Hetlevik Øystein, Meland Eivind, Hufthammer Karl Ove, Breidablik Hans J, Jahanlu David, Vie Tina L
Department of Global Public Health and Primary Care, University of Bergen, 5020, Bergen, Norway.
Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
SSM Popul Health. 2020 May 20;11:100604. doi: 10.1016/j.ssmph.2020.100604. eCollection 2020 Aug.
Self-rated health (SRH) is a marker of future health and a possible predictor of future multimorbidity, which is a major challenge for population health and health care. There is a lack of studies on adolescent SRH and patterns of health problems across the transitional period from adolescence to early adulthood. Therefore, this study aimed to identify groups of people with similar health problems in early adulthood and explore the predictive value of adolescent SRH on the group classification after a period of 10-19 years. Data from 8828 adolescents participating in the Young HUNT-1 survey (1995-1997) were linked to the Norwegian registry of general practitioner (GP) claims, which includes diagnoses recorded in GP consultations in 2006-2014. We used latent class analysis (LCA) to identify groups of patients with similar health problems in early adulthood and explored SRH as a predictor of class membership using latent class regression, adjusting for baseline chronic disease, frequency of health care attendance, sex and age. The mean age at baseline was 16 years, and 50% of the participants were female. SRH was reported as by 28%, by 61% and by 11%. We identified five groups of patient classification (): (35%), (26%), (21%), (6%) and (13%). We found a gradual increase in the probability of belonging to the class with better SRH, and an inverse pattern for the and classes. This pattern remained after adjusting for baseline variables. In conclusion, there is a clear association between adolescent SRH and the risk of having multi-illness in early adulthood, seen as a proxy for later multimorbidity. This finding warrants greater attention to SRH in adolescence as a possible indicator in targeted prevention of future health problems.
自评健康状况（SRH）是未来健康的一个指标，也是未来多种疾病并存的一个可能预测因素，而多种疾病并存是人群健康和医疗保健面临的一项重大挑战。目前缺乏关于青少年自评健康状况以及从青春期到成年早期这一过渡阶段的健康问题模式的研究。因此，本研究旨在确定成年早期有相似健康问题的人群组，并探讨青少年自评健康状况在10至19年后对组分类的预测价值。来自参与“青年HUNT - 1”调查（1995 - 1997年）的8828名青少年的数据与挪威全科医生（GP）索赔登记处相关联，该登记处包括2006 - 2014年全科医生会诊中记录的诊断信息。我们使用潜在类别分析（LCA）来确定成年早期有相似健康问题的患者组，并使用潜在类别回归探讨自评健康状况作为类别归属的预测因素，同时对基线慢性病、医疗保健就诊频率、性别和年龄进行了调整。基线时的平均年龄为16岁，50%的参与者为女性。报告自评健康状况为“良好”的占28%，“中等”的占61%，“差”的占11%。我们确定了五组患者分类（）：“良好健康组”（35%）、“中等健康组”（26%）、“轻度疾病组”（21%）、“中度疾病组”（6%）和“重度疾病组”（13%）。我们发现自评健康状况越好，属于“良好健康组”的概率逐渐增加，而对于“重度疾病组”和“中度疾病组”则呈现相反的模式。在对基线变量进行调整后，这种模式仍然存在。总之，青少年自评健康状况与成年早期患多种疾病的风险之间存在明显关联，这可被视为后期多种疾病并存的一个代表。这一发现值得更加关注青少年的自评健康状况，将其作为针对性预防未来健康问题的一个可能指标。
