Vegard Skirbekk

The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013

Background The Global Burden of Diseases (GBD), Injuries, and Risk Factors study used the disability-adjusted life year (DALY) to quantify the burden of diseases, injuries, and risk factors. This paper provides an overview of injury estimates from the 2013 update of GBD, with detailed information on incidence, mortality, DALYs and rates of change from 1990 to 2013 for 26 causes of injury, globally, by region and by country. Methods Injury mortality was estimated using the extensive GBD mortality database, corrections for ill-defined cause of death and the cause of death ensemble modelling tool. Morbidity estimation was based on inpatient and outpatient data sets, 26 cause-of-injury and 47 nature-of-injury categories, and seven follow-up studies with patient-reported long-term outcome measures. Results In 2013, 973 million (uncertainty interval (UI) 942 to 993) people sustained injuries that warranted some type of healthcare and 4.8 million (UI 4.5 to 5.1) people died from injuries. Between 1990 and 2013 the global age-standardised injury DALY rate decreased by 31% (UI 26% to 35%). The rate of decline in DALY rates was significant for 22 cause-of-injury categories, including all the major injuries. Conclusions Injuries continue to be an important cause of morbidity and mortality in the developed and developing world. The decline in rates for almost all injuries is so prominent that it warrants a general statement that the world is becoming a safer place to live in. However, the patterns vary widely by cause, age, sex, region and time and there are still large improvements that need to be made.

Birth Month, School Graduation, and the Timing of Births and Marriages

We investigated the timing of fertility and marriage in Sweden using exogenous variation in the age at school graduation that results from differences in birth month. Our analysis found that the difference of 11 months in the age at leaving school between women who were born in two consecutive months, December and January, implies a delay in the age at first birth of 4.9 months. This effect of delayed graduation also persists for the timing of second births and first marriages, but it does not affect completed fertility or the overall probability of marriage before age 45. These results suggest the existence of a relatively rigid sequencing of demographic events in early adulthood, and the age at graduation from school emerges as an important factor in determining the timing—but not the quantum—of family formation. In addition, these effects point to a potentially important influence of social age, defined by an individual’s school cohort, instead of biological age. The relevance of social age is likely due to social interactions and peer-group influences exerted by individuals who are in the same school cohort but are not necessarily of the same age.

Does education improve cognitive performance four decades after school completion

We study the effect of secondary education on cognitive performance toward the end of working age. We exploit the exogenous variation in years of schooling arising from compulsory schooling reforms implemented in six European countries during the 1950s and 1960s. Using data of individuals, approximately age 60, from the Survey of Health, Ageing and Retirement in Europe (SHARE), we assess the causal effect of education on memory, fluency, numeracy, and orientation-to-date. Furthermore, we study education effects on cognitive decline. We find a positive impact of schooling on memory scores. One year of education increases the memory score approximately four decades later by about 0.2, which amounts to 10 % of a standard deviation. Furthermore, we find some evidence for a protective effect of schooling on cognitive decline in terms of verbal fluency.

The changing face of cognitive gender differences in Europe

Significance Results showing that gender differences in mathematics and science are smaller in countries with higher gender equality have led researchers to conclude that cognitive gender differences are decreasing as a function of increased gender equality. Instead, we find that improved living conditions and less gender-restricted educational opportunities are associated with increased gender differences favoring women in some cognitive functions and decreases or elimination of gender differences in other cognitive abilities. Our results suggest that these changes take place as a result of women gaining more than men from societal improvements over time, thereby increasing their general cognitive ability more than men. Cognitive gender differences and the reasons for their origins have fascinated researchers for decades. Using nationally representative data to investigate gender differences in cognitive performance in middle-aged and older populations across Europe, we show that the magnitude of these differences varies systematically across cognitive tasks, birth cohorts, and regions, but also that the living conditions and educational opportunities individuals are exposed to during their formative years are related to their later cognitive performance. Specifically, we demonstrate that improved living conditions and less gender-restricted educational opportunities are associated with increased gender differences favoring women in some cognitive functions (i.e., episodic memory) and decreases (i.e., numeracy) or elimination of differences in other cognitive abilities (i.e., category fluency). Our results suggest that these changes take place due to a general increase in women’s cognitive performance over time, associated with societal improvements in living conditions and educational opportunities.

Social involvement, behavioural risks and cognitive functioning among older people

ABSTRACT This study analyses the relationships between cognitive performance, social participation and behavioural risks, taking into account age and educational attainment. We examine individual data for 11 European countries and Israel from the first wave of the Survey on Health, Ageing and Retirement in Europe (SHARE). The stochastic frontier approach methodology enables us to identify different sources of plasticity on cognitive functioning while taking into account age-related decline in cognitive performance. Several social participation variables were examined: employment status, attending educational courses, doing voluntary or charity work, providing help to family, friends or neighbours, participating in sports, social or other clubs, in a religious organisation and in a political or community organisation, and we controlled for age, education, income, physical activity, body-mass index, smoking and drinking. In the pooled sample, the results clearly show that all kinds of social involvement enhance cognitive functions, in particular in work. Moreover, behavioural risks such as physical inactivity, obesity, smoking or drinking were clearly detrimental to cognitive performance. Models for men and women were run separately. For both genders, all social involvement indicators associated with better cognitive performance. The results varied by countries, however, particularly the signs of the associations with a number of indicators of social involvement and behavioural risks.

Personality Traits Increasingly Important for Male Fertility: Evidence from Norway

We study the relationship between personality traits and fertility using a survey of Norwegian men and women born from 1927 to 1968 (N = 7017 individuals). We found that personality relates to mens and womens fertility differently; conscientiousness decreases female fertility, openness decreases male fertility and extraversion raises the fertility of both sexes. Neuroticism depresses fertility for men, but only for those born after 1956. The lower male fertility in younger cohorts high in neuroticism cannot be explained by partnership status, income or education. The proportion of childless men (at age 40 years) has increased rapidly for Norwegian male cohorts from 1940 to 1970 (from about 15 to 25 per cent). For women, it has only increased marginally (from 10 to 13 per cent). Our findings suggest that this could be partly explained by the increasing importance of personality characteristics for mens probability of becoming fathers. Men that have certain personality traits may increasingly be avoiding the long–term commitment of having children, or their female partners are shunning entering this type of commitment with them. Childbearing in contemporary richer countries may be less likely to be influenced by economic necessities and more by individual partner characteristics, such as personality. Copyright

Can personality predict retirement behaviour? A longitudinal analysis combining survey and register data from Norway

This study investigates how far personality can predict the timing and routes of people’s retirement. It uses a large comprehensive Norwegian survey, with larger sample size than earlier related studies, providing estimates of personality based on the five-factor model. The survey data are matched with administrative data, allowing observations of retirement over the 2002–2007 period. The analysis distinguishes between the disability and the non-disability retirements. Retirement is investigated using discrete time, competing risk, logistic regression models amongst individuals aged 50–69. Results indicate that personality predicts disability retirement but not non-disability retirement. Neuroticism increases the risk of disability retirement in women. Agreeableness and extraversion may prevent disability retirement, whereas openness may increase the risk of disability in men. Personality effects are generally consistent across models controlling, or not controlling, for well-known predictors of retirement behaviour including education, income and occupational group. The main exception is that poor health explains the effect of neuroticism on women’s disability retirement.

The association of grip strength from midlife onwards with all-cause and cause-specific mortality over 17 years of follow-up in the Tromsø Study

Background Grip strength has consistently been found to predict all-cause mortality rates. However, few studies have examined cause-specific mortality or tested age differences in these associations. Methods In 1994, grip strength was measured in the population-based Tromsø Study, covering the ages 50–80 years (N=6850). Grip strength was categorised into fifths, and as z-scores. In this cohort study, models with all-cause mortality and deaths from specific causes as the outcome were performed, stratified by sex and age using Cox regression, adjusting for lifestyle-related and health-related factors. Results During 17 years of follow-up, 2338 participants died. A 1 SD reduction in grip strength was associated with HR=1.17 (95% CI 1.12 to 1.22) for all-cause mortality in a model adjusted for age, gender and body size. This association was similar across all age groups, in men and women, and robust to adjustment for a range of lifestyle-related and health-related factors. Results for deaths due to cardiovascular disease (CVD), respiratory diseases and external causes resembled those for all-cause mortality, while for cancer, the association was much weaker and not significant after adjustment for lifestyle-related and health-related factors. Conclusions Weaker grip strength was associated with increased all-cause mortality rates, with similar effects on deaths due to CVD, respiratory disease and external causes, while a much weaker association was observed for cancer-related deaths. These associations were similar in both genders and across age groups, which supports the hypothesis that grip strength might be a biomarker of ageing over the lifespan.

Musculoskeletal disorders in Norway: prevalence of chronicity and use of primary and specialist health care services

BackgroundUncertainty exists with regards to the extent of prevalence and health care use for musculoskeletal disorders in Norway. The aim of this study was to estimate the prevalence of chronic musculoskeletal disorders and to estimate the prevalence of persons receiving primary and specialist health services for these disorders.MethodsWe used three data-sources. First, four discrete years of the nationally representative cross-sectional Survey of Health and Living Conditions (SHLC) conducted in 2002, 2005, 2008 and 2012 by Statistics Norway. Second, we used the Norwegian Patient Registry (NPR) to estimate the proportion of the population who used specialist health services in 2012. Third, we used the national register dataset for reimbursement of primary care physicians, chiropractors and physiotherapists (KUHR) to estimate the proportion of the population attending primary care physicians, chiropractors or physiotherapists in 2012. Age- and sex-specific prevalence/utilization estimates for musculoskeletal disorders were calculated.ResultsIn 2012, 18% of men and 27% of women reported musculoskeletal disorders lasting for six months or more in the SHLC. Primary health care services reimbursed for musculoskeletal disorders were used by 37% of women and 30% of men. Of these 32% (women) and 26% (men) were physician contacts and between 5 and 9% physiotherapist or chiropractor or combined contact types. Corresponding numbers for specialist services were 5% in men and 7% in women, where the majority was out-patient consultations. Low back and neck pain were the most common diagnoses both in the general population and as reason for health care utilization. We found that musculoskeletal disorders increased with age, however our results showed no variation in prevalence of chronic disorders between 2002 and 2012.ConclusionChronic musculoskeletal disorders were common in the general population, with higher prevalence among women compared to men, and increasing prevalence with age. Musculoskeletal disorders had considerable impact on the use of primary and specialist health services in Norway. The use of register data on health service utilization may be a useful source for monitoring population trends, and for estimating the burden in terms of health and health service use.

National Stereotypes of Older People’s Competence Are Related to Older Adults’ Participation in Paid and Volunteer Work

OBJECTIVES Why are older people perceived as more competent in some countries relative to others? In the current study, we investigate the extent to which national variation in perceptions of older peoples competence is systematically related to national variation in the extent to which older people participate in paid and volunteer work. METHOD We used multilevel regression to analyze data from the European Social Survey and test the relationship between perceptions of older peoples competence and older peoples participation in paid and volunteer work across 28 countries. We controlled for a number of potentially confounding variables, including life expectancy as well as the gender ratio and average education of the older population in each country. We controlled for the average objective cognitive abilities of the older population in a subsample of 11 countries. RESULTS Older people were perceived as more competent in countries in which more older people participated in paid or volunteer work, independent of life expectancy and the average education, gender makeup, and average cognitive abilities of the older population. DISCUSSION The results suggest that older peoples participation in paid and volunteer work is related to perceptions of older peoples competence independent of older peoples actual competence.