{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T02:31:04Z","timestamp":1776825064476,"version":"3.51.2"},"reference-count":83,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,3,22]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to examine associations between educational level, serving as an indicator of socioeconomic position, and prevalence of WHO-established leading behavioural and biological risk factors for non-communicable diseases (NCDs), in middle-aged to older women and men.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Population-based cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>All inhabitants of the municipality of Troms\u00f8, Norway, aged \u226540 years, were invited to the seventh survey (2015\u20132016) of the Troms\u00f8 Study; an ongoing population-based cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Of the 32\u2009591 invited; 65% attended, and a total of 21\u2009069\u2009women (53%) and men aged 40\u201399 years were included in our study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>We assessed associations between educational level and NCD behavioural and biological risk factors: daily smoking, physical inactivity (sedentary in leisure time), insufficient fruit\/vegetable intake (&lt;5 units\/day), harmful alcohol use (&gt;10\u202fg\/day in women, &gt;20\u202fg\/day in men), hypertension, obesity, intermediate hyperglycaemia and hypercholesterolaemia. These were expressed as odds ratios (OR) per unit decrease in educational level, with 95% CIs, in women and men.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In women (results were not significantly different in men), we observed statistically significant associations between lower educational levels and higher odds of daily smoking (OR 1.69; 95%\u2009CI 1.60 to 1.78), physical inactivity (OR 1.38; 95%\u2009CI 1.31 to 1.46), insufficient fruit\/vegetable intake (OR 1.54, 95%\u2009CI 1.43 to 1.66), hypertension (OR 1.25; 95%\u2009CI 1.20 to 1.30), obesity (OR 1.23; 95%\u2009CI 1.18 to 1.29), intermediate hyperglycaemia (OR 1.12; 95%\u2009CI 1.06 to 1.19), and hypercholesterolaemia (OR 1.07; 95%\u2009CI 1.03 to 1.12), and lower odds of harmful alcohol use (OR 0.75; 95%\u2009CI 0.72 to 0.78).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We found statistically significant educational gradients in women and men for all WHO-established leading NCD risk factors within a Nordic middle-aged to older general population. The prevalence of all risk factors increased at lower educational levels, except for harmful alcohol use, which increased at higher educational levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-080611","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T12:49:22Z","timestamp":1714481362000},"page":"e080611","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Social inequality in prevalence of NCD risk factors: a cross-sectional analysis from the population-based Troms\u00f8 Study 2015\u20132016"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6998-9697","authenticated-orcid":false,"given":"Rebecca A","family":"Hetland","sequence":"first","affiliation":[{"name":"Department of Community Medicine, UiT The Arctic University of Norway, Troms\u00f8, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2709-9472","authenticated-orcid":false,"given":"Tom","family":"Wilsgaard","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, UiT The Arctic University of Norway, Troms\u00f8, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0072-7421","authenticated-orcid":false,"given":"Laila Arnesdatter","family":"Hopstock","sequence":"additional","affiliation":[{"name":"Department of Health Care Sciences, UiT The Arctic University of Norway, Troms\u00f8, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8529-4826","authenticated-orcid":false,"given":"Inger","family":"Ariansen","sequence":"additional","affiliation":[{"name":"Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7912-5786","authenticated-orcid":false,"given":"Jonas","family":"Johansson","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, UiT The Arctic University of Norway, Troms\u00f8, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0781-3349","authenticated-orcid":false,"given":"Bjarne K","family":"Jacobsen","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, UiT The Arctic University of Norway, Troms\u00f8, Norway"},{"name":"Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Troms\u00f8, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameline","family":"Grimsgaard","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, UiT The Arctic University of Norway, Troms\u00f8, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,4,30]]},"reference":[{"key":"2025121300042852000_14.4.e080611.1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)30925-9"},{"key":"2025121300042852000_14.4.e080611.2","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/S0140-6736(18)31992-5","article-title":"NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards sustainable development goal target 3.4","volume":"392","author":"Bennett","year":"2018","journal-title":"The Lancet"},{"key":"2025121300042852000_14.4.e080611.3","doi-asserted-by":"crossref","DOI":"10.1177\/2040622319880392","article-title":"Common risk factors for major Noncommunicable disease, a systematic overview of reviews and commentary: the implied potential for targeted risk reduction","volume":"10","author":"Peters","year":"2019","journal-title":"Ther Adv Chronic Dis"},{"key":"2025121300042852000_14.4.e080611.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1203528"},{"key":"2025121300042852000_14.4.e080611.5","unstructured":"Global Burden of Disease Collaborative Network . 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