Insufficient sleep in the Danish adult population: A 10-year trend analysis Hannah Ahrensberg, Sofie Rossen Møller, Anne Illemann Christensen, Susan Andersen, Christina Bjørk Petersen Sleep Health, 2025 OBJECTIVES: To examine (1) trends in insufficient sleep among adults in Denmark from 2013 to 2023; (2) sociodemographic characteristics associated with insufficient sleep; and (3) self-reported reasons for insufficient sleep. METHODS: Data were derived from the nationally representative Danish Health and Morbidity Surveys conducted in 2013, 2017, 2021, and 2023. In each wave 25,000 individuals aged 16 years or older were invited to participate (response proportions: 40%-60%). Insufficient sleep was measured as never or almost never getting enough sleep to feel well-rested. RESULTS: The proportions reporting insufficient sleep increased from 10.3% in 2013 to 15.9% in 2023. Consistently, a higher proportion was observed among women, and among the younger age groups (age 16-44years). A clear social gradient was observed, with higher odds of insufficient sleep among those with <10years education (OR 2.13, 95% CI: 1.91; 2.37) compared to those with ≥15years of education. Self-reported reasons for insufficient sleep varied slightly across survey waves. In 2023, primary reasons included thoughts and worries related to family or personal matters (44.4%) and getting to bed too late due to entertainment from digital devices (35.5%). However, the specific reasons varied by sex and age groups. CONCLUSIONS: The proportion of adults reporting insufficient sleep has increased substantially over the past decade. Clear and consistent sex and age differences, as well as social inequalities in insufficient sleep in all waves indicate the need for targeted initiatives promoting sleep health.
Trends in the use of complementary and alternative medicine between 1987 and 2021 in Denmark Sofie Rossen Møller, Ola Ekholm, Anne Illemann Christensen BMC Complementary Medicine and Therapies, 2024 Background Complementary and alternative medicine (CAM) has been widely and increasingly used worldwide during the past decades. Nevertheless, studies in long-term trends of CAM use are limited. The aim of this study was to assess long-term trends in the prevalence of CAM use (both overall and for specific CAMs) between 1987 and 2021 in the adult Danish population and to examine certain sociodemographic characteristics of CAM users. Methods Data derived from nationally representative health surveys in the general adult population (≥ 16 years) in Denmark (the Danish Health and Morbidity Surveys) conducted in 1987, 1994, 2000, 2005, 2010, 2013, 2017, and 2021. The response proportion declined from 79.9% in 1987 to 45.4% in 2021. CAM use was assessed by questions on ever use of specific types of CAMs and overall use within the past 12 months. Differences in use of CAMs across educational levels were assessed using the Slope Index of Inequality (SII). Results An overall increase in the prevalence of CAM use within the past 12 months was found between 1987 (10.0%) and 2021 (24.0%). However, a stagnation was observed between 2010 and 2017, after which the prevalence decreased in 2021. In all survey waves, the prevalence was higher among women than men. For both sexes, the prevalence tended to be highest among respondents aged 25–44 years and 45–64 years. The group with 13–14 years of education had the highest prevalence of CAM use compared to the other educational groups (< 10 years, 10–12 years, and ≥ 15 years). SII values for both men and women increased between 1987 and 2021, which indicates an increase in differences of CAM use across educational groups. In all survey waves the most frequently used CAMs included massage and other manipulative therapies, acupuncture, and reflexology. Conclusions The use of CAM has increased markedly within the last decades and recently stagnated at high levels, which underlines the importance of securing high quality information and education for the public, health professionals, and legislators to ensure and promote safe use of CAMs.
Socioeconomic patterns in indoor environment in Denmark: cross-sectional studies from 2000 and 2021 S. Kloster, S.R. Møller, M. Davidsen, L. Gunnarsen, N.S. Nielsen, A.I. Christensen, A.K. Ersbøll Public Health, 2024 OBJECTIVES: To examine changes and socioeconomic patterns in indicators of a poor indoor environment in 2000 and 2021. STUDY DESIGN: Cross-sectional data from the Danish Health and Morbidity Survey in 2000 and 2021. METHODS: The study included 27,068 participants. Indicators of indoor environment (annoyances from mould, temperature, draught, traffic and neighbour noise, and presence of water damage) were obtained from questionnaires (2021) and partly by interview (2000). Socioeconomic status included home ownership, educational level, and household income. The degree of social inequality in the indoor environment was estimated using the concentration index of inequality. RESULTS: The prevalence of annoyances due to draught, temperature, and noise increased significantly from 2000 to 2021 (e.g., temperature 5.9%-25.1%, odds ratio (OR) 6.72, 95% confidence interval (CI) 6.12-7.38), whereas the prevalence of water damage decreased (17.7%-13.8%, OR 0.85, 95% CI 0.76-0.96). No difference was seen in annoyances due to mould (3.1% in 2000 and 2.5% in 2021, OR 0.90, 95% CI 0.69-1.17). Social inequality was present for thermal conditions, annoyances due to noise and presence of water damage when assessed by income but not by educational level. Conditions were more prevalent among individuals with low income in both 2000 and 2021. CONCLUSIONS: The proportion of individuals reporting a poor indoor environment due to thermal conditions and noise increased in the period 2000-2021. Social inequality was observed in all indicators of a poor indoor environment for household income, whereas the inequality was less pronounced when assessed by educational level.
The Danish National Health Survey 2023: study design and participant characteristics Andrea H. Jezek, Ola Ekholm, Michael Davidsen, Christina B. Petersen, Heidi Rosendahl, Sofie R. MØller, Martin EghØj, Lau C. Thygesen, Anne I. Christensen Scandinavian Journal of Public Health, 2024 Aim: To describe the design of the Danish National Health Survey (DNHS) 2023, participants’ demographic characteristics and differences in demographic and selected health-related characteristics between respondents invited by web-mode and paper-mode. Methods: A sample of 25,000 residents in Denmark aged 16 years or above was invited to participate in the DNHS 2023 using a mixed-mode approach (web/paper mode). Web-mode invited were additionally invited to participate in an accelerometer study. The self-administered questionnaire included 83 questions about health, health behaviour and morbidity. Descriptive statistics were used to describe characteristics associated with response and invitation mode. Results: The response proportion was 40.8%. Non-response was more frequent among men, individuals of the youngest age groups, individuals with non-Western backgrounds, unmarried and individuals from densely populated areas. The response proportion was higher among web-mode invited (42.0%) than paper-mode invited (22.6%). Paper-mode invited respondents were more often women, aged 80 years or older, and widowed compared with web-mode invited respondents. Conclusions: The DNHS 2023 is a national health survey including adult residents in Denmark. Non-response was more pronounced among some subgroups; however, calibrated weights were calculated to minimise non-response bias. The survey is essential for public health surveillance and can be used in health planning and policy development. Furthermore, the data from the survey can be used for research on the population’s health and health behaviour. For future waves of the DNHS, it should be considered whether resources should be used to invite people unsubscribed from digital-post due to the low response proportion.
Trends in social inequality in mortality in Denmark 1995-2019: the contribution of smoking- and alcohol-related deaths Heidi Amalie Rosendahl Jensen, Sofie Rossen Møller, Anne Illemann Christensen, Michael Davidsen, Knud Juel, Christina Bjørk Petersen Journal of Epidemiology and Community Health, 2023 BackgroundDuring the past decades, social inequality in mortality has increased in several countries, including Denmark. Modifiable risk factors, such as smoking and harmful alcohol consumption, have been suggested to moderate the association between socioeconomic position and health-related outcomes. The present study aims to investigate the contribution of smoking- and alcohol-related deaths to the trends in educational inequality in mortality in Denmark 1995–2019 among individuals aged 30–74 years.MethodsNationwide data on mortality and highest attained educational level divided into quartiles were derived from administrative registers. Alcohol-related mortality was directly estimated using information on alcohol-related deaths from death certificates. Smoking-related mortality was indirectly estimated using the Peto-Lopez method. The contribution of smoking- and alcohol-related deaths to the social inequality gap in mortality 1995–2019 was calculated.ResultsAlongside a decrease in all-cause mortality in Denmark 1995–2019, absolute differences in the mortality rate (per 100 000 person-year) between the lowest and the highest educational quartile increased from 494 to 607 among men and from 268 to 376 among women. Among both men and women, smoking- and alcohol-related deaths explained around 60% of the social inequality in mortality and around 50% of the increase in mortality inequality.ConclusionSmoking and harmful alcohol consumption continue to be important risk factors and causes of social inequality in mortality, with around half of the increase in Denmark 1995–2019 being attributable to smoking- and alcohol-related deaths. Future healthcare planning and policy development should aim at reducing social inequality in modifiable health risk behaviours and their negative consequences.
