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Article ; Online: Aggregated data from the same laboratories participating in two glucose external quality assessment schemes show that commutability and transfers of values to control materials are decisive for the biases found.

Gidske, Gro / Sandberg, Sverre / Fauskanger, Pernille / Pelanti, Jonna / Tollånes, Mette C / Solsvik, Anne E / Sølvik, Una Ø / Vie, Wenche S / Stavelin, Anne

Clinical chemistry and laboratory medicine

2023 Volume 62, Issue 1, Page(s) 77–84

Abstract: Objectives: We report the results of glucose measurements performed during one year by the same measurement procedures (MPs) in 58 Norwegian hospital laboratories using control materials provided by external quality assessment (EQA) schemes from two ... ...

Abstract	Objectives: We report the results of glucose measurements performed during one year by the same measurement procedures (MPs) in 58 Norwegian hospital laboratories using control materials provided by external quality assessment (EQA) schemes from two different providers. The providers used materials with presumed vs. verified commutability and transfers of values using reference material vs. using a highest-order reference MP. Methods: Data from six Labquality and three Noklus glucose EQA surveys were aggregated for each MP (Abbott Alinity, Abbott Architect, Roche Cobas, and Siemens Advia) in each scheme. For each EQA result, percent difference from target value (% bias) was calculated. Median percent bias for each MP per scheme was then calculated. Results: The median % biases observed for each MP in the Labquality scheme were significantly larger than those in the Noklus scheme, which uses verified commutable control materials and highest-order reference MP target values. The difference ranged from 1.2 (Roche Cobas, 2.9 vs. 1.7 %) to 4.4 percentage points (Siemens Advia, 3.2 % vs. -1.2 %). The order of bias size for the various MPs was different in the two schemes. In contrast to the Labquality scheme, the median % biases observed in the Noklus scheme for Abbott Alinity (-0.1 %), Abbott Architect (-0.5 %), and Siemens Advia (-1.2 %) were not significantly different from target value (p>0.756). Conclusions: This study underlines the importance of using verified commutable EQA materials and target values traceable to reference MPs in EQA schemes designed for assessment of metrological traceability of laboratory results.
MeSH term(s)	Humans ; Laboratories ; Quality Control ; Glucose ; Bias ; Laboratories, Hospital ; Reference Values ; Reference Standards
Chemical Substances	Glucose (IY9XDZ35W2)
Language	English
Publishing date	2023-07-21
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1418007-8
ISSN	1437-4331 ; 1434-6621 ; 1437-8523
ISSN (online)	1437-4331
ISSN	1434-6621 ; 1437-8523
DOI	10.1515/cclm-2023-0532
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Article ; Online: Spirometry in chronic obstructive pulmonary disease in Norwegian general practice.

Tollånes, Mette C / Sjaastad, Geir E / Aarli, Bernt B / Sandberg, Sverre

BMC family practice

2020 Volume 21, Issue 1, Page(s) 235

Abstract: Background: General practitioners (GPs) in Norway increasingly use spirometry diagnostically as well as in follow up of patients with respiratory complaints, but little is known about their skills and knowledge in this area. The aim of the present study ...

Abstract	Background: General practitioners (GPs) in Norway increasingly use spirometry diagnostically as well as in follow up of patients with respiratory complaints, but little is known about their skills and knowledge in this area. The aim of the present study was to investigate how GPs interpret a case history and spirometry recordings of a patient with chronic obstructive pulmonary disease (COPD), and their knowledge about their own spirometer. Methods: A web-based survey, consisting of a case history and spirometry recordings of a patient with COPD, was distributed to the 4700 members of the Norwegian GP Association. In addition to background information about themselves and their spirometer, topics included whether they requested, and how they interpreted, a spirometry reversibility-test, identification of the of most likely diagnosis, and recognition of the spirometry parameters used to diagnose COPD and grade airway obstruction. Immediate feedback was provided for educational purposes. Results: Six hundred thirty GPs responded. Twenty six percent would not request a reversibility test, but 81% identified COPD as the most likely diagnosis. Less than 50% correctly identified the spirometry parameters used for diagnosis of COPD and grading the airway obstruction. One in five (21%) did not know which spirometer was used in their own practice, and 49 and 61% did not know which reference values were used for adults and children, respectively. Participants evaluated the survey as useful (average 74 points on a 0-100 scale) and would like more case-based surveys concerning use of spirometry in the future (average 91 points). Conclusion: In this cohort of self-selected GPs, probably more interested in respiratory medicine than the average GP, we identified several problem areas and gaps in knowledge regarding the use of spirometry.
MeSH term(s)	Adult ; Child ; Family Practice ; General Practice ; Humans ; Norway ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Spirometry
Language	English
Publishing date	2020-11-18
Publishing country	England
Document type	Journal Article
ISSN	1471-2296
ISSN (online)	1471-2296
DOI	10.1186/s12875-020-01310-x
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Article ; Online: Maternal Chronic Conditions and Risk of Cerebral Palsy in Offspring: A National Cohort Study.

Strøm, Marianne S / Tollånes, Mette C / Wilcox, Allen J / Lie, Rolv Terje / Forthun, Ingeborg / Moster, Dag

Pediatrics

2021 Volume 147, Issue 3

Abstract: Background and objectives: Previous studies suggest that children of mothers with certain chronic conditions may be at increased risk of cerebral palsy (CP). We explored possible associations between 17 maternal chronic conditions and CP in offspring.!## ...

Abstract	Background and objectives: Previous studies suggest that children of mothers with certain chronic conditions may be at increased risk of cerebral palsy (CP). We explored possible associations between 17 maternal chronic conditions and CP in offspring. Methods: We conducted a prospective cohort study of Norwegian children born in 1990-2012 and surviving to 2 years of age. Information on maternal chronic conditions during pregnancy were extracted from the Medical Birth Registry of Norway (1990-2012). Information on chronic conditions in mothers and fathers recorded in the Norwegian Patient Registry (2008-2014) was available for a subset of children. CP diagnoses were extracted from the National Insurance Scheme (1990-2014) and the Norwegian Patient Registry (2008-2014). We estimated relative risks (RRs) and 95% confidence intervals (CIs) of CP in offspring of parents with chronic conditions compared with the general population using log binominal regression models. Results: A total of 1 360 149 Norwegian children, including 3575 children with CP (2.6 per 1000 live births), fulfilled the inclusion criteria. The highest risk of CP was among offspring of mothers with type 2 diabetes (RR 3.2; 95% CI 1.8-5.4), lupus erythematosus (RR 2.7; 95% CI 0.9-8.3), type 1 diabetes (RR 2.2; 95% CI 1.4-3.4), and Crohn disease (RR 2.1; 95% CI 1.0-4.1) during pregnancy. No increased risks were seen for offspring of fathers with chronic conditions. Conclusions: Several maternal chronic conditions were associated with increased risk of CP in offspring. Maternal autoimmune disorders carried a particular risk.
MeSH term(s)	Adult ; Cerebral Palsy/diagnosis ; Cerebral Palsy/epidemiology ; Cerebral Palsy/etiology ; Chronic Disease ; Cohort Studies ; Confidence Intervals ; Crohn Disease ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Fathers ; Female ; Hepatitis, Autoimmune ; Humans ; Infant ; Linear Models ; Lupus Erythematosus, Systemic ; Maternal Age ; Mothers ; Norway/epidemiology ; Prospective Studies ; Registries ; Risk Factors
Language	English
Publishing date	2021-02-18
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2020-1137
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Article ; Online: Porphyria cutanea tarda and patterns of long-term sick leave and disability pension: a 24-year nationwide matched-cohort study.

Baravelli, Carl Michael / Aarsand, Aasne Karine / Sandberg, Sverre / Tollånes, Mette Christophersen

Orphanet journal of rare diseases

2022 Volume 17, Issue 1, Page(s) 72

Abstract: ... enzyme uroporphyrinogen decarboxylase and is associated with hepatitis C virus infection, high alcohol ...

Abstract	Background: Porphyria cutanea tarda (PCT) is a skin disorder caused by a defect in the liver enzyme uroporphyrinogen decarboxylase and is associated with hepatitis C virus infection, high alcohol intake, smoking and iron overload. Data on the long-term morbidity of PCT is lacking. Methods: We conducted a nationwide matched cohort study over a 24-year period. The study sample included 534 persons aged 18-67 years with a biochemically confirmed PCT diagnosis and a sample of 21,360 persons randomly selected from the working age population, matched on age, sex and educational attainment. We investigated if persons with sporadic and familial PCT had an increased risk of long-term sick leave (LTSL) or disability pension. We further assessed risk before (pre-PCT), during (during-PCT) and after (post-PCT) the typical period of first onset to diagnosis, treatment and remission. Results: Overall, persons with PCT had a 40% increased risk (hazard ratio [HR] = 1.4, 95% confidence interval [CI] = 1.3, 1.5) of LTSL and a 50% increased risk (HR = 1.5, CI = 1.3, 1.7) of disability pension. Risk of disability pension was increased pre-PCT (HR = 1.3, CI 1.3 (1.0, 1.6), during-PCT (HR 1.5, CI 1.0, 2.2) and post-PCT (HR = 2.0, CI 1.5, 2.6). For LTSL, risk was increased pre-PCT (HR = 1.3, CI 1.1, 1.4) and during-PCT (HR = 1.5, CI 1.1, 2.1), but not post-PCT. Risk was greatest in persons with sporadic than familial PCT. Diagnostic reasons for disability pension that were increased compared to matched controls were PCT or skin disease in 11 of 199 cases (PCT: n = 7, incident rate ratios [IRR] = 49.2, CI = 38.8, 62.4; diseases of the skin and subcutaneous tissue, n = 4, IRR = 4.2, CI = 1.6, 11.0). The vast majority of diagnostic reasons for accessing disability pension were related to comorbidities, PCT susceptibility factors and more general health issues such as: malignant neoplasms (n = 12, IRR = 2.4, CI = 1.4, 4.2), substance and alcohol dependence (n = 7, IRR = 5.0, CI = 2.5, 10.1), neurotic and mood-disorders (n = 21, IRR = 1.7, CI = 1.1, 2.6), and diseases of the musculoskeletal system and connective tissue (n = 71, IRR = 2.5, CI = 1.9, 3.2). Conclusions: Persons with PCT have an increased risk of LTSL and disability pension indicating significant morbidity in this patient group. Appropriate long-term follow-up and monitoring for relapses and co-morbid diseases are recommended.
MeSH term(s)	Cohort Studies ; Disabled Persons ; Humans ; Pensions ; Porphyria Cutanea Tarda/complications ; Sick Leave
Language	English
Publishing date	2022-02-22
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2225857-7
ISSN	1750-1172 ; 1750-1172
ISSN (online)	1750-1172
ISSN	1750-1172
DOI	10.1186/s13023-022-02201-3
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Article ; Online: Evaluation of 32 rapid tests for detection of antibodies against SARS-CoV-2.

Tollånes, Mette C / Jenum, Pål A / Kierkegaard, Helene / Abildsnes, Eirik / Bævre-Jensen, Roar Magne / Breivik, Anne C / Sandberg, Sverre

Clinica chimica acta; international journal of clinical chemistry

2021 Volume 519, Page(s) 133–139

Abstract: Aims: To evaluate the analytical performance of 32 rapid tests for detection of antibodies against coronavirus SARS-CoV-2.: Materials and methods: We used at total of 262 serum samples (197 pre-pandemic and 65 convalescent COVID-19), and three ... ...

Abstract	Aims: To evaluate the analytical performance of 32 rapid tests for detection of antibodies against coronavirus SARS-CoV-2. Materials and methods: We used at total of 262 serum samples (197 pre-pandemic and 65 convalescent COVID-19), and three criteria to evaluate the rapid tests under standardized and optimal conditions: (i) Immunoglobulin G (IgG) specificity "good" if lower limit of the 95% confidence interval was ≥ 97.0%, "acceptable" if point estimate was ≥ 97.0%, otherwise "not acceptable". (ii) IgG sensitivity "good" if point estimate was ≥ 90.0%, "acceptable" if ≥ 85.0%, otherwise "not acceptable". (iii) User-friendliness "not acceptable" if complicated to perform or difficult to read result, otherwise "good". We also included partial evaluations of three automated immunoassay systems. Results: Sensitivity and specificity varied considerably; IgG specificity between 90.9% (85.9-94.2) and 100% (97.7-100.0), and IgG sensitivity between 53.8% (41.9-65.4) and 98.5% (91.0-100.0). Combining our evaluation criteria, none of the 28 rapid tests that detected IgG had an overall performance considered "good", seven tests were considered "acceptable", while 21 tests were considered "not acceptable". Four tests detected only total antibodies and were not given an overall evaluation. IgG sensitivity and/or specificity of the automated immunoassays did not exceed that of many rapid tests. Conclusion: When prevalence is low, the most important analytical property is a test's IgG specificity, which must be high to minimize false positive results. Out of 32 rapid tests, none had a performance classified as "good", but seven were classified as "acceptable".
MeSH term(s)	Antibodies, Viral ; COVID-19 ; Humans ; Immunoassay ; Immunoglobulin M ; Pandemics ; SARS-CoV-2 ; Sensitivity and Specificity
Chemical Substances	Antibodies, Viral ; Immunoglobulin M
Language	English
Publishing date	2021-04-27
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	80228-1
ISSN	1873-3492 ; 0009-8981
ISSN (online)	1873-3492
ISSN	0009-8981
DOI	10.1016/j.cca.2021.04.016
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Article ; Online: Parental income gradients in adult health: a national cohort study.

Evensen, Miriam / Klitkou, Søren Toksvig / Tollånes, Mette C / Øverland, Simon / Lyngstad, Torkild Hovde / Vollset, Stein Emil / Kinge, Jonas Minet

BMC medicine

2021 Volume 19, Issue 1, Page(s) 152

Abstract: Background: Disparities in health by adult income are well documented, but we know less about the childhood origins of health inequalities, and it remains unclear how the shape of the gradient varies across health conditions. This study examined the ... ...

Abstract	Background: Disparities in health by adult income are well documented, but we know less about the childhood origins of health inequalities, and it remains unclear how the shape of the gradient varies across health conditions. This study examined the association between parental income in childhood and several measures of morbidity in adulthood. Methods: We used administrative data on seven complete Norwegian birth cohorts born in 1967-1973 (N = 429,886) to estimate the association between parental income from birth to age 18, obtained from tax records available from 1967, linked with administrative registries on health. Health measures, observed between ages 39 and 43, were taken from registry data on consultations at primary health care services based on diagnostic codes from the International Classification of Primary Care (ICPC-2) and hospitalizations and outpatient specialist consultations registered in the National Patient Registry (ICD-10). Results: Low parental income during childhood was associated with a higher risk of being diagnosed with several chronic and pain-related disorders, as well as hospitalization, but not overall primary health care use. Absolute differences were largest for disorders related to musculoskeletal pain, injuries, and depression (7-9 percentage point difference). There were also differences for chronic disorders such as hypertension (8%, CI 7.9-8.5 versus 4%, CI 4.1-4.7) and diabetes (3.2%, CI 3.0-3.4 versus 1.4%, CI 1.2-1.6). There was no difference in consultations related to respiratory disorders (20.9%, CI 20.4-21.5 versus 19.7%, CI 19.2-20.3). Childhood characteristics (parental education, low birth weight, and parental marital status) and own adult characteristics (education and income) explained a large share of the association. Conclusions: Children growing up at the bottom of the parental income distribution, compared to children in the top of the income distribution, had a two- to threefold increase in somatic and psychological disorders measured in adulthood. This shows that health inequalities by socioeconomic family background persist in a Scandinavian welfare-state context with universal access to health care.
MeSH term(s)	Adolescent ; Adult ; Child ; Cohort Studies ; Humans ; Income ; Mental Disorders ; Middle Aged ; Parents ; Poverty ; Socioeconomic Factors
Language	English
Publishing date	2021-07-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1741-7015
ISSN (online)	1741-7015
DOI	10.1186/s12916-021-02022-4
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Article ; Online: Evaluation of eleven rapid tests for detection of antibodies against SARS-CoV-2.

Tollånes, Mette C / Bakken Kran, Anne-Marte / Abildsnes, Eirik / Jenum, Pål A / Breivik, Anne C / Sandberg, Sverre

Clinical chemistry and laboratory medicine

2020 Volume 58, Issue 9, Page(s) 1595–1600

Abstract: Objectives: SARS-CoV-2, causing COVID-19, has emerged to cause a human pandemic. Detection of SARS-CoV-2 in respiratory samples by using PCR is the standard laboratory diagnostic tool. Our aim was to perform a limited evaluation of the diagnostic ... ...

Abstract	Objectives: SARS-CoV-2, causing COVID-19, has emerged to cause a human pandemic. Detection of SARS-CoV-2 in respiratory samples by using PCR is the standard laboratory diagnostic tool. Our aim was to perform a limited evaluation of the diagnostic performance and user-friendliness of eleven rapid tests for detection of antibodies against SARS-CoV-2. Methods: All participants were tested with PCR against SARS-CoV-2 at a clinical microbiology laboratory. Comparing with results from PCR tests, we evaluated the rapid tests' performances in three arms; 1) 20 hospitalized patients with PCR-confirmed COVID-19, 2) 23 recovered outpatients with former PCR-confirmed COVID-19, and 3) 49 participants with suspected COVID-19 presenting at a primary care emergency room. Results: All eleven tests detected antibodies in hospitalized COVID-19 patients, though with varying sensitivities. In former outpatients recovered from COVID-19, there were differences between tests in the immunoglobulin type G (IgG) sensitivity, with five tests having a sensitivity below 65%. In participants with suspected COVID-19 infection, the rapid tests had very low sensitivities. Most rapid tests were easy to perform and interpret. Conclusions: Rapid tests were not suited as stand-alone tests to detect present infection in a Norwegian primary care emergency room population. All the rapid tests were able to detect SARS-CoV-2 antibodies, although sensitivities varied and were generally higher in the study arm of more severely affected participants. Rapid tests with high IgG sensitivity (and specificity) may be useful for confirmation of past infection. An independent evaluation should be performed in the intended population before introducing a rapid test.
MeSH term(s)	Antibodies, Viral/blood ; Antibodies, Viral/immunology ; Betacoronavirus/immunology ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques/methods ; Coronavirus Infections/blood ; Coronavirus Infections/diagnosis ; Humans ; Immunoassay/methods ; Immunoglobulin G/blood ; Immunoglobulin G/immunology ; Immunoglobulin M/blood ; Immunoglobulin M/immunology ; Pandemics ; Pneumonia, Viral/blood ; Pneumonia, Viral/diagnosis ; SARS-CoV-2 ; Sensitivity and Specificity
Chemical Substances	Antibodies, Viral ; Immunoglobulin G ; Immunoglobulin M
Keywords	covid19
Language	English
Publishing date	2020-06-29
Publishing country	Germany
Document type	Evaluation Study ; Journal Article
ZDB-ID	1418007-8
ISSN	1437-4331 ; 1434-6621 ; 1437-8523
ISSN (online)	1437-4331
ISSN	1434-6621 ; 1437-8523
DOI	10.1515/cclm-2020-0628
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Article ; Online: Parental education and the risk of cerebral palsy for children: an evaluation of causality.

Forthun, Ingeborg / Lie, Rolv Terje / Strandberg-Larsen, Katrine / Solheim, Magne Haugland / Moster, Dag / Wilcox, Allen J / Mortensen, Laust Hvas / Tollånes, Mette C

Developmental medicine and child neurology

2020 Volume 62, Issue 10, Page(s) 1176–1181

Abstract: Aim: To explore whether increasing parental education has a causal effect on risk of cerebral palsy (CP) in the child, or whether unobserved confounding is a more likely explanation.: Method: We used data from Norwegian registries on approximately 1 ... ...

Abstract	Aim: To explore whether increasing parental education has a causal effect on risk of cerebral palsy (CP) in the child, or whether unobserved confounding is a more likely explanation. Method: We used data from Norwegian registries on approximately 1.5 million children born between 1967 and 2011. We compared results from a traditional cohort design with results from a family-based matched case-control design, in which children with CP were matched to their first cousins without CP. In addition, we performed a simulation study to assess the role of unobserved confounding. Results: In the cohort design, the odds of CP were reduced in children of mothers and fathers with higher education (adjusted odds ratio [OR] 0.67, 95% confidence interval [CI] 0.60-0.75 for maternal education, and adjusted OR 0.75, 95% CI 0.67-0.85 for paternal education). In the family-based case-control design, only an association for maternal education remained (adjusted OR 0.80, 95% CI 0.64-0.99). Results from a simulation study suggested that this association could be explained by unobserved confounding. Interpretation: A causal effect of obtaining higher education on risk of CP in the child is unlikely. Results stress the importance of continued research on the role of genetic and environmental risk factors that vary by parents' educational level. What this paper adds: Children of higher-educated parents had significantly lower odds of cerebral palsy (CP). There was no evidence of difference in risk of CP within first cousins whose mothers or fathers had different educational levels. Association between parental education and odds of CP did not reflect a causal effect.
MeSH term(s)	Adult ; Case-Control Studies ; Causality ; Cerebral Palsy/epidemiology ; Educational Status ; Female ; Humans ; Male ; Norway ; Parents ; Prevalence ; Registries ; Risk
Language	English
Publishing date	2020-04-27
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't
ZDB-ID	80369-8
ISSN	1469-8749 ; 0012-1622
ISSN (online)	1469-8749
ISSN	0012-1622
DOI	10.1111/dmcn.14552
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Article ; Online: Availability and analytical quality of hemoglobin A1c point-of-care testing in general practitioners' offices are associated with better glycemic control in type 2 diabetes.

Tollånes, Mette C / Jenum, Anne K / Berg, Tore Julsrud / Løvaas, Karianne F / Cooper, John G / Sandberg, Sverre

Clinical chemistry and laboratory medicine

2020 Volume 58, Issue 8, Page(s) 1349–1356

Abstract: Background It is not clear if point-of-care (POC) testing for hemoglobin A1c (HbA1c) is associated with glycemic control in type 2 diabetes. Methods In this cross-sectional study, we linked general practitioner (GP) data on 22,778 Norwegian type 2 ... ...

Abstract	Background It is not clear if point-of-care (POC) testing for hemoglobin A1c (HbA1c) is associated with glycemic control in type 2 diabetes. Methods In this cross-sectional study, we linked general practitioner (GP) data on 22,778 Norwegian type 2 diabetes patients to data from the Norwegian Organization for Quality Improvement of Laboratory Examinations. We used general and generalized linear mixed models to investigate if GP offices' availability (yes/no) and analytical quality of HbA1c POC testing (average yearly "trueness score", 0-4), as well as frequency of participation in HbA1c external quality assurance (EQA) surveys, were associated with patients' HbA1c levels during 2014-2017. Results Twenty-eight out of 393 GP offices (7%) did not perform HbA1c POC testing. After adjusting for confounders, their patients had on average 0.15% higher HbA1c levels (95% confidence interval (0.04-0.27) (1.7 mmol/mol [0.5-2.9]). GP offices participating in one or two yearly HbA1c EQA surveys, rather than the maximum of four, had patients with on average 0.17% higher HbA1c levels (0.06, 0.28) (1.8 mmol/mol [0.6, 3.1]). For each unit increase in the GP offices' HbA1c POC analytical trueness score, the patients' HbA1c levels were lower by 0.04% HbA1c (-0.09, -0.001) (-0.5 mmol/mol [-1.0, -0.01]). Conclusions Novel use of validated patient data in combination with laboratory EQA data showed that patients consulting GPs in offices that perform HbA1c POC testing, participate in HbA1c EQA surveys, and maintain good analytical quality have lower HbA1c levels. Accurate HbA1c POC results, available during consultations, may improve diabetes care.
MeSH term(s)	Aged ; Aged, 80 and over ; Blood Glucose/analysis ; Diabetes Mellitus, Type 2/blood ; Female ; General Practice/organization & administration ; Glycated Hemoglobin A/analysis ; Humans ; Male ; Middle Aged ; Norway ; Point-of-Care Systems
Chemical Substances	Blood Glucose ; Glycated Hemoglobin A
Language	English
Publishing date	2020-03-10
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1418007-8
ISSN	1437-4331 ; 1434-6621 ; 1437-8523
ISSN (online)	1437-4331
ISSN	1434-6621 ; 1437-8523
DOI	10.1515/cclm-2020-0026
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Article ; Online: Parental income gradients in adult health

Miriam Evensen / Søren Toksvig Klitkou / Mette C. Tollånes / Simon Øverland / Torkild Hovde Lyngstad / Stein Emil Vollset / Jonas Minet Kinge

BMC Medicine, Vol 19, Iss 1, Pp 1-

a national cohort study

2021 Volume 14

Abstract: Abstract Background Disparities in health by adult income are well documented, but we know less about the childhood origins of health inequalities, and it remains unclear how the shape of the gradient varies across health conditions. This study examined ... ...

Abstract	Abstract Background Disparities in health by adult income are well documented, but we know less about the childhood origins of health inequalities, and it remains unclear how the shape of the gradient varies across health conditions. This study examined the association between parental income in childhood and several measures of morbidity in adulthood. Methods We used administrative data on seven complete Norwegian birth cohorts born in 1967–1973 (N = 429,886) to estimate the association between parental income from birth to age 18, obtained from tax records available from 1967, linked with administrative registries on health. Health measures, observed between ages 39 and 43, were taken from registry data on consultations at primary health care services based on diagnostic codes from the International Classification of Primary Care (ICPC-2) and hospitalizations and outpatient specialist consultations registered in the National Patient Registry (ICD-10). Results Low parental income during childhood was associated with a higher risk of being diagnosed with several chronic and pain-related disorders, as well as hospitalization, but not overall primary health care use. Absolute differences were largest for disorders related to musculoskeletal pain, injuries, and depression (7–9 percentage point difference). There were also differences for chronic disorders such as hypertension (8%, CI 7.9–8.5 versus 4%, CI 4.1–4.7) and diabetes (3.2%, CI 3.0–3.4 versus 1.4%, CI 1.2–1.6). There was no difference in consultations related to respiratory disorders (20.9%, CI 20.4–21.5 versus 19.7%, CI 19.2–20.3). Childhood characteristics (parental education, low birth weight, and parental marital status) and own adult characteristics (education and income) explained a large share of the association. Conclusions Children growing up at the bottom of the parental income distribution, compared to children in the top of the income distribution, had a two- to threefold increase in somatic and psychological disorders measured in adulthood. ...
Keywords	Health inequalities ; Childhood ; Parental income ; Cohort study ; Medicine ; R
Subject code	796 ; 360
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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