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      Is self-rated health in adolescence a predictor of prescribed medication in adulthood? Findings from the Nord Trøndelag Health Study and the Norwegian Prescription Database

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          Abstract

          Self-rated health (SRH) is a commonly used health indicator predicting morbidity and mortality in a range of populations. However, the relationship between SRH and medication is not well established. The aim of this study was to examine adolescent SRH as a predictor for prescribed medication later in young adulthood. Eighteen years’ prospective data from the Nord-Trøndelag Health Study (HUNT) and the Norwegian Prescription Database (NorPD) were analyzed. Baseline data, gathered from 8982 adolescents (mean age 16.0 years) in the Young-HUNT I survey (1995–1997), were linked to individual data from NorPD, including information on all medications prescribed in 2013–2014. Gender-stratified negative binomial regression models were used to investigate the association between SRH and medication, also adjusted for age, baseline self-reported medicine use, physical and mental disability, smoking, and physical activity. Based on the Anatomical Therapeutic Chemical (ATC) Classification System, total consumption and consumption related to various ATC groups were examined.

          The adjusted analyses showed a dose–response relationship for females, with poorer SRH predicting higher average medication for both total consumption and for the ATC groups “Musculoskeletal system” (M), “Nervous system” (N; Analgesics (N02), Opioids (N02A)) and “Respiratiory system” (R). The predictive power of SRH, as well as the role of the adjustment factors, varies by gender and drug groups. This knowledge is important in order to identify risks for later disease and to capture pathological changes before and beyond the disease diagnosis, potentially preventing morbidity in the adult population.

          Highlights

          • SRH in adolescence predicts prescribed medication in young adulthood

          • The predictive power of SRH, as well as the role of the adjustment factors, varies by gender and drug groups.

          • This knowledge may be used to identify those at risk for later disease.

          • Such information is essential for health promotion, as we know some of the important antecedents leading to improved SRH.

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          Most cited references53

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          Regional alcohol consumption and alcohol-related mortality in Great Britain: novel insights using retail sales data

          Background Regional differences in population levels of alcohol-related harm exist across Great Britain, but these are not entirely consistent with differences in population levels of alcohol consumption. This incongruence may be due to the use of self-report surveys to estimate consumption. Survey data are subject to various biases and typically produce consumption estimates much lower than those based on objective alcohol sales data. However, sales data have never been used to estimate regional consumption within Great Britain (GB). This ecological study uses alcohol retail sales data to provide novel insights into regional alcohol consumption in GB, and to explore the relationship between alcohol consumption and alcohol-related mortality. Methods Alcohol sales estimates derived from electronic sales, delivery records and retail outlet sampling were obtained. The volume of pure alcohol sold was used to estimate per adult consumption, by market sector and drink type, across eleven GB regions in 2010–11. Alcohol-related mortality rates were calculated for the same regions and a cross-sectional correlation analysis between consumption and mortality was performed. Results Per adult consumption in northern England was above the GB average and characterised by high beer sales. A high level of consumption in South West England was driven by on-trade sales of cider and spirits and off-trade wine sales. Scottish regions had substantially higher spirits sales than elsewhere in GB, particularly through the off-trade. London had the lowest per adult consumption, attributable to lower off-trade sales across most drink types. Alcohol-related mortality was generally higher in regions with higher per adult consumption. The relationship was weakened by the South West and Central Scotland regions, which had the highest consumption levels, but discordantly low and very high alcohol-related mortality rates, respectively. Conclusions This study provides support for the ecological relationship between alcohol-related mortality and alcohol consumption. The synthesis of knowledge from a combination of sales, survey and mortality data, as well as primary research studies, is key to ensuring that regional alcohol consumption, and its relationship with alcohol-related harms, is better understood.
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            Self-ratings of health: do they also predict change in functional ability?

            Self-ratings of health by individuals responding to surveys have shown themselves to be potent predictors of mortality in a growing number of studies; they appear to contribute significant additional independent information to health status indicators gathered through self-reported health histories or medical examinations. A key question raised by these studies is: What are the mediating processes involved in the association? Specifically, do poor self-ratings increase the risk of disability and morbidity, and are these outcomes intervening steps in the link to mortality? In this report we address the first question, of self-ratings predicting future levels of functional disability, our choice of an index of overall impact of morbidity. Data come from the New Haven Established Populations for Epidemiologic Studies of the Elderly (EPESE) site (N = 2,812). Results show that self-ratings of health in 1982, net of baseline functional ability, health and sociodemographic status, are associated with changes in functional ability over periods of one through six years. These findings extend our understanding of the meaning of excellent, good, fair, and poor ratings of health, and that they have implications not just for survival but for the loss or maintenance of functional ability in daily life.
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              Health-related quality of life in parents of school-age children with Asperger syndrome or high-functioning autism

              Background The estimated prevalence rate of Pervasive Developmental Disorders (PDD) in children is 6 per 1.000. Parenting children who are intellectually impaired and have PDDs is known to be linked to the impaired well-being of the parents themselves. However, there is still little available data on health-related quality of life (HRQL) in parents of children with Asperger Syndrome (AS) and High-Functioning Autism (HFA), or other PDD diagnoses in children of normal intelligence. The present study aimed to evaluate aspects of HRQL in parents of school-age children with AS/HFA and the correlates with child behaviour characteristics. Methods The sample consisted of 31 mothers and 30 fathers of 32 children with AS/HFA and 30 mothers and 29 fathers of 32 age and gender matched children with typical development. Parental HRQL was surveyed by the use of the 12 Item Short Form Health Survey (SF-12) which measures physical and mental well-being. The child behaviour characteristics were assessed using the structured questionnaires: The High-Functioning Autism Spectrum Screening Questionnaire (ASSQ) and The Strengths and Difficulties Questionnaire (SDQ). Results The mothers of children with AS/HFA had lower SF-12 scores than the controls, indicating poorer physical health. The mothers of children with AS/HFA also had lower physical SF-12 scores compared to the fathers. In the AS/HFA group, maternal health was related to behaviour problems such as hyperactivity and conduct problems in the child. Conclusion Mothers but not fathers of children with AS/HFA reported impaired HRQL, and there was a relationship between maternal well-being and child behaviour characteristics.
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                Author and article information

                Contributors
                Journal
                SSM Popul Health
                SSM Popul Health
                SSM - Population Health
                Elsevier
                2352-8273
                09 December 2017
                April 2018
                09 December 2017
                : 4
                : 144-152
                Affiliations
                [a ]Helse Førde HF/Førde Health Trust, postboks 1000, 6807 Førde, Norway
                [b ]Centre for Clinical Research, Haukeland University Hospital, Norway
                [c ]HUNT Research Centre, Department of Public health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Norway
                [d ]Department of Global Public Health and Primary Care, University of Bergen, Norway
                [e ]Helse Førde HF/Førde Health Trust, postboks 1000, 6807 Førde, Norway
                Author notes
                [* ]Corresponding author. tina.lokke.vie@ 123456helse-forde.no
                Article
                S2352-8273(17)30083-6
                10.1016/j.ssmph.2017.11.010
                5769112
                29349283
                9c389d06-9782-494c-994b-bb75f8cd8d91
                © 2017 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 3 April 2017
                : 16 November 2017
                : 18 November 2017
                Categories
                Article

                norway,self-rated health,medication,medicine use,prescription drug,pharmacoepidemiology,hunt,norpd

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