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ABSTRACT: Gambling is a worldwide phenomenon. For most persons this causes only small or no problems, but for some, pathological gambling can be the result of entering the gambling environment. The objectives were to estimate the past year and lifetime prevalence of problem gambling in the adult Danish population (16 years or older) in 2010 and trends since 2005 and, furthermore, to investigate whether problem gamblers differed from non-problem gamblers with regard to sociodemographic and socioeconomic factors. Data were derived from two national representative Danish health surveys. The survey in 2005 was based on region-stratified random sample of 10,916 Danish citizens (response rate: 52.1 %) and the survey in 2010 was based on a random sample of 23,405 Danish citizens (response rate: 62.7 %). Problem gambling was defined using the lie/bet questionnaire. The past year prevalence of problem gamblers in Denmark remained stable from 2005 to 2010 (0.9 and 0.8 %, respectively). The highest past year prevalence of problem gamblers was found among young men in both 2005 and 2010. Furthermore, problem gamblers were more prevalent among men, disability pensioners, less educated and those not married or cohabiting. The present study indicates that a high level of education and being employed have a protective effect against problem gambling. More research is needed in order to understand what attracts and maintains the interest of men in gambling environments as well as why women are not occupied by gambling in the same degree as men.
Journal of Gambling Behavior 11/2012; · 1.28 Impact Factor
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ABSTRACT: Occupational workload has been associated with an increased risk of osteoarthritis (OA), but only little research has been conducted among female workers. The objective of this study was to analyse if men and women in farming, construction or healthcare work have increased risk of developing OA of the hip or knee.
A follow-up study based on register data of the whole Danish working population in the period 1981 to 2006 followed up for hip or knee OA during 1996 to 2006. Cumulative years in occupation were calculated for assessment of dose-response relationship. Gender-specific analyses were carried out with Cox regression models using age as timescale and adjusting for calendar period, income, unemployment and previous knee injury, and done separately for hip and knee OA.
Male floor layers and bricklayers and male and female healthcare assistants had the highest risks of knee OA, and farmers had the highest risk of hip OA. Male farmers had increased risk of hip OA already after 1-5 years in occupation (HR, 1.63) and a dose-response-related risk of hip OA (HR up to 4.22). Generally, the risk of OA increased with cumulative years in the occupation in both men and women.
Occupations with heavy physical workload present a strong risk for hip and knee OA in both men and women, and the risks increase with cumulative years in occupation and noticeable hip OA among male farmers.
Occupational and environmental medicine 01/2012; 69(5):325-30. · 3.64 Impact Factor
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ABSTRACT: INTRODUCTION: The Danish National Cohort Study (DANCOS) is a nationally representative public health survey based on linkage of information in the repeated Danish Health Interview surveys, 1986-2005, to the national Danish registers on health and welfare. It facilitates studies of self-reported health behaviour and utilisation of healthcare services by subgroups and analysis of non-response bias. RESEARCH TOPICS: DANCOS data are utilised in a variety of analyses presented here by a few examples that emphasise the impact of modifiable risk factors on public health, description of non-response bias, and the epidemiology of chronic pain and of osteoarthritis. Examples of DANCOS-based results are shown for each of the four topics. Smoking results in 24% of all deaths and, compared to other risk factors for public health, smoking accounts for the highest number of years of life lost. For non-response the mortality is higher among non-respondents than among respondents, but no significant bias on healthcare estimates can be seen. On average individuals with chronic pain had 12.8 contacts per year to the primary healthcare sector compared with 7.3 for individuals without. For osteoarthritis it is estimated that in 2020 there will be 22,600 incident cases. CONCLUSION: DANCOS is a public health survey linked with registers with many research possibilities. With this article we hope to stimulate further interest in the survey.
Scandinavian Journal of Public Health 07/2011; 39(7 Suppl):131-5. · 1.39 Impact Factor
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ABSTRACT: The Danish National Institute of Public Health, University of Southern Denmark has carried out national representative health interview surveys among adult Danes in 1987, 1994, 2000 and 2005. The aim of this study is to describe the characteristics of the design, including the response rates of the four surveys.
The samples in 1987 and 1994 are based on simple random sampling. The samples in 2000 and 2005 are based on stratified random sampling. In addition, all invited to the survey in 1994 were re-invited in both 2000 and 2005. Data were collected via face-to-face interview at the respondent's home. Following the interview in 1994, 2000 and 2005, all respondents were asked to complete a self-administered questionnaire.
The response rate for the face-to-face interview fell from 79.9% in 1987 to 66.7% in 2005 and the response rate for the self-administered questionnaire from 68.1% in 1994 to 51.5% in 2005. The decrease is particularly marked among the young. The mean interview length has increased from 33.3 minutes in 1987 to 50.2 minutes in 2005.
The declining response rate in the surveys is a major concern and can pose problems in generalizing data from the surveys to the Danish population. However, these surveys are essential, as the information collected cannot be gathered by means of official statistical registers. Hence, efforts to increase the response rate will be important in the forthcoming surveys.
Scandinavian Journal of Public Health 08/2009; 37(7):758-65. · 1.39 Impact Factor
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ABSTRACT: The EQ-5D is a widely used generic health-related quality of life instrument that has been used to describe population health and health outcomes in clinical trials and health economic evaluations.
To generate Danish population norms for the EQ-5D index score, stratified by age and gender.
The EQ-5D data from three population health surveys were pooled, thus providing EQ-5D profile data for 15,700 individuals aged 20-79 years. The Danish TTO scoring algorithm was used to weight each respondent's profile data to derive a single index score. Mean values were computed by gender and 10-year age groups, and educational groups.
In a random sample from the general Danish population, the mean EQ-5D index score ranged between 0.93 for 20-29 year-olds and 0.83 for 70-79 year-olds. Men had a significantly higher score than women in all age groups. Longer education was associated with higher EQ-5D index score in most age groups.
The calculated mean values for the EQ-5D index score may be used as reference values for comparative purposes in future Danish population health and evaluative studies.
Scandinavian Journal of Public Health 07/2009; 37(5):467-74. · 1.39 Impact Factor
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ABSTRACT: Danish women aged 16-29 from two nationwide, representative, cross-sectional interview/questionnaire surveys from 2000 and 2005 are analyzed for trends in prevalence of risk behaviour for developing eating disorders and associations to BMI and age.
Participants completed the Danish Health Interview Survey and an 8-item screen, RiBED-8, for risk behaviour for eating disorders. To analyze how the prevalence of risk behaviour depends on age, BMI, and year of survey, logistic regression analyses were applied. On acceptance of no interaction, the effect of each variable was tested and described using odds ratios with 95% confidence intervals.
Women aged 16-19 or with a BMI of>25 had the greatest chance of reporting risk behaviour for eating disorders. However, many women in their 20s also had risk behaviour. Prevalence of risk behaviour for eating disorders did not change from 2000 to 2005.
The shared risk factors for obesity and eating disorders require further investigation for development of collaborative prevention and treatment strategies that should also be directed towards young women in their 20s as well as young teenagers.
Scandinavian Journal of Public Health 06/2009; 37(7):736-43. · 1.39 Impact Factor
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ABSTRACT: The aim of this study was to analyse to what extent individuals with coronary heart disease (CHD) leave the labour market earlier than individuals without CHD and to discuss the implications for rehabilitation.
Individuals with CHD were identified from the Danish National Cohort study and were followed from the year of their first hospital admission for CHD and onwards for up to 23 years. Individuals with CHD were individually matched with individuals without CHD. We analysed their short-term labour market participation and compared the long-term withdrawal risk for the two groups through Cox regression.
In the year after the first CHD-related admission, 79% of individuals with CHD maintained their labour force participation compared with 93% of individuals without CHD. Individuals with CHD had a hazard ratio of 1.32 for withdrawal compared with their matched counterparts. This means that the individuals with CHD were on the labour market, on average, for 0.8 years less than the individuals without CHD. Stratified analyses showed that, in particular, individuals with CHD aged below 60 years and individuals employed as manual labour may benefit from cardiac rehabilitation, which aims to maintain labour market participation.
Individuals with CHD have a significantly increased risk of withdrawing from the labour market. Especially younger individuals and those employed as manual labour seem to have greater problems in maintaining labour market participation. This suggests that greater focus in cardiac rehabilitation on returning these individuals to the labour market might be worthwhile.
European journal of cardiovascular prevention and rehabilitation: official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology 04/2009; 16(3):387-91. · 2.51 Impact Factor
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ABSTRACT: Possibilities for early identification of eating disorders among 16-29-year-old women are investigated regarding physical and mental health-related determinants.
The study was a representative cross-sectional survey of 16-29-year-old women, and was part of the Danish Health Interview Survey 2005. The response rate was 53.3%. Participants responded to RiBED-8, a screening instrument for identification of risk behaviour for eating disorders. Relative Risk (RR) for the development of risk behaviour was shown for each variable to identify the effect on prevalence of risk behaviour for eating disorders. Analyses showed no effect of non-response on prevalence of risk behaviour for eating disorders.
19% of 16-29-year-old women had risk behaviour for eating disorders. Women had a higher RR for developing risk behaviour if they had had sick leave from work, complained of nervousness, anxiety and depression in the last 2-4 weeks, or had had suicidal thoughts within the last year. Furthermore, overweight and a desire to lose weight and intense physical activity were factors connected with risk behaviour.
Young women with risk behaviour for eating disorders may be identified since they often present themselves in general practice with mental problems, overweight and a wish to lose weight.
Ugeskrift for laeger 03/2009; 171(9):713-7.
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ABSTRACT: To improve the early identification of eating disorders the study tested whether women with risk behaviour for eating disorders have lower health-related life quality and more perceived stress than women without risk behaviour.
The study was a representative cross sectional survey of 16-29-year old women and was part of the Danish Health Interview Survey 2005. After the personal interviews, 487 returned the questionnaires, with a response rate of 53.3%. Participants responded to RiBED-8, a screening instrument for identification of risk behaviour for eating disorders and also to SF-36 and Perceived Stress Scale (PSS).
Women with risk behaviour for eating disorders have a lower score on all subscales of SF-36 than women without risk behaviour. The differences are significant for the subscales for mental health, vitality, social function and general health. They also have a higher mean score on PSS than women without risk behaviour.
Women with risk behaviour for eating disorders have lower mental health-related life quality than women without risk behaviour. They also experience daily life as more unpredictable, stressful and difficult.
Ugeskrift for laeger 03/2009; 171(9):709-12.
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ABSTRACT: The objective of this paper is firstly to estimate the healthcare costs attributable to heart disease in Denmark using recently available data for 2002-05. Secondly, to estimate the attributable healthcare costs of lifestyle risk factors among heart patients, in order to inform decision making about prevention programmes specifically targeting patients with heart disease.
For a cohort consisting of participants in a national representative health interview survey, register-based information about hospital diagnosis was used to identify patients with heart disease. Healthcare consumption during 2002- 05 among individuals developing heart disease during 2002-05 was compared with individuals free of heart disease. Healthcare costs attributable to heart disease were estimated by linear regression with adjustment for confounding factors. The attributable costs of excess drinking, physical inactivity and smoking among future heart patients were estimated with the same method.
Individuals with heart disease cost the healthcare system on average 3,195 (p<0.0001) per person-year more than individuals without heart disease. The attributable cost of unhealthy lifestyle factors among individuals at risk of heart disease was about 11%-16% of the attributable cost of heart disease.
Heart disease incurs significant additional costs to the healthcare sector, and more so if heart patients have a history of leading an unhealthy life. Consequently, strategies to prevent or cease unhealthy lifestyle may not only result in cost savings due to avoided heart disease. Additional cost savings may be obtained because heart patients who prior to the disease led a more healthy life consume fewer healthcare resources.
Scandinavian Journal of Public Health 11/2008; 36(8):850-6. · 1.39 Impact Factor
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ABSTRACT: To estimate the impacts of tobacco smoking, high alcohol consumption, physical inactivity and overweight on expected lifetime with and without long-standing, limiting illness.
Life tables for each level of exposure to the risk factors were constructed, mainly on the basis of the Danish National Cohort Study. Expected lifetime without long-standing, limiting illness was estimated for exposed and unexposed persons by combining life tables and prevalence data from the Danish Health Interview Survey 2000 (14,503 participants aged 25+).
The life expectancy of 25-year-olds was 9-10 years shorter for heavy smokers than for those who never smoke, and all the lifetime lost would have been without long-standing, limiting illness. Similarly, all 5 years of expected lifetime lost by men with high alcohol consumption would have been without illness. The expected lifetime without long-standing, limiting illness was 8-10 years shorter among sedentary than physically active people. Obesity shortened lifetime without illness by 5 years for men and ten years for women.
The results of this study could be used in health policy-making, as the potential gains in public health due to interventions against these risk factors could be evaluated, when the prevalence of exposure to the risk factor is available.
Preventive Medicine 08/2007; 45(1):49-53. · 3.22 Impact Factor
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ABSTRACT: There are only a few studies on the frequency of sexual desire in the general population, whereas studies investigating the frequency of disordered sexual desire are more common.
The aim of this study was to describe the frequency of sexual desire in a representative sample of the adult Danish population and to analyze the relationships between a number of relevant variables and sexual desire.
The study population (N = 10,458, response rate 84.8%) answered a questionnaire with questions on sexual matters. The representativity of the population was examined. The frequency of self-reported sexual desire and decrease in sexual desire over a 5-year period was calculated for the two genders across age cohorts. Multiple logistic regression analysis was used to analyze the relationship between potential determinants and sexual desire.
The frequency of self-reported sexual desire and decrease in sexual desire was examined. Factors of importance for sexual desire were tested using two outcome measures: (i) often having sexual desire; and (ii) seldom having sexual desire.
A significant association between gender and sexual desire was found in all age groups, as men had a significantly higher level of sexual desire than women. In both genders, the frequency of sexual desire was significantly reduced with increasing age. Among the 45- to 66-year-olds, 57% of the men and 47% of the women reported no change in the level of sexual desire over the past 5 years. In general terms, factors related to seldom having sexual desire were age and social, psychological, and physical distress in both genders.
This study shows that overall, men have a higher level of sexual desire than women; sexual desire decreases with increasing age; and social, psychological, or physical distress are associated with low level of sexual desire in both genders.
Journal of Sexual Medicine 02/2007; 4(1):47-56. · 3.55 Impact Factor
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ABSTRACT: The construct quality-adjusted life years (QALYs) combines mortality and overall health status and can be used to quantify the impact of risk factors on population health. The purpose of the study was to estimate the impact of tobacco smoking, high alcohol consumption, physical inactivity, and overweight on QALYs.
Life tables for each level of exposure to the risk factor were constructed mainly on the basis of the Danish National Cohort Study. QALYs were estimated for exposed and unexposed by Sullivan's method, by combining life tables, EQ-5D self-classified health status from the Danish Health Survey 2000, and Danish EQ-5D values.
The quality-adjusted life expectancy of 25-year-olds was 10-11 QALYs shorter for heavy smokers than for those who never smoke. The difference in life expectancy was 9-10 years. Men and women with high alcohol consumption could expect to lose about 5 and 3 QALYs, respectively. Sedentary persons could expect to have about 7 fewer QALYs than physically active persons. Obesity shortened QALYs by almost 3 for men and 6 for women.
Smoking, high alcohol consumption, physical inactivity, and obesity strongly reduce life expectancy and health-related quality of life. These results could be used by health policy-makers to evaluate the potential gains in public health due to interventions against these risk factors, when the prevalence of exposure to the risk factor is available.
Scandinavian Journal of Public Health 02/2007; 35(5):510-5. · 1.39 Impact Factor
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ABSTRACT: The study evaluated the health impact of specific diseases.
Life tables and health survey data are combined to estimate expected lifetime with and without long-standing illness. We compared estimates based on observed rates of mortality and prevalence of illness with those based on hypothetical rates from which a specific disease has been eliminated.
Life expectancy would increase by 4.0 years for 65-year-olds if circulatory diseases are eliminated, and the proportion of expected lifetime without long-standing, limiting illness would increase from 59.2% to 66.5% for men and from 52.2% to 55.6% for women. Elimination of musculoskeletal diseases would not change life expectancy but would increase the proportion of expected lifetime without long-standing illness.
Because of comorbidity, more years of illness are to be expected if lethal diseases are to be eliminated. Elimination of nonfatal diseases would mainly transfer years with long-standing illness to years without illness.
Journal of Aging and Health 09/2006; 18(4):491-506. · 1.56 Impact Factor
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ABSTRACT: The purpose of this study was to determine whether suicidal ideation and/ or suicide attempts have any long-term health effects. The relationship between suicidal thoughts and/or a previous suicide attempt in 1994 and the presence of suicidal ideation in 2000 was analyzed. We found that health status in 1994 differed significantly between the groups with and without suicidal ideation or a previous suicide attempt and that the differences persisted or even deepened (not significant) after 6 years. Further, people who had suicidal ideation or a suicide attempt in 1994 had a significantly greater risk (OR = 7.4) of having suicidal ideation in 2000 than people who had not.
Suicide and Life-Threatening Behavior 03/2006; 36(1):103-12. · 1.33 Impact Factor
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ABSTRACT: To estimate the impact of diseases on social differences in life expectancy and expected lifetime with illness among Danes in 1995-99.
Expected lifetime with and without long-standing illness were calculated for groups with low, medium and high educational levels. Estimates based on observed rates of mortality and prevalence of illness were compared with those based on rates from which a specific disease had been eliminated.
Partial life expectancy (age 30-75) would increase by almost 1.5 years if cancer were eliminated. Expected lifetime without long-standing illness would increase by approximately 1 year. Elimination of cardiovascular diseases would increase partial life expectancy, mainly among men with a low educational level. If diseases of the musculoskeletal system were eliminated the benefit would be greatest for persons with a low educational level.
The gain in life expectancy to be expected by eliminating certain diseases decreased with educational level. Elimination of cancer would extend lifetime both with and without illness for all educational levels.
Sozial- und Präaventivmedizin SPM 02/2006; 51(4):221-31. · 0.82 Impact Factor
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ABSTRACT: Decreasing rates of participation in population-based studies increasingly challenge the interpretation of study results, in both analytic and descriptive epidemiology. Consequently, estimates of possible differences between participants and non-participants are increasingly important for the interpretation of study results and generalization to the background population.
An age-specific, population-based cohort of 1,198 individuals was examined at age 40, 45, 51, and 60. Participants were compared with non-participants and when possible also with the background population using a wide range of detailed information on somatic and mental health collected at each examination, including data from a clinical examination, biochemical measurements, questionnaires, interviews, and public registers.
Participation rates were higher than 80% at examinations at age 40, 45, and 51, but decreased to 65% at age 60. At the baseline investigation at age 40, analyses indicated that participants were representative of the cohort as well as the background population. However, the mortality rate was higher among non-participants in the succeeding 20 years. Among living cohort members at the 60-year examination, non-participants had lower socioeconomic status, higher hospitalization rate, and a worse overall health profile than participants.
The detailed data presented reinforce the contention that the health profile of non-participants is typically worse than that of participants. The results also indicate that while data from public registers give easily accessible information about non-participants, these crude proxy measures of health may not be enough to document representativeness.
Scandinavian Journal of Public Health 02/2006; 34(6):623-31. · 1.39 Impact Factor
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ABSTRACT: In this study indicators associated with suicidal ideation and suicide attempts in a nationwide representative sample (N=3184) of Danes aged 16-35 years were examined. The study was cross-sectional and had three aims: (1) to draw a profile of persons with and without suicidal tendency established on a combined quartered variable on current suicidal thoughts and/or ever attempted suicide; (2) to explore whether the different suicidal tendencies constitute a severity continuum; and (3) to identify factors of significance for suicidal tendency. Factors included were demographic characteristics, living conditions, social network, external health risks, lifestyle, health-related quality of life, symptoms, morbidity, and illness behavior. A continuum hypothesis was not supported, as the multiple logistic regression analysis showed no clear gradient in the different forms of suicidal tendency. Cohabitation status (single, p < 0.0001), exposure to violent threats (p < 0.0001), exposure to sexual abuse (p < 0.0001), being a daily smoker (p < 0.0001), doing nothing to stay healthy (p < 0.0004), poor mental health (p < 0.0001), mental symptoms within the past 2 weeks (p = 0.0003), contact with psychologist (p < 0.0001), and absence from work due to illness (p = 0.005) were indicators significantly related to suicidal tendency.
Suicide and Life-Threatening Behavior 07/2005; 35(3):291-308. · 1.33 Impact Factor
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ABSTRACT: To identify risk factors for hip fracture and to examine whether hormone replacement therapy (HRT) modifies the effect of these risk factors.
Prospective cohort study. Setting: The Danish Nurse Cohort Study.
14,015 female nurses aged 50 years and above who in 1993 completed a questionnaire on general health and lifestyle issues, reproductive history including information on HRT, and family history of osteoporosis and personal history of a wrist fracture.
End-point was the first-ever hip fracture registered in the Danish National Hospital Register during the period from 1993 to 1999.
During the follow-up period 245 hip fractures were identified. Ever users of HRT had a lower risk of hip fracture (hazard ratio 0.69; 0.50-0.94). Women reporting a poor health (hazard ratio 2.01; 1.30-3.11), restrictions in daily activities (hazard ratio 1.52; 1.05-2.21), low body mass index (hazard ratio 1.65; 0.98-2.77), and leisure time sedentary physical activity (hazard ratio 1.88; 1.30-2.70) were main identified risk factors for hip fracture. HRT did not modify the effect of risk factors on the risk of hip fracture.
This study confirms that women with a frail health are at increased hip fracture risk and that ever use of HRT decreases the risk of hip fracture. HRT did not modify the effect of these risk factors, indicating that the preventive effect of this therapy is independent of risk factors.
European Journal of Epidemiology 02/2005; 20(10):871-7. · 4.71 Impact Factor
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Ugeskrift for laeger 05/2004; 166(15-16):1441-4.
