Life expectancy in the province of Halland, Sweden. A historic to modern, socio-epidemiological perspective with focus on cardiovascular diseases

Abstract: Introduction One of the most concrete expressions of mortality in a population is the so-called life expectancy, i.e. a figure that indicates the average life span of an individual under the prevailing conditions. The life expectancy of a population is considered as a generic measure of public health. The province of Halland is situated in the Southwestern part of Sweden and has today a population of approximately 270 000 inhabitants. The province has retained its agrarian character, more so than the country as a whole. Today, the population of Halland has a life expectancy of 79.37 years, which is the highest in Sweden.The aim of the thesis was to study life expectancy and causes of death, in particular cardiovascular diseases in the province of Halland, compared to Sweden as a whole, for the purpose of identifying, from a socio-epidemiological perspective, important factors contributing to life expectancy during the 20th century.Material and Method Data on population, death rates and causes of death in Halland and Sweden between 1911 and 1950 were processed in a computer program specially designed for the purpose of studying life expectancy and causes of death from a historical perspective. From a modern perspective, mortality from cardiovascular diseases in both Halland and Sweden between 1980-1990 was investigated by means of a prospective design, the aim being to establish whether or not any association with socio-economic status exists. In addition, the incidence of acute myocardial infarction in the period 1980-1992 as well as chest pain in 1997 was studied with socio-economic status as a background variable. Poisson distribution, Poisson regression and logistic regression with 95% CI and p-value were employed.Results Since 1911, Halland has shown a longer life expectancy when compared to Sweden as a whole. From a historical perspective, this difference could be explained by lower infant mortality in combination with lower mortality from infectious diseases while, from a modern perspective, the explanations are lower mortality from cardiovascular diseases in general and ischaemic heart disease in particular. The favourable conditions in Halland can most likely be explained by the socio-structural differences in past times and individual differences in the present day.Conclusion The favourable health situation in Halland is based on a combination of a high standard of living and the associated rich nutritional intake resulting from the agricultural development of the province, in addition to the agrarian environment and the relatively homogeneous social structure.