Scandinavian Journal of Public Health最新文献

Aims: To assess whether lifestyle factors, including sleep pattern, are predictors for the development of functional somatic disorder (FSD).

Methods: A population-based prospective cohort of 9656 men and women aged 18-76 years was established in 2011-2015 and invited for re-examination in 2017-2020, when 5738 participated. Median follow-up period was 65 months. Participants filled in validated questionnaires on lifestyle, sleep pattern and various delimitations of FSD, which were operationalized using two different approaches: bodily distress syndrome (BDS) and functional somatic syndromes (FSS) (i.e. chronic fatigue, chronic widespread pain (CWP), irritable bowel, and multiple chemical sensitivity (MCS)). Baseline lifestyle and sleep pattern in relation to incidence of BDS and FSS (chronic fatigue, CWP, irritable bowel, MCS) was analysed by logistic regressions, adjusted for age, sex and subjective social status.

Results: Inferior sleep quality at baseline predicted both incidence of BDS and all FSS delimitations except MCS. Smoking, alcohol intake, and low physical activity, but not diet, were predictors for the development of BDS. No uniform pattern was observed for the FSS. Smoking predicted development of chronic fatigue, CWP and irritable bowel, but not MCS. Alcohol and food quality only influenced the development of chronic fatigue whereas low physical activity only influenced the development of chronic fatigue and CWP.

Conclusions: Lifestyle factors and sleep pattern seem to be predictors for some delimitations of FSD, but the importance of the various lifestyle factors is different for the different delimitations. The study shows the importance of analysing the various FSSs separately.

Aims: Reproductive history conveys information about potential health risks later in adulthood. This study aimed to examine the validity of self-reported number of pregnancies and maternal age at first birth (AFB) among females attending BreastScreen Norway.

Methods: Participants were identified through the Janus Serum Bank cohort in Norway and were eligible for this cross-sectional validation study if they participated in a health survey issued by BreastScreen Norway between 2006 and 2015. Retrospective self-reported survey information on number of pregnancies and AFB in years was validated against prospectively collected information from the Medical Birth Registry of Norway (MBRN) using the Spearman rank (r_s) and intraclass correlation coefficients (ICC) with 95% confidence intervals (CI).

Results: After exclusions, 51,598 subjects were included in the analysis on number of pregnancies and 46,919 in the analysis on AFB. On average, study subjects were 59-60 years old when completing the health survey and had become first-time mothers roughly 36 years earlier. Survey-based information about number of pregnancies was highly correlated and demonstrated high agreement with the registry data (r_s=0.967, 95% CI 0.964-0.969; ICC=0.884, 95% CI 0.882-0.885). Survey-based information about AFB demonstrated even higher correlation and very high agreement with the registry data (r_s=0.975, 95% CI 0.973-0.976; ICC=0.974, 95% CI 0.974-0.975).

Conclusions: Retrospectively recalled survey-based information about number of pregnancies and AFB was highly accurate when validated against prospectively collected information in the MBRN. These survey-based data are valuable for future epidemiological research, and linkage to the MBRN may not be required when these data are available.

Background: Effective public health initiatives should be founded on a comprehensive and robust understanding of health-related factors including societal and community contexts. The Norwegian Counties Public Health Survey (NCPHS) aims for insights into the adult population on topics relevant for planning public health practices at county and municipality levels.

Methods: The NCPHS includes a core questionnaire on public health-related topics and demographics, including indicators of socio-economy, with additional optional questions and scales varying across data collections. Samples are drawn from the Norwegian National Population Register and 'washed' against the Common Contact Register to retrieve digital contact information and exclude those who cannot be contacted electronically. NCPHS was piloted in 2015 and 2018 (four counties). After some revision of instruments and sampling procedures, surveys have been carried out in most Norwegian counties since 2019. The total number of participants has now passed 400,000.

Results: Expedient data analysis has enabled the Norwegian Institute of Public Health to present comprehensive reports within 6 weeks of completed data collections. In these, outcome variables are analysed against district (within counties), gender, age, educational attainment and self-reported sufficiency of household income. Tables are also made available at the municipality level.

Conclusions: The NCPHS represents a valuable addition to existing data sources, providing critical information for planning purposes for local and regional public health authorities, for assessing trends over time, comparisons across counties and regions and for evaluation of policies and interventions. The value of such a system during times of crisis was demonstrated during the COVID-19 pandemic.

Background: Studying complete hospital care episodes from register data, for instance when assessing length of stay, discharges and readmissions, can cause methodological difficulties due to the lack of a contact linkage identifier. We aimed to develop an algorithm combining sequential attendance contacts in the Danish National Patient Register (DNPR) into hospital care episodes, spanning the entire duration and all contacts from hospital arrival to departure.

Methods: The algorithm was developed under the consensus of experts from research institutions across Denmark. It reads in second and third version DNPR data, deletes contacts without attendance, duplicates elective outpatient contacts corresponding to attendance dates and modifies contact types (e.g. repeated acute contacts), among others. Thereafter, sequential contacts within 4 h are marked as the same hospital care episode, consisting of one or more DNPR contact. We tested the algorithm in a data set of adults living in Denmark during 2013-2021 and compared different hourly cut-offs.

Results: For the demonstration, we included 120.2 m contacts from 5.7 m persons, combined into 105.9 m hospital care episodes. Of the hospital care episodes, 6.4% were acute inpatients, 8.3% were acute outpatients, 2.0% were elective inpatients and 83.3% were elective outpatients. Using 4 h as our recommendation, 3-h, 5-h and 6-h cut-offs for contact combining revealed only minor differences in the number of hospital care episodes (<0.4%), whereas 12-h (<1.7%) and 24-h cut-offs (<43.1%) had a larger impact.

Conclusions: The algorithm automates data reading, modification and linkage of sequential attendance contacts. The algorithm can be initiated as a SAS macro and is available from an online repository.

Aim: Since a lack of financial security among vulnerable groups could further hamper health and well-being, this study scrutinises factors predicting rejected prolonged sickness cash benefit claims among people on compensated sick leave of more than 180 days with a rejection between days 181 and 365.

Methods: All 246,872 claims for employed people on sick leave recorded in the Swedish official statistics register between January 2018 and June 2021 were analysed. Claim outcome was evaluated using logistic regression with odds ratios recalculated to relative risks (RR) with 95% confidence intervals (CI), mutually adjusted for sociodemographic, work and health-related factors.

Results: Overall, 46,611 (19%) of the claims were rejected, with slightly lower rates among women (RR=0.97; 95% CI 0.95-0.99). Musculoskeletal diseases had the highest rejection rates (RR=1.84; 95% CI 1.75-1.94) followed by injuries (RR=1.57; 95% CI 1.50-1.64) and symptoms (RR=1.51; 95% CI 1.46-1.56). Mental disorders also had above-average rates (RR=1.14; 95% CI 1.09-1.19), whereas the lowest rates were found among pregnancy-related diagnoses (RR=0.13; 95% CI 0.12-0.14) and neoplasms (RR=0.18; 95% CI 0.18-0.18). Higher rates were found among immigrants (RR=1.37; 95% CI 1.34-1.40), those with only primary education (RR=1.09; 95% CI 1.06-1.12) and among blue-collar workers. The regional variation was substantial (RR range 0.41-1.72).

Conclusions: High rejection rates were found for complex diagnoses and diagnoses with presupposed work ability in physically lighter occupations and among groups with assumed precarious positions at the labour market. Systematic differences in rates were identified between geographic regions. More studies are warranted to conclude if the differences found could be justified by other factors.

Aim: To describe the design of the Danish National Health Survey (DNHS) 2023, participants' demographic characteristics and differences in demographic and selected health-related characteristics between respondents invited by web-mode and paper-mode.

Methods: A sample of 25,000 residents in Denmark aged 16 years or above was invited to participate in the DNHS 2023 using a mixed-mode approach (web/paper mode). Web-mode invited were additionally invited to participate in an accelerometer study. The self-administered questionnaire included 83 questions about health, health behaviour and morbidity. Descriptive statistics were used to describe characteristics associated with response and invitation mode.

Results: The response proportion was 40.8%. Non-response was more frequent among men, individuals of the youngest age groups, individuals with non-Western backgrounds, unmarried and individuals from densely populated areas. The response proportion was higher among web-mode invited (42.0%) than paper-mode invited (22.6%). Paper-mode invited respondents were more often women, aged 80 years or older, and widowed compared with web-mode invited respondents.

Conclusions: The DNHS 2023 is a national health survey including adult residents in Denmark. Non-response was more pronounced among some subgroups; however, calibrated weights were calculated to minimise non-response bias. The survey is essential for public health surveillance and can be used in health planning and policy development. Furthermore, the data from the survey can be used for research on the population's health and health behaviour. For future waves of the DNHS, it should be considered whether resources should be used to invite people unsubscribed from digital-post due to the low response proportion.

Aims: We tested the polarization hypothesis, which postulates that during times of crises, such as the COVID-19 pandemic, alcohol consumption increases among the heaviest drinkers but decreases among most other drinkers, resulting in an overall decrease in consumption among the population. We posited the increase in heavy drinking would lead to increases in 100% alcohol-attributable (AA) mortality. Furthermore, based on the high level of alcohol consumption in the Baltic countries compared to other European countries, we predicted that the increases in AA mortality would be more pronounced in these countries.

Methods: Data for 100% AA deaths were obtained from the World Health Organization for the period 2010 to 2022, and standardized to the regional age distribution for 2010. Parametric and non-parametric tests were used to test the study hypotheses.

Results: The mean age-standardized 100% AA mortality rate increased during the COVID-19 pandemic in the 19 European countries with data by 3.12 deaths per 100,000 population, constituting an 18% increase (tested against no change: t = 2.52; df = 18; p = 0.021). This increase was higher in the Baltic countries (mean difference = 13.41 deaths per 100,000 population; standard deviation (SD) = 7.44; 46% increase) than for other European countries (mean difference = 1.19; SD = 1.55; 8% increase). The increases in 100% AA mortality were associated with decreases in the level of alcohol consumption in the majority of countries.

Conclusions: As predicted, 100% AA mortality increased in 19 European countries during the COVID-19 pandemic, with the Baltic countries seeing a higher increase. Renewed alcohol control policy efforts should be considered.

Study aim: The objective of this scoping review was to explore and summarise emerging themes in existing studies on personal experiences of migrant parents of children with special health and welfare needs and their interaction with health and welfare services in the Nordic countries.

Methods: A comprehensive and systematic search for relevant articles in electronic databases was conducted in PubMed, PsycINFO and Web of Science between 2 April 2023 and 31 May 2023. The scoping review followed identified guidelines in conducting scoping reviews. Out of the initial 1836 study results, 62 studies were read and assessed as full text and a total of 13 studies met the inclusion criteria.

Results: Using thematic analysis, three key thematic categories were identified: (a) Initial responses to having a child with health and welfare challenges; (b) encountering the Nordic health and welfare services; (c) implications on social inclusion. The challenges to participation faced by migrants threatened their wellbeing, impacted their relationships and influenced their coping strategies and opportunities for social inclusion.

Conclusions: The Nordic countries have accessible, affordable and well-equipped infrastructure for health and welfare services compared with the home countries of most migrants. Future research is necessary to explore alternative strategies and spaces to promote participation and involvement of migrant parents of children with special health and welfare needs to inform public health and welfare services development and research.

Aims: We aim to address the knowledge gap surrounding food insecurity in general practice in Norway, focusing on its prevalence among patients, sociodemographic correlates and its relationship with chronic diseases across different age groups.

Methods: This study is cross-sectional, collecting data through 69 general practice clinics in 2022 from patients >18 years old visiting their general practitioner. They answered an anonymous questionnaire with the Cornell-Radimer hunger scale. Questions addressed hunger, concerns about food access, financial difficulties purchasing food, impact on children, patient demographics, children, and use of medications for chronic disease. We present logistic regression models with odds ratios (ORs) with 95% confidence intervals to examine associations between food insecurity and patient characteristics.

Results: Among 2571 invited patients, 81.2% (n=2089) participated in the study. Of the participants, 40.1% were considered food insecure. The questions in the Cornell-Radimer hunger scale indicated that most had a mild degree of food insecurity. Food insecurity ranged from 28.9% among those >70 years old to 68.0% among those <30 years old. Food insecurity was associated with age <30 years, being migrant, inversely associated with higher educational levels (OR 0.60, 0.41-0.87) or having own children (OR 0.24, 0.18-0.31). Food insecurity was higher among participants using medications for chronic disease (OR 1.33, 1.05-1.68).

Conclusions: This study underscores the presence of food insecurity in high-income countries like Norway, particularly among specific groups such as young adults, migrants and patients with chronic diseases. These categories of patient could benefit from screening of food insecurity during medical contact.

Aims: Both social sustainability and health promotion emphasize the development of local communities that satisfy human needs and enhance health and well-being. This scoping review aimed to identify frameworks, components, and operationalizations of social sustainability described in peer-reviewed articles and systematize the results from a health promotion perspective.

Methods: Six databases were searched for relevant articles following the JBI methodology and PRISMA guidelines. Articles were included if they provided a unique framework for social sustainability, that is, a conceptual model outlining the essential components of this concept. Information concerning the components of social sustainability and their operationalizations was analyzed through a six-step narrative synthesis. The final step involved categorizing the operationalizations of social sustainability into distinct levels by employing a socio-ecological model as an analytical tool.

Results: This review identified 22 articles presenting a social sustainability framework. The frameworks covered 11 components, of which social equity, safety, and neighborhood quality were the most frequent, while only five included health and well-being. The frameworks commonly provided practical interpretations of the concept with limited theoretical considerations. Furthermore, the identified operationalizations revealed a diverse understanding of social sustainability, encompassing all levels of the socio-ecological model applied.

Conclusions: Health promotion research can offer theoretical and empirical insights that enhance the understanding of social sustainability, especially how societal, physical, and social determinants of health and well-being interact to create socially sustainable places. Likewise, the social sustainability literature may provide valuable knowledge underscoring the importance of contextual factors of health and well-being within the field of health promotion.