WP 3 Conception-Next Generation and into Old Age-social and behavioral pathways

Work package leaders:

Professor Torkjel M Sandanger
Professor Sameline Grimsgaard

Main objective:

To provide novel insights on the complex interrelationship between the social and behavioral pathways that shape health over the life course, identify key modifiable risk factors at transition phases and across social gradients, and identify vulnerable groups for selected interventions.

Tasks

Title	Description	Pl	Participants	Collaborators	Status

Identify the best markers of inequality in health and healthy aging	We will describe and compare different measures of inequalities in SES (education, income, occupation) in the different cohorts and time periods, and link these factors with health outcomes (cancer, CVD, metabolic syndrome, self-reported health, mental health) and healthy aging.	Jan Abel Olsen	Marie Hella Lindberg (PhD-student),
Assess the relationship between key modifiable lifestyle factors over the social gradient and their impact on health and disease during transition phases	The contribution of selected modifiable risk factors (diet, physical activity, obesity, alcohol, and smoking) to inequality in health outcomes will be calculated using Comparative Risk Assessment methods and risk prediction models that are tailored to the target population.	Tonje Braaten
Examine factors affecting self-reported health and different health trajectories	We will investigate the relationship between physical activity, diet, anthropometry, self-reported health (SRH,) health outcomes and survival. Analyses include the Tromsø, NOWAC, and SAMINOR studies, who contribute cohorts with repeated measurements. Latent trajectory models will be used to assess SRH changes over time, and to identify subgroups with different trajectories.	Geir F Lorem	Ida Killie (Ph.D. student), Eva T.Næss (clinical psychologist and ph.d. student), Ida Opdahl (reseacher), Kristin B. Borch (associate professor), Tonje Braathen (professr)	Kristin B. Borch (associate professor), Tonje Braathen (professor)	The project investigating self -rated health among cancer-survivors in the NOWAC study is ongoing, a project on self rated healtn and post traumatic stress disorder among heart-disease pateinent is being initiated with funding from Regional Health Authoriries. A project on mental health among cancer survivores is in the planning.
Identify resilient and vulnerable individuals and develop targeted interventions	We will Identify, describe and explore resilient and vulnerable individuals and groups within the NOWAC, SAMINOR and Tromsø study cohorts, and expand this knowledge to develop targeted interventions. A piloted intervention to improve lifestyle and physical function in elderly individuals with a low SES and a high disease risk will be further developed and tested, and we will include social networks and NGO’s in the follow-up to improve sustainability of potential effects.	Sameline Grimsgaard, Ann-Ragnhild Broderstad	Trygve S. Deraas (researcher), Jonas Johansson (postdoc), Laila Arnesdatter Hopstock (researcher), Torbjørn Wisløff (professor)	Tromsø municipality, The National Heart and Lung Association, The Norwegian Trekking Association, University Hospital of North Norway, University of Umeå, Vestfold Hospital Trust, The Norwegian University of Science and Technology	In in February 2021 we apply Research Council Norway for funding to test the intervention comprising exercise, dietary advice, behavioral strategies and physical activity monitoring in a randomized controlled trial: The RESTART-study, scheduled for 2022.
Assess the association between modifiable risk factors and “omic” markers	In this task the association between modifiable risk factors and the transcriptome and the epigenome will be investigated using existing omics data in the NOWAC cohort. We will further explore how parental and individual lifestyle can possibly impact on alterations of the transcriptome and the epigenome, including the epigenetic clock. The possible impacts of social inequalities and social relations on epigenetic alterations in blood will be examined in the Tromsø and SAMINOR studies.	Torkjel Sandanger
Examine the relationship between SES, anthropometry and epigenetic factors	A critical appraisal of the validity of traditional SES indicators (income and education length) and their temporal relationship to epigenetic markers and anthropomtry (height, weight, waist circumference) will be explored in data derived from regional (Finnmark, Tromsø SAMINOR) and national (NOWAC) cohorts.	Inger Njølstad
Fill the knowledge gap on youth health in Finnmark County	In this collaborative project, we will conduct a population-based study based on co-created public and professional identification and priorities for knowledge needs in former Finnmark county. The study will reveal challenges a) in an age group sparsely investigated, b) in a region characterised by cultural, social and ethnical variation and c) in communities with an increased burden of disease. Furthermore, the study will be rigged for follow-up every 3 to 5 years, making it possible to explore early predictors for disease development and health status. An expansion in collaboration with SAMINOR will aim to continue data acquisition, including the rest of Troms and Finnmark county together with Nordland county.	Ane Kokkvoll, Tore Christoffersen	Eirik Lind Irgens, Mette Kjær, Gunnhild Berglen	Finnmark Hospital Trust, Troms and Finnmark County Municipality, The County Governor
Study CVD risk and cognitive function by SES and local environment	In a joint project using Australian and Tromsø Study data, we will study the interactive effects of physical activity, diet, smoking, alcohol consumption and sleep quality on cognitive function, CVD risk factors and disease, and whether these effects vary across SES. We will explore adding environmental data (physical and social characteristics of geographical areas) to the Tromsø Study to investigate the effects of direct, or lifestyle behaviour-mediated environmental exposures on CVD and cognitive health.	Maja-Lisa Løchen	Sweta Tiwari (postdoc) , Ester Cerin (professor), Ola Løvsletten (researcher), Tom Wilsgaard (professor), Katrine Kristoffersen (MD), Inger Njølstad (professor), Sameline Grimsgaard (professor), Laila Hopstock, Henrik Schirmer (professor), Annika Rosengren (professor)		Report with cross sectional data from the Tromsø Study published.First scientific paper in preparation based on Tromsø Study data
Ongoing and partly funded projescts included in WP3
Tracing causes of inequalities in health and well-being: Analysis of rich longitudinal data	Objective and subjective measures of health in the Tromsø Study, including sudden health events, allow us to study how “health shocks” may lead to changes in health-related behaviors and job market participation. By linking data on health and well-being with information on early life events, health-related behavior, socio-economic characteristics, and social support, we will explore how individuals' early life circumstances and life course impact on their ability to cope with adverse health events. How people can partake through own efforts to improve their health, is of central importance for healthcare planners worldwide.	Jan Abel Olsen	Førsteaman Birgit Abelsen ISM (20%), Prof Gang Chen Monash University Australia (20%), Prof Dorte Gyrd-Hansen Syddandsk Universitet (20%), Prof Trine Kjær Syddandsk Universitet (10%), Dr Nils Gutacker, University of York, UK (15%). PhD studenter: Espen Berthung (NFR), Marie Lindberg (UiT), Ana Sanchez (UiT), Maiken Aaskoven (SDU) (europeiske SHARE-data) (NFR)
Sociocultural and structural factors determining health, illness and survival in Finnmark	We will combine qualitative and quantitative research methods in two sub-studies to:I) Study determinants and variation of survival over 30 years, linking population-based survey data from Finnmark III in 1987-88 with the Norwegian Cause of death Registry. We will explore how geographic, socioeconomic and cultural inequalities influence long-term survival, and employ a theoretical model comprising social and structural aspects, health perceptions, reported disease and illness experience with CVD-risk and behaviors u as health risks. II) Investigate how social, structural and cultural factors influence people’s perception of their health and well-being. We will use in-depth interviews of young and older adults in different (coastal, urban, Sami) municipalities in Finnmark, and focus on how informants perceive and experience their own health, and describe how it relates to their life situation, lifestyle and living conditions.	Jorid Anderssen	Monika Dybdahl Jakobsen (postdoc)