Increasing socio-economic inequalities in life expectancy and QALYs in Sweden 1980-1997.

The aim of this study was to estimate the change in socio-economic differences in life expectancy and in quality-adjusted life years (QALYs), for men and women at different ages, in Sweden 1980 to 1997. We used data from the Swedish Survey of Living Conditions (the ULF survey), which is linked to mortality data, to estimate the life expectancy in different socio-economic groups in 1980 and 1997 (n=100 868). Health state scores were obtained by mapping responses to selected ULF survey interview questions into the generic health-related quality of life measure EQ-5D, using the UK EQ-5D index tariff (n=34 447). For 20-year-old men the difference in life expectancy between the highest (higher non-manual) and the lowest socio-economic group (unskilled manual) was 2.11 years in 1980 and 3.79 years in 1997. The corresponding figures for 20-year-old women were 1.56 in 1980 and 2.15 in 1997. The difference in QALYs between the highest and the lowest socio-economic group increased from 5.76 QALYs in 1980 to 7.06 QALYs in 1997 for 20-year-old men, and from 4.14 QALYs in 1980 to 5.66 QALYs in 1997 for 20-year-old women. The widening socio-economic inequalities over time were more stable for men than for women. We conclude that our results suggest that the socio-economic inequality in health has increased between 1980 and 1997 in Sweden.