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Background The purpose of the study was to quantify the association between body weight and health by estimating the expected lifetime with and without diabetes (diabetes-free life expectancy) at age 30 and 65. In addition, the diabetes-free life expectancy was stratified by educational level. Methods Life tables by sex, level of education and obese/not obese were constructed using nationwide register data and self-reported data on body weight and height and diabetes from the Danish National Health Survey in 2021. Diabetes-free life expectancies were estimated by Sullivan's method. Results The difference in life expectancy between not obese 30-year-old men with a long and a short education was 5.7 years. For not obese women, the difference was 4.1 years. For obese men and women, the difference in life expectancy at age 30 was 7.0 and 5.2 years. Women could expect more years without and fewer years with diabetes than men regardless of body weight and educational level. Diabetes-free life expectancy differed by 6.9 years between not obese 30-year-old men with a short and a long education and by 7.7 years for obese men with a short and a long education. For women, the differences were 5.9 and 6.6 years. Conclusion The results demonstrate an association of obesity and educational level with life expectancy and diabetes-free life expectancy. There is a need for preventive efforts to reduce educational inequality in life expectancy and diabetes-free life expectancy. Structural intervention will particularly benefit overweight people with short education. [ABSTRACT FROM AUTHOR]

Background In 2013, Denmark implemented a reform that tightened the criteria for disability pension, expanded a subsidized job scheme ('flexi-job') and introduced a new vocational rehabilitation scheme. The overall aim of the reform was to keep more persons attached to the labour market. This study investigates the impact of the reform among persons with chronic disease and whether this impact differed across groups defined by labour market affiliation and chronic disease type. Methods The study was conducted as a register-based, nationwide cohort study. The study population included 480 809 persons between 40 and 64 years of age, who suffered from at least one of six chronic diseases. Hazard ratios (HR) and 95% confidence intervals (CI) of being awarded disability pension or flexi-job in the 5 years after vs. the 5 years prior to the reform were estimated. Results Overall, the probability of being awarded disability pension was halved after the reform (HR = 0.49, CI: 0.47–0.50). The impact was largest for persons receiving sickness absence benefits (HR = 0.31, CI: 0.24–0.39) and for persons with functional disorders (HR = 0.38, CI: 0.32–0.44). Also, the impact was larger for persons working in manual jobs than for persons working in non-manual jobs. The probability of being awarded a flexi-job was decreased by one-fourth (HR = 0.76, CI: 0.74–0.79) with the largest impact for high-skilled persons working in non-manual jobs. Conclusion Access to disability pension and flexi-job decreased after the reform. This impact varied according to labour market affiliation and chronic disease type. [ABSTRACT FROM AUTHOR]

Background: Cardiac rehabilitation participation is an essential component of the contemporary management of coronary heart disease. However, patients with low socioeconomic position are less likely to attend the rehabilitation programme. Aim: We aimed to explore the effect of potential mediators between socioeconomic position defined by educational attainment and cardiac rehabilitation attendance. Methods: Prospective observational study of patients with acute coronary syndrome (N=302). Logistic regression and mediation analysis was conducted to explore mechanisms of non-attendance. Results: Thirty per cent attended full cardiac rehabilitation. Patients with low educational attainment, comorbidities, long commute to cardiac rehabilitation centre, and lone dwelling were less likely to attend full cardiac rehabilitation, whereas patients with high anxiety and depression score were more likely to attend full cardiac rehabilitation. Patients with low educational attainment had lower self-efficacy and longer commute compared with patients with high educational attainment. The potential mediators included in the study, however, did not have a significant mediation effect. Conclusion: Our study demonstrated a variety of mechanisms contributing to cardiac rehabilitation non-attendance. Further, the study demonstrated that non-attendance was especially related to the cardiac rehabilitation elements involving lifestyle modifications. However, the mechanisms explaining social inequality in full cardiac rehabilitation are still not fully understood. [ABSTRACT FROM AUTHOR]

Background: The Danish public healthcare system provides comprehensive care based on the principle of equal access. However, it is well documented that patients with low socioeconomic position are less likely to participate in cardiac rehabilitation. More knowledge is needed to understand this phenomenon. The aim of the study was to explore the patient experience of barriers to completion of phase II cardiac rehabilitation, and to investigate the impact of socioeconomic factors on completion of cardiac rehabilitation. Methods: The study had a qualitative explorative design using semi-structured individual or dyadic interviews with patients (n = 24) and close relatives (n = 12). Informants were sampled from a quantitative prospective study of 302 patients with acute coronary syndrome and data were analyzed using the framework method. Results: Patients in different socioeconomic groups were challenged by a rigid and non-individualized rehabilitation program. A total of five themes were identified that might explain non-participation in cardiac rehabilitation: exclusion by time and place, exclusion by health beliefs, exclusion from counseling, exclusion by alienation, and exclusion of relatives. The themes were described in a matrix of socioeconomic factors of age, sex, education and employment. Conclusions: Patients in various socioeconomic subgroups felt excluded from cardiac rehabilitation for different reasons. This study supports earlier findings and provides examples of real-life issues that need to be addressed to prevent attrition and encourage participation. Equal access to cardiac rehabilitation can only be reached if the physical and psychological needs of patient and family are met by tailoring therapy to consider age, sex, education and employment groups. [ABSTRACT FROM AUTHOR]

The Social Inequality in Cancer (SIC) cohort study was established to determine pathways through which socioeconomic position affects morbidity and mortality, in particular common subtypes of cancer. Data from seven well-established cohort studies from Denmark were pooled. Combining these cohorts provided a unique opportunity to generate a large study population with long follow-up and sufficient statistical power to develop and apply new methods for quantification of the two basic mechanisms underlying social inequalities in cancer—mediation and interaction. The SIC cohort included 83 006 participants aged 20–98 years at baseline. A wide range of behavioural and biological risk factors such as smoking, physical inactivity, alcohol intake, hormone replacement therapy, body mass index, blood pressure and serum cholesterol were assessed by self-administered questionnaires, physical examinations and blood samples. All participants were followed up in nationwide demographic and healthcare registries. For those interested in collaboration, further details can be obtained by contacting the Steering Committee at the Department of Public Health, University of Copenhagen, at inan@sund.ku.dk. [ABSTRACT FROM AUTHOR]

Background: Denmark, like other Western countries, is recently burdened by increasingly high social spending on employment consequences caused by ill mental health. This might be the result of high work demands affecting persons with ill mental health. Therefore, this study assesses to what extent depressive symptoms and high work demands, individually and combined, have an effect on employment consequences. Methods: We conducted a population-based 7-year longitudinal follow-up study with baseline information from the year 2000 on socio-demographics, lifestyle, depressive symptoms and work demands. In total, 5785 employed persons, aged 40 and 50 years, were included. Information about employment status, sick leave and work disability was obtained from registers. Logistic regression models were used to measure separate and combined effects of depressive symptoms and work demands on job change, unemployment and sick leave during 2001–02 and work disability during 2003–07. Results: After adjustment for covariates, high physical work demands and depressive symptoms had a graded effect on subsequent unemployment, sick leave and permanent work disability. Persons with both depressive symptoms and high physical demands had the highest risks, especially for sick leave, but the combined effect did not exceed the product of single effects. Persons who perceived high amount of work changed job significantly more frequently. Conclusion: Persons with depressive symptoms might have an increased risk of negative employment consequences irrespective of the kind and amount of work demands. This might be an effect on the level of work ability in general as well as partly the result of health selection and co-morbidity. [ABSTRACT FROM PUBLISHER]

Background Stress is a consequence of different types of external demands, most of which have been shown to be associated with increased risk of ischaemic heart disease (IHD), but whether accumulation of stressors over a life-course results in additional risk of IHD remains unknown. This study investigates the impact of major life events (MLE) in childhood, adulthood and at work, singly and accumulated, on incident IHD in men and women and examines vital exhaustion (VE) and use of tranquillizers as potential mediators.Material and methods The study includes 8738 participants, 57% women, from the third wave of the Copenhagen City Heart Study, who in 1991–93 answered a range of questions on MLE, VE and use of tranquillizers. The participants were followed in a nationwide hospital discharge register until 2007.Results During follow-up, 653 experienced a first-time incident of IHD. In general, there were no associations between MLE and incidence of IHD. However, being placed in care during childhood was associated with a higher risk of IHD among women [hazard ratio (HR) = 1.36; 95% confidence interval (95% CI) 0.97–1.89], but a lower risk of IHD among men (HR = 0.72; 95% CI 0.51–1.03). MLE showed a dose–response association with psychological risk factors with highest estimates for those exposed to MLE in all three life domains: VE [odds ratio (OR) = 15.07; 95% CI 8.97–25.31] and use of tranquillizers (OR = 4.41; 95% CI 3.10–6.26).Conclusion This prospective study finds no associations between accumulated MLE and IHD. MLE is, however, strongly associated with VE and use of tranquillizers. The results underscore the problems in conceptualizing and measuring MLE. [ABSTRACT FROM AUTHOR]

Introduction. Proportion of populations that are overweight and obese are on the rise and generally affecting more than 50% of the adult Western male population. It is, therefore, of interest to look at possible associations between obesity and sexual function in a homogeneous population. Aim. To examine a possible association between sexual disorders (erectile dysfunction, ejaculatory disorders, and sexual desire disorders) and obesity among younger men born and living in Denmark. Methods. A community-based cross-sectional study of sexual health among Danish younger men. Questionnaires were mailed to 3,300 men, aged 20–45 years and divided into six 5-year age cohorts. Odds ratios were calculated using logistic regression modeling. In total, 863 men (26%) responded anonymously. A similar set of data from 600 older men aged 50–75 years and from same community was used for comparison. Main Outcome Measures. The associations between self-reported erectile, ejaculatory and desire disorders, and body mass index (BMI) were examined, stratified by age group and smoking status. Results. The material was found to be generally representative of the Danish population of men of similar age in regard to height, weight, smoking status, and alcohol consumption. Erectile dysfunction (ED) was more prevalent among these younger and older men with higher BMI, but only significant among men 20–45 years old, with an odds ratio of 2.74 (95% confidence interval 1.1–6.8). The prevalence of ED was higher among the younger obese nonsmokers than obese smokers. Premature ejaculation, retarded ejaculation, and sexual desire disorders were all unrelated to overweight or obesity. Conclusion. Obesity (BMI ≥ 30 kg/m2) seems associated with ED among younger men aged 20–45 years. Health programs directed toward preventing obesity in younger men may benefit from informing about an almost three-fold occurrence of erectile dysfunction associated with obesity. Andersen I, Heitman B, and Wagner G. Obesity and sexual dysfunction in younger Danish men. J Sex Med 2008;5:2053–2060. [ABSTRACT FROM AUTHOR]