Population Health

At a Glance Projects Publications Team


Behavioral Determinants of Health and Mortality

Conducted by Mikko Myrskylä; Kieron Barclay, Maarten Jacob Bijlsma, Alyson van Raalte, Christian Dudel, Yaoyue Hu, Enrique Acosta, Christina Bohk-Ewald (MPIDR / University of Helsinki, Finland), Pekka Martikainen (MPIDR / University of Helsinki, Finland)

Detailed Description

The objectives of this project are to determine to what degree risky health behavior (including smoking, obesity as manifestation of poor diet and lack of physical exercise, and alcohol consumption) individually and cumulatively affect health and mortality within and across populations. We take both a macro- and a micro-perspective, examining how health behaviors influence population-level trends in health and mortality, and we look at the extent to which health behaviors can explain socioeconomic variation in health and mortality.

We use register and survey data from a wide range of high-income countries, including the US, continental Europe, and the Nordic region to analyze the population-level health damage attributable to poor health behaviors. We also study the health-related behavioral mechanisms behind the long life and the good health enjoyed by vanguard populations, i.e., groups who experience the best health and lowest mortality. The profiles of vanguard groups help us to understand the extent to which risky health behaviors limit healthy and total life expectancy. They also indicate the level of health improvements that  can be gained without requiring medical or technological innovations but can be achieved through policies that effectively reduce risky health behaviors.

Our analysis of trends in obesity-related mortality in eight European countries has found that the prevalence of obesity increased throughout Europe in the last decades. In 2012, between 5 and 8% of deaths in the examined countries were attributable to obesity, representing an increase from past years. While obesity-related mortality rates generally declined due to significant reductions in mortality from all causes, there were important exceptions. In contrast to older birth cohorts, increases in obesity-related mortality rates among UK cohorts born after 1950 overshadowed improvements in all-cause mortality. Our work on US and Canadian cohorts paints a similar picture for the tail end of the baby boom generation born after 1950, finding that members of this cohort are more likely to die from a myriad of causes related to health behavior, including drug overdoses, excessive alcohol consumption, and smoking.

At the same time, vanguard groups continue to make strides in mortality improvements. Our work on Finnish men and women with doctorate degrees has shown that the life expectancy of doctorate recipients outpaces that of even other, highly-educated adults. In 2012, men with doctorates enjoyed more than two years of higher life expectancy than men with tertiary degrees, an advantage that has remained constant since the 1970’s. Using survey data from Eastern Europe, we have also found that men and women who adhere to the Mediterranean diet have better physical functioning than their peers. However, the results have also revealed that the diet can only do so much. While the level of functioning for diet adherents remains higher throughout older ages, it is not associated with a slowing decline in functioning with age.

Research Keywords:

Aging, Mortality and Longevity, Health Care, Public Health, Medicine, and Epidemiology


Acosta, E.; Gagnon, A.; Ouellette, N.; Bourbeau, R. R.; Nepomuceno, M. R.; van Raalte, A. A.:
MPIDR Working Paper WP-2020-003. (2020)    
McMinn, M.; Gray, L.; Härkänen, T.; Tolonen, H.; Pitkänen, J.; Molaodi, O. R.; Leyland, A. H.; Martikainen, P.:
Epidemiology. forthcoming. (2020)
Mehta, N. K.; Abrams, L. R.; Myrskylä, M.:
Proceedings of the National Academy of Sciences of the United States of America 117:13, 6998–7000. (2020)    
Bijwaard, G. E.; Tynelius, P.; Myrskylä, M.:
Population Studies 73:2, 217–232. (2019)    
Martikainen, P.; Jasilionis, D.; Junna, L. M.; Tarkiainen, L.:
Epidemiology 30:6, e32–e33. (2019)    
Stefler, D.; Hu, Y.; Malyutina, S.; Pajak, A.; Kubinova, R.; Peasey, A.; Pikhart, H.; Rodriguez-Artalejo, F.; Bobak, M.:
PLoS One 13:7, e0200460–e0200460. (2018)    
Vidra, N.; Bijlsma, M. J.; Trias Llimós, S.; Janssen, F.:
International Journal of Public Health 63:6, 683–692. (2018)    
Bijwaard, G. E.; Myrskylä, M.; Tynelius, P.; Rasmussen, F.:
MPIDR Working Paper WP-2017-003. (2017)    
Herttua, K.; Östergren, O.; Lundberg, O.; Martikainen, P.:
Journal of Epidemiology and Community Health 71:12, 1168–1176. (2017)    
Vogt, T. C.; van Raalte, A. A.; Grigoriev, P.; Myrskylä, M.:
Demography 54:3, 1051–1071. (2017)    
van Raalte, A. A.; Myrskylä, M.; Martikainen, P.:
Demographic Research 32:20, 589–620. (2015)
The Max Planck Institute for Demographic Research (MPIDR) in Rostock is one of the leading demographic research centers in the world. It's part of the Max Planck Society, the internationally renowned German research society.