Health asset profiles and health indicators among 13- and 15-year-old adolescents

Objectives: We examined the associations between adolescents’ health assets and various health indicators (smoking, alcohol use, sleep length, physical activity, healthy eating, oral health, self-reported health, multiple health complaints). Methods: A nationally representative sample was drawn from Finnish-speaking schools, comprising 13- and 15-year-old adolescents (n = 3833). The measures taken covered the adolescents’ health assets, which were labelled Family-financial, Psychological, Family-social, Friends-social, School-social, and Human. Our analysis applied two-step cluster analysis and multilevel mixed-effects binary logistic regression. Results: Six asset profiles were identified: ‘Limited in most assets, despite medium affluence’, ‘Mostly average assets, but low affluence’, ‘Mostly average assets, though high affluence’, ‘Mostly above average assets’, ‘Rich in most assets’, and ‘Rich in all assets’. There were significant differences between the profiles in terms of risk level and desirable level health outcomes. Conclusions: Adolescents differ in their asset profiles. Having multiple health assets appears to protect adolescents from risky behaviour or poor health, and to promote positive health. There is a need for health initiatives to develop a range of health-protecting and health-promoting assets, rather than focus on only one.peerReviewe

Comparison of trends in ischaemic heart disease between North Karelia, Finland, and Kaunas, Lithuania, from 1971 to 1987

OBJECTIVE--To compare the long-term trends in mortality and attack rate of ischaemic heart disease in North Karelia, Finland, and in Kaunas, Lithuania, from 1971 to 1987. DESIGN--Data on routine mortality statistics were obtained from the Central Statistical Office of Finland and from the Central City Archives of Kaunas. In addition, data from the community based myocardial infarction registers were used. The registers used similar diagnostic criteria and had operated in both areas during the entire study period. SETTING--The province of North Karelia in Finland and the city of Kaunas in Lithuania. SUBJECTS--The target populations were the people of North Karelia and Kaunas aged 35-64 years. MAIN OUTCOME MEASURES--Mortality from ischaemic heart disease and the attack rate of acute myocardial infarction. RESULTS--In North Karelia mortality from ischaemic heart disease and the attack rate of acute myocardial infarction declined steeply both in men and women. This decline was accompanied by a decrease in total mortality. In Kaunas, both mortality and the attack rate increased in men but remained unchanged in women. In 1985 to 1987, age standardised total mortality per 100,000 inhabitants was similar in the two populations in men (1081 (95% confidence interval (CI) 1013 to 1149), in North Karelia; 1082 (95% CI 1032 to 1132), in Kaunas). The proportional mortality from ischaemic heart disease was considerably higher in North Karelia (40%) than in Kaunas (28%). In women, age standardised total mortality was lower in North Karelia (350 (95% CI 312-388)) than in Kaunas (440 (95% CI 413 to 467)). The proportional mortality from ischaemic heart disease in women was also higher in North Karelia (28%) than in Kaunas (13%). CONCLUSIONS--Despite the remarkable decline in the occurrence of ischaemic heart disease, it still remains the most important cause of premature mortality in North Karelia. In Kaunas ischaemic heart disease mortality and attack rate increased in mKauno medicinos universiteto Kardiologijos institutasKauno medicinos universiteto Kardiologijos institutas, [email protected] medicinos universiteto Kardiologijos institutas, [email protected]