Marita Melhus

Universitetet i Tromsø, Tromsø, Troms, Norway

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Publications (23)31.87 Total impact

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    ABSTRACT: To assess the population burden of angina pectoris symptoms (APS), self-reported angina and a combination of these, and explore potential ethnic disparity in their patterns. If differences in APS were found between Sami and non-Sami populations, we aimed at evaluating the role of established cardiovascular risk factors as mediating factors. Cross-sectional population-based study. A health survey was conducted in 2003-2004 in areas with Sami and non-Sami populations (SAMINOR). The response rate was 60.9%. The total number for the subsequent analysis was 15,206 men and women aged 36-79 years (born 1925-1968). Information concerning lifestyle was collected by 2 self-administrated questionnaires, and clinical examinations provided data on waist circumference, blood pressure and lipid levels. This study revealed an excess of APS, self-reported angina and a combination of these in Sami relative to non-Sami women and men. After controlling for age, the odds ratio (OR) for APS was 1.42 (p<0.001) in Sami women and 1.62 (p<0.001) for men. When including relevant biomarkers and conventional risk factors, little change was observed. When also controlling for moderate alcohol consumption and leisure-time physical activity, the OR in women was reduced to 1.24 (p=0.06). Little change was observed in men. This study revealed an excess of APS, self-reported angina and a combination of these in Sami women and men relative to non-Sami women and men. Established risk factors explained little or none of the ethnic variation in APS. In women, however, less moderate alcohol consumption and leisure-time physical activity in Sami may explain the entire ethnic difference.
    International journal of circumpolar health. 01/2014; 73.
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    ABSTRACT: To describe the method, data collection procedure and participation in The Population-based Study on Health and Living Conditions in Areas with both Sami and Norwegian Settlements - the SAMINOR 2 questionnaire study.
    International journal of circumpolar health 01/2014; 73. · 1.30 Impact Factor
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    ABSTRACT: BACKGROUND: Like other indigenous peoples, the Sami have been exposed to the huge pressures of colonisation, rapid modernisation and subsequent marginalisation. Previous studies among indigenous peoples show that colonialism, rapid modernisation and marginalisation is accompanied by increased stress, an unhealthy cardiovascular risk factor profile and disease burden. Updated data on the general burden of cardiovascular disease among the Sami is lacking. The primary objective of this study was to assess the relationship between marginalisation and self-reported lifetime cardiovascular disease (CVD) by minority/majority status in the rural Sami population of Norway. METHODS: A cross-sectional population-based study (the SAMINOR study) was carried out in 2003[box drawings light horizontal]2004. The overall participation rate was 60.9% and a total of 4027 Sami individuals aged 36[box drawings light horizontal]79 years were included in the analyses. Data was collected by self-administrated questionnaires and a clinical examination. RESULTS: The logistic regression showed that marginalised Sami living in Norwegian dominated areas were more than twice as likely to report CVD as non-marginalised Sami living in Sami majority areas (OR 2.10, 95% CI: 1.40[box drawings light horizontal]3.14). No sex difference was found in the effects of marginalisation on self-reported life-time cardiovascular disease. Moderate to no intermediate effects were seen after including established CVD risk factors. CONCLUSIONS: This study showed that marginalised Sami living in Norwegian dominated areas were more than twice as likely as non-marginalised Sami from Sami majority areas to report lifetime cardiovascular disease (CVD). Moderate to no intermediate effects were seen after including established CVD risk factors, which suggest little difference in lifestyle related factors. Chronic stress exposure following marginalisation may however be a plausible explanation for some of the observed excess of CVD.
    BMC Public Health 05/2013; 13(1):522. · 2.08 Impact Factor
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    ABSTRACT: Self-rated health (SRH) and associated risk and protective correlates were investigated among two indigenous adolescent populations, Greenlandic Inuit and Norwegian Sami. Cross-sectional data were collected from "Well-being among Youth in Greenland" (WBYG) and "The Norwegian Arctic Adolescent Health Study" (NAAHS), conducted during 2003-2005 and comprising 10th and 11th graders, 378 Inuit and 350 Sami. SRH was assessed by one single item, using a 4-point and 5-point scale for NAAHS and WBYG, respectively. Logistic regressions were performed separately for each indigenous group using a dichotomous measure with "very good" (NAAHS) and "very good/good" (WBYG) as reference categories. We simultaneously controlled for various socio-demographics, risk correlates (drinking, smoking, violence and suicidal behaviour) and protective correlates (physical activity, well-being in school, number of close friends and adolescent-parent relationship). A majority of both Inuit (62%) and Sami (89%) youth reported "good" or "very good" SRH. The proportion of "poor/fair/not so good" SRH was three times higher among Inuit than Sami (38% vs. 11%, p≤0.001). Significantly more Inuit females than males reported "poor/fair" SRH (44% vs. 29%, p≤0.05), while no gender differences occurred among Sami (12% vs. 9%, p≤0.08). In both indigenous groups, suicidal thoughts (risk) and physical activity (protective) were associated with poor and good SRH, respectively. In accordance with other studies of indigenous adolescents, suicidal thoughts were strongly associated with poorer SRH among Sami and Inuit. The Inuit-Sami differences in SRH could partly be due to higher "risk" and lower "protective" correlates among Inuit than Sami. The positive impact of physical activity on SRH needs to be targeted in future intervention programs.
    International journal of circumpolar health. 01/2013; 72.
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    ABSTRACT: BACKGROUND: Acculturation is for indigenous peoples related to the process of colonisation over centuries as well as the on-going social transition experienced in the Arctic today. Changing living conditions and lifestyle affect health in numerous ways in Arctic indigenous populations. Self-rated health (SRH) is a relevant variable in primary health care and in general public health assessments and monitoring. Exploring the relationship between acculturation and SRH in indigenous populations having experienced great societal and cultural change is thus of great importance. METHODS: The principal method in the Survey of Living Conditions in the Arctic (SLiCA) was standardised face-to-face interviews using a questionnaire. Very high overall participation rates of 83% were obtained in Greenland and Alaska, whilst a more conventional rate of 57% was achieved in Norway. Acculturation was conceptualised as certain traditional subsistence activities being of lesser importance for people's ethnic identity, and poorer spoken indigenous language ability (SILA). Acculturation was included in six separate gender- and country-specific ordinal logistic regressions to assess qualitative effects on SRH. RESULTS: Multivariable analyses showed that acculturation significantly predicted poorer SRH in Greenland. An increased subsistence score gave an OR of 2.32 (P<0.001) for reporting poorer SRH among Greenlandic men, while an increased score for Greenlandic women generated an OR of 1.71 (P=0.01). Poorer SILA generated an OR of 1.59 in men (p=0.03). In Alaska, no evidence of acculturation effects was detected among Inupiaq men. Among Inupiaq women, an increased subsistence score represented an increased odds of 73% (p=0.026) for reporting poorer SRH. No significant effects of acculturation on SRH were detected in Norway. CONCLUSIONS: This study shows that aggregate acculturation is a strong risk factor for poorer SRH among the Kalaallit of Greenland and female Inupiat of Alaska, but our cross-sectional study design does not allow any conclusion with regard to causality. Limitations with regard to wording, categorisations, assumed cultural differences in the conceptualisation of SRH, and confounding effects of health care use, SES and discrimination, make it difficult to appropriately assess how strong this effect is though.
    BMC Public Health 11/2012; 12(1):948. · 2.08 Impact Factor
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    ABSTRACT: The main objective of this study is to describe the methods and design of the survey of living conditions in the Arctic (SLiCA), relevant participation rates and the distribution of participants, as applicable to the survey data in Alaska, Greenland and Norway. This article briefly addresses possible selection bias in the data and also the ways to tackle it in future studies. Population-based cross-sectional survey. Indigenous individuals aged 16 years and older, living in Greenland, Alaska and in traditional settlement areas in Norway, were invited to participate. Random sampling methods were applied in Alaska and Greenland, while non-probability sampling methods were applied in Norway. Data were collected in 3 periods: in Alaska, from January 2002 to February 2003; in Greenland, from December 2003 to August 2006; and in Norway, in 2003 and from June 2006 to June 2008. The principal method in SLiCA was standardised face-to-face interviews using a questionnaire. A total of 663, 1,197 and 445 individuals were interviewed in Alaska, Greenland and Norway, respectively. Very high overall participation rates of 83% were obtained in Greenland and Alaska, while a more conventional rate of 57% was achieved in Norway. A predominance of female respondents was obtained in Alaska. Overall, the Sami cohort is older than the cohorts from Greenland and Alaska. Preliminary assessments suggest that selection bias in the Sami sample is plausible but not a major threat. Few or no threats to validity are detected in the data from Alaska and Greenland. Despite different sampling and recruitment methods, and sociocultural differences, a unique database has been generated, which shall be used to explore relationships between health and other living conditions variables.
    International journal of circumpolar health. 01/2012; 71:17229.
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    ABSTRACT: For many years political and professional concerns have centred on the health service access of Norway's modern Indigenous Sami people. Thirty years ago, a study determined that a low rate of health expenditure on Sami patients had lead to inferior health services for the Sami people, with their average consultation rate 6 times lower than the Norwegian national average. Since 1980, there have been few studies of differences in the utilization of medical services between the Sami people and the rest of the Norwegian population. There are few official statistics relating to the ethnic category Sami. This study explored the present utilization of healthcare services among the Sami people by investigating Sami municipalities' current expenditure on somatic hospital and specialist service. To assess the use of health care in Sami municipalities, data on expenditure of somatic hospitals and specialist services were retrieved from the Norwegian Patient Registry, and age- and sex-adjusted expenditure rates were calculated. Predominantly Sami and non-Sami municipalities were compared, as well as a comparison with the national average. Factors considered to be explanatory variables for expenditure rates were distance to care, the supply and characteristics of the healthcare system, and the stability of GPs. The overall public hospital expenditure in Sami municipalities was above the national average and equivalent to corresponding municipalities in the same geographical area. However, there was considerable variation among the Sami municipalities. The age groups 35-49 and 50-64 years in all Sami municipalities had higher expenditure rates than the national average regarding out-patient contacts and hospitalizations, while the expenditure on the elderly (&num;8805;80 years) was below the national average in most Sami municipalities. In addition to the public sector, there was a considerable volume of private practice specialist health care, mostly public funded and in urban parts of Norway. If the use of specialists in private practice is included, there is less variation in total out-patient expenditure rates in the Sami municipalities, with one exception. The municipalities with the lowest rate of public expenditure have the highest rate of private expenditure. No marked differences in healthcare expenditure was observed between the Sami and other municipalities. Overall healthcare use in Sami municipalities is above the national average and similar to corresponding municipalities in the same geographic area. However, a considerable variation in expenditure was observed among the Sami municipalities. These results do not indicate that ethnic barriers prevent Sami inhabitants from utilization of somatic hospital and specialist services. Disregarding the magnitude of expenditure, however, it is not possible to exclude that Sami patients experience a patient-physician relationship of lower quality.
    Rural and remote health 01/2011; 11(2):1655. · 0.98 Impact Factor
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    ABSTRACT: We evaluated the association between serum ferritin (s-ferritin), transferrin saturation and dietary patterns, in connection with ethnicity, geographical settlement and lifestyle factors. In 2003-2004, a cross-sectional study of health and living conditions was carried out in northern Norway. A questionnaire explored, among other factors, ethnicity and food consumption habits. Principal component analysis was used to assess the association between variables. Seven principal components were then used as input to a cluster analysis. To characterise food consumptions, five dietary patterns were identified and used to assess the effect of food consumption habits on Fe stores. A total of 16 323 men and women between the ages of 36 and 79 years participated. Participants who frequently consumed reindeer meat had higher levels of s-ferritin (P < 0.0001) than did individuals with other dietary patterns. This pattern was highly represented by subjects with three generations of Sami language (Sami I). Further, mean transferrin saturation in the reindeer group was higher compared with the other dietary clusters for men (P < 0.04) and women (P < 0.02). However, the reindeer pattern individuals also had the highest proportion of subjects with overweight and obesity. Obesity was positively associated with s-ferritin in both men and women (P < 0.0001). The differences in Fe status described earlier between inland Sami and non-Sami can be explained by several factors such as food habits, age and obesity. High level of s-ferritin may reflect high intake of reindeer meat. Being overweight and obese is also associated with s-ferritin levels.
    Public Health Nutrition 01/2011; 14(6):1039-46. · 2.25 Impact Factor
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    ABSTRACT: The Survey of Living Condition in the Arctic (SLiCA) is an international research project on health and living conditions among Arctic indigenous peoples. The main objective of this article is to examine the prevalence of self-reported suicide thoughts among the study population in Alaska, Greenland, Sweden and Norway. Population-based survey. Indigenous participants aged 16 years (15 years in Greenland) and older living in traditional settlement regions in Alaska, Sweden and Norway and across the entire Greenland were invited to participate. Data were collected in three periods: in Alaska from January 2002 to February 2003, in Greenland from December 2003 to August 2006, in Sweden from spring 2004 to 2006 and in Norway in 2003 and from June 2006 to June 2008. The principal method in SLiCA was standardised face-to-face interviews using a questionnaire. A questionnaire had among other things, questions about health, education, traditional activities, ethnicity and suicidal thoughts. Information about suicidal thoughts, gender and age were available in 2,099 participants between the ages of 16 and 84 from Alaska, Greenland, Sweden and Norway. Greenland had the highest rates of suicidal thoughts when adjusting for age and gender (p=0.003). When stratifying on age and gender, significant differences across countries were only found for females in the two youngest age groups. Differences in suicidal thoughts across countries could partly be explained by educational level. Swedish respondents had less suicidal thoughts than those in any other countries. In the future, analyses of suicidal thoughts should take socioeconomic status into account as well as self-reported health, depression and anxiety.
    Global Health Action 01/2011; 4. · 2.06 Impact Factor
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    ABSTRACT: Investigate the association between ethnicity, social factors and self-reported health conditions of Sami and non-Sami Norwegian populations. Cross-sectional questionnaire. SAMINOR is a population-based study of health and living conditions that was conducted in 24 municipalities in northern Norway during 2003 and 2004. The present study included 12,265 individuals aged between 36 and 79, whose ethnicity was categorized as Sami (33.1%), Kven (7.8%) and Norwegian majority population (59.1%). Sami respondents reported inferior health conditions in comparison to the Norwegian majority population. The most unsatisfactory conditions were reported by Sami females living outside the defined Sami area (with greater integration and assimilation) (p<0.05). Females typically reported less favourable health conditions than did males. Health inequalities varied by age and were more apparent in persons aged in their mid-50s or above. Across ethnic groups, respondents with the highest education and household income were healthier than others. Furthermore, those reporting to have been frequently discriminated against were more likely to report poorer health than those who did not; the odds ratios (95% CI) was found to be 2.88 (1.92-4.32) for women and 1.61 (1.08-2.42) for men. When discrimination was included in the logistical model, the increased risk of poor self-reported health decreased to non-significance for Sami respondents. The estimated risk decreased further when the socio-economic status was taken into account. The findings of this study suggest that self-reported ethnic discrimination combined with low socio-economic status contributes to inequalities in self-reported health when Sami and Norwegian majority population are compared.
    International journal of circumpolar health 04/2010; 69(2):111-28. · 1.30 Impact Factor
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    ABSTRACT: To assess coffee consumption in the Sami and Norwegian populations and to investigate the impact of unfiltered boiled coffee consumption on serum cholesterol concentrations. A cross-sectional study. Information was collected by self-administrated questionnaires and total serum cholesterol was analysed. Participants were divided into three ethnic groups: Sami I (Sami used as home language in the last three generations), Sami II (at least one Sami identity marker) and Norwegian. In an area with Sami, Kven/Finnish and Norwegian populations, the SAMINOR study, 2003-2004. A total of 5647 men and 6347 women aged 36-79 years. More than 90 % of the study populations were coffee drinkers. Only 22 % were unfiltered coffee consumers. Sami I had the highest proportion of participants who consumed nine or more cups of unfiltered coffee per day, although the number of participants was limited. Total coffee consumption was associated with increased total cholesterol for men (P < 0·01) and women (P < 0·0001). For those who drank only unfiltered coffee, a significant association was found only in Norwegian men, adjusted for physical activity in leisure time, BMI and smoking habits (P < 0·001). From the lowest (less than five cups) to the highest (nine or more cups) unfiltered coffee consumption category, the mean total cholesterol levels increased by 0·29 mmol/l in Norwegian men. Unfiltered coffee consumption was lower in the present study compared to previous reports. In general, total coffee consumption was positively associated with total cholesterol levels. However, for unfiltered coffee consumption, an association was found only in Norwegian men.
    Public Health Nutrition 03/2010; 13(11):1818-25. · 2.25 Impact Factor
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    ABSTRACT: It has been hypothesized that Laestadianism has contributed to the less drinking observed among indigenous Sami. This paper further investigates the bivariate protective influence of Sami ethnicity on youth drinking behavior using logistic regressions. We simultaneously controlled for the influence of religious revival movements (Laestadianism or evangelic) and religious importance (being personally Christian), in addition to socio-demographics and parental factors. Cross-sectional data from the 1994/95 North Norwegian Youth Study including 2,950 (675 Sami) 15-19 year-old high school students (RR: 85%) was used. Sami ethnicity was statistically significant for two out of six alcohol outcome measures, after adjustment for religiosity and other covariates, indicating less current drinking and party drinking. Religiousness was associated with higher youth and parental abstinence across ethnicities. Generally, stronger protective influences on drinking behavior were found for religious importance (being personally Christian) than religious affiliation (Laestadianism). The non-significance between Sami and non-Sami drinking may partly be explained by ethnic differences in religiosity, but also socio-demographics (e.g., residing in the Sami Highland) and parental factors (e.g., abstinence) contributed to such a result. Laestadianism`s profound impact on Sami culture, and its strong anti-alcohol norms may have contributed to a religious-socio-cultural context of abstinence.
    Journal of Religion and Health 02/2010; 50(4):1024-39. · 1.02 Impact Factor
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    ABSTRACT: To estimate the prevalence of general (body mass index) and central (waist circumference and waist/hip ratio) obesity in an area with a mixed Sami and Norwegian population. A cross-sectional population-based study carried out in 2003- 2004, the SAMINOR study. The attendance rate was 60.6%. A total of 7,301 men and 7,841 women, aged 36-79, were included in the analyses. Height, weight, waist and hip circumference were measured, body mass index (BMI) calculated and information concerning lifestyle was collected by questionnaire. The prevalence of general obesity (BMI > or = 30 kg/m(2)) in participants who had Sami as their home language for three generations (Sami I) and Norwegian participants was 38.7% and 24.3% for women respectively; and for men 26.9% and 23.4% respectively. More than 40% of the women had central obesity (waist circumference > or = 88 cm), and the highest prevalence was found in Sami I women (45%). The highest prevalence of central obesity (waist circumference > or = 102 cm) was found in Norwegian men (24.2%). The ethnic differences persisted after adjustment for age, education, physical activity in leisure time, and smoking habits. The prevalence of obesity was high in this population and central obesity was most pronounced in women, particularly in Sami women. Sami men were less obese than Norwegian men. Further studies are necessary to examine a possible explanation for these findings, especially to elaborate on the impact of diet.
    Scandinavian Journal of Public Health 11/2009; 38(1):17-24. · 1.97 Impact Factor
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    ABSTRACT: The aim of this study was to study mortality patterns in the population in different geographical locations in northern Norway on the basis of Sami population density. Mortality statistics by sex and age from 1991 to 2006 were obtained from Statistics Norway. Mortality rates, including infant mortality rates, were compared across geographical locations. The data material was divided into within and outside the the geographical areas of the Sami Development Fund (SUF) and into coastal and inland residence. Differences in mortality rates were tested by chi-quadrate tests. Overall, no pronounced difference in mortality rate was found in the population between geographical areas. For men, mortality rates differed only between geographical residence in the time intervals 1991-95 and 1996-2000 for the age groups 45-59 years and 60-74 years, respectively, with outside SUF area, inland having the lowest rate. For women, there were no differences between geographical areas except for the age group 60-74 years in the time period 1991-95, where SUF coast had the highest mortality rate. For the SUF area, men had the lowest probabilities for surviving the age of 74 years and women had among the highest. No geographical difference was found in infant mortality. During the time period 1991-2006, the outside SUF area, inland had an average infant mortality rate of 1.8/1000 per year, and for SUF coast it was 6.2/1000 per year. This difference was, however, not significant (p = 0.08). Overall, mortality rates were similar across geographical areas with low and with high Sami population density. However, indications of geographical differences in infant mortality should be investigated further.
    Scandinavian Journal of Public Health 07/2009; 37(5):475-80. · 1.97 Impact Factor
  • Tove Nystad, Marita Melhus, Eiliv Lund
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    ABSTRACT: The government's Action Plan for Health and Social Services states as a goal that the Sami population's encounter with health and social services should be just as good as what the rest of the population experiences. The goal of this study is to investigate patient satisfaction with the municipal GP service in areas with both a Sami and Norwegian population. A cross-sectional population study using questionnaires. The data were taken from the population based study of health and living conditions in areas with both Sami and Norwegian populations (SAMINOR) in which respondents were asked about their satisfaction with GP services in their municipalities. This population survey was carried out in the period 2002-2004. The analyses include 15,612 men and women aged 36-79. The Sami-speaking patients were less satisfied with the municipal GP service as a whole than were the Norwegian speakers; RR 2.4 (95% CI 2.1-2.7). They were less satisfied with the physicians' language skills; RR 5.8 (95% CI 4.8-7.0); and they felt that misunderstandings between physician and patient due to language problems were more frequent; RR 3.8 (95% CI 3.3-4.3). One-third expressed that they did not wish to use an interpreter. The results indicate that it is necessary to place greater emphasis on the physicians' language competency when hiring GPs in municipalities within the Administrative Area for the Sami Language. This could improve satisfaction with the physicians' services.
    International journal of circumpolar health 03/2008; 67(1):114-21. · 1.30 Impact Factor
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    ABSTRACT: To assess the distribution of blood lipids, lipoprotein and apoB/apoA-1 ratio in a multi-ethnic population of Sami, Kvens and Norwegians in Norway. Study design. A population-based cross-sectional study was carried out in 2003-2004 in an area with a mixed Sami, Kvens/Finns and Norwegian population, the SAMINOR study. A self-administrated questionnaire was distributed and total cholesterol, HDL cholesterol, triglycerides, apoB and apoA-1 counts were analysed in 6461 women and 5772 men between the ages of 36 and 79. In 36-64 age group, Sami men and women had the highest apoB/apoA-1 ratio of the ethnic groups. The ethnic differences remained after adjustment for waist hip ratio, cigarette smoking, systolic and diastolic pressures, alcohol consumption, physical activity during leisure time and family history of myocardial infarction (MI). There were no significant ethnic differences in apoB/apoA-1 ratio in the older age group. Total cholesterol was significantly lower among Sami men and women, aged 65-79 years, than among the Norwegian. The opposite occurred in the 36-49 age group, with higher levels in the Sami population. We found no ethnic differences in HDL cholesterol and triglycerides. Middle-aged Sami women and men have increased levels of apoB/apoA-1 ratio and total cholesterol compared with Norwegians.
    International journal of circumpolar health 03/2008; 67(1):67-81. · 1.30 Impact Factor
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    ABSTRACT: To identify dietary patterns and to investigate their association with selected life-style and demographic factors, ethnicity and self-perceived health. Study design. Population-based cross-sectional design, using food frequency questionnaires. A total of 12,811 subjects aged 36-79 years participated from the municipalities in Norway where more than 5-10% of the population reported to be Simi in the 1970 Census, in addition to some selected districts. The data were collected during 2003-2004. A principal component analysis was used to assess the associations among food variables. Seven principal components were then used as input in a cluster analysis. Five dietary patterns were identified and labelled "reindeer", "fish", "average", "fruits and vegetables" and "Westernised, traditional marine". The reindeer pattern was highly represented by subjects with three generations of Sámi language (Sámi I), obese subjects and those with low levels of physical activity. The fish pattern was dominated by women and had the largest proportion of individuals who reported their health as being "not so good" (35%). However, this pattern had the largest proportion of subjects in the oldest age categories. The fruits and vegetables pattern was characterised by a health-conscious life-style, included more women than men, and had the largest proportion of subjects reporting "very good" health. Ethnicity did not play a major role in predicting dietary patterns except for the reindeer pattern, especially in the inland areas. In the dietary cluster analysis we identified five distinct dietary patterns that were also characterised by additional life-style factors.
    International journal of circumpolar health 03/2008; 67(1):82-96. · 1.30 Impact Factor
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    M Brustad, C L Parr, M Melhus, E Lund
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    ABSTRACT: The purpose of this work was to identify dietary patterns in the past using cluster analysis of reported diet in childhood, and to assess predictors for dietary patterns in relation to ethnicity in the population in the Sámi core areas in Norway. The Sámis are an indigenous population living in the border areas of Norway, Sweden, Finland and Russia. Population-based, cross-sectional study, using self-administered questionnaires. A food-frequency questionnaire covering selected food items eaten in childhood was used. The questionnaire also provided data on ethnicity. This study was based on data collected from 7614 subjects participating in The Population Based Study of Health and Living Conditions in Areas with a Mixed Sámi and Norwegian Population (the SAMINOR study) who grew up in the SAMINOR geographical areas, i.e. areas with mixed Sámi and Norwegian populations in Norway. Four dietary clusters were identified: a reindeer meat cluster; a cluster with high intakes of fish, traditional fish products and mutton, in addition to food sources from the local environment; a Westernised food cluster with high intakes of meat balls and sausages; and a cluster with a high intake of fish, but not any other foods in the questionnaire. The cluster distribution differed by ethnicity, but the effect of ethnicity on diet differed by coastal and inland residence. Our study has shown that data gathered through the limited questionnaire could be used to group the study sample into different dietary clusters, which we believe will be useful for further research on relationships between diet in childhood and health in the Sámi core areas in Norway.
    Public Health Nutrition 03/2008; 11(2):168-75. · 2.25 Impact Factor
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    ABSTRACT: To investigate the prevalence of self-reported experiences of ethnic discrimination and bullying among Sami and non-Sami adults. Cross-sectional, questionnaire-based survey. SAMINOR is a population-based study of health and living conditions that was administered in 2003-2004 in 24 different Norwegian and Sami populated municipalities within central and northern Norway. This analysis was based on 12,265 men and women aged 36-79 years. Ethnic distribution was Sami (33.1%), Kvens (7.8%) and the ethnic Norwegian majority (59.1%). Overall, Sami and Kven respondents reported more ethnic discrimination and bullying in general than ethnic Norwegians (p < 0.001). The reporting was highest among the younger participants (p < 0.001). Men reported more ethnic discrimination than women, while women reported more bullying. Respondents with the strongest Sami affiliation reported higher levels of ethnic discrimination outside the Sami Language Act's district, while respondents with weak Sami affiliation, Kvens and ethnic Norwegians, reported higher levels inside this district. Among the respondents that reported bullying previously, the most common type was discriminating remarks and the most common location was public schools. For those who reported bullying in the past year, the most common types were gossiping and discriminating remarks, and the most common locations were at work and in the local community. Two out of three of those reporting ethnic discrimination, independent of ethnicity, also reported bullying. The findings from this study show that the Sami and Kven population more often experience bullying and ethnic discrimination than ethnic Norwegians. These results are consistent with experiences from other minority and marginalized groups that experienced colonization. More research is needed to understand the role bullying and ethnic discrimination play in the wellbeing and health of the Sami and Kven population.
    International journal of circumpolar health 02/2008; 67(1):97-113. · 1.30 Impact Factor
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    ABSTRACT: Northern Norway consists of a multiethnic population of Sámi and non-Sámi. We evaluated iron status in these two groups with respect to gender, age and residence. In 2002-2004, a cross-sectional study of health and living conditions in areas with both Sámi and Norwegian populations, SAMINOR, was performed in northern Norway. In total, 16,538 men and women between the age of 36 and 79 yr, participated. Response rate was 60.9%. Information about ethnic belonging, s-ferritin and transferrin saturation were available in 14,873 persons (54.8% of the invited sample). A questionnaire delivered at attendance had several questions on family background language and self-perceived ethnicity. Sámi men and women living in the inland areas had significantly higher mean s-ferritin than non-Sámi living in the same area (P < 0.0001). The inland Sámi also had significantly higher s-ferritin than the coastal Sámi and non-Sámi populations, both genders (P < 0.013). S-ferritin increased with increasing age for all women, while the opposite was true for men. Lifestyle factors had impact on s-ferritin level. Also mean transferrin saturation was higher at the inland residents but significant only for the male participants. The results from our analyses indicate that individuals living at the inland areas have higher s-ferritin and transferrin saturation than the coastal population. There were also differences in iron levels between Sámi and non-Sámi groups at the inland areas. Iron levels are influenced by lifestyle factors. The observed differences in iron levels might therefore be explained by nutritional habits.
    European Journal Of Haematology 11/2007; 79(5):447-54. · 2.55 Impact Factor