Background: Smoking, physical inactivity
and obesity are modifiable risk factors for morbidity and mortality. The
aim of this study was
to examine the extent to which the co-occurrence of
these behaviour-related risk factors predict healthy life expectancy
and
chronic disease-free life expectancy in four
European cohort studies.

Methods: Data were drawn from repeated waves of four cohort studies in England, Finland, France and Sweden. Smoking status, physical
inactivity and obesity (body mass index ≥30 kg/m²)
were examined separately and in combination. Health expectancy was
estimated by using two health indicators: suboptimal
self-rated health and having a chronic disease
(cardiovascular disease, cancer, respiratory disease and diabetes).
Multistate
life table models were used to estimate
sex-specific healthy life expectancy and chronic disease-free life
expectancy from
ages 50 to 75 years.

Results: Compared with
men and women with at least two behaviour-related risk factors, those
with no behaviour-related risk factors
could expect to live on average8 years longer in
good health and 6 years longer free of chronic diseases between ages 50
and
75. Having any single risk factor was also
associated with reduction in healthy years. No consistent differences
between cohorts
were observed.

Conclusions: Data from
four European countries show that persons with individual and
co-occurring behaviour-related risk factors have
shorter healthy life expectancy and shorter chronic
disease-free life expectancy. Population level reductions in smoking,
physical inactivity and obesity could increase
life-years lived in good health.