What is wrong with non-respondents? Alcohol-, drug- and smoking related mortality and morbidity in a 12-year follow up study of respondents and non-respondents in the Danish Health and Morbidity Survey

Aim: Response rates in health surveys have diminished over the last two decades, making it difficult to obtain reliable information on health and health-related risk factors in different population groups. This study compared cause-specific mortality and morbidity among survey respondents and different types of non-respondents to estimate alcohol-, drug- and smoking related mortality and morbidity among non-respondents. Design: Prospective follow-up study of respondents and non-respondents in two cross-sectional health surveys. Setting: Denmark. Participants: A total sample of 39,540 Danish citizens aged 16 or older. Measurements: Register-based information on cause-specific mortality and morbidity at the individual level was obtained for respondents (n=28,072) and different types of non-respondents (refusals n=8,954; illness/disabled n=731, uncontactable n=1,593). Cox proportional hazards models were used to examine differences in alcohol-, drug- and smoking-related mortality and morbidity, respectively, in a 12 year follow-up period. Findings: Overall, non-response was associated with a significantly increased hazard ratio of 1.56 (95% CI: 1.36–1.78) for alcohol-related morbidity, 1.88 (95% CI: 1.38-2.57) for alcohol-related mortality, 1.55 (95% CI: 1.27–1.88) for drug-related morbidity, 3.04 (95% CI: 1.57–5.89) for drug-related mortality and 1.15 (95% CI: 1.03–1.29) for smoking-related morbidity. The hazard ratio for smoking-related mortality also tended to be higher among non-respondents compared with respondents although no significant association was evident (HR: 1.14; 95% CI: 0.95-1.36). Uncontactable and ill/disabled non-respondents generally had a higher hazard ratio of alcohol-, drug- and smoking related mortality and morbidity compared with refusal non-respondents. Conclusion: Health survey non-respondents in Denmark have an increased hazard ratio of alcohol-, drug-, and smoking-related mortality and morbidity compared with respondents, which may indicate more unfavourable health behaviours among non-respondents

Brugen af alternativ behandling i Danmark. Resultater fra den nationalt repræsentative Sundheds- og sygelighedsundersøgelse 2005

Formålet med denne artikel er at belyse udbredelsen af og udviklingen i brugen af alternativ behandling i Danmark. Data stammer fra den nationalt repræsentative Sundheds- og sygelighedsundersøgelse 2005. Den samlede stikprøve omfattede 21.832 danske statsborgere på 16 år eller derover. Der blev i alt opnået interview med 14.566 personer (66,7 %). Resultaterne viser, at andelen, der har brugt alternativ behandling inden for det seneste år, er steget fra 10,0 % i 1987 til 22,5 % i 2005, og at  massage, osteopati og andre manipulative terapier, zoneterapi og akupunktur er de tre mest brugte alternative behandlingsformer i den danske befolkning. Forbruget af alternativ behandling har været stigende igennem de seneste decennier men med svage tegn på stagnation inden for de seneste år

Brugen af alternativ behandling i Danmark. Resultater fra den nationalt repræsentative Sundheds- og sygelighedsundersøgelse 2005

Formålet med denne artikel er at belyse udbredelsen af og udviklingen i brugen af alternativ behandling i Danmark. Data stammer fra den nationalt repræsentative Sundheds- og sygelighedsundersøgelse 2005. Den samlede stikprøve omfattede 21.832 danske statsborgere på 16 år eller derover. Der blev i alt opnået interview med 14.566 personer (66,7 %). Resultaterne viser, at andelen, der har brugt alternativ behandling inden for det seneste år, er steget fra 10,0 % i 1987 til 22,5 % i 2005, og at  massage, osteopati og andre manipulative terapier, zoneterapi og akupunktur er de tre mest brugte alternative behandlingsformer i den danske befolkning. Forbruget af alternativ behandling har været stigende igennem de seneste decennier men med svage tegn på stagnation inden for de seneste år

Cost-effectiveness of changes in alcohol taxation in Denmark:a modelling study

INTRODUCTION: Excessive alcohol consumption is a public health problem in many countries including Denmark, where 6% of the burden of disease is due to alcohol consumption, according to the new estimates from the Global Burden of Disease 2010 study. Pricing policies, including tax increases, have been shown to effectively decrease the level of alcohol consumption. METHODS: We analysed the cost-effectiveness of three different scenarios of changed taxation of alcoholic beverages in Denmark (20% and 100% increase and 10% decrease). The lifetime health effects are estimated as the difference in disability-adjusted life years between a Danish population that continues to drink alcohol at current rates and an identical population that changes their alcohol consumption due to changes in taxation. Calculation of cost offsets related to treatment of alcohol-related diseases and injuries, was based on health care system costs from Danish national registers. Cost-effectiveness was evaluated by calculating cost-effectiveness ratios (CERs) compared to current practice. RESULTS: The two scenarios of 20% and 100% increased taxation could avert 20,000 DALY and 95,500 DALY respectively, and yield cost savings of -€119 million and -€575 million, over the life time of the Danish population. Both scenarios are thus cost saving. The tax decrease scenario would lead to 10,100 added DALY and an added cost of €60 million. For all three interventions the health effects build up and reach their maximum around 15–20 years after implementation of the tax change. CONCLUSION: Our results show that decreased taxation will lead to an increased burden of disease and related increases in health care costs, whereas both a doubling of the current level of alcohol taxation and a scenario where taxation is only increased by 20% can be cost-saving ways to reduce alcohol related morbidity and mortality. Our results support the growing evidence that population strategies are cost-effective and should be considered for policy making and prevention of alcohol abuse