- How are the health services functioning?
- Are there inequalities in health from one local district to another?
- Are women healthier than men?
- Can the increasing prevalence of diseases such as osteoporosis (bone fragility) and diabetes be explained?
- What are some of the reasons and risk factors for the changing trends and patterns of chronic diseases?
These are some of the many unanswered questions about the health status and conditions of residents in the Capital city of Norway.
Why conduct a health survey in Oslo?
As a general overview of health status and conditions of Oslo is lacking, the data generated from this health study was used to build a Health profile for Oslo – adolescents, adults and the elderly , in other words gain a comprehensive overview of the health status of Oslo residents. This profile was handed over to the municipality of Oslo in august 2002.
The information thus provided will also be a good basis for future health planning and service delivery in the Capital City. In addition, this data will be able to clarify, describe and explain the variations and differences in health.
Researchers will be able to gain new knowledge about health, disease and new trends through the data collected in the Oslo Health Study. Furthermore, the participants in the health survey have a unique opportunity to discover either the existence of certain diseases, or whether they are at risk of developing them in the future.
The Steering Group for the Oslo Health Study
While the National Health Screening Service - now Norwegian Institute of Public Health, takes the lead in the implementation of all aspects of the study, a Steering Group with two representatives from each of the three collaborating partners, make all the important decisions. The partners are: Oslo kommune (Municipality of Oslo), Universitetet i Oslo (University of Oslo) and Nasjonalt folkehelseinstitutt (Norwegian Institute of Public Health).
Who has been invited to participate in this study?
All men and women residing in Oslo Dec. 1999, from nine different age groups got an invitation. This included persons born in 1924, 1925, 1940, 1941, 1955, 1960, 1970, 1984 and 1985. It was noted that among the youngest cohorts a lower proportion were willing to participate, compared to the other age groups. Therefore, invitations were also sent to persons born in 1954 and 1969 (additional age groups). A total of 67 000 individuals including the youth cohorts and the two additional age groups, received an invitation.
Persons born in the above mentioned years got a personal invitation in the post. In other words, individuals could not apply to participate themselves. However, those 15-16 years old were invited through the schools.
How is the study being conducted?
For the youngest participants i.e. persons born in 1984 and 1985, the two appropriate questionnaires were filled out during school hours in the classroom. No physical examination was performed.
The remaining age groups were invited to participate in the study through a postal invitation including a standard main questionnaire. It was expected that they filled this out before attending the clinical examination. This examination was conducted at a central screening station in the city and included height, weight and waistline (girth) measurements in addition to blood pressure and pulse recordings. Blood samples were also collected and analysed for lipids, blood sugar, hormones, liver and kidney functions. Some of the participants had their bone density measured.
Protection of privacy confidentiality
All information from the health study is confidential and guidelines from the Data Inspectorate have been strictly adhered to. All the staff and others closely associated with the study are bound to secrecy. When the data is made available for research purposes, all names, personal ID numbers or means of tracing back to the individual are erased from the files.
Participants of the Oslo Health Study signed a declaration of consent. This means that they have consented to subsequent tests and other kinds of follow-up measures, the use of data and blood samples for research purposes, and the possibility to link up to other registers in some cases (subject to approval from the Data Inspectorate).
The Oslo Health Study has been approved by the Data Inspectorate, and it has been presented to the Regional Committee for Medical Research Ethics.
The main investigative tool for the study is the different categories of questionnaires. There are 3 kinds of main questionnaires: one for those in the age group 15-16, another one for those in the 30, 40, 45, and 59/60 age group, and one for those aged 75/76 years. There are also supplementary questionnaires for each of the three categories and a second supplementary questionnaire for the adult categories. In other words the age group 15-16 receive two sets of questionnaires and those between 30-76 years receive three sets. The 15-16 year olds receive the two sets at school, the adults receive one set with the invitation letter and the rest when they came for the clinical examination.
The Oslo Health Study provided information in 11 languages: Albanian, Arabic, English, Farsi, Serbo-Croatian, Somalian, Spanish, Tamil, Turkish, Urdu and Vietnamese.
The invitation brochure, consent form, main questionnaire and one of the additional questionnaires were translated into these 11 languages. The other questionnaires were translated only into English, except the main questionnaire for those 75-76 years old.
Currently, about 90 subprojects are included in the Oslo Health Study. While some projects cover all the participants in the health survey, others cover only selected groups.
Some of the key areas covered by the supplementary projects are as follows:
- Chronic muscle and body complaints
- Working environment and health problems
- Domestic dogs and quality of life
- Social differences in diet and health
- Respiratory tract illnesses
- Dementia and senile disorders
- Osteoporosis (bone fragility)
- Risk for accidental injury among youth in Oslo
- Mental health among youth.
Researchers and experts from different institutions and organisations are responsible for the supplementary projects. The University of Oslo is actively engaged in many of these projects, and the Universities of Bergen and Trondheim are also engaged. In addition to the Universities, representatives from the National Institute of Occupational Health, Aker University Hospital, Ulleval University Hospital and Diakonhjemmet College, are among those which have their own projects.
Response to the participants
Four weeks after attending the clinical examination, participants received a letter with their test results, informing them of their cholesterol, blood pressure, blood sugar in comparison to the recommended levels. Those at high risk of developing heart disease, cardiovascular disease or diabetes, were referred to Centre for Preventive Medicine, Ullevål University Hospital for further examinations and follow up.
When the Oslo Health Study was completed, we compiled a report with aggregated results for the entire city and its various districts. The public, district councils and politicians were then informed about the health situation in Oslo. Those responsible for the supplementary projects will present their findings subsequently.