Journal of Epidemiology and Community Health最新文献

{"title":"Five-year changes in loneliness and mental health among adults 41-85 years: the Doetinchem Cohort Study.","authors":"Tijmen Maas, Gerrie-Cor Herber, W M Monique Verschuren, H Susan J Picavet","doi":"10.1136/jech-2024-222099","DOIUrl":"https://doi.org/10.1136/jech-2024-222099","url":null,"abstract":"<p><strong>Background: </strong>Both loneliness and mental health represent important public health themes with stable or even worsening population figures. The association between loneliness and mental health is cross-sectionally well-established, but longitudinal studies are scarce. The aim of this study is to explore the individual changes in loneliness and mental health and the relation between these changes.</p><p><strong>Methods: </strong>We used data from wave 5 (years: 2007-2012, n: 4016) and wave 6 (years: 2013-2017, n: 3437) of the Doetinchem Cohort Study, consisting of participants aged 41-86 years. Loneliness was measured using the De Jong-Gierveld 6-item Loneliness Scale and mental health was measured with the 5-item Mental Health Inventory. We assessed changes in loneliness and mental health over a 5-year period. Generalised estimating equations and linear regression were performed to determine the longitudinal association. Associations were adjusted for various sociodemographic, lifestyle and health factors.</p><p><strong>Results: </strong>Over a 5-year period, 23.4% experienced a change in loneliness and 9.7% in mental health.Higher levels of loneliness were significantly associated with poor mental health both cross-sectionally and over time (β:-3.56, 95% CI: -3.79 to -3.32). Increasing feelings of loneliness were associated with worsening mental health, and decreasing feelings of loneliness were associated with improving mental health (β:-2.35, 95% CI: -2.61 to -2.08).</p><p><strong>Conclusion: </strong>The high rate of individual changes in loneliness, combined with the association between changes in loneliness and changes in mental health, shows a possible potential in improving poor mental health by designing public health interventions aimed at reducing feelings of loneliness.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of mental health problems on having a 'neither in employment nor in education or training' period and the mediating role of high school dropout: a register-based study with a 14-year follow-up.","authors":"Roos Hijdra, Joost Oude Groeniger, Alex Burdorf, Merel Schuring","doi":"10.1136/jech-2024-222197","DOIUrl":"https://doi.org/10.1136/jech-2024-222197","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigates (1) whether mental health problems among individuals aged 12-15 years impact (a) high school dropout (ages 16-20 years) and (b) having a 'neither in employment nor in education or training' (NEET) period (ages 21-26 years); (2) the process of mediation and interaction by high school dropout in the association between mental health problems and NEET; and (3) whether these associations differ based on (non-)employment and mental health problems of parents.</p><p><strong>Methods: </strong>Longitudinal register data were used (n=196 227). Log-linear regression analyses were used to assess the association between reimbursed medication for mental health problems and high school dropout or NEET period for at least 12 months. Causal mediation analysis was used to assess the mediation and interaction effects of high school dropout in the association between mental health problems and NEET. Stratified analyses were performed based on parental employment and mental health status.</p><p><strong>Results: </strong>Mental health problems were strongly associated with high school dropout (RR 1.96, 95% CI 1.88; 2.04) and NEET (RR 2.44, 95% CI 2.35; 2.52). High school dropout had a small mediating effect in the relationship between mental health problems and NEET. Individuals with parents with mental health problems or non-employment more often experienced high school dropout and being NEET, but the mediating effect of dropout on NEET was lower in these individuals.</p><p><strong>Conclusion: </strong>Preventing mental health problems early in the lifecourse is of paramount importance to promote educational outcomes and employment participation, but high school dropout only plays a marginal role in this relationship.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body mass index trajectories and all-cause mortality in older Chinese adults: Hong Kong's Elderly Health Service Cohort.","authors":"Man Ki Kwok, Siu Yin Lee, Gabriel M Leung, C Mary Schooling","doi":"10.1136/jech-2025-223659","DOIUrl":"https://doi.org/10.1136/jech-2025-223659","url":null,"abstract":"<p><strong>Background: </strong>Weight loss at older ages appears to be associated with higher mortality in Western and some East Asian countries, despite differences in the prevalence of obesity; whether it is relevant to China is unknown. We examined the association of body mass index (BMI) trajectories with all-cause mortality in older Chinese adults by sex and baseline age (65-69 years, 70+ years).</p><p><strong>Methods: </strong>54 160 participants aged 65 or above from Hong Kong's Elderly Health Service Cohort with at least five BMI measurements were included. We identified distinct BMI trajectories using group-based trajectory modelling. We assessed the associations of BMI trajectories with mortality risk using a Cox model stratified by sex and age.</p><p><strong>Results: </strong>Compared with 'normal weight, stable', the 'low-normal weight, decreasing' had higher mortality risk in both sexes and age groups (eg, HR 1.43, 95% CI 1.24 to 1.66 in men aged 65-69 years). The 'overweight, stable' and 'obese, stable' had lower mortality risk, especially in men at older ages. However, the proportion in the 'low-normal weight, decreasing' was greater at 70+ years than at 65-69 years, while the proportion in the 'overweight, stable' and 'obese, stable' was lower in the older group.</p><p><strong>Conclusions: </strong>Decreasing BMI is a likely symptom of ill health in older adults. Inconsistency between the risks and the proportion in each BMI trajectory group by age suggests the observed associations could be driven by changes in weight and preferential recruitment of survivors. Maintaining a healthy weight remains relevant at older ages.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Māori work-related fatal injury in Aotearoa-New Zealand, 2005-2014: a decade of continued inequities for Indigenous Māori.","authors":"Taitimuroa Akuhata, Gabrielle Davie, Rebbecca Lilley","doi":"10.1136/jech-2024-222808","DOIUrl":"https://doi.org/10.1136/jech-2024-222808","url":null,"abstract":"<p><strong>Objectives: </strong>Using Coronial data, this observational study describes and compares the characteristics of work-related fatal injury (WRFI) in Indigenous Māori and non-Māori workers to identify disparities in WRFI in Aotearoa New Zealand (NZ) for the period 2005-2014.</p><p><strong>Methods: </strong>A population-level WRFI dataset was created by coding Coronial case files for the period 1995-2014. WRFI frequencies and rates were calculated by age, sex, socioeconomic deprivation, occupation and industry, stratified for Māori and non-Māori. Standardisation of rates was used to examine possible reasons for differences.</p><p><strong>Results: </strong>The crude rate of WRFI in Māori workers was 7.6 fatalities per 100 000 workers over the decade: almost double that for non-Māori workers (incident rate ratio (IRR) 1.9, 95% CI 1.6, 2.3). Of variables considered in standardisation, occupation made the biggest difference to the crude IRR (SIRR 1.5, 95% CI 1.2, 1.7). The largest equity gaps occurred in the transport sector (IRR 2.1, 95% CI 1.6, 2.9) and for machinery operators (IRR 2.2, 95% CI 1.6, 3.2). Vehicle crashes accounted for 33% of Māori WRFI compared with 25% of non-Māori (difference 8%, 95% CI 2%, 16%).</p><p><strong>Conclusions: </strong>WRFI continues to be a significant and systemic source of inequity for Indigenous Māori in NZ. Consistent with previous decades, Māori workers experience disproportionately higher rates of WRFI in NZ, largely explained by the higher representation of Māori workers in high-risk occupations and industries. Future efforts to address inequities in WRFI for Māori workers should focus on high-risk industries and occupations, as well as address the inequitable distribution of WRFI risks.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive maintenance in older adults in social classes: a secondary analysis of the longitudinal SHARE data.","authors":"Yuliya Bodryzlova, Bouchra Nasri, Rado Malalatiana Ramasy Razafindratovo, Yan Kestens, Emmanuelle Bélanger, Grégory Moullec","doi":"10.1136/jech-2023-220542","DOIUrl":"https://doi.org/10.1136/jech-2023-220542","url":null,"abstract":"<p><strong>Background: </strong>Cognitive maintenance-defined as a capacity to maintain good or excellent cognitive functioning-is a valuable ageing outcome. Socio-demographic, dementia risk and protective factors may contribute differently to it across social classes. However, these effects have not been adequately assessed yet.</p><p><strong>Objective: </strong>This study aims to evaluate the effects of socio-demographic, risks and protective factors on the probability of cognitive maintenance in older adults stratified by social classes.</p><p><strong>Methods: </strong>Participants aged 65-85 years at the baseline from the Survey on Health, Ageing and Retirement in Europe (Waves 5 (2013) and 7 (2017)) were included. Cognitive maintenance was operationalised as six or more words recalled on the 10-word delayed recall test at baseline and follow-up. Dementia-specific risks and protective factors were selected from global strategies for dementia prevention. Multilevel logistic regressions with the country of residence as a random-effect variable were constructed to compare the relative effect of contributors across social classes.</p><p><strong>Results: </strong>20 960 participants from 14 countries were included in the analysis. The pseudo-R² was 0.24, 0.28, 0.41 and 0.32 in participants of higher, middle, lower and not known social classes. Age, number of leisure activities and country of residence were significant predictors for all social classes. Effects of gender, depression, obesity, frailty, alcohol, education, occupation and personality traits vary across social classes.</p><p><strong>Conclusion: </strong>Studying contributors to cognitive maintenance separately in social classes may show possible targets of public health strategies for improving cognitive health in populations and reducing social inequalities in cognitive health.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal associations between residential density and body mass index: the mediating role of walking for transport and the moderating effect of neighbourhood disadvantage.","authors":"Samjhana Shrestha, Gavin Turrell, Suzanne J Carroll","doi":"10.1136/jech-2024-223095","DOIUrl":"https://doi.org/10.1136/jech-2024-223095","url":null,"abstract":"<p><strong>Background: </strong>Longitudinal evidence regarding the associations between residential density, walking for transport (WfT) and body mass index (BMI) is limited, and how these relationships vary across different neighbourhood socioeconomic contexts is not yet known. Therefore, we examined longitudinal associations between residential density and BMI: the mediating role of WfT and the moderating effects of neighbourhood disadvantage.</p><p><strong>Methods: </strong>Data from the HABITAT (<u>H</u>ow <u>A</u>reas in <u>B</u>risbane <u>I</u>nfluence Heal<u>T</u>h and <u>A</u>c<u>T</u>ivity) multilevel longitudinal (2007-2016) study of 11 035 middle-aged adult residents of 200 neighbourhoods in Brisbane, Australia, were used. Residential density was objectively assessed within a 1 km network buffer around residents' homes, and BMI was calculated from self-reported height and weight. Participants self-reported their previous week's minutes of WfT. Generalised structural equation modelling was used to estimate the mediating effect of WfT in explaining residential density-BMI associations across the quintiles of neighbourhood disadvantage, adjusting for time-varying and time-invariant confounders, including distance to Brisbane Central Business District (CBD) and residential self-selection.</p><p><strong>Results: </strong>Residents living in high-density neighbourhoods were found to engage in more WfT and maintain a lower BMI. WfT mediated approximately 6.44% of the density-BMI relationships. These longitudinal relationships remained consistent in moderately disadvantaged neighbourhoods but differed in areas with other levels of disadvantage and when accounting for CBD distance.</p><p><strong>Conclusion: </strong>Residentially dense neighbourhoods facilitate transport-related walking, potentially reducing the risk of weight-related chronic conditions. However, these effects vary across different neighbourhood socioeconomic contexts. Urban planning and policy efforts should focus on context-specific measures to leverage the anticipated benefits of residential density.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in acute coronary syndrome hospitalisation, incidence and mortality rates in young adults: an Australian linked data study.","authors":"Samantha L Stiles, Ingrid Stacey, Judith M Katzenellenbogen, Tom Briffa, Karice Hyun, Frank M Sanfilippo, Derek P Chew, David Brieger, Lee Nedkoff","doi":"10.1136/jech-2024-223615","DOIUrl":"https://doi.org/10.1136/jech-2024-223615","url":null,"abstract":"<p><strong>Background: </strong>Australian and international studies have reported an attenuation in previous declines in acute coronary syndrome (ACS) events in young adults. This study examines temporal trends in admission, mortality and incidence rates for ACS in men and women aged <55 years using multijurisdictional data for 2007-2016.</p><p><strong>Methods: </strong>This population-based linked data study used hospital and mortality records from New South Wales, Western Australia and South Australia for 2002-2016. We identified all ACS hospitalisations and deaths, and first-ever (incident) events using a 5-year lookback period. Age-specific rates were calculated for ACS subgroups. Average annual percentage changes (95% CI) were estimated from age-adjusted Poisson regression models.</p><p><strong>Results: </strong>There were 202 327 ACS events from 2007 to 2016, 27.6% (n=55 764) of which occurred in 20-54 years. ACS admission rates declined in all age and sex groupings, with greater declines in 55-74 years. Substantial declines in mortality rates of 6%-9%/year were seen across all sex and age groups. Reductions in total incidence were driven by declines in hospitalised ACS incidence. A decline in ST-segment elevation myocardial infarction (STEMI) incidence rates was observed, with the smallest reduction in younger women (-1.7%/year). Non-STEMI incidence rates increased by 1.9%/year (95% CI +0.8, +3.0) in women aged 20-54 years while remaining unchanged in young men.</p><p><strong>Conclusions: </strong>While reductions in ACS incidence and mortality overall are encouraging, this study highlights increasing NSTEMI incidence and a smaller decline in STEMI incidence in young women compared with young adult men. A better understanding of sex-specific factors responsible for increasing rates is essential to continue to improve cardiovascular health.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of maternal substance use problems during pregnancy and the first 2 years of life: a whole-population birth cohort of 970 470 Australian children born 2008-2017.","authors":"Madeleine Powell, Rhiannon Pilkington, Tasnia Ahmed, Mark Hanly, B J Newton, John W Lynch, Timothy Dobbins, Jessica Stewart, Michelle Cretikos, Alys Havard, Kathleen Falster","doi":"10.1136/jech-2024-223439","DOIUrl":"https://doi.org/10.1136/jech-2024-223439","url":null,"abstract":"<p><strong>Objectives: </strong>To estimate the prevalence of maternal substance use problems during the first 1000 days of children's lives, to inform planning and resourcing of antenatal screening and substance use in pregnancy services, alongside antenatal and postnatal health, parenting and social support services for pregnant women/new mothers and their babies.</p><p><strong>Method: </strong>This whole-population cohort was assembled from birth registration, perinatal and hospital data for children born 2008-2017, and their mothers, using data linked for the New South Wales (NSW) Child E-Cohort Project. The primary outcome was maternal substance use conditions and treatment recorded in six health, death and child protection data sources from the child's conception to age 2 years (the first 1000 days), including illicit substances, alcohol, opioid-agonist treatment and misuse of psychoactive medicines or substances.</p><p><strong>Results: </strong>Of 970 470 children born to 625 856 mothers, 3.4% (N=32 647) had ≥1 maternal substance use problem records in the first 1000 days, including alcohol use (N=13 637; 1.4%) and other drug use (N=23 485; 2.4%). Maternal substance use problems were recorded during the pregnancy period for 1.4% of children, and from 28 to 1000 days postbirth for 2.7% of children. Outcome ascertainment was highest from child protection records (N=26 045), followed by mother's (N=10 793) then children's hospital records (N=3827). Child protection records more than doubled the prevalence of health and death records alone (1.4%). Social and health disadvantage was more common among children with maternal substance use problems.</p><p><strong>Conclusions: </strong>During the first 1000 days of life, 3.4% of NSW children had ≥1 maternal substance use problem recorded in health, child protection and death data sources. Child protection data enhance public health intelligence on the burden of maternal substance use problems among whole child populations. Near universal health system contact during pregnancy and birth is an opportunity to initiate early support for maternal substance use and co-occurring health and social disadvantage, to promote child health and development.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between spatial social polarisation and high blood pressure in older adults.","authors":"Hoda S Abdel Magid, Samuel Jaros, Gina S Lovasi, Andrea L Rosso, Annabel X Tan, David H Rehkopf, Lorene M Nelson, Michelle Carlson, Suzanne E Judd, Michelle C Odden","doi":"10.1136/jech-2024-223191","DOIUrl":"10.1136/jech-2024-223191","url":null,"abstract":"<p><strong>Background: </strong>Using data from the Cardiovascular Health Study (CHS) and the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, we investigate the association between socioeconomic polarisation and blood pressure outcomes in black and white adults. We also validate previous findings that joint racial/ethnic and income measures of spatial social polarisation (SSP) outperform single domain measures.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis using a retrospective cohort combining CHS (recruited 1989-1990 and 1992-1993) and REGARDS (recruited 2003-2007). The study included 5888 CHS participants aged ≥65 years and 30 183 REGARDS participants aged ≥45 years. SSP was measured using the Index of Concentration at the Extremes for education, race/ethnicity, income, home ownership, and joint race/ethnicity and income at ZIP code, census tract and county levels. The SSP measures were modelled against the presence of high blood pressure and systolic blood pressure.</p><p><strong>Results: </strong>The sample had a mean age of 66 (SD: 9), was majority female (56%), white/other (63%), and at least high school graduates (85%). A total of 26% had high blood pressure, with a mean systolic blood pressure of 129 mm Hg (SD: 18). Census tract-level models showed low-income black areas had 25% (95% CI 11%-40%) higher odds of high blood pressure and 1.8 mm Hg (95% CI 1.0-2.5) higher mean systolic blood pressure than high-income White areas.</p><p><strong>Conclusion: </strong>Greater SSP is associated with a higher risk of high blood pressure and higher systolic blood pressure. Further investigating and reducing polarisation could help mitigate cardiovascular health disparities, improving outcomes for socioeconomically deprived communities.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-life death of a sibling and primary care utilisation during middle age: a population-wide cohort study.","authors":"Bjørn-Atle Reme, Rannveig Kaldager Hart, Jo Thori Lind","doi":"10.1136/jech-2024-222632","DOIUrl":"https://doi.org/10.1136/jech-2024-222632","url":null,"abstract":"<p><strong>Background: </strong>The death of a family member has been linked to higher mortality for those grieving. However, much less is known about different types of health problems of the surviving sibling during middle age.</p><p><strong>Methods: </strong>Individual-level register data on all Norwegian residents born between 1969 and 1979 were linked to cause-specific primary care utilisation between 2015 and 2019. Incidence rate ratios (IRRs) of different types of health conditions in mid-life (age 36-50) were calculated, comparing individuals who experienced the death of a sibling during childhood or early adulthood (age 0-29) and those who did not.</p><p><strong>Results: </strong>The study included 556 593 participants (mean (SD) age in 2017, 43.3 (3.15) years; 273 491 women (49.1%)). The death of a sibling was positively associated with all-cause primary care utilisation (IRR=1.11; 95% CI, 1.08 to 1.13). The highest cause-specific estimates were found for psychological (IR=1.17; 95% CI, 1.11 to 1.23) and cardiovascular (IRR=1.14; 95% CI, 1.05 to 1.23) health problems. Suicide was the cause of death with the strongest association with all-cause primary care (IRR=1.16; 95% CI, 1.09 to 1.23). When examining the intersection of type-specific health problems and causes of death, the highest estimate was found for psychological problems and sibling suicide (IRR=1.53, 95% CI, 1.32 to 1.77).</p><p><strong>Conclusion: </strong>Early-life sibling death was associated with more health problems several decades after the trauma. The persistence of these associations suggests that these problems are substantial, and at least partly caused by the trauma. More needs to be learnt interventions that could mitigate these adverse effects.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}