Publications by authors named "Claus D Hansen"

11 Publications

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The association between perceived social support in adolescence and positive mental health outcomes in early adulthood: a prospective cohort study.

Scand J Public Health 2021 Mar 1:1403494821993718. Epub 2021 Mar 1.

Danish Ramazzini Centre, Regional Hospital West Jutland, Denmark.

Aims: The link between perceived social support and mental health has received much attention from numerous scientific fields in recent years. Most studies, however, have examined associations only over relatively short follow-up periods using global measures of perceived social support and dichotomous negative indicators of mental health. We investigated the long-term association between perceived social support from friends, parents and teachers and multiple positive hedonic and eudemonic indicators of mental health, including hope, meaningfulness and subjective well-being.

Methods: This study used questionnaire data from 2004, 2007 and 2010 from the West Jutland Birth Cohort study with linked register data. The study population consisted of 3681 adolescents born in 1989. Multiple linear and ordered logistic regression were used to analyse the association between perceived social support at age 14/15 years and mental health indicators at age 20/21 years while controlling for possible confounders, including the Big Five personality traits and baseline symptoms of depression.

Results: The results show that perceived social support from friends in adolescence was positively associated with all indicators of mental health in early adulthood. Furthermore, perceived paternal social support was positively associated with meaningfulness and subjective well-being, while perceived social support from teachers was positively associated with meaningfulness.

Conclusions:
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http://dx.doi.org/10.1177/1403494821993718DOI Listing
March 2021

Coping strategies in adolescence and labour-market participation in young adulthood: A prospective birth cohort study.

Scand J Public Health 2020 Jul 13;48(5):537-543. Epub 2019 Aug 13.

Centre for Social Medicine, Frederiksberg and Bispebjerg Hospital, Denmark.

The aim of this study was to investigate whether coping strategies in adolescence (14-15 years of age) were associated with labour-market participation (LMP) in young adulthood (25-26 years of age) and whether the association differed by sex. A birth cohort from the former county of Ringkjoebing, Denmark, consisting of 2826 individuals, comprised the study population. In 2004, the study population completed a questionnaire from which information about coping and covariates were gathered. Coping strategies were measured using five sub-scales of the Brief COPE Scale, which were combined into two overall coping strategies: active coping and avoidant coping. Ten years later, the participants were followed for a 52-week period in a register on social benefits. Logistic regression was applied to data, with adjustment for covariates: sex, parents' socio-economic status (education and income) and self-rated health. A total of 2203 (78%) participants were categorised as high LMP at follow-up. No significant associations were found between active coping in adolescence and LMP in 2014/2015. For avoidant coping, in the fully adjusted model, medium-level avoidant coping was associated with higher odds (odds ratio (OR)=1.02 (95% confidence interval (CI) 0.83-1.25) of high LMP. For low avoidant coping, the OR was 1.37 (95% 1.07-1.75). For both coping strategies, sex did not modify the association.
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http://dx.doi.org/10.1177/1403494819865644DOI Listing
July 2020

Cohort profile: the Danish Future Occupation of Children and Adolescents cohort (the FOCA cohort): education, work-life, health and living conditions in a life-course perspective.

BMJ Open 2019 02 15;9(2):e022784. Epub 2019 Feb 15.

Department of Public Health, University of Aarhus, Aarhus, Denmark.

Purpose: The Future Occupation of Children and Adolescents cohort (the FOCA cohort) is a large population-based cohort study that was established as a resource for research in order to study adolescence factors and future educational and vocational trajectories in a life-course perspective. The cohort covers a broad array of themes within public health, including diseases and health behaviours. Through linkage to register data on the participants' parents, the cohort allows investigation of parental effects over time on adolescents' behaviours and interactions across generations.

Participants: The FOCA cohort consists of 13 100 adolescents attending ninth grade in Denmark during the first quarter of 2017, independent of school type.

Findings To Date: Included were 6685 girls (51.03%) and 6415 boys (48.97%) with an average age of 15.85 years, representing 650 schools (37.23%), covering all options in the Danish school system and widely distributed across the country. The use of the personal identification number allowed for a merge of parents to all adolescents in the cohort, resulting in the identification of 25 911 registered parents. Register data on parents' socio-economic position and labour market history showed representativeness among the adolescents' socio-economic background compared with the general population in Denmark.

Future Plans: The adolescents will be followed by ongoing linkage to administrative registers. Future studies will focus on factors affecting future health, education, work and well-being in a life-course perspective and for specific research projects, it will be possible to apply for permission to link data to further ongoing national registers covering all participants.
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http://dx.doi.org/10.1136/bmjopen-2018-022784DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398691PMC
February 2019

The effect of early-life and adult socioeconomic position on development of lifestyle-related diseases.

Eur J Public Health 2019 06;29(3):562-567

Unit for Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.

Background: Early-life socioeconomic position (SEP) is associated with lifestyle-related diseases in adulthood. However, evidence is lacking on the extent to which adult SEP mediates this association.

Methods: Time to either chronic obstructive pulmonary disease (COPD), cardiovascular disease or diabetes were assessed in the Danish population born between 1961 and 1971 (n = 793 674) from age 30 until 2015. Early-life position was assessed in 1981 (by parental) and again at age 30 (own) by four markers; income, occupation, education-divided into high, middle, low-and a combined score for all markers. Using a counterfactual approach, we estimated the total effect of early-life position on disease onset and the degree to which adult position mediated this effect.

Results: Results of the time-to-event analysis showed a gradient of all early-life markers on the risk of developing all lifestyle-related diseases. Notably, comparing those in the lowest to the highest educational position, the hazard of COPD was 130% higher for women [hazard ratio = 2.30(95% confidence interval = 2.20-2.41)] and 114% higher for men [2.14 (2.05-2.25)]. About 67%(63-70%) of the effect of educational position was mediated through adult position for COPD, 55% for cardiovascular disease and 50% for diabetes. For the combined score 44, 29 and 33%, respectively, was mediated.

Conclusion: About one-tenth to two-thirds of the effect of early-life position is mediated by the position attained in adulthood. The degree mediated depend on the outcome investigated, gender and the social position marker used indicating that alternative pathways may play a key role in developing effective policies targeting early-life behaviours.
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http://dx.doi.org/10.1093/eurpub/cky237DOI Listing
June 2019

Bullied at school, bullied at work: a prospective study.

BMC Psychol 2015 Oct 12;3:35. Epub 2015 Oct 12.

Department of Sociology & Social Work, Kroghstrædet 5, Aalborg University, Aalborg, 9220, Denmark.

Background: The consequences of childhood bullying victimisation are serious. Much previous research on risk factors for being bullied has used a cross-sectional design, impeding the possibility to draw conclusions on causality, and has not considered simultaneous effects of multiple risk factors. Paying closer attention to multiple risk factors for being bullying can provide a basis for designing intervention programmes to prevent or reduce bullying among children and adolescents.

Methods: Risk factors for bullying were examined by using questionnaire data collected in 2004 and 2007. In 2004, the participants were aged 14-15 years and 17-18 years in 2007. The baseline questionnaire was answered by 3054 individuals in 2004, and 2181 individuals participated in both rounds. We analysed risk factors for being bullied at the individual and societal level. Information on the social background of the participants was derived from a national register at Statistics Denmark.

Results: Several risk factors were identified. Being obese, low self-assessed position in school class, overprotective parents, low self-esteem, low sense of coherence and low socioeconomic status were risk factors for being bullied at school. Being overweight, smoking, low self-assessed position in class, low sense of coherence and low socioeconomic status were risk factors for being bullied at work. However, most associations between risk factors in 2004 and being bullied in 2007 disappeared after adjustment for being bullied in 2004.

Conclusions: The strongest risk factor for being bullied was being previously bullied. Our results stress the importance of early prevention of bullying at schools. In addition, attention should be drawn to the role of overprotective parents.
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http://dx.doi.org/10.1186/s40359-015-0092-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603733PMC
October 2015

Individual social capital and survival: a population study with 5-year follow-up.

BMC Public Health 2014 Oct 2;14:1025. Epub 2014 Oct 2.

Department of Health Science and Technology, Public Health and Epidemiology, Aalborg University, Niels Jernes Vej 14, 9220 Aalborg, Denmark.

Background: The concept of social capital has received increasing attention as a determinant of population survival, but its significance is uncertain. We examined the importance of social capital on survival in a population study while focusing on gender differences.

Methods: We used data from a Danish regional health survey with a five-year follow-up period, 2007-2012 (n = 9288, 53.5% men, 46.5% women). We investigated the association between social capital and all-cause mortality, performing separate analyses on a composite measure as well as four specific dimensions of social capital while controlling for covariates. Analyses were performed with Cox proportional hazard models by which hazard ratios and 95% confidence intervals were calculated.

Results: For women, higher levels of social capital were associated with lower all-cause mortality regardless of age, socioeconomic status, health, and health behaviour (HR = 0.586, 95% CI = 0.421-0.816) while no such association was found for men (HR = 0.949, 95% CI = 0.816-1.104). Analysing the specific dimensions of social capital, higher levels of trust and social network were significantly associated with lower all-cause mortality in women (HR = 0.827, 95% CI = 0.750-0.913 and HR = 0.832, 95% CI = 0.729-0.949, respectively). For men, strong social networks were associated with a higher risk of all-cause mortality (HR = 1.132, 95% CI = 1.017-1.260). Civic engagement had a similar effect for both men (HR = 0.848, 95% CI = 0.722-0.997) and women (HR = 0.848, 95% CI = 0.630-1.140).

Conclusions: We found differential effects of social capital in men compared to women. The predictive effects on all-cause mortality of four specific dimensions of social capital varied. Gender stratified analysis and the use of multiple indicators to measure social capital are thus warranted in future research.
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http://dx.doi.org/10.1186/1471-2458-14-1025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195999PMC
October 2014

Can negative life events and coping style help explain socioeconomic differences in perceived stress among adolescents? A cross-sectional study based on the West Jutland cohort study.

BMC Public Health 2013 Jun 2;13:532. Epub 2013 Jun 2.

Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital Herning, Herning, Denmark.

Background: Previous research suggests that perceived stress in adolescence is socially patterned, but that this relationship may depend on the measure of socioeconomic status (SES) used. This study examines if social gradients in perceived stress, negative life events, and coping exist amongst Danish adolescents, and, if life events and coping strategies can partly account for an association between SES and perceived stress. These relationships are studied separately for two different measures of SES.

Methods: Questionnaire data were collected from 3054 14-15 year old youths (83% response rate) during baseline measurement in the West Jutland birth cohort study. Parents were identified via the Central Office of Civil Registration in which the respondents are linked to their parents or guardians via their CPR-number, a personal identification number given to everyone in Denmark. The study employs data from two independent sources, adolescent self-report data (stress, life events and coping) and national registers (parental educational level, household income and confounder variables). Ordinary Least Squares regression estimated the effects of parental SES, negative life events and coping on perceived stress. Analyses were stratified by gender.

Results: Girls reported more perceived stress than boys. SES accounted for a small but significant amount of the variance in perceived stress. Lower parental education and lower household income were associated with higher stress levels irrespective of gender, but the social gradient was strongest amongst girls when parents' education was used to measure SES, and strongest for boys when income was used. Life events and coping were also found to be associated with SES and both mediated part of the SES-perceived stress relationship. In general, the social gradient in perceived stress was accounted for by the study variables to a higher degree among girls than among boys.

Conclusions: Lower parental education and household income are associated with higher levels of perceived stress amongst Danish adolescents. Furthermore, both life events and coping appear to mediate this relation. Gender differences in the ways SES and stress are related may exist.
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http://dx.doi.org/10.1186/1471-2458-13-532DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679909PMC
June 2013

Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel - a cross-sectional study.

BMC Public Health 2012 Jul 23;12:534. Epub 2012 Jul 23.

Department of Sociology and Social Work, Aalborg University, Aalborg University, Kroghstræde 5, DK 9220, Aalborg Ø, Denmark.

Background: Reviews of the literature on the health and work environment of ambulance personnel have indicated an increased risk of work-related health problems in this occupation. The aim of this study was to compare health status and exposure to different work environmental factors among ambulance personnel and the core work force in Denmark. In addition, to examine the association between physical and psychosocial work environment factors and different measures of health among ambulance personnel.

Methods: Data were taken from a nationwide sample of ambulance personnel and fire fighters (n = 1,691) and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality.

Results: Ambulance personnel have half the prevalence of poor self-rated health compared to the core work force (5% vs. 10%). Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%). The ambulance personnel had higher levels of emotional demands and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor that was associated with both poorer mental health and worse sleep quality.

Conclusions: Ambulance personnel have similar levels of mental health but substantially higher levels of musculoskeletal pain than the work force in general. They are more exposed to emotional demands and these demands are associated with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal problems and the presence of positive organizational support mechanisms that can prevent negative effects from the high levels of emotional demands.
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http://dx.doi.org/10.1186/1471-2458-12-534DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3439275PMC
July 2012

Incidence of work injuries amongst Danish adolescents and their association with work environment factors.

Am J Ind Med 2011 Feb 8;54(2):143-52. Epub 2010 Nov 8.

Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital Herning, Denmark.

Background: The objective was to examine the incidence of work accidents that required medical attention among Danish adolescents and to identify possible work environment factors associated with such accidents.

Methods: We collected information in two questionnaire rounds (2004 and 2007) from a birth cohort comprising all adolescents born in 1989 (n = 3,687) living in Ringkjøbing County, Denmark. The questionnaire contained items on self-reported number of accidents and number of working hours in both rounds and on work environment factors in the second round.

Results: Approximately 5% of the adolescents who held a job, experienced a work injury at the age of 17. This equals an incidence of 65 accidents per million working hours. Most adolescents had decent working conditions, although nearly half reported that their work was heavy, monotonous or psychologically demanding. Heavy work, high psychological demands and low social support increased the risk of experiencing work injuries after adjustment for a number of factors.

Conclusions: The incidence of work injuries among adolescents appears to be higher than the incidence among their older colleagues. Lack of social support from management significantly raised adolescents' risk of experiencing a work injury. This suggests that more direct supervision may be a good way of preventing accidents in this age group.
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http://dx.doi.org/10.1002/ajim.20911DOI Listing
February 2011

[Social inequality and health in adolescents].

Ugeskr Laeger 2010 Mar;172(11):857-63

Arbejdsmedicinsk Klinik, Regionshospitalet Herning, DK-7400 Herning, Denmark.

Introduction: Previous studies indicate that social disparities in health exist in the Danish population. We examined the relationship between parental socioeconomic status (SES) and a number of indicators of physical and mental health amongst 14-15 year old adolescents from the former Ringkoebing County, now a part of the Central Jutland Region, Denmark. SES was measured in terms of education and income, which, in part, correspond with the concepts of cultural and economic capital.

Material And Methods: Information concerning parents' level of education and income was obtained from central registers via Statistics Denmark. Health-related data for a total of 3,058 adolescents, corresponding to a response rate of 83%, was gathered via questionnaires. Prevalence proportion ratios (PPR) were calculated and are used in the article as risk estimates.

Results: Adolescents with less educated parents had a significantly greater risk of poor self-rated health, high self-perceived stress and being overweight, compared with those with better educated parents. The most substantial difference was seen for self-rated health with a PPR of 3.44. Adolescents with low-income parents had poorer health when compared with higher-income groups on eight out of 11 health indicators. Most noticeable were differences for self-rated health and self-perceived stress with PPRs of 1.86 and 1.54, respectively.

Conclusion: The study shows that social disparities in health exist among adolescents from the western part of central Jutland corresponding to the former Ringkoebing County. Both low parental education and income had a negative effect on adolescent health. The study also indicates that education and income affect health in different ways. For this reason it is desirable to use both indicators as measures of SES when studying social disparities in health.
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March 2010

Going ill to work--what personal circumstances, attitudes and work-related factors are associated with sickness presenteeism?

Soc Sci Med 2008 Sep 19;67(6):956-64. Epub 2008 Jun 19.

Department of Occupational Medicine, Herning Hospital, Herning, Denmark.

The aim of this study is to assess the impact of a broad range of possible factors relating to work, personal circumstances and attitudes towards sickness absence on a person's decision to go to work despite feeling ill, a phenomenon that has been termed sickness presence (SP), or 'presenteeism', in the literature. Using data from a random sample of 12,935 members from the core Danish work force the hypotheses were tested in a cross-sectional design utilising ordered logistic regression models. The results indicate that more than 70% of the core work force goes ill to work at least once during a 12-month period. This means that SP is just as prevalent a phenomenon as sickness absence. Many of the results from earlier studies of SP were replicated and new factors were discovered: for example time pressure (having a supervisory role and/or working more than 45 h per week) and relationship with colleagues (measured by working in a small company, having non-standard hours and degree of cooperation) both increase the likelihood of SP. However, personal circumstances and attitudes, e.g. treating work as home (cf. Hochschild's thesis) and being over-committed to work, were also found to lead to higher levels of SP. Finally, we found that those with a conservative attitude to absence were most likely to turn up ill at work. Overall, work-related factors seem to be slightly more important than personal circumstances or attitudes in determining people's 'decision' to go ill at work. However, the relatively low explanatory power of these combined factors suggests that there are still many unknowns in this field of research.
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http://dx.doi.org/10.1016/j.socscimed.2008.05.022DOI Listing
September 2008
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