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Herraiz-Adillo Á, Ahlqvist VH, Daka B, Wångdahl J, Wennberg P, Carlsson J, Higueras-Fresnillo S, Lenander C, Östgren CJ, Berglind D, Rådholm K, Henriksson P. Life's Essential 8 in relation to self-rated health and health-related quality of life in a large population-based sample: the SCAPIS project. Qual Life Res 2024:10.1007/s11136-023-03580-1. [PMID: 38270740 DOI: 10.1007/s11136-023-03580-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/26/2024]
Abstract
PURPOSE To monitor cardiovascular health, in 2022, the American Heart Association (AHA) updated the construct "Life's Simple 7" (LS7) to "Life's Essential 8" (LE8). This study aims to analyze the associations and capacity of discrimination of LE8 and LS7 in relation to self-rated health (SRH) and health-related quality of life (HRQoL). METHODS This study from the Swedish CArdioPulmonary bioImage Study (SCAPIS) included 28 731 Swedish participants, aged 50-64 years. Three different scores were derived from the SF-12 questionnaire: 1-item question SRH ("In general, would you say your health is …?"), mental-HRQoL and physical-HRQoL. Logistic regression, restricted cubic splines, and ROC analysis were used to study the associations between the AHA scores in relation to SRH and HRQoL. RESULTS Compared to those with a LE8 score of 80, participants with a LE8 score of 40 were 14.8 times more likely to report poor SRH (OR: 14.8, 95% CI: 13.0-17.0), after adjustments. Moreover, they were more likely to report a poor mental-HRQoL (OR: 4.9, 95% CI: 4.2-5.6) and a poor physical-HRQoL (OR: 8.0, 95% CI: 7.0-9.3). Area under curves for discriminating poor SRH were 0.696 (95% CI: 0.687-0.704), 0.666 (95% CI: 0.657-0.674), and 0.643 (95% CI: 0.634-0.651) for LE8, LS7 (0-14), and LS7 (0-7), respectively, all p values < 0.001 in the DeLong's tests. CONCLUSION LE8 and LS7 had strong and inverse associations with SRH, mental-HRQoL, and physical-HRQoL, though LE8 had a somewhat higher capacity of discrimination than LS7. The novel LE8, a construct initially conceived to monitor cardiovascular health, also conveys SRH and HRQoL.
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Affiliation(s)
- Ángel Herraiz-Adillo
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Viktor H Ahlqvist
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Bledar Daka
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Josefin Wångdahl
- Aging Research Center, Karolinska Institutet & Stockholm University, Stockholm, Sweden
- Department of Public Health & Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Patrik Wennberg
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Jakob Carlsson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Sara Higueras-Fresnillo
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
| | - Cecilia Lenander
- Department of Clinical Sciences in Malmö, Centre for Primary Health Care Research, Lund University, Lund, Sweden
| | - Carl Johan Östgren
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Centre of Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Daniel Berglind
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
| | - Karin Rådholm
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Harris SM, Jørgensen M, Lowthian E, Kristensen SM. Up in smoke? Limited evidence of a smoking harm paradox in 17-year cohort study. BMC Public Health 2023; 23:2022. [PMID: 37848880 PMCID: PMC10580607 DOI: 10.1186/s12889-023-16952-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/10/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Socioeconomic differences in the impact of alcohol consumption on health have been consistently reported in the so-called "alcohol harm paradox" (i.e., individuals from higher socioeconomic backgrounds (SES) drink more alcohol than individuals from lower SES, but the latter accrue more alcohol-related harm). Despite the severe health risks of smoking however, there is a scarcity of studies examining a possible "smoking harm paradox" (SHP). We aim to fill this gap. METHODS We conducted a prospective cohort study with adolescents from the Norwegian Longitudinal Health Behaviour Study (NLHB). Our study used data from ages 13 to 30 years. To analyse our data, we used the random-intercept cross-lagged panel model (RI-CLPM) with smoking and self-reported health as mutual lagged predictors and outcomes as well as parental income and education as grouping variables. Parental income and education were used as proxies for adolescent socioeconomic status (SES). Smoking was examined through frequency of smoking (every day, every week, less than once a week, not at all). General health compared to others was measured by self-report. RESULTS Overall, we found inconclusive evidence of the smoking harm paradox, as not all effects from smoking to self-reported health were moderated by SES. Nevertheless, the findings do suggest that smoking predicted worse subjective health over time among individuals in the lower parental education group compared with those in the higher parental education group. This pattern was not found for parental income. CONCLUSIONS While our results suggest limited evidence for a smoking harm paradox (SHP), they also suggest that the impact of adolescent smoking on later subjective health is significant for individuals with low parental education but not individuals with high parental education. This effect was not found for parental income, highlighting the potential influence of parental education over income as a determinant of subjective health outcomes in relation to smoking.
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Affiliation(s)
- Samantha Marie Harris
- Department of Health Promotion and Development, University of Bergen, Alrek helseklynge, Årstadveien 17, Bergen, 5009, Norway
| | - Magnus Jørgensen
- Department of Health Promotion and Development, University of Bergen, Alrek helseklynge, Årstadveien 17, Bergen, 5009, Norway.
| | - Emily Lowthian
- Department of Education and Childhood Studies, Swansea University, Singleton Campus, Swansea, Wales, SA2 8PP, UK
| | - Sara Madeleine Kristensen
- Department of Health Promotion and Development, University of Bergen, Alrek helseklynge, Årstadveien 17, Bergen, 5009, Norway
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Marco JCPD, Souza FUD, Pinto ADA, Bim MA, Barbosa RMDSP, Nahas MV, Pelegrini A. Isolated and combined association of excessive screen time and physical inactivity with negative self-rated health in adolescents. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2022077. [PMID: 37042945 PMCID: PMC10088469 DOI: 10.1590/1984-0462/2023/41/2022077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 10/16/2022] [Indexed: 04/13/2023]
Abstract
OBJECTIVE The aim of this study was to analyze isolated and combined associations of physical inactivity excessive screen time with negative self-rated health, according to sex, among school adolescents. METHODS In this cross-sectional study conducted with 2,517 adolescents in Amazonas State, participants were asked about their self-rated health with the following question: How do you rate your health? Responses were dichotomized into positive (excellent and good) and negative (regular, bad, and terrible). Information on sex, age group, family income, physical activity, and screen time (watching TV, using a computer, or playing video games) was collected through a self-administered questionnaire. Adolescents simultaneously classified as physically inactive (<60 min/day) and having excessive screen time (>2 h/day) were considered to have two risk factors. Data was analyzed using binary logistic regression. RESULTS Out of every 10 adolescents, 2 had a negative self-rated health. After adjusting for age and family income, there were no isolated or combined associations between physical inactivity or excessive screen time and negative self-rated health in girls. In boys, negative self-rated health was associated with insufficient levels of physical activity (odds ratio [OR]: 2.39; 95% confidence interval [CI]: 1.03-5.59) and with the accumulation of two risk factors (OR: 1.61; 95%CI 1.10-2.34). CONCLUSIONS Being insufficiently active and the combination of physical inactivity and excessive screen time become exposure factors to the negative self-rated health of adolescent boys.
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Kasenda S, Meland E, Hetlevik Ø, Mildestvedt T, Dullie L. Factors associated with self-rated health in primary care in the South-Western health zone of Malawi. BMC PRIMARY CARE 2022; 23:88. [PMID: 35439944 PMCID: PMC9016970 DOI: 10.1186/s12875-022-01686-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 04/04/2022] [Indexed: 11/30/2022]
Abstract
Background Self-rated health (SRH) is a single-item measure of current health, which is often used in community surveys and has been associated with various objective health outcomes. The prevalence and factors associated with SRH in Sub-Saharan Africa remain largely unknown. This study sought to investigate: (1) the prevalence of poor SRH, (2) possible associations between SRH, and socio-demographic and clinical parameters, and (3) associations between SRH and the patients’ assessment of the quality of primary care. Methods A cross-sectional study was conducted in 12 primary care facilities in Blantyre, Neno, and Thyolo districts of Malawi among 962 participants who sought care in these facilities. An interviewer-administered questionnaire containing the Malawian primary care assessment tool, and questions on socio-demographic characteristics and self-rated health was used for data collection. Descriptive statistics were used to determine the distribution of variables of interest and binary logistic regression was used to determine factors associated with poor SRH. Results Poor SRH was associated with female sex, increasing age, decreasing education, frequent health care attendance, and with reported disability. Patients content with the service provided and who reported higher scores of relational continuity from their health care providers reported better SRH as compared with others. Conclusion This study reports findings from a context where SRH is scarcely examined. The prevalence of poor SRH in Malawi is in line with findings from clinical populations in other countries. The associations between poor SRH and socio-demographic factors are also known from other populations. SRH might be improved by emphasizing continuity of care in primary care services.
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Lee K. Self-perceived weight and self-rated health have distinct relationships according to body mass index in Korean teenagers. Nutr Res 2022; 107:179-186. [PMID: 36288656 DOI: 10.1016/j.nutres.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 12/27/2022]
Abstract
It was hypothesized that adolescents who perceived themselves as underweight or overweight would be positively associated with poor self-rated health (SRH), regardless of their actual weight status, and that the SRH would be varied depending on the combination of their actual weight and their perceived weight. The study aimed to evaluate associations of self-perceived weight and body mass index (BMI)-based weight status with SRH in Korean adolescents. A cross-sectional study was conducted in 1658 female and 1888 male adolescents aged 10 to 18 years based on the Korea National Health and Nutrition Examination Survey using complex-samples logistic regression. Weight estimation was determined by comparing BMI-based weight and self-perceived body shape. Age, family affluence, and health status were confounders. In sex-specific analysis, the odds for poor SRH were higher in males who accurately estimated underweight or overweight and those who were normal weight, but overestimated weight compared with those who accurately self-perceived as being normal weight. In females, the odds for poor SRH were higher in those with normal weight but underestimated or overestimated weight compared with a female comparison group. In the overall analysis, males who accurately perceived their weight as underweight, males and females who perceived their weight as overweight despite being normal weight or overweight, and females who perceived weight as underweight despite being normal weight had higher odds for poor SRH compared with a female comparison group. In conclusion, as the hypothesis of this study, self-perceived overweight and underweight in adolescents were associated with poor SRH regardless of BMI, and the association differed by BMI in Korean adolescents.
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Affiliation(s)
- Kayoung Lee
- Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
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Bernstorff M, Rask CU, Rytter D, Hansen SN, Bech BH. Multiple health complaints in preadolescence and hospital contacts during adolescence: a prospective cohort study. Sci Rep 2022; 12:7412. [PMID: 35523807 PMCID: PMC9076908 DOI: 10.1038/s41598-022-11167-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 04/13/2022] [Indexed: 11/10/2022] Open
Abstract
Multiple health complaints (MHC) is increasing among preadolescents in many countries, but their prognostic effect for individual thriving or societal resource use is scarcely studied. This makes interpreting the significance of this increase challenging. We contribute by examining whether MHC in preadolescence predicts hospital contacts in adolescence by doing a nation-wide population-based cohort-study following preadolescents from the Danish National Birth-Cohort from 2010 to 2018. 96,382 children were invited at age 11. Responses to a modified version of the Health Behaviour in School Children Symptom Checklist (headache, dizziness, stomachache, irritability, feeling nervous, difficulty in getting to sleep and feeling low) was dichotomized into MHC (≥ 2 concurrent symptoms, each with a frequency of at least weekly, yes/no). Hospital contacts were derived from Danish registers from the date of answering the questionnaire to December 31st 2018. Negative binomial regression estimated incidence rate ratios (IRRs) comparing children with MHC to children without. Analyses were further broken down by hospital sector (psychiatric/somatic) and contact type (in-patient/out-patient/emergency room). 47,365 (49.1%) responded. Mean age was 11.2 years, 52% girls. 10.3% of responders reported MHC. For hospital contacts, the unadjusted IRR was 1.74 [95% CI 1.65, 1.83]. Results were robust to adjustment for sociodemographic variables and somatic/psychiatric morbidity diagnosed before baseline, IRR 1.62 [95% CI 1.54-1.71]. In conclusion, MHC in preadolescents are prognostic of hospital contacts. This shows that we cannot ignore MHC, and to prevent potentially unhelpful healthcare use, we must act. Future research should focus on the underlying causes of MHC to understand which changes will be most helpful and thus how to act.
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Affiliation(s)
- Martin Bernstorff
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.
| | - Charlotte Ulrikka Rask
- Department of Child and Adolescent Psychiatry, Research Unit, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Dorte Rytter
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
| | - Stefan Nygaard Hansen
- Research Unit for Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Bodil Hammer Bech
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
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Kasenda S, Meland E, Hetlevik Ø, Mildestvedt T, Dullie L. Factors associated with self-rated health in primary care in the South-Western health zone of Malawi. BMC PRIMARY CARE 2022; 23:88. [PMID: 35439944 PMCID: PMC9016970 DOI: 10.1186/s12875-022-01686-y#citeas] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Self-rated health (SRH) is a single-item measure of current health, which is often used in community surveys and has been associated with various objective health outcomes. The prevalence and factors associated with SRH in Sub-Saharan Africa remain largely unknown. This study sought to investigate: (1) the prevalence of poor SRH, (2) possible associations between SRH, and socio-demographic and clinical parameters, and (3) associations between SRH and the patients' assessment of the quality of primary care. METHODS A cross-sectional study was conducted in 12 primary care facilities in Blantyre, Neno, and Thyolo districts of Malawi among 962 participants who sought care in these facilities. An interviewer-administered questionnaire containing the Malawian primary care assessment tool, and questions on socio-demographic characteristics and self-rated health was used for data collection. Descriptive statistics were used to determine the distribution of variables of interest and binary logistic regression was used to determine factors associated with poor SRH. RESULTS Poor SRH was associated with female sex, increasing age, decreasing education, frequent health care attendance, and with reported disability. Patients content with the service provided and who reported higher scores of relational continuity from their health care providers reported better SRH as compared with others. CONCLUSION This study reports findings from a context where SRH is scarcely examined. The prevalence of poor SRH in Malawi is in line with findings from clinical populations in other countries. The associations between poor SRH and socio-demographic factors are also known from other populations. SRH might be improved by emphasizing continuity of care in primary care services.
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Affiliation(s)
- Stephen Kasenda
- grid.512477.2Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Eivind Meland
- grid.7914.b0000 0004 1936 7443Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway
| | - Øystein Hetlevik
- grid.7914.b0000 0004 1936 7443Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway
| | - Thomas Mildestvedt
- grid.7914.b0000 0004 1936 7443Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway
| | - Luckson Dullie
- grid.7914.b0000 0004 1936 7443Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway ,Partners in health, Neno, Malawi
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Gong WJ, Fong DYT, Wang MP, Lam TH, Chung TWH, Ho SY. Worsening trends in self-rated health and correlates in Chinese adolescents in Hong Kong: a population-based panel study from 1999/2000 to 2014/15. BMJ Open 2022; 12:e055842. [PMID: 35165111 PMCID: PMC8845170 DOI: 10.1136/bmjopen-2021-055842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To examine the 15-year secular trends of self-rated health (SRH) and correlates in Chinese adolescents in Hong Kong. DESIGN A territory-wide population-based panel data study. SETTING Anonymised records of the annual health examination from the Student Health Service, Department of Health in Hong Kong. PARTICIPANTS 397 324 students in Secondary 2 (US grade 8), 335 902 in Secondary 4 and 113 892 in Secondary 6 during the academic year 1999/2000 and 2014/15. OUTCOME MEASURES SRH and lifestyles were self-reported using standardised questionnaires. Sex-standardised and age-standardised prevalence of very poor/poor SRH and its secular annual changes across sex, grade, weight status, breakfast habits, and frequency/duration of aerobic exercises were examined. Their disparities over time were examined by interactions with the academic year in generalised estimating equations. RESULTS The overall prevalence of very poor/poor SRH increased from 9.3% (95% CI: 8.9% to 9.7%) in 1999/2000 to 15.5% (15.1% to 15.8%) in 2014/15. Very poor/poor SRH was more prevalent in girls (adjusted OR: 1.02), in those having unemployed parents (1.29), being overweight (1.42) or obese (2.62), eating breakfast away from home (1.27) and skipping breakfast (1.49) or doing <1 time/week or ≤60 min/week aerobic exercises (1.78 and 1.88, respectively) than others. The corresponding disparities increased over time (ratios of OR: 1.006-1.042). CONCLUSIONS Increasing prevalence of very poor/poor SRH from 1999/2000 to 2014/15 was found among Hong Kong Chinese adolescents, which was greater in girls, adolescents being overweight/obese and those having unemployed parents or unhealthy lifestyles. Strategies to reduce health inequality should consider multiple factors, especially modifiable factors including lifestyles.
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Affiliation(s)
- Wei Jie Gong
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | | | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | | | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
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Knebel MTG, Matias TS, Lopes MVV, Dos Santos PC, da Silva Bandeira A, da Silva KS. Clustering of Physical Activity, Sleep, Diet, and Screen-Based Device Use Associated with Self-Rated Health in Adolescents. Int J Behav Med 2022; 29:587-596. [PMID: 35028932 DOI: 10.1007/s12529-021-10043-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Little is known about how the interplay among health-related behaviors impacts self-rated health (SRH). We examined the clustering of physical activity (PA), sleep, diet, and specific screen-based device use, and the associations between the emergent clusters and SRH among Brazilian adolescents. METHOD The data used in this cross-sectional study were from the baseline of the Movimente Program. Self-reported data were analyzed. SRH was recorded as a 5-point scale (from poor to excellent). Daily duration of exposure to the computer, the television, the cell phone, and games; PA; sleep; and weekly consumption of fruits and vegetables and ultra-processed foods were included in a Two-Step cluster analysis. Multilevel ordered logistic regressions assessed the associations between the clusters and SRH. RESULTS The data of 750 students (girls: 52.8%, 13.1 ± 1.0 years) were analyzed. Good SRH was more prevalent (52.8%). Three clusters were identified: the Phubbers (50.53%; characterized by the longest cell phone use duration, shortest gaming and computer use, lowest PA levels, and low consumption of fruits and vegetables), the Gamers (22.80%; longest gaming and computer use duration, PA < sample average, highest intake of ultra-processed foods), and a Healthier cluster (26.67%; physically active, use of all screen-based devices < sample average, and healthier dietary patterns). For both Gamers (-0.85; 95% CI -1.24, -0.46) and Phubbers (-0.71; 95% CI -1.04, -0.38), it was found a decrease in the log-odds of being in a higher SRH category compared with the Healthier cluster. CONCLUSION Specific clusters represent increased health-related risk. Assuming the interdependence of health-related behaviors is indispensable for accurately managing health promotion actions for distinguishable groups.
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Affiliation(s)
- Margarethe Thaisi Garro Knebel
- School of Sports, Research Centre in Physical Activity and Health, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil.
| | - Thiago Sousa Matias
- School of Sports, Research Centre in Physical Activity and Health, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil
| | - Marcus Vinicius Veber Lopes
- School of Sports, Research Centre in Physical Activity and Health, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil
| | - Priscila Cristina Dos Santos
- School of Sports, Research Centre in Physical Activity and Health, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil
| | - Alexsandra da Silva Bandeira
- School of Sports, Research Centre in Physical Activity and Health, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil
| | - Kelly Samara da Silva
- School of Sports, Research Centre in Physical Activity and Health, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil
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Wahlström J, Modin B, Svensson J, Löfstedt P, Brolin Låftman S. Sense of Unity and Self-Reported Health Among 15-year-Olds: Findings From the Swedish 2017/18 Health Behavior in School-Aged Children Study. Int J Public Health 2021; 66:621964. [PMID: 34744583 PMCID: PMC8565282 DOI: 10.3389/ijph.2021.621964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/29/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Sense of unity refers to the positive feeling of being part of a larger social structure. This study aimed to investigate to what extent adolescents report sense of unity and if this differs across groups, and to assess the associations between sense of unity and self-reported health while taking into account sociodemographic characteristics and tangible social relationships. Methods: Data were obtained from the 2017/18 Swedish Health Behavior in School-aged Children study, using information collected among 15-year-old students (n = 1,392). Linear and binary logistic regression analyses were performed. Results: The participants reported overall high levels of sense of unity. Sense of unity did not differ by gender, but adolescents without an immigrant background and those with higher family affluence reported higher levels. Sense of unity was inversely associated with psychological complaints, somatic complaints, and less than good self-rated health, even when adjusting for sociodemographic characteristics and family, classmate, and teacher relationships. Conclusion: This study suggests that sense of unity may be an important social determinant for adolescent health. More research is needed on the origins and implications of sense of unity.
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Affiliation(s)
- Joakim Wahlström
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, Stockholm, Sweden
| | - Bitte Modin
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, Stockholm, Sweden
| | - Johan Svensson
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Stockholm, Sweden
| | - Petra Löfstedt
- Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sara Brolin Låftman
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, Stockholm, Sweden
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Bernstorff M, Rask CU, Rytter D, Hansen SN, Bech BH. Pre-adolescents with multiple health complaints redeem more prescriptions: A follow-up study in the Danish National Birth Cohort. Scand J Public Health 2021; 50:1071-1080. [PMID: 34448658 DOI: 10.1177/14034948211036619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims: This study aimed to examine the association between multiple health complaints (MHC) in pre-adolescence and prescription redemption in adolescence. Methods: This was a nationwide population-based study based on the Danish National Birth Cohort for an average of 6.9 years (2010-2018). A total of 96,382 children were invited at the age of 11. A modified version of the Health Behaviour in School Children Symptom Checklist was dichotomised into the World Health Organization's definition of MHC (⩾2 complaints, each with a frequency of at least weekly, yes/no). The number of prescriptions was retrieved from Danish registries. Negative binomial regression estimated incidence rate ratios (IRRs) comparing children with MHC to children without. Prescription redemption was further stratified by psychiatric/somatic medication and into subtypes of prescriptions. Results: A total of 47,365 (49.1%) children participated (Mage=11.2 years, 52% girls). MHC were reported by 10.3%. The unadjusted IRR (MHC vs. no MHC) of all types of redemptions was 1.57 (95% confidence interval (CI) 1.49-1.64). Results were robust to adjustment for socio-demographic variables and somatic/psychiatric morbidity at baseline (IRR=1.47; 95% CI 1.40-1.54). Associations were especially strong for psychiatric medication (adjusted IRR=3.88; 95% CI 3.43-4.40) and were modified by neither sex nor maternal education. Conclusions: MHC in pre-adolescents predict prescription redemption. This implies that changes in MHC might be indicative of changes in public health. This requires further study, as the cause of a change in reporting of symptoms might also cause a change in treatment response. The latter determines whether prescriptions are treating ill-being or needlessly medicalising subjective symptoms.
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Affiliation(s)
- Martin Bernstorff
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Denmark
| | - Charlotte Ulrikka Rask
- Research Unit for Biostatistics, Department of Public Health, Aarhus University, Denmark.,Research Unit, Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Denmark.,Department of Clinical Medicine, Aarhus University, Denmark
| | - Dorte Rytter
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Denmark
| | - Stefan Nygaard Hansen
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Denmark
| | - Bodil Hammer Bech
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Denmark
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12
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Fylkesnes K, Jakobsen MD, Henriksen NO. The value of general health perception in health equity research: A community-based cohort study of long-term mortality risk (Finnmark cohort study 1987-2017). SSM Popul Health 2021; 15:100848. [PMID: 34195347 PMCID: PMC8237603 DOI: 10.1016/j.ssmph.2021.100848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 11/08/2022] Open
Abstract
Background General health perception as measured by self-rated health (SRH) is an individual's synthesis of personal overall health and has value in its own right. In addition, this subjective perspective has a unique predictive power of subsequent mortality and adds valuable information not captured by objective measures. We studied the relationship between SRH and subsequent mortality to demonstrate how simple self-ratings can enhance our understanding of health inequities. Methods Data from a population-based survey conducted in Finnmark 1987/1988 were linked to the Norwegian Cause of Death Registry for information on all deaths by the end of 2017. We used Cox proportional hazard regression modelling to estimate the relative effects of all-cause mortality separately for sex and age (30–49 and 50–62 years) with stepwise adjustment for socio-demographics and various other health status and behavioural measures. Results The age-adjusted power of mortality prediction of SRH was strong (most pronounced in the youngest age-group) but markedly attenuated by other factors. Education inequality in mortality was most substantial in the youngest age-group, which might partly be due to a combination of selective mortality and historical changes in health inequality. In comparison, educational inequality in SRH was clearly pronounced regardless of age. Work disability pension appeared as the common key factor affecting the mortality prediction of SRH and educational inequity for both subsequent mortality and SRH. Conclusion SRH adds unique information to our understanding of health inequities. The consistency in shared predictors of educational inequity concerning both mortality and SRH underscores the correspondence of these measures. In addition to predicting the fatal effects of social selection mechanisms, SRH adds non-fatal effects and seems less prone to selective mortality. The results are relevant to approaches in health equity research and have important policy implications. Self-rated health yielded robust age adjusted mortality predictions. Self-rated health adds unique information to our understanding of health inequities. Educational inequity in mortality is extensive, but it narrows with age, which can be explained by selective mortality and historical changes. Measures to reduce preventable workforce exclusions can be effective for achieving or maintaining health equity.
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Affiliation(s)
- Knut Fylkesnes
- Centre for International Health University of Bergen, Norway
| | - Monika Dybdahl Jakobsen
- Centre for Care Research North, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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13
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Falskog F, Landsem AM, Meland E, Bjorvatn B, Hjelle OP, Mildestvedt T. Patients want their doctors' help to increase physical activity: a cross sectional study in general practice. Scand J Prim Health Care 2021; 39:131-138. [PMID: 33871303 PMCID: PMC8293971 DOI: 10.1080/02813432.2021.1910670] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Inactivity is prevalent in patients presenting in general practice, and the health benefits of increased physical activity (PA) are well known. Few studies have explored whether patients want their general practitioner's (GPs) contribution in facilitating a lifestyle change. OBJECTIVE To identify the characteristics of patients who expect help from their doctor in increasing levels of PA. DESIGN We collected data via questionnaires for this cross-sectional study from general practices. SETTING General practices in Norway, during Spring 2019. SUBJECTS A total of 2104 consecutive patients (response rate 75%) participated. MAIN OUTCOME MEASURES The questionnaire included questions about self-rated health, level of physical activity, the desire to become more physically active, and questions about the role of the GP in increasing the level of physical activity in their patients. We analysed our data using Pearson chi-square and binary logistic regression. RESULTS Female patients were less active, but their motivation to increase activity and their expectations of receiving help from their doctor were similar to males. Younger patients were more motivated for increased activity, and to manage without help from their doctors. Impaired self-rated health (SRH) was associated with inactivity and, at the same time, with the motivation to become more active with help from general practitioners. CONCLUSION Most patients in the GPs' office are physically inactive. This study revealed an important message for GPs: in clinical work, emphasise physical activity for health gains, especially for patients with impaired SRH.Key PointsFour out of five patients attending Norwegian general practice are inactiveMore than 85% of these patients want to increase their physical activity levelMore than 50% would like help from their GP to achieve this goal.
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Affiliation(s)
- Frida Falskog
- Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ane M. Landsem
- Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Eivind Meland
- Department of Global Public Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Ole P. Hjelle
- Faculty of Health and Social Sciences, Department of Nursing and Health Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Thomas Mildestvedt
- Department of Global Public Health and Primary Health Care, University of Bergen, Bergen, Norway
- CONTACT Thomas Mildestvedt Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, BergenNO 5018, Norway
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14
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Meland E, Breidablik HJ, Thuen F, Samdal GB. How body concerns, body mass, self-rated health and self-esteem are mutually impacted in early adolescence: a longitudinal cohort study. BMC Public Health 2021; 21:496. [PMID: 33711967 PMCID: PMC7953559 DOI: 10.1186/s12889-021-10553-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/02/2021] [Indexed: 11/10/2022] Open
Abstract
Background Impaired self-rated health (SRH) and self-esteem (SE) in adolescents are associated with increased body mass index (BMI). These associations are often studied using cross-sectional designs; we performed a longitudinal cohort survey to examine them. Methods A longitudinal cohort study of 1225 Norwegian high school students, with SRH, SE and BMI as primary outcomes. We reported the results from temporal causal and residual change analyses separately, with odds ratios (ORs) and standardised regression coefficients (b) and 95% confidence limits. Results Body and weight concerns had unfavourable effects on SRH and SE, which both had favourable effects on each other. Increased BMI had unfavourable effects on SRH, but less so on SE. Body and weight concerns impacted SE change only among girls. Paradoxically, the intention of becoming thinner was associated with an increase in BMI, and the intention of becoming fatter predicted a decrease in BMI during the 2 years. SE and SRH were associated with a leaner body after 2 years. Conclusions This study confirms that body concerns had unfavourable effects on subjective health, and that positive self-concepts predicted a leaner body. Health promotion strategies built on body acceptance should be increasingly emphasised in clinical and public health practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10553-x.
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Affiliation(s)
- Eivind Meland
- Department of Global Public Health and Primary Care, Research Group for General Practice, Årstadveien 17, 5018, Bergen, Norway.
| | - Hans Johan Breidablik
- Department of Research and Development, District General Hospital of Førde, 6800, Førde, Norway
| | - Frode Thuen
- Center for Evidence-Based Practice, Western Norway University of Science, Inndalsveien 28, 5063, Bergen, Norway
| | - Gro Beate Samdal
- Faculty of Health, VID Specialized University, 5145 Fyllingsdalen, Bergen, Norway
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15
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Excellent Self-Rated Health among Swedish Boys and Girls and Its Relationship with Working Conditions in School: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031310. [PMID: 33535643 PMCID: PMC7908486 DOI: 10.3390/ijerph18031310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 11/17/2022]
Abstract
The aim of this study was to investigate the extent to which school demands, teacher support, and classmate support were associated with excellent self-rated health among students, and to examine if any such statistical predictions differed by gender. Data were drawn from the Swedish Health Behaviour in School-aged Children (HBSC) study of 2017/18, performed among adolescents in grades five, seven, and nine (n = 3701). Linear probability models showed that school demands were negatively associated with excellent self-rated health, whereas teacher and classmate support showed positive associations. The link with school demands was stronger for girls than boys, driven by the finding that in grades five and nine, school demands were associated with excellent self-rated health only among girls. In conclusion, the study suggests that working conditions in school in terms of manageable school demands and strong teacher and classmate support may benefit adolescents’ positive health. The finding that the link between school demands and excellent self-rated health was more evident among girls than among boys may be interpreted in light of girls’ on average stronger focus on schoolwork and academic success. The study contributes with to knowledge about how working conditions in school may impede or promote students’ positive health.
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Meland E, Breidablik HJ, Thuen F. Family factors predicting self-rated health during early adolescence. Scand J Public Health 2020; 49:546-554. [PMID: 33245020 DOI: 10.1177/1403494820972282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Health impairments in adolescents associated with divorce and loss of parental contact are frequently reported. However, other family factors more likely to promote health are less researched. We examined the impact of several family factors on self-rated health (SRH). METHODS A longitudinal cohort study of 1225 students in high school aged 11 and 13 years in 2011. The students were surveyed at onset and after 2 years with SRH as the outcome measure. We adjusted for sex, age and self-rated socioeconomic status in temporal causal analyses, and adjusted for SRH at onset in residual change analyses, applying an ordinal logistic method. Adjusted analyses with each factor and multivariable models with backward exclusion were performed. We reported the predictive associations with odds ratios and 95% confidence limits. RESULTS The most decisive factors predicting future positive SRH were linked to confidence in communicating with both parents about bothersome issues, and the experience of parental support with school work. Furthermore, the experience of opinions being taken seriously in the family and the absence of excessive parental expectations predicted SRH positively after 2 years. Divorce had a modest impact on SRH and was mediated by the other factors. Only the absence of contact with fathers moderated the effect that divorce experience had on SRH. We ascertained the causal relationships through residual change analyses. CONCLUSIONS As SRH in adolescence has an impact on later health and is amendable, it is important, from a public health perspective, to preserve and improve relationships and confidence between children and both parents.
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Affiliation(s)
- Eivind Meland
- Department of Global Public Health and Primary Care, Research Group for General Practice, Universitetet i Bergen Det medisinsk-odontologiske fakultet, Bergen, Norway
| | - Hans Johan Breidablik
- Department of Research and Development, District General Hospital of Førde, Førde, Norway
| | - Frode Thuen
- Center for Evidence-Based Practice, Western Norway University of Science, Bergen, Norway
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17
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Dangmann CR, Solberg Ø, Steffenak AKM, Høye S, Andersen PN. Health-related quality of life in young Syrian refugees recently resettled in Norway. Scand J Public Health 2020; 48:688-698. [PMID: 32613905 PMCID: PMC7604933 DOI: 10.1177/1403494820929833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Aims: Millions have fled from the civil unrest in Syria, and half of these are children and youth. Although they are a population with an elevated risk of health problems due to adverse pre-migratory and post-migratory experiences, few studies have explored their health-related quality of life (HRQoL). This is considered a fundamental construct in public health and might provide complementary descriptions of their health and well-being after resettling in a new country. Methods: This was a cross-sectional study of 160 Syrian youth aged 13–24 years. Using KIDSCREEN-27, the results for five dimensions of HRQoL was compared to population norm data. Demographic factors and war-related adverse events were used to predict HRQoL in hierarchical regression. Results: For most participants, the overall HRQoL was good, but it was lower in the dimensions for friends, physical well-being and psychological well-being compared to population norms. Scores in the dimensions for autonomy/parental relation and the school environment were high and were the main contributors to a positive HRQoL. Age and number of reported stressful events (SE) had the greatest impact on HRQoL, but the final regression model only accounted for 21% of the total variance. Conclusions: HRQoL is a relevant and non-invasive measure for refugee youth. Contributors to lower scores in physical and psychological well-being should be explored further and indicate the potential for future interventions focussing on general psychological well-being and networks, regardless of the SE that have been experienced. These interventions could potentially be based in schools or in families in order to benefit from these being seemingly safe environments for the majority of the group.
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Affiliation(s)
| | - Øivind Solberg
- Norwegian Centre for Violence and Traumatic Stress Studies, Norway
| | | | - Sevald Høye
- Inland Norway University of Applied Sciences and Nord University, Norway
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18
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Hetlevik Ø, Meland E, Hufthammer KO, Breidablik HJ, Jahanlu D, Vie TL. Self-rated health in adolescence as a predictor of 'multi-illness' in early adulthood: A prospective registry-based Norwegian HUNT study. SSM Popul Health 2020; 11:100604. [PMID: 32509958 PMCID: PMC7265049 DOI: 10.1016/j.ssmph.2020.100604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 03/11/2020] [Accepted: 05/15/2020] [Indexed: 01/22/2023] Open
Abstract
Self-rated health (SRH) is a marker of future health and a possible predictor of future multimorbidity, which is a major challenge for population health and health care. There is a lack of studies on adolescent SRH and patterns of health problems across the transitional period from adolescence to early adulthood. Therefore, this study aimed to identify groups of people with similar health problems in early adulthood and explore the predictive value of adolescent SRH on the group classification after a period of 10–19 years. Data from 8828 adolescents participating in the Young HUNT-1 survey (1995–1997) were linked to the Norwegian registry of general practitioner (GP) claims, which includes diagnoses recorded in GP consultations in 2006–2014. We used latent class analysis (LCA) to identify groups of patients with similar health problems in early adulthood and explored SRH as a predictor of class membership using latent class regression, adjusting for baseline chronic disease, frequency of health care attendance, sex and age. The mean age at baseline was 16 years, and 50% of the participants were female. SRH was reported as very good by 28%, good by 61% and not good by 11%. We identified five groups of patient classification (classes): Healthy (35%), Infections and general problems (26%), Musculoskeletal problems (21%), Psychological problems (6%) and Multi-illness (13%). We found a gradual increase in the probability of belonging to the Healthy class with better SRH, and an inverse pattern for the Psychological and Multi-illness classes. This pattern remained after adjusting for baseline variables. In conclusion, there is a clear association between adolescent SRH and the risk of having multi-illness in early adulthood, seen as a proxy for later multimorbidity. This finding warrants greater attention to SRH in adolescence as a possible indicator in targeted prevention of future health problems. Adolescent self-rated health (SRH) predicted health problems 10–19 years later. Patients were classified into five groups with similar patterns of health problems. Better SRH increased the probability of adults belonging to the healthiest group. Not good SRH tripled the risk for multi-illness compared to very good SRH. Low SRH in adolescence is a possible predictor of multimorbidity in adulthood.
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Affiliation(s)
- Øystein Hetlevik
- Department of Global Public Health and Primary Care, University of Bergen, 5020, Bergen, Norway
| | - Eivind Meland
- Department of Global Public Health and Primary Care, University of Bergen, 5020, Bergen, Norway
| | | | - Hans J Breidablik
- Centre of Health Research, Førde Hospital Trust, PO Box1000, 6807, Førde, Norway
| | - David Jahanlu
- Faculty of Health Sciences, Oslo Metropolitan University, PO Box 4, St. Olavs Plass, 0130, Oslo, Norway
| | - Tina L Vie
- Centre of Health Research, Førde Hospital Trust, PO Box1000, 6807, Førde, Norway
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