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Abstract Background This study explored the association of unemployment and an increased risk of receiving disability pension, and the possibility that this risk is attributed to municipality-specific characteristics. Methods A cohort of 7,985 40-42 year olds was followed for 18 years in national registers, identifying new episodes of unemployment and cases of disability pension. The association between an unemployment period and disability pension in the subsequent year was estimated using discrete time multilevel logistic regressions and clustering individuals by municipality. The association between unemployment and disability pension was adjusted for age in the follow up-period, sex, baseline health status, health behaviour and education level. A conditional intra-class correlation coefficient (ICC) was estimated as a measure of inter-municipality variance. Results In the follow-up period, 2784 (35%) of the participants were granted disability pension. The crude odds ratio for receiving disability pension after unemployment (adjusted for age in follow-up period and sex only) was 1.42 (95% CI 1.1-1.8). Adjusting for baseline health indicators reduced the odds ratio of unemployment to 1.33 (CI 1.1-1.7). A fully adjusted model, including education level, further reduced the odds ratio of unemployment to 1.25 (CI 1.00-1.6). The ICC of the municipality level was approximately 2%. Conclusions Becoming unemployed increased the risk of receiving subsequent disability pension. However, adjusting for baseline health status, health behaviour and education attenuated this impact considerably. The multilevel analysis indicated that a minor, yet statistically significant, proportion of the risk of disability pension can be attributed to the municipality of residence.

Abstract Background Welfare dependence and low work participation among young people have raised concern in many European countries. Reading and writing difficulties (RWD) might make young people vulnerable to work integration problems and welfare dependence through negative influences on education and health. Our main objective of this study was to examine if RWD in adolescence affected the risk of welfare dependence in young adulthood. Methods Baseline information on self-reported RWD, health and family was obtained for 8950 school-attending adolescents in Nord-Trøndelag County, Norway, participating in the Young-HUNT1 survey, 1995-97. All individuals were linked to biological parents to identify siblings and parental education from national registers. Welfare dependence was assessed by the reception of social benefits (medical and economic) from the national social insurance database (1998-2007). Only long-term benefits (> 180 days) were included. Results The adolescents who reported RWD at baseline were more likely to receive medical or social benefits during follow-up compared with those who did not report RWD. In girls with RWD, the adjusted 5-year risk (at age 24 to 28) for receiving medical benefits was 0.20 (95% confidence interval 0.14-0.26), compared with 0.11 (0.09-0.12) in girls without RWD. In boys the corresponding risks were 0.13 (0.09-0.17) and 0.08 (0.07-0.09). Conclusions The associations between RWD in adolescence and welfare dependence later in life suggest that increased attention should be paid to these problems when discussing the public health aspects of work integration, since there might be a potential for prevention.

Background: General Practitioners' (GPs') workload has been suggested to increase in many countries; how does this impact patient follow-up?Objective: To investigate trends in GP consultation patterns for adults according to baseline hypertension and anxiety/depression symptoms and attribution of the GP to trend differences.Methods: Prospective cohort study, linking survey data and clinical measurements from the Norwegian HUNT3 study (2006-08) with national administrative data on GP list assignment and consultations with GP services. We grouped participants aged 40-59 years according to sex and their baseline status regarding hypertension and anxiety/depression symptoms. We registered GP consultations in 2007-16 and used general estimation equation models to estimate the level of GP consultations per month per year during follow-up. We used multilevel models with participants nested in their assigned regular GP to calculate GP-level intra-class correlation coefficients, reflecting to what extent patients' consultation patterns could be attributed to the individual GP.Results: In total, 47 550 HUNT3 participants were registered with 102 different GPs in Nord-Trøndelag County, Norway, in 2007. Adjusted for age, we observed an overall increase in GP consultations in 2007-16, particularly in those with a better health status at baseline. About 2% of the variance of patient consultations could be attributed to differences between GPs and 10% to the use of lengthy consultations. Out-of-hours consultations did not change much in the study period 2007-16.Conclusion: Increased use of GP consultations, mainly among the healthiest participants, encourage further research into whether these patients displace patients with heavier and more complex needs. [ABSTRACT FROM AUTHOR]

Introduction: There is scarce knowledge on the use of primary health care prior to emergency hospitalisation. Aims: To assess contacts with general practitioners (regular GP and municipal out-of-hours emergency services) during the year prior to hospitalisation for five common acute diagnoses (acute myocardial infarction; hip fracture; stroke; heart failure; and pneumonia) for patients aged 50 years and older. Methods: Longitudinal population-based design with linked data from Norwegian national- and municipal registers. Register-based information on all health care contacts and use of municipality services for the inhabitants aged 50 and older in four municipalities in central Norway collected for a two-year period from 2012 to 2013. In total, 66952 participants were included: 53% female, and mean age (in 2012) 65 years (11.1SD). We used generalized estimation equation models (GEE) to investigate the use of health care during 1) the year and 2) the month prior to hospitalisation for each of the six patient groups. We used the estimates to calculate the predicted level of health care use at different time points prior to hospitalisation. Results: Patients in the age group 50 years and older hospitalised for different severe conditions had a stable and frequent contact with general practitioners the year prior to the admission. Level and patterns of increase close to the time of hospital admission differed between the diagnose groups. The group hospitalised for heart failure stood out with a clear increasing share that visited their general practitioner and municipal out-of-hours emergency services the closer they got to the acute admission; OR 1.97 (CI 1.44-2.68) for seeing a GP the last month prior to hospitalisation compared to 6 months prior to hospitalisation. Nevertheless, 21% (heart failure) to 50% (hip fracture) of hospitalised patients were "non-users"; they visited neither their general practitioner nor municipal out-of-hours emergency services the last month prior to admission. Conclusion: General practitioners are in frequent contact with patients hospitalised for different severe emergency conditions. This underscores the general practitioners vital role in these patients' health care. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Obesity develops in a complex interplay between genetic and environmental factors. We aimed to examine how genetic predisposition influences obesity development early in life, by estimating the association between polygenic obesity risk and weight at birth (ponderal index) and throughout adolescence (BMI). Methods: We included 8561 parent-offspring trios who participated in the HUNT/Young-HUNT surveys in 1995-97 or 2006-08 when the offspring were 13-19 years of age. Additional weight data were included from a follow-up study in 2000-01 and from birth for 1026 and 8370 offspring participants, respectively. A weighted parental genetic risk score (GRS) based on maternal and paternal genetic data was constructed from 96 SNPs that have been robustly associated with adult BMI previously. Linear mixed effect models were employed to study sex-specific associations between parental GRS and children's ponderal index at birth and BMI at adolescents (ranging from 13-19 years). Results: The parental GRS was positively associated with BMI in both boys and girls at all ages from 13 to 19 years. The estimates were of similar magnitude as associations between parents' own GRS and their BMI at age 42. No association was found between the parental GRS and ponderal index at birth, nor did parental education modify any associations. Conclusions: Genetic predisposition for adult obesity, expressed by a parental genetic risk score for BMI, had an adverse effect on adolescent BMI that was similar in boys and girls at all ages from 13 to 19 years, but was not associated with ponderal index at birth. [ABSTRACT FROM AUTHOR]

Objective: This study examined the relationship between parental obesity polygenic risk and children's BMI throughout adolescence. Additionally, from a smaller subsample, the objective was to assess whether parental polygenic risk score (PRS) may act as a proxy for offspring PRS in studies lacking offspring genetic data., Methods: A total of 8,561 parent-offspring (age 13-19 years) trios from the Trøndelag Health Study (the HUNT Study) were included, of which, 1,286 adolescents had available genetic data. Weighted parental PRSs from 900 single-nucleotide polymorphisms robustly associated with adult BMI were constructed and applied in linear mixed-effects models., Results: A positive association between parental PRS and offspring sex- and age-adjusted BMI (iso-BMI) throughout adolescence was identified. The estimated marginal effects per standard deviation increase in parental PRS were 0.26 (95% CI: 0.18-0.33), 0.36 (95% CI: 0.29-0.43), and 0.62 kg/m 2 (95% CI: 0.51-0.72) for maternal, paternal, and combined parental PRS, respectively. In subsample analyses, the magnitude of association of the parental PRS versus offspring PRS with iso-BMI in adolescents was similar., Conclusions: Parental PRS was consistently associated with offspring iso-BMI throughout adolescence. Results from subsample analyses support the use of parental PRS of obesity as a proxy for adolescent PRS in the absence of offspring genetic data., (© 2021 The Authors. Obesity published by Wiley Periodicals LLC on behalf of The Obesity Society (TOS).)