New Global Burden of Disease estimates show health inequalities in Norway have decreased over the past 30 years, but more work is needed to close the gap

SEATTLE, Wash. – From 1990 to 2019, Norway reduced inequality in disease burden; however, an examination at a more granular level shows inequalities still exist. That’s according to the latest study based on the Global Burden of Disease 2019 conducted by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine and a Norwegian team of researchers, which was published today in The Lancet Public Health.

This is the first time researchers have analyzed differences in life expectancy and disease burden by sex across all 11 Norwegian counties. The new analysis of all counties during the 30-year span shows the leading causes of disease burden were low back pain, ischemic heart disease, and headache disorders. In Oslo, depressive disorders were the leading cause of disease burden for females and the second-highest cause for both sexes combined. Between 1990 and 2019, Oslo had the highest increase in life expectancy, from 79 to 84.6 years for females and from 71.9 to 81.3 for males. The highest life expectancies in 2019 were 85.4 years for females in Vestland county and 81.9 years for males in Møre og Romsdal and Viken counties.

Norway is now ranked among the top 10 countries in the world for life expectancy at birth, healthy life expectancy, and age-standardized rate of disability-adjusted life years. The findings show that Norwegians are living longer due to reductions in cardiovascular disease, neoplasms, and respiratory infections.

“The primary reason we saw an increase in life expectancy across all counties in Norway was due to a decrease in death rates from ischemic heart disease and lung cancer,” said Dr. Ben Clarsen, lead author on the study and researcher at the Norwegian Institute of Public Health. “One of the reasons we saw a drop in mortality in cardiovascular diseases and lung cancer is a 50-year policy that helped cut the prevalence of smoking by more than half from 1990 to 2019.” Despite this progress, tobacco is still a leading risk factor across all Norwegian counties.

Other risk factors that remain health challenges in Norway include high fasting plasma glucose, high body mass index, alcohol use, and drug use, which increased substantially in all counties in the last three decades.  

Clarsen and the coauthors highlight that substantial variation does exist at an inter-county level. For example, the richest 1% of men can expect to live 8.4 years longer than the poorest 1%, while for women that difference is 13.8 years. Previous studies have shown large differences in the socioeconomic and educational profiles of certain municipalities within specific counties, and the link between these factors and population health has been well established. Studies have also shown a rural-urban divide in mortality and morbidity in Norway.

“Despite the low inequality in life expectancy and disease burden between the Norwegian counties, much work remains in reducing socioeconomic inequalities in health,” said Dr. Ann Skrindo Knudsen, the senior author on the study and director of the Department of Disease Burden at the Norwegian Institute of Public Health. “Policies should not only focus on equal access to health services and healthy lifestyle options based on where people live in the country, they should also focus on equal access regardless of neighborhood, income, and education.”

Media contacts:

IHME: [email protected]

Norwegian Institute of Public Health’s Department of Disease Burden: Catharina Wold Robson [email protected]

The Lancet: [email protected]

About the Institute for Health Metrics and Evaluation

An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. In making our research available and approachable, we aim to inform health policy and practice in pursuit of our vision: all people living long lives in full health.

About the Global Burden of Disease study

The Global Burden of Disease (GBD) study is the largest and most comprehensive effort to quantify health loss across places and over time. It draws on the work of more than 7,000 collaborators from 157 countries and territories. The Institute for Health Metrics and Evaluation coordinates the study. The GBD 2019 study was published in October 2020 and includes more than 38 billion estimates of 369 diseases and injuries and 87 risk factors in 204 countries and territories from 1990 to 2019.