Table 3

Estimated pre-intervention and post-intervention annual burden of disease in the study population

Determinant of healthOutcomePIF (%)Burden of disease in the study population (DALY)*
Pre-interventionPost-intervention
Physical inactivityIschaemic heart disease−1.582096.62063.6
Ischaemic stroke−1.47988.9 974.3
Type II diabetes−1.13961.5 950.6
Breast cancer−0.68963.8957.2
Colon cancer−1.75624.0§ 613.0
Total (physical inactivity) 5634.85558.7
Air pollutionCardiopulmonary diseases0.058219.18223.4
Lung cancer0.071565.21566.3
Total (air pollution) 9784.39789.7
Traffic accidentsPolice-reported injuries or death due to bicycle and car accidents16.9303.2 354.3§
Burden of disease from included outcomes 13625.6** 13606.1
  • * Burden of disease for the study population was calculated based on WHO's estimates of burden of disease in Denmark,28 allowing for the absolute size of the population (437 000 people) and the age groups included. Age was adjusted using the age distribution of burden of disease from WHO subregion EUR-A11 since age-specific estimates are not available at country level.

  • WHO's estimate of burden of disease from stroke covers both ischaemic and haemorrhagic stroke. However, only ischaemic stroke was associated with physical inactivity.1 Assuming equal burden of disease from the two outcomes, burden of disease from ischaemic stroke was calculated as the relative share of ischaemic stroke in Denmark (80%–85%).33

  • WHO estimates the total burden of disease from type I and II diabetes. Due to differences in the duration of type I and type II diabetes, the burden of disease from type II diabetes alone is difficult to estimate. WHO's estimate was therefore used. We did not expect this to introduce great uncertainty, since type II diabetes accounts for 85%–90% of diabetes cases in Denmark.33

  • § WHO estimates burden of disease from colorectal cancer. However, only colon cancer was associated with physical inactivity.1 Assuming equal burden of disease from the two outcomes, burden of disease from colon cancer was calculated as the proportion of colorectal cancers in Denmark made up of colon cancer (71.8%).34

  • WHO estimates the total burden of disease from road traffic accidents. Assuming the same relative severity of accidents involving different travel modes, burden of disease in the population due to bicycle and car accidents was calculated based on the distribution of accidents in Denmark (60.5% bicycle or car accidents)21 and adjusted for lower burden of disease from accidents in Copenhagen and surrounding municipalities than in Denmark overall.29

  • ** Change in burden of disease from ischaemic heart disease was affected by both physical inactivity and air pollution. Therefore, the total burden of disease did not equal the sum of burden of disease from the individual outcomes.

  • DALY, disability-adjusted life years; PIF, potential impact fraction.