Journal
ADDICTION
Volume 110, Issue 9, Pages 1505-1512Publisher
WILEY
DOI: 10.1111/add.12939
Keywords
Alcohol; bias; cause-specific morbidity; cause-specific mortality; drug; health survey; non-response; smoking; survival
Categories
Funding
- UK Medical Research Council
- Chief Scientist Office of the Scottish Government Health Directorates (CSO) at the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow [MC_UU_12017/5, SPHSU2]
- CSO [MC_A540_5TK10]
- Chief Scientist Office [SPHSU13, SPHSU2] Funding Source: researchfish
- Medical Research Council [MC_UU_12017/13, MR/J013498/1, MC_EX_UU_MR/J013498/1, MC_EX_MR/J013498/1, MC_UU_12017/5] Funding Source: researchfish
- MRC [MC_EX_UU_MR/J013498/1, MC_EX_MR/J013498/1, MC_UU_12017/13, MC_UU_12017/5] Funding Source: UKRI
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AimResponse rates in health surveys have diminished over the last two decades, making it difficult to obtain reliable information on health and health-related risk factors in different population groups. This study compared cause-specific mortality and morbidity among survey respondents and different types of non-respondents to estimate alcohol-, drug- and smoking-related mortality and morbidity among non-respondents. DesignProspective follow-up study of respondents and non-respondents in two cross-sectional health surveys. SettingDenmark. ParticipantsA total sample of 39540 Danish citizens aged 16years or older. MeasurementsRegister-based information on cause-specific mortality and morbidity at the individual level was obtained for respondents (n=28072) and different types of non-respondents (refusals n=8954; illness/disabled n=731, uncontactable n=1593). Cox proportional hazards models were used to examine differences in alcohol-, drug- and smoking-related mortality and morbidity, respectively, in a 12-year follow-up period. FindingsOverall, non-response was associated with a significantly increased hazard ratio (HR) of 1.56 [95% confidence interval (CI)=1.36-1.78] for alcohol-related morbidity, 1.88 (95% CI=1.38-2.57) for alcohol-related mortality, 1.55 (95% CI=1.27-1.88) for drug-related morbidity, 3.04 (95% CI=1.57-5.89) for drug-related mortality and 1.15 (95% CI=1.03-1.29) for smoking-related morbidity. The hazard ratio for smoking-related mortality also tended to be higher among non-respondents compared with respondents, although no significant association was evident (HR=1.14; 95% CI=0.95-1.36). Uncontactable and ill/disabled non-respondents generally had a higher hazard ratio of alcohol-, drug- and smoking-related mortality and morbidity compared with refusal non-respondents. ConclusionHealth survey non-respondents in Denmark have an increased hazard ratio of alcohol-, drug- and smoking-related mortality and morbidity compared with respondents, which may indicate more unfavourable health behaviours among non-respondents.
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