Journal of Public Health

, Volume 23, Issue 5, pp 257–265 | Cite as

Relationship of behavioral risk factors for chronic diseases and preventive health services utilization among adults, aged 50+, from eleven European countries

  • Manolis Linardakis
  • Angeliki Papadaki
  • Emmanouil Smpokos
  • Katerina Micheli
  • Maria Vozikaki
  • Anastas Philalithis
Original Article



The current study aims to assess the relationship between behavioral risk factors (BRFs) for chronic diseases and preventive health services utilization among European adults.

Subjects and Methods

We used data from 16,125 adults, aged 50+ years, from 11 countries participating in the Survey of Health, Ageing and Retirement in Europe (2004/05). Prevalence of BRFs (high body weight, smoking, physical inactivity and risky alcohol consumption) was examined in relation to preventive health services utilization, which was assessed via a 12-component score (PHSUs) (scale: 0–100). Estimations were based on the complex study design.


Of the participants, 90.7% were seeing a general practitioner (GP) and 52.7% had 2+ BRFs. Adults with high body weight had lower odds of seeing a dentist (0.75, p < 0.05) or having sigmoidoscopy/colonoscopy (0.70, p < 0.05) and higher odds of receiving GP advice to exercise regularly (1.56, p < 0.05). Smokers had lower odds of having mammograms (0.76, p < 0.05), sigmoidoscopy/colonoscopy (0.72, p < 0.05) and being tested for hidden blood in stool (0.63, p < 0.05). Risky drinkers had lower odds of having mammograms (0.23, p < 0.05). Lower mean PHSUs were found for adults with high body weight (p = 0.001), smokers (p = 0.001) and risky drinkers (p = 0.008), while PHSUs did not differ by BRF clusters (p = 0.218). In adults with 2+ BRFs, Greece was the country with the lowest mean PHSUs (28.0, p < 0.05).


Adults with high body weight, those who smoked and were risky drinkers used fewer preventive health services. Primary prevention programs should be developed to reduce BRF prevalence and promote preventive health services use in this population.


Preventive health services Behavioral risk factors Chronic disease SHARE study 



Study of Health, Ageing and Retirement in Europe


Behavioral Risk Factors


Preventive Health Services Utilization score



The European Union (EU) provided funding to the present study through the co-funded program of “Thalis-Panteion-Investigating Crucial Interdisciplinary Linkages in Ageing Societies,” which is part of the Operational Program of “Education and Lifelong Learning” (MIS380266).

Conflict of interest

The authors declare that they have no conflicts of interests.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Manolis Linardakis
    • 1
  • Angeliki Papadaki
    • 2
  • Emmanouil Smpokos
    • 1
  • Katerina Micheli
    • 1
  • Maria Vozikaki
    • 1
  • Anastas Philalithis
    • 1
  1. 1.Department of Social Medicine, Faculty of MedicineUniversity of CreteHeraklionGreece
  2. 2.Centre for Exercise, Nutrition & Health Sciences, School for Policy StudiesUniversity of BristolBristolUK

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