correlated data. First-generation labour-migrant women (OR=1.86) and refugee women (OR=1.75) had an increased risk of LLSI compared to Swedish-born women. The risk decreased only marginally (OR=1.64 and 1.48, respectively) after adjustment for marital status, socio-economic status, feelings of insecurity and the longitudinal effect of age. Women without employment, with a low attained level of education, without children, with feelings of insecurity or poor economic resources showed a high risk of LLSI. Similar results were observed when second-generation women were compared to Swedish-born women. However, immigrant women's health did not deteriorate more than that of Swedish-born women. First- and second-generation immigrant women of reproductive age had an increased risk of LLSI, compared to their Swedish counterparts. Furthermore, immigrant women's health did not become proportionally worse than the health of Swedish women during the 8-year period.

To estimate the impact of diseases on social differences in life expectancy and expected lifetime with illness among Danes in 1995-99. Expected lifetime with and without long-standing illness were calculated for groups with low, medium and high educational levels. Estimates based on observed rates of mortality and prevalence of illness were compared with those based on rates from which a specific disease had been eliminated. Partial life expectancy (age 30-75) would increase by almost 1.5 years if cancer were eliminated. Expected lifetime without long-standing illness would increase by approximately 1 year. Elimination of cardiovascular diseases would increase partial life expectancy, mainly among men with a low educational level. If diseases of the musculoskeletal system were eliminated the benefit would be greatest for persons with a low educational level. The gain in life expectancy to be expected by eliminating certain diseases decreased with educational level. Elimination of cancer would extend lifetime both with and without illness for all educational levels.[PUBLICATION ABSTRACT]

Background: There Is only scant evidence for the long-term health effects of road traffic Injuries. We therefore assessed the extent to which motor vehicle driver Injuries influence limiting long-standing illness and psychological distress using data from a nationwide study (the 1958 British birth cohort) in early adulthood. Methods: Information was obtained on driver injuries occurring between ages 23 and 33 years and limiting illnesses and psychological distress at age 33 years. The risks of injury-related adverse consequences were derived using logistic regression and expressed as odds ratios (ORs) and 95% confidence intervals. Results: A single injury was associated with limiting illness (OR=2.01 and 95% Cl: 1.38–2.94). The association between a single injury and psychological distress was strong for a recent injury occurring between ages 30 and 33 years (OR=1.86 and 95% Cl: 1.24–2.81), but not for Injuries occurring earlier on. The population attributable fraction for limiting illness with one injury was 3.8% (range 1.7–5.3%) and with two or more injuries was 1.0% (range 0.5–1.3%). After controlling for potential confounding factors the corresponding figures were 4.2% (range 2.2–5.6%) and 1.1% (range 0.5–1.3%) respectively. Conclusions: Driver injuries are associated with a substantial increase in disability and, also in the short term, with increases In psychological distress. These results highlight the need for identifying effective strategies for the prevention of road traffic injuries as well as more effective approaches for rehabilitation of the injured.

Background: Despite a number of studies focusing on the health of immigrants, our knowledge of the risk of limiting long‐standing illness (LLSI)) in migrant women of reproductive age is restricted. Methods: A simple random sample of 5037 Swedish‐born and 629 foreign‐born women (aged 20–41 at the first occasion) were interviewed over the periods 1983–1990 and 1991–1998. The risk of LLSI was estimated by applying logistic regression for correlated data. Results: First‐generation labour‐migrant women (OR=1.86) and refugee women (OR=1.75) had an increased risk of LLSI compared to Swedish‐born women. The risk decreased only marginally (OR=1.64 and 1.48, respectively) after adjustment for marital status, socio‐economic status, feelings of insecurity and the longitudinal effect of age. Women without employment, with a low attained level of education, without children, with feelings of insecurity or poor economic resources showed a high risk of LLSI. Similar results were observed when second‐generation women were compared to Swedish‐born women. However, immigrant women's health did not deteriorate more than that of Swedish‐born women. Conclusions: First‐ and second‐generation immigrant women of reproductive age had an increased risk of LLSI, compared to their Swedish counterparts. Furthermore, immigrant women's health did not become proportionally worse than the health of Swedish women during the 8‐year period.

Two competing hypotheses underpinned an investigation into limiting long-standing illness (LLI) among UK graduates. Hypothesis 1 proposed childhood social class (CSC) influences LLI independently of educational attainment and adult income. Hypothesis 2 proposed typical middle-class graduates would have lower LLI prevalence than typical and atypical working-class and atypical middle-class graduates. Working/middle-class refers to childhood circumstances. Atypical/typical refers to full-time employment duration before attending university. Graduates (1985; N = 5093 and 1990; N = 8147) were followed up in 1996. Logistic regression was used to examine LLI in 1996 by CSC only and CSC, atypical graduate status and their interaction, adjusting for age and adult income. Hypothesis 1 was not confirmed. Hypothesis 2 was partially confirmed. Typical middle-class graduates had a lower LLI prevalence than typical working-class and atypical middle-class graduates. These results support the idea that opportunities for good human functioning are culturally determined and affect health.

There is only scant evidence for the long-term health effects of road traffic injuries. We therefore assessed the extent to which motor vehicle driver injuries influence limiting long-standing illness and psychological distress using data from a nationwide study (the 1958 British birth cohort) in early adulthood. Information was obtained on driver injuries occurring between ages 23 and 33 years and limiting illnesses and psychological distress at age 33 years. The risks of injury-related adverse consequences were derived using logistic regression and expressed as odds ratios (ORs) and 95% confidence intervals. A single injury was associated with limiting illness (OR = 2.01 and 95% CI: 1.38-2.94). The association between a single injury and psychological distress was strong for a recent injury occurring between ages 30 and 33 years (OR = 1.86 and 95% CI: 1.24-2.81), but not for injuries occurring earlier on. The population attributable fraction for limiting illness with one injury was 3.8% (range 1.7-5.3%) and with two or more injuries was 1.0% (range 0.5-1.3%). After controlling for potential confounding factors the corresponding figures were 4.2% (range 2.2-5.6%) and 1.1% (range 0.5-1.3%) respectively. Driver injuries are associated with a substantial increase in disability and, also in the short term, with increases in psychological distress. These results highlight the need for identifying effective strategies for the prevention of road traffic injuries as well as more effective approaches for rehabilitation of the injured.