Information on Measles, Mumps and Rubella Vaccine in the Copenhagen School Health Records Register.

BACKGROUND: The Copenhagen School Health Record Register (CSHRR) includes health information from school examinations and is now updated with information on measles, mumps and rubella vaccines for the cohorts born from 1977 to 1994. AIM: The aim of this study is to provide a comprehensive description and validation the newly digitised vaccine information in the CSHRR. METHODS: We describe the data collection and the newly digitalised information in the CSHRR. We investigate the extent to which the full CSHRR population is representative of Copenhagen and the entire Danish population. Furthermore, we explore how the registry information on vaccination uptake based on reimbursement data matches the vaccine information obtained from CSHRR for the period during which both data are available. RESULTS: The CSHRR population matches closely the complete population of all schoolchildren in Copenhagen, and information on vaccine uptake in CSHRR matches with vaccine registry data for later cohorts. However, a sizable proportion of the immigrant children in the CSHRR have missing information on vaccination. Removing children who have had no additional immunisations enhances data quality. CONCLUSIONS: The CSHRR covers a large share of the Danish population and includes detailed vaccine information. By linking the data to other registry data, the updated CSHRR is valuable resource for future research.

The impact of excess body weight on employment outcomes: A systematic review of the evidence.

BACKGROUND: Excess body weight has been recognised as an important factor in influencing labour market outcomes. Several hypotheses explain the causal effect of excess body weight on employment outcomes, including productivity, labour supply, and discrimination. In this review, we provide a systematic synthesis of the evidence on the causal impact of excess body weight on labour market outcomes worldwide. METHODS: We searched Econ Lit, and Web of Science databases for relevant studies published from 1st Jan 2010-20 th Jan 2023. Studies were included if they were either longitudinal analysis, pooled cross-sectional or cross-sectional studies if they used instrumental variable methodology based on Mendelian Randomisation. Only studies with measures of body weight and employment outcomes were included. RESULTS: The number of potentially relevant studies constituted 4321 hits. A total of 59 studies met the inclusion criteria and were qualitatively reviewed by the authors. Most of the included studies were conducted in the USA (N=18), followed by the UK (N=9), Germany (N=6), Finland (N=4), and non-EU countries (N=22). Evidence from the included studies suggests that the effect of excess weight differs by gender, ethnicity, country, and time period. White women with excess weight in the USA, the UK, Germany, Canada, and in the EU (multi-country analyses) are less likely to be employed, and when employed they face lower wages compared to normal weight counterparts. For men there is no effect of excess weight on employment outcomes or the magnitude of the effect is much smaller or even positive in some cases. CONCLUSIONS: This review has shown that despite ample research on the relationship between excess weight and employment status and wages, robust causal evidence of the effects of excess weight on employment outcomes remains scarce and relies significantly on strong statistical and theoretical assumptions. Further research into these relationships outside of USA and Western Europe context is needed.

Ethnic networks in neighborhoods affect mental health: Evidence from a quasi-random assignment of applicants in the public social housing system.

This paper examines the impact of residence-based ethnic networks on mental health; such networks are defined as the concentration of residents from the same country of origin in a neighborhood. To estimate the effect, we utilize administrative registry data, together with data on quasi-random assignment of apartments to non-Western households with housing needs to various neighborhoods. After controlling for individual characteristics, time-invariant neighborhood characteristics, and general practitioners (GP) fixed effects, we find that a 1-percentage-point increase in the concentration of residence-based co-ethnics (RBCEs) increases the probability of being treated with psychiatric medications by 0.7-percentage point over a 5-year period after the assignment. With 19% of the population being treated with psychiatric medications the year before assignment, the result translates into an effect size of 3.7%. The results indicate that relatively high concentrations of co-ethnics treated with psychiatric medications increase the probability of being treated with psychiatric medications. The positive impact on treatment with psychiatric medication reflects an increase in the demand for these drugs when moving into a neighborhood with neighbors of the same ethnicity. If new residents are in good mental health condition when moving, these results suggest that moving into a neighborhood with a high co-ethic concentration worsens mental health status. However, as the population in this study is a vulnerable group an increase in treatment with psychiatric medications likely reflects that untreated mental health problems are treated, and the mental health status improved. The group of non-Western immigrants in this study differs significantly from the population in general, thus, results may not be generalized to all non-Western immigrants.

Patient and peer: Guideline design and expert response.

We examine how patients' medical expertise influences adherence to clinical guidelines for a treatment that is common, costly, and rationed by the clinical guidelines. Using administrative data on prenatal diagnostic testing (PDT), we compare the testing rates of medically trained patients (experts) and non-medically trained patients (non-experts) on the margin of eligibility thresholds in clinical guidelines. We find that experts are 9 percentage points more likely to receive PDT than non-experts when they are not eligible for testing and that more than 80% of the difference can be attributed to medical expertise. Our results suggest that the design of clinical guidelines is important for adherence and that having medical expertise as a patient affects treatment, when there is room for a deviation from the guideline.

Enlightenment and measurement - a way to improve health among high school students.

This paper examines the effect of participating in a web-based health programme that promotes personal tracking of high school students' own measurements of a number of health-related parameters. Danish cross-sectional survey data were used to examine the effects of the health programme on various health measures. Both quantile regression models and standard ordinary least squares (OLS) models were used to explore the correlations between the students' participation in the health programme and their body mass index (BMI), body fat percentage, aerobic fitness, and well-being. Participation in the health programme increased BMI and aerobic fitness among students with a BMI or an aerobic fitness value ranging from the 25th percentile to the 75th percentile and reduced body fat percentage among students with the highest percentages of body fat. In addition, the health programme led to an increased feeling of wellbeing among students, especially those with high BMI levels and poor aerobic fitness. As the schools participated in the health programme on voluntary basis and at a financial cost to themselves, the positive effects of participation found can only be stated to be valid among students from committed schools.

Overweight and obesity and the utilization of primary care physicians.

We investigate whether overweight or obese individuals utilize more medical care than normal weight individuals by estimating a finite mixture model which splits the population into frequent and non-frequent users of primary care physician (GP) services. Based on a survey sample aged 25-60 years from the National Health Interview (NHI) 2000 merged to Danish register data, we compare differences in the impact of being overweight and obese relative to being normal weight on the utilization of GP services. Estimated bodyweight effects vary across latent classes and show that being obese or overweight does not increase the utilization of GP services among infrequent users but does so among frequent users. Obese (and to a lesser extent, overweight) infrequent users are observed 5 years later to substantially increase their health-care usage as measured by doctor visits, hospitalizations, and number of bed days.

Obesity and labor market outcomes in Denmark.

This paper analyzes the relationship between body mass index (BMI) and employment status and wages. The analysis uses a unique data set from a Danish panel survey from 1995 and 2000, combined with administrative registers, covering 8000 individuals. Results show a negative effect of BMI on employment for women and an inverted u-shaped effect for men. Results further indicate that in the private sector BMI has a negative effect on wages for women but an inverted u-shaped effect on wages for men, whereas results from the public sector show that BMI has no influence on wages for either men or women.

Evaluating the impact of contracting out basic health care services in the state of São Paulo, Brazil.

As a means of dealing with shortcomings in the coverage, quality and efficiency of the public health care sector, several municipalities in the state of São Paulo, Brazil, have started to contract pre-certified non-profit or non-governmental organizations to take part in the delivery of health care services.This paper explores the impact of introducing these contracts in the primary health care sector. Using data on the 645 municipalities in the state of São Paulo and difference-in-differences methods, we estimate the effect of contracting out in the primary health care sector on various dimensions of mortality and health care use. The results show that implementation of the contracting out strategy significantly increases the number of primary health care appointments by approximately one appointment per user of the national health care system per year. Point estimates indicate a reducing effect on hospitalization for preventable diseases.

Labor market effects of intrauterine exposure to nutritional deficiency: Evidence from administrative data on Muslim immigrants in Denmark.

This paper examines whether nutritional disruptions experienced during the stage of fetal development impair an individual's labor market productivity later in life. We consider intrauterine exposure to the month of Ramadan as a natural experiment that might cause shocks to the inflow of nutrients essential for fetal development. Specifically, we use administrative data from Denmark to investigate the impact of exposure to Ramadan in utero on labor market outcomes of adult Muslim males, including employment status, annual salary, hourly wage rate, and hours of work. Our findings indicate that potential exposure to nutritional disruptions during a critical stage of fetal development is likely to have scarring effects on the fetus expressed as poor labor market outcomes later in life. Specifically, exposure to Ramadan around the 7th month of gestation results in a lower likelihood of employment and, to a lesser extent, a lower salary, and reduced labor supply. For example, the 7th month intrauterine exposure to Ramadan is associated with a 2.6 percentage points reduction in the likelihood of employment among Muslim males. We do not find an impact on the wage rate. Finally, we also document suggestive evidence that these results may partially be driven by increased disability and to a lesser extent by poor educational attainment among those who were exposed to Ramadan during this particular period in utero.

Evaluating the impact of a school-based health intervention using a randomized field experiment.

We conduct an econometric evaluation of a health-promoting programme in primary and lower secondary schools in Denmark. The programme includes health-related measurements of the students, communication of knowledge about health, and support of health-promoting projects for students. Half of the schools in the fourth largest municipality in Denmark were randomly selected into a treatment group implementing the programme, while the remainder served as a control group. We estimate both OLS models using only post-intervention observations and difference in differences (DID) models using also pre-intervention observations. We estimate effects of the initiative on BMI, waist/height ratio, overweight and obesity for the entire sample and by gender and grade. We find no consistent effect of the programme. When we use the entire sample, no estimates are statistically significant at conventional levels, although the point estimates for the effect on BMI, indicating an average reduction in the range of 0.10-0.15 kg/m(2), are consistent with the results in a recent Cochrane review evaluating 55 studies of diet and exercise interventions targeting children; and DID estimates which are marginally significant (at the 10% level) indicate that the intervention reduces the risk of obesity by 1% point. Running separate estimations by gender and grade we find a few statistically significant estimates: OLS estimates indicate that the intervention reduces BMI in females in grade 5 by 0.39 kg/m(2) and reduces the risk of obesity in females in grade 9 by 2.6% points; DID estimates indicate an increase in waist for females in preschool class by 1.2 cm and an increase in the risk of obesity in grade 9 males by 4% points. However, if we corrected for multiple hypotheses testing these estimates would be insignificant. There is no statistically significant correlation between participation in the programme and the number of other health-promoting projects at the schools.

Useful beautiful minds-an analysis of the relationship between schizophrenia and employment.

This paper examines the relationship between schizophrenia and employment. We use longitudinal register data and show a considerable drop in the employment rate for people with schizophrenia six years before the first treatment at a psychiatric facility. After the first treatment, the employment rate stabilizes at 18%. The difference in the employment rate in 2007 for siblings with and without schizophrenia is estimated at 67%. This difference is reduced to 62% when we include additional control variables. The results remain unchanged when we apply a sibling fixed effects approach that controls for the unobserved family specific characteristics that the siblings share.