Health In Denmark Research Articles

Associations of types of physical activity with self-rated physical and mental health in Denmark

The purpose of this article is to analyse the association between types of physical activity and self-rated physical and mental health. The analyses are based on data from a Danish 2020 survey of adults’ exercise habits. The questionnaire was answered by 163,131 adults of whom 55 pct. were women and relatively evenly distributed by age. The questionnaire included questions about participation in different types of physical activity, self-rate of physical and mental health and sociodemographic and socioeconomic background. The analysis distinguishes between 16 main types of sports and exercise activities, cycling as a mode of transport, and gardening at home. The statistical analysis consists of ordinal regression, where the association between practicing a certain form of physical activity and self-rated health takes into account the adults other physical activity habits and their socio-economic and socio-demographic background. The analyses show, firstly, that the association, for most types of physical activity, is stronger for self-rated physical health than for self-rated mental health. Secondly, there are large differences in the strength of the association between the different types of physical activity. Thirdly, the association is significantly stronger for those who practise an activity type most days of the week than for those who do it less often. Fourthly, the analyses show small gender differences in the association between types of physical activity and self-rated health. Finally, the more different types of activity a person practises during a week, the better the self-rated health, but this primarily applies to self-rated physical health.

Rickettsiosis in Denmark: A nation-wide survey

Rickettsia helvetica has been reported at varying prevalences in Danish and other European Ixodes ricinus populations. Though apparently widespread and with reported cases of human infection, the significance of the bacteria as a threat to public health remains unclear. We present a nation-wide survey of rickettsia in ticks, roe deer and humans in Denmark.Ticks were collected by flagging and screened for presence of rickettsial DNA by polymerase chain reaction. Sera from roe deer, hunters, neuroborreliosis patients and blood donors were analyzed for presence of anti-R. helvetica and Rickettsia felis antibodies by immunofluorescence microscopy.The Rickettsia minimum infection rate in ticks was 4.9 % (367/973 pools positive, 7510 ticks in total), with 3.9 % in nymphs and 9.3 % in adults. Rickettsia helvetica accounted for 4.17 % and Rickettsia monacensis for 0.03 %, 0.6 % comprised non-differentiable rickettsial DNA. The prevalence of antibodies against R. helvetica was 2.8 % (9/319) in roe deer, while no hunters (n = 536) or blood donors (n = 181) were positive. The prevalence of anti-R. helvetica antibodies among Lyme neuroborreliosis patients was 6 % (3/47), where it co-occurred with Anaplasma phagocytophilum.Based on our study autochthonous rickettsiosis is of limited concern to the public health in Denmark, but our finding of R. monacensis for the first time in Denmark illustrates the dynamic nature of tick-borne pathogens, emphasizing that continuous surveillance is necessary.

Study design of National Surveillance of the Work Environment of Employees in Denmark (NASWEED): Prospective cohort with register follow-up.

The aim is to report the design and baseline data of the 'National Surveillance of the Work Environment of Employees in Denmark' study (NASWEED). NASWEED consist of (a) bi-annual cross-sectional samples, based on probability samples of wage earners of the general working population in Denmark from 2021 onwards (surveillance), (b) a prospective cohort of all previous respondents every two years (epidemiology, questionnaire follow-up) and (c) longitudinal follow-up in Danish registers about work and health (epidemiology, register follow-up). Between February and May 2021, a stratified (38 occupational industries) probability sample of 63,391 Danish residents aged 15-69 years who were employed for at least 34 hours per month received an invitation to participate, of whom 30,099 (47.5%) completed the questionnaire, 897 (1.4%) partially completed the questionnaire and 32,395 (51.1%) did not respond. Baseline was completed in June 2021. NASWEED covers various topics about the work environment (psychosocial, ergonomic, chemical, biological, safety, accidents, working from home, etc), health behaviours and somatic and mental health-related conditions. Statistical analyses will mainly build on survey procedures with model-assisted weights to ensure that the sample will yield representative estimates of the general working population. NASWEED will monitor the development of the work environment and health in Denmark until 2030. The survey data will be included in epidemiological studies with repeated measurement of the work environment, health variables and covariates, and follow-ups in national registers to investigate the prospective association in the years and decades to come between the work environment and workers' health and labour market participation.

(049) Project SEXUS – Baseline Findings from a Nationwide Cohort Study on Sexual Behavior and Health in Denmark

Abstract Introduction Project SEXUS (www.projectsexus.dk) is a nationwide cohort study on sexual behavior and health in Denmark that was initiated in 2017 by two state research institutions. The aim of this presentation is to introduce the methodology of the study and to present key findings from its baseline data collection. Objective The objectives of the Project SEXUS study were 1) to provide a thorough insight into the sexual landscapes of the general Danish population, 2) to shed light on the sexual health of understudied groups such as elderly people, chronically ill individuals and LGBT+ persons and 3) to investigate the interplay between sex lives, lifestyles and general health. Methods The cohort was created using a probability-based sampling frame, and the questionnaire comprised more than 600 items, including brief versions of validated measurement instruments such as the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI). Due to strategic filter questions, the median number of items addressed by respondents was 180. Between September 2017 and August 2018, 187,084 Danes aged 15-89 years were invited to participate in the study by filling out an online questionnaire. 64,706 individuals gave complete or almost-complete responses (AAPOR response rate 1: 34.6%). Individual weighting procedures ensured exact national representativeness regarding sex, birth year, region of residence, marital status, cultural background and twin status, and logistic regression analyses provided age-adjusted odds ratios as measures of relative risk at baseline. Results Based on complete and validated questionnaire data from 62,675 participants, key findings concerning sexual orientation, needs, experiences, satisfaction and current behaviors will be presented, and various dimensions of sexual health in the Danish population will be discussed. Moreover, topics such as relationship satisfaction, pornography consumption, risky sexual behavior, body contentment and childhood gender non-conformity will be addressed. Further, noteworthy associations between general and sexual lifestyles and health will be emphasized, and main findings regarding general and sexual wellbeing in strata of different sexual and gender identities will be shown. Conclusions The presented baseline findings from Project SEXUS provide a detailed account of the sex life situation in contemporary Denmark. Due to its huge size, national representativeness and ability to follow individual cohort members over time through identity-secure linkage with information in national health registers, the study offers internationally unique opportunities for detailed prospective assessments of the complex interplay between sex life, lifestyles and health. This is of obvious relevance to sexologists, sexual health promoters and general health-care providers around the world. Disclosure No

Working together: the National Centre for Arts and Mental Health in Denmark

Working together: the National Centre for Arts and Mental Health in Denmark

Participatory System Dynamics Approach Targeting Childhood Health in a Small Danish Community (Children’s Cooperation Denmark): Protocol for a Feasibility Study Design

Improving childhood health is complex due to the multifactorial nature and interaction of determinants. Complex problems call for complex intervention thinking, and simple one-size-fits-all solutions do not work to improve childhood health. Early awareness is important, as behavior in childhood often is manifested across adolescence and into adulthood. To facilitate shared understanding of the complex structures and relationships that determine children's health behavior, participatory system approaches in, for example, local communities have shown promising potential. However, such approaches are not used systematically within public health in Denmark, and before being rolled out, they should be tested for their feasibility within this context. This paper describes the study design for Children's Cooperation Denmark (Child-COOP) feasibility study that is aiming to examine the feasibility and acceptability of the participatory system approach and the study procedures for a future scale-up controlled trial. The feasibility study is designed as a process evaluation of the intervention with the use of both qualitative and quantitative methods. A local childhood health profile will provide data for childhood health issues, for example, daily physical activity behavior, sleep patterns, anthropometry, mental health, screen use, parental support, and leisure-time activities. Data at system level are collected to assess development in the community, for example, readiness to change, analysis of social networks with stakeholders, rippled effects mapping, and changes in system map. The setting is a small rural town in Denmark, Havndal, with children as the primary target group. Group model building, a participatory system dynamics method, will be used to engage the community, create consensus on the drivers of childhood health, identify local opportunities, and develop context-specific actions. The Child-COOP feasibility study will test the participatory system dynamics approach for intervention and evaluation design and survey objective measures of childhood health behavior and well-being among the ~100 children (6-13 years) attending the local primary school. Community-level data will also be collected. We will assess the contextual factors, implementation of interventions, and mechanisms of impact as part of a process evaluation. Data will be collected at baseline, at 2 years, and 4 years of follow-up. Ethical approval for this study was sought and granted from the Danish Scientific Ethical Committee (1-10-72-283-21). s: The potential of this participatory system dynamics approach includes opportunities for community engagement and local capacity building to improve children's health and health behavior, and this feasibility study holds the potential to prepare an upscaling of the intervention for effectiveness testing. DERR1-10.2196/43949.

Veterinary bacteriology in Denmark from the 1880s to 2022.

This paper gives an account of the history of veterinary bacteriology including clinical veterinary bacteriology as well as the area of veterinary public health in Denmark from the 1880s to 2022. We describe key persons, including B. Bang, C.O. Jensen, K.A. Jensen and others who made important contributions to the development of these areas of microbiological expertise, and we discuss how challenges ranging from bovine tuberculosis to bacterial antimicrobial resistance have been met. Further, we describe progress in research on important bacterial pathogens both with regard to animal clinical aspects and zoonotic food-related aspects. Finally, we describe current issues in relation to One Health and research organization.

Implementing Mental Health Promotion Initiatives - Process Evaluation of the ABCs of Mental Health in Denmark

Abstract Treatment and prevention alone are unlikely to make a significant difference in reducing the burden of poor mental health and mental illness. Therefore, mental health promotion (MHP) initiatives are advocated. In 2014, the ABCs of mental health (ABCs) partnership was established in Denmark; in the partnership, partner organisations, e.g., municipalities and NGOs, use a research-based framework for MHP, the ABC-framework, to develop and implement MHP initiatives. This presentation has two aims: (1) to outline the overall characteristics of these MHP initiatives; and (2) to explore local coordinator and stakeholder perceptions of the implementation processes and the impact of the MHP initiatives. Questionnaire surveys, individual interviews and group interviews were conducted during 2017-2020. The MHP initiatives were grouped according to three strategies: building MHP capacity, campaign activities to promote mental health awareness and knowledge and establishing and promoting opportunities to engage in mentally healthy activities. The ABC-framework was positively received and viewed as providing relevant knowledge for working with MHP as well as fostering intersectoral and interprofessional collaborations. However, using a bottom-up approach to develop and implement MHP initiatives can be time-consuming and resource demanding, and it requires a deliberate balancing of local adaptability and concrete guidance when engaging stakeholders and implementers. Overall, using the ABC-framework to develop and implement MHP initiatives holds great promise for advancing and promoting MHP practice.

Do different job demands interact as predictors of long-term sickness absence? A register-based follow-up on 55 467 Danish workers

ObjectivesTo assess interactions between combinations of quantitative demands, emotional demands, unclear and contradictory demands, and violence/threats of violence in the prospective association with risk of long-term sickness absence (LTSA).MethodsWe included...

Motivational predictors of children's involvement in out-of-school activities: An application of a football program.

The "11 for Health in Denmark" in-school educational football program has shown to have numerous positive physiological and psychological effects in 10- to 12-year-old schoolchildren. A key part of the successful application of the program, however, has not yet been examined, namely the motivational processes underlying participation and behavioral changes. This study examined such motivational processes (i.e., autonomous motivation, beliefs, and intentions) using the trans-contextual model (TCM) and investigated if the 11 for Health in Denmark program increased intentions to participate in physical activity (PA) outside of school in 10- to 12-year-old schoolchildren. Using a web-based questionnaire, Danish-speaking schoolchildren (N=276 [boys, 50.4%]; Mage =10.44, SD=0.35) from three schools and seven classes completed TCM-based questionnaires at three time-points (weeks 0, 1, and 5) while participating in the 11 for Health in Denmark program. Single-indicator structural equation modeling was performed to examine goodness-of-fit and parameter estimates. A path analysis using maximum likelihood estimation was used to test the direct and indirect effects of the TCM model. The results partly supported a mediation sequence, as we found significant direct effects in eight of 13 motivational variables (β=-0.25-0.83, p < 0.05), indirect effects in one of nine variables (β=0.15, p < 0.01), but no effects with regard to PA behavior. Findings provide evidence for a motivational link between Danish-speaking schoolchildren's autonomous and controlled motivation from in school to out of school, and may inform future interventions promoting motivation and participation in out of school PA.

Impact evaluation of the “ABCs of Mental Health” in Denmark and the role of mental health-promoting beliefs and actions

PurposeThe purpose of this paper is to investigate the overall campaign reach and impact of the ABCs of Mental Health in Denmark; a secondary objective is to investigate how mental health-promoting beliefs and actions are associated with good mental health.Design/methodology/approachA questionnaire was administered to two representative cross-sectional samples of the Danish population (1,508 respondents in 2019; 1,507 respondents in 2021) via an online survey. The data were subsequently pooled together into one sample consisting of 3,015 respondents. In addition to questions pertaining to campaign reach and impact, the questionnaire also included a validated scale for mental well-being and questions about beliefs and actions in regard to enhancing mental health.FindingsAbout 7.6% had been reached by the campaign (familiar with ABC name or messages), or 11.9% when also counting familiarity with campaign slogans. Among these, respondents reported (proportions in parentheses) that the campaign had 1) made them reflect on their mental health (74.2%), talk to friends and family about mental health (35.5%), given them new knowledge about what they can do to enhance mental health (78.4%), or take action to enhance their own mental health (16.2%). An internal well-being locus of control and proactive behaviours towards enhancing mental health are shown to be associated with higher mean scores on mental well-being, lower odds of low mental well-being and higher odds of higher mental well-being.Originality/valueAn internal well-being locus of control and proactive behaviours towards enhancing mental health are suggested to both prevent low levels of mental well-being and promoting high levels of mental well-being. The results indicate that the ABCs of Mental Health campaign may be implemented to promote such beliefs and actions universally throughout the population.

Implementation facilitation of the "11 for Health in Denmark": A case study in a Danish 5th grade class.

The “11 for Health in Denmark” concept aims to enhance 10–12‐year‐old schoolchildren's physical activity levels and health knowledge through an 11‐week football intervention and has been shown to induce positive effects in numerous areas. However, little is known about the implementation facilitation of this concept in schools. This case study therefore aims to gain a deeper understanding of the implementation facilitation of “11 for Health” in a Danish 5th grade class comprising 22 schoolchildren (12 boys and 10 girls, M age 11.86±) and one teacher. Data were derived from multiple school situations using photographs and videos, observations, and informal interviews. Five themes were identified: (1) environmental and organizational factors impacting on the implementation; (2) familiarization with the concept for the teacher and schoolchildren; (3) previous clique formation; (4) the central role of the teacher; and (5) the importance of how praise partners are allocated. We found high adherence to the “11 for Health” concept, in which the teacher played a key role by applying an autonomy‐supportive style of teaching and using the praise partner concept in a suitable manner. A clique of football‐playing boys was a resource, as their praising of classmates encouraged adherence. However, familiarization with the “11 for Health” concept was a challenge and the clique's competitive nature occasionally built barriers to other schoolchildren without football experience, potentially leading to a more controlled form of motivation. Based on the results, we encourage teachers to apply autonomy‐supportive teaching when applying the “11 for Health” concept.

The Danish "11 for Health" program raises health knowledge, well-being, and fitness in ethnic minority 10- to 12-year-olds.

This study investigated the effects of the health promotion intervention "11 for Health in Denmark" program on 10- to 12-year-old ethnic minority schoolchildren's enjoyment, health knowledge, well-being, and fitness. 1122Danish 5th grade schoolchildren with ethnic minority background from 154schools were randomized (5:1) to an intervention group (IG, n=944) or a control group (CG, n=178). The IG and CG were also divided into subgroups of children active in a sports club (IGPA: n=644; CGPA: n=122) and not active in a sports club (IGPI: n=300, CGPI: n=56). IG participated in the "11 for Health in Denmark" 11-week program, consisting of 2×45min per week of football drills, small-sided games, and health education, whereas CG continued their regular activities. Pre-post physical testing and questionnaires were applied (short version of the multidimensional well-being questionnaire KIDSCREEN-27, and a 34-item health knowledge questionnaire). The "11 for Health in Denmark" program was rated moderate-to-high on a 1-5scale for enjoyment by girls (3.57) and boys (3.65). The intervention had positive between-group effect on health knowledge in relation to hygiene (IG vs GC: 10.6% points (CI95%: 6.9:14.3), p<0.05), nutrition (9.6% point (CI95%: 7.4:11.8), p<0.01) and physical activity 4.4% points (CI95%: 2.2:6.6) as well as overall health knowledge (5.7% points, (CI95%: 4.3;7.1), p<0.05), with similar effects for girls and boys. The IGPI subgroup showed a positive effect on well-being (p=0.04, school and learning) and also fitness effects on performance and VO2 max (p=0.02: p=0.01). The IGPA subgroup showed a positive effect on fitness scores (p=0.02, BMI). The intervention program was enjoyable and had a positive impact on health knowledge of ethnic minority background schoolchildren. In addition, the intervention program had the strongest positive effects on well-being and fitness scores for the non-sports club-active children.

The impact of the Covid-19 pandemic on mental and physical health in Denmark \u2013 a longitudinal population-based study before and during the first wave

BackgroundIn the continuation of the first wave of the Covid-19 outbreak in Denmark, unprecedented restrictions with great impact on the citizen’s everyday life were implemented. The objectives of this study were to investigate the influence of the Covid-19 pandemic on mental and physical health in the Danish population during the spring 2020 first wave outbreak and lockdown.MethodsA sample from the adult Danish population (n = 2190) were included. Self-reported measures of illness worry (Whiteley-6-R), emotional distress (SCL-90), and physical symptom load (SLC-90) were obtained before and during the first wave of the pandemic and compared with Wilcoxon signed-rank tests. Impact of covariates on physical and mental health was evaluated with ordinal regression analyses. Results from a tailored questionnaire regarding the Covid-19 pandemic were presented to explore the direct impact of the pandemic.ResultsWe only found minor increases in illness worry, emotional distress and physical symptom load (0–1 points difference, p ≤ 0.007) during the Covid-19 pandemic compared to before the pandemic. Sex, age, education, and physical disease were not associated with illness worry, emotional distress, or physical symptom load. Overall, the participants were trustful in the authorities’ recommendations and felt that they managed the pandemic and the restrictions to a great extent despite that some expected great/major future consequences of the pandemic.ConclusionsThis study suggested that the first wave of the Covid-19 pandemic only had minor impact on mental and physical health in the Danish general population. Future studies should address the impact of the second wave of the pandemic and the renewed implementation of the concomitant restrictions.

Home prices, fertility, and early-life health outcomes

We estimate the effect of housing price changes on fertility and early-life child health in Denmark. Using rich population register data among women aged 20–44 who own a home, we find that for each 100,000 DKK increase in home prices (equivalent to $12,000), the likelihood of giving birth increases by 0.27 percentage points or 2.35%. These estimates are similar to findings from the US per dollar of home price change, which is surprising given the strong pro-natalist policies and generous government programs in Denmark. We also present the first estimates of the effect of home prices on infant health. Our findings indicate that housing price increases lead to better child health at birth in terms of low birth weight and prematurity, however most of these effects reflect changes in the composition of births. There is no evidence of an effect on health during the first five years of life. These findings are consistent with both children and child health being normal goods that are similarly-valued in the US and Denmark.

An 11-week school-based ‘health education through football programme’ improves health knowledge related to hygiene, nutrition, physical activity and well-being—and it’s fun! A scaled-up, cluster-RCT with over 3000 Danish school children aged 10–12 years old

ObjectivesOur large-scale cluster randomised controlled trial aimed to investigate the effects on health knowledge and enjoyment of an 11 week ‘health education through football’ programme for children aged 10–12 years...

Interrelationships between job demands, low back pain and depression: A four-way decomposition analysis of direct and indirect effects of job demands through mediation and/or interaction

Psychosocial work stressors may lead to low back pain (LBP) through depressive symptoms or to depression through LBP. Depressive symptoms or LBP may also modify these associations. We examined prospective interrelationships between job demands, LBP and depressive symptoms. We used comparable data from three consecutive biennial surveys in 2010-2016, from the Swedish Longitudinal Occupational Survey of Health (SLOSH) and the Work Environment and Health in Denmark (WEHD) cohorts, broadly representative of the working populations in Sweden and Denmark. We conducted multivariate counterfactual based mediation analyses allowing for four-way decomposition of the total effect of job demands, on incident LBP (N=2813, 2701) and incident major depression (N=3707, 5496). The four components estimated direct and indirect effects through mediation and/or interaction. We observed no association between job demands and incident LBP four years later, but job demands was associated with later major depression (relative risks=1.88, 95% confidence interval=1.45-2.31 in SLOSH and 1.64, 1.18-2.11 in WEHD, adjusted for age, sex, panel (SLOSH data), education, cohabitation, physically strenuous work and chronic diseases. About 37% of the association was attributed to interaction between job demands and LBP in SLOSH. No interaction was found in WEHD. LBP partly mediated the relationship, by 14% in SLOSH and 2%, while statistically insignificant in WEHD. Possible limitations include lack of comparable data on disabling low back pain, different scales for depressive symptoms, misclassification and residual confounding. This suggests mainly a direct effect of job demands on major depression, or through other pathways than LBP.

Associations between physical and psychosocial work environment factors and sickness absence incidence depend on the lengths of the sickness absence episodes: a prospective study of 27 678 Danish employees

ObjectivesThis study examined if the association between work environment factors and sickness absence (SA) depended on the inclusion or exclusion of short-term SA episodes.MethodsWe linked the ‘Work Environment and Health...

Implementing Mental Health Promotion Initiatives-Process Evaluation of the ABCs of Mental Health in Denmark.

Treatment and prevention alone are unlikely to make a significant difference in reducing the burden of poor mental health and mental illness. Therefore, mental health promotion (MHP) initiatives are advocated. In 2014, the ABCs of mental health (ABCs) partnership was established in Denmark; in the partnership, partner organisations, e.g., municipalities and NGOs, use a research-based framework for MHP, the ABC-framework, to develop and implement MHP initiatives. This paper has two aims: (1) to outline the overall characteristics of these MHP initiatives; and (2) to explore local coordinator and stakeholder perceptions of the implementation processes and the impact of the MHP initiatives. Questionnaire surveys, individual interviews and group interviews were conducted during 2017–2020. The MHP initiatives were grouped according to three strategies: building MHP capacity, campaign activities to promote mental health awareness and knowledge and establishing and promoting opportunities to engage in mentally healthy activities. The ABC-framework was positively received and viewed as providing relevant knowledge for working with MHP as well as fostering intersectoral and interprofessional collaborations. However, using a bottom-up approach to develop and implement MHP initiatives can be time-consuming and resource demanding, and it requires a deliberate balancing of local adaptability and concrete guidance when engaging stakeholders and implementers. Overall, using the ABC-framework to develop and implement MHP initiatives holds great promise for advancing and promoting MHP practice.

Home Prices, Fertility, and Early-Life Health Outcomes

We estimate the effect of housing price changes on fertility and early-life child health in Denmark. Using rich population register data among women aged 20-44 who own a home, we find that for each 100,000 DKK increase in home prices (equivalent to $12,000), the likelihood of giving birth increases by 0.27 percentage points or 2.32%. These estimates are similar to findings from the US per dollar of home price change, which is surprising given the strong pro-natalist policies and generous government programs in Denmark. We also present the first estimates of the effect of home prices on infant health. Our findings indicate that housing price increases lead to better child health at birth in terms of low birth weight and prematurity, however most of these effects reflect changes in the composition of births. There is no evidence of an effect on health during the first five years of life. These findings are consistent with a lack of credit constraints among homeowner families and with both children and child health being normal goods that are similarly-valued in the US and Denmark.