TY - JOUR T1 - The potential impact of a social redistribution of specific risk factors on socioeconomic inequalities in mortality: illustration of a method based on population attributable fractions JF - J Epidemiol Community Health Y1 - 2013 A1 - Hoffmann,R. A1 - Eikemo,T.A. A1 - Kulhanova,I. A1 - Dahl,E. A1 - Deboosere,P. A1 - Dzurova,D. A1 - Herman Van Oyen A1 - Rychtarikova,J. A1 - Strand,B.H. A1 - Mackenbach,J.P. KW - Activity KW - alcohol KW - ALL KW - an KW - application KW - approach KW - approaches KW - article KW - Attributable KW - authors KW - Belgium KW - BODY MASS KW - Body Mass Index KW - Body-mass KW - cause specific KW - cause specific mortality KW - cause-specific KW - challenge KW - conventional KW - Countries KW - CZECH KW - Czech Republic KW - data KW - differences KW - Educational level KW - Educational-level KW - electronic KW - EPIDEMIOLOGICAL KW - factors KW - Fraction KW - Gender KW - health KW - Health inequalities KW - Health inequality KW - health survey KW - health surveys KW - im KW - Impact KW - index KW - inequalities KW - inequalities in mortality KW - inequality KW - INFORMATION KW - intervention KW - interventions KW - IS KW - journal KW - LEVEL KW - Literature KW - Mass KW - Mass index KW - medical KW - MEN KW - method KW - methods KW - mortality KW - national KW - National Health Survey KW - National-health KW - Netherlands KW - Norway KW - norwegian KW - ON KW - PAF KW - physical KW - Physical activity KW - Physical-activity KW - POPULATION KW - prevalence KW - public KW - public health KW - Public-health KW - RANGE KW - Reduction KW - regression KW - Research KW - Research Support KW - result KW - results KW - risk KW - Risk factor KW - Risk Factors KW - Risk-factor KW - Risk-factors KW - SB - IM KW - SCENARIO KW - SCENARIOS KW - SMOKING KW - SOCIAL KW - Socioeconomic KW - Socioeconomic differences KW - Socioeconomic inequalities KW - specific KW - survey KW - surveys KW - The Netherlands KW - WOMEN AB - BACKGROUND: Socioeconomic differences in health are a major challenge for public health. However, realistic estimates to what extent they are modifiable are scarce. This problem can be met through the systematic application of the population attributable fraction (PAF) to socioeconomic health inequalities. METHODS: The authors used cause-specific mortality data by educational level from Belgium, Norway and Czech Republic and data on the prevalence of smoking, alcohol, lack of physical activity and high body mass index from national health surveys. Information on the impact of these risk factors on mortality comes from the epidemiological literature. The authors calculated PAFs to quantify the impact on socioeconomic health inequalities of a social redistribution of risk factors. The authors developed an Excel tool covering a wide range of possible scenarios and the authors compare the results of the PAF approach with a conventional regression. RESULTS: In a scenario where the whole population gets the risk factor prevalence currently seen among the highly educated inequalities in mortality can be reduced substantially. According to the illustrative results, the reduction of inequality for all risk factors combined varies between 26% among Czech men and 94% among Norwegian men. Smoking has the highest impact for both genders, and physical activity has more impact among women. CONCLUSIONS: After discussing the underlying assumptions of the PAF, the authors concluded that the approach is promising for estimating the extent to which health inequalities can be potentially reduced by interventions on specific risk factors. This reduction is likely to differ substantially between countries, risk factors and genders VL - 67 CP - 1 U1 - 35655 M3 - http://dx.doi.org/10.1136/jech-2011-200886 ER -