Ola Ekholm

Aims: The foundation for future educational and job opportunities is laid during the crucial years of primary education. Navigating them while a parent has heart disease adds a potential stressor. We investigated whether childhood experience of parental heart disease was associated with (1) primary and secondary education completion and (2) grade point average (GPA) in primary education. Methods and results: This national register study included adolescents from the Danish Fertility Register born between 1979 and 2003. Through the National Patient Register, adolescents were linked with their parents who either had ischaemic heart disease, arrhythmia, heart failure, or heart valve disease. Statistical analyses included descriptive statistics, multivariate logistic, and linear regression models. The population consisted of 102 829 adolescents with at least one parent diagnosed with heart disease. The matched reference population included 411 311 children without parental heart disease. Having a parent with heart disease was associated with lower odds of not completing primary education (OR: 0.56, 95% CI 0.52;0.62), corresponding to absolute risks of 0.6% among exposed and 1.9% among unexposed adolescents, and a lower GPA (estimate: −0.10, 95% CI: −0.12; −0.08) compared to peers. Parental ischaemic heart disease was associated with higher odds of not completing secondary education (OR: 1.31, 95% CI 1.17;1.47). Conclusion: Exposure to parental heart disease was associated with lower odds of non-completion of primary education and slightly lower GPA, with small absolute differences and showed no overall association with secondary education completion. Adolescents with a parent diagnosed with ischaemic heart disease had a lower completion of secondary education. These findings indicate diagnosis-specific differences in educational outcomes, with an overall limited impact on educational completion.

Introduction: Chronic noncancer pain affects approximately one-fourth in population-based studies calling for more nuanced insights by applying the Graded Chronic Pain Scale-Revised (GCPS-R) framework for classifying graded chronic noncancer pain distribution in national disease surveillance. Objectives: The GCPS-R framework was included in the comprehensive questionnaire repeatedly used in the Danish National Health and Morbidity Surveillance program to provide more distinct measures for chronic non-malignant pain disease manifestation in Denmark. Methods: A cross-sectional study inviting randomly 25,000 adults 16 years and older to self-report questionnaires comprising the GCPS-R framework as part of the nationwide Danish National Health Survey 2023. Prevalences (%) and multivariate-adjusted odds ratios (ORs) with 95% confidence intervals (95% CI) by ordinal logistic regression were calculated for GCPS-R by sex, area of living, age, country of origin, socioeconomic factors, body mass index, and Charlson Comorbidity Index. Results: The prevalence of chronic noncancer pain was overall 28.1% (95% CI 27.2%–29.0%) in 8,643 included individuals without cancer diagnosis counting 7.4% (6.9%–8.0%) with mild-impact, 7.1% (6.6%–7.6%) with bothersome-impact, and 13.6% (12.9%–14.4%) with high-impact chronic noncancer pain. Women had 66% (odds ratio (OR) 1.66; 95% CI 1.50–1.84) elevated odds of more severely graded chronic noncancer pain referenced to men. Socioeconomic factors influenced odds inversely. Body mass index was related to GCPS-R by dose-response effects of more than doubled elevated odds in World Health Organization obese class II (2.42; 1.92–3.06) and obese class III (4.43; 3.30–5.93) referenced to normal body mass index individuals. Comorbidity elevated odds of more severely graded chronic noncancer pain by 86% (1.86; 1.57–2.19) referenced to individuals without comorbidity. Conclusions: More than one-quarter individuals reported chronic noncancer pain characterized particularly by high-impact graded chronic noncancer pain when applying the GCPS-R framework for classifying graded chronic noncancer pain distribution in national disease surveillance for rational health care administration.

Introduction: Venous thromboembolism (VTE) is a common disease with a serious prognosis. Nonetheless, many aspects of this multicausal disease are poorly understood. The aim of establishing The Danish Venous Thromboembolism Cohort was to study VTE risk and prognosis within a life-course context. Methods: The Danish Venous Thromboembolism Cohort was based on respondents to the questionnaire-based Danish National Health Survey (DNHS) conducted in 2010, 2013, and 2017 and was linked to Danish national health and administrative registries. Results: A total of 474,022 unique respondents to the DNHS were included in this cohort, 8,460 of whom were diagnosed with VTE before the survey response date. The survey’s response rate varied between 54% and 60%. The median age at the survey response date was 54 years (interquartile range: 40– 66 years), and 46.1% of respondents were men. The cohort contains detailed information on lifestyle factors (smoking habits, alcohol consumption, physical activity level, and dietary habits), health status indicators (healthcare-seeking behavior, body mass index, self-rated health, and mental distress), and self-reported morbidities. In addition, the survey data were linked to records in Danish medical and administrative registries to obtain information on clinical data and outcomes, including hospitalizations, medication use, laboratory test results, labor market participation, vital status, and causes of death. Discussion: The Danish Venous Thromboembolism Cohort is a valuable data resource for use in future studies on VTE research, with a focus on risk factors, complications, interactions, and prognosis.

Declining response proportions in health surveys may lead to increased non-response bias. Multiple reminders are often used to increase response proportions, and, thus, we aimed to determine if the use of reminders decreased the magnitude of non-response bias among web-mode invited in the Danish National Health Survey 2023. In the Danish National Health Survey 2023, a national random sample of 23 467 individuals (aged ≥16 years) with residence in Denmark were invited by a secure electronic mail service. Invited individuals received up to five inquiries: (i) web invitation, (ii) web reminder, (iii) paper invitation including a questionnaire and a prepaid return envelope, (iv) paper reminder, and (v) paper reminder including a questionnaire and a prepaid return envelope. The cumulative response proportions after first-, second-, third-, fourth-, and fifth inquiries were 19.1%, 28.9%, 37.2%, 39.3%, and 42.0%, respectively. In general, third, fourth, and fifth mailing respondents were more often men, at younger ages, with non-Western backgrounds, and unmarried compared to first mailing respondents. Furthermore, third, fourth, and fifth mailing respondents were in general found to have less favorable health behavior than first mailing respondents, but also a lower prevalence of fair or poor self-rated health and long-standing health problems. In conlusion, reminders are an effective way to increase the response proportion. Furthermore, the use of reminders was found to decrease the magnitude of non-response bias; however, the decrease was small due to the low number of individuals responding after fourth and fifth inquiries.

Background: Prior research has shown that using lifetime abstainers as the reference group to examine the association between alcohol use and health‐related consequences has several disadvantages. The aim of the present study was to examine the consistency of self‐reported lifetime abstention and never‐binge drinking, respectively, using national, longitudinal data collected in 2019 and 2020. Additionally, the prevalence of alcohol‐related morbidity among lifetime abstainers was examined by linking survey data to alcohol‐related morbidity data in a national patient register.Methods: Data come from the Danish Health and Wellbeing Survey in 2019 and from a follow‐up survey of the same individuals in 2020. A random sample of 14,000 individuals aged 15 years or older was drawn in mid‐August 2019. Data were collected between September and December 2019. All those who were invited to the survey in 2019 and who were still alive and living in Denmark were invited to participate in a follow‐up survey in 2020. Data in both waves were collected by self‐administered questionnaires. Both questionnaires included the standard questions on alcohol consumption from the European Health Interview Survey model questionnaire. Information on alcohol‐related morbidity was obtained from the Danish National Patient Register.Results: In all, 5000 individuals completed the questionnaire in both waves. Approximately half (44.4%) of the individuals who declared that they were lifetime abstainers in 2020 (n = 252) had reported in 2019 to have drunk at some point in their life. Moreover, 39.7% contradicted earlier reported binge drinking. Furthermore, 2.4% of the respondents who defined themselves as lifetime abstainers in 2020 had earlier been diagnosed with an alcohol‐related health condition.Conclusion: The present research reaffirms previous studies which have found self‐reported lifetime abstainers to be unreliable as a consistent reference group. Additionally, the results indicated that a non‐negligible proportion of lifetime abstainers had been diagnosed with an alcohol‐related health condition.

Aims: The aim of this study was to investigate: (1) whether self-reported acute alcohol-related consequences among adolescents in the Nordic countries have declined in concert with the decline in alcohol consumption; (2) whether the relationship between alcohol consumption and alcohol-related consequences has strengthened; and (3) whether the decline in alcohol-related consequences can be attributed to the decline in alcohol consumption. Methods: Data are from the European School Survey Project on Alcohol and Other Drugs (ESPAD) cross-sectional surveys in 2007, 2011 and 2015. Participants were students aged 15–16 years in 2007 (n = 16,035), 2011 (n = 14,765) and 2015 (n = 13,517). Alcohol consumption variables included lifetime and 12-month alcohol use, volume ethanol at last drinking occasion and heavy episodic drinking in the past 30 days. Self-reported acute alcohol-related consequences were measured as a sum index of experiencing the following at least once within the last 12 months: (1) an accident or injury; (2) being victimised by robbery or theft; or (3) had trouble with the police. Results: For all alcohol indicators, adolescent alcohol use decreased between 2007 and 2015. The highest prevalence estimates were found in Denmark, and here only the number of current drinkers decreased significantly. In addition, a decreasing trend in self-reported acute alcohol-related consequences was observed. We did not find a strengthening of the alcohol consumption consequences association from 2007 to 2015, except in Iceland. When all surveys were combined, the decrease in alcohol-related consequences could be explained by a decrease in alcohol consumption. Conclusions: Overall, adolescents aged 15–16 years exhibited decreasing trends in both alcohol consumption, less markedly in Denmark, and in our sum index of alcohol-related consequences between 2007 and 2015. Except for Iceland, we found no support for a strengthening of the alcohol-consequences association with declining drinking among adolescents.