Social inequalities in ageing. Copenhagen Life Course Epidemiology in Aging Research (CLEAR)
Our purpose is to study social inequalities in health and aging in a life course perspective, and to explore the pathways through and interactions with psychosocial, psychological and biological factors. We want to inform policy makers on intervention possibilities aiming at reducing social inequality in health among middle-aged and older adults.
To inform intervention strategies a better understanding of life course social determinants of aging as well as their interplay with psychological, behavioural and biological factors is of huge importance in today’s aging society. Knowledge about risk factors and development of interventions in the most vulnerable older citizens will add important new knowledge to this area.
It is increasingly recognized that the ageing process is shaped over the life course. Disadvantage in childhood, adolescence and early adulthood increases the risk of early onset of chronic disease, accelerated decline in physiological functions and loss of functional ability. Ageing can manifest as subclinical adverse levels of biological and physiological indicators, as well as onset of physical or cognitive decline or fatigue in daily activities.
We aim to investigate the influence of factors in childhood, adolescence, adulthood and cross generational (e.g. adverse socioeconomic position, social relations, psychosocial stressors and health problems) on ageing (e.g. levels of inflammatory markers, allostatic load, physical and cognitive function). Furthermore, we aim to investigate the association between midlife markers of aging on later life development of disability, disease and mortality. We additionally aim to map potential mediating pathways linking early life exposures with ageing outcomes.
Research is needed to understand the everyday life of old-age populations with or without disease or disability. Aging-related outcomes of interest include chronic conditions, physical and cognitive decline and disability, life expectancy with or without disability, and mortality.
Using cohort studies and registries, we investigate how socioeconomic and psychosocial factors (e.g. social relations, major life events, stress, work environment, lifestyle and retirement) affect health, function and longevity of older adults. We also study mechanisms through which these factors affect health.
In the CLEAR research group, we are leading a large research project with a focus including a natural experiment and the development of interventions among middle-aged and older people in a disadvantaged area. The project is collaborative across research groups at the Section of Social Medicine and the Department of Public Health (Section of Health Services Research).
“Health, Well-being and Social Relations in a Changing Neighbourhood: a longitudinal, multi-methods study of the consequences of large structural changes in a diverse social housing area” (In Danish: “Sundhed, Trivsel og Relationer i Taastrupgaard”, STRIT) is funded by the Nordea-fonden with 8.8 mio. DKK and initiated in January 2018. The aim of the study is to investigate changes in well-being, health and social relationships in a larger social housing community in Høje Taastrup municipality in the period 2018-2021. The community is undergoing large-scale (900 mill. DKK) changes over the coming years in both the build environment/housing, recreational areas, infrastructure and institutions.
A longitudinal design using a multi-methods approach will be used to analyse how large-scale structural changes (in combination with a social intervention) in a social housing area are experienced by the residents aged 45 + years (N~600), and how the changes are associated with health, well-being and social relations at the individual and aggregated level across time before, during and after the structural changes. Through register linkage, development in health related and social factors will be compared to a control area not undergoing structural changes (N~5,000). Qualitative interviews with residents representing the two largest ethnic groups together with a household baseline survey conducted in eight languages will serve as needs assessment for two interventions to be planned in a participatory process building on co-creation with the residents and local stakeholders representing municipal and non-governmental health and social care services.
In the developed countries life expectancy has increased annually by 2-3 months for more than 150 years. This is due to reduced mortality in different ages at different periods. Today, the survival improvement in older ages is the main contributor to the ever-increasing life expectancy.
We investigate changes in mortality patterns with focus on social disparity in lifespan. Furthermore, we study whether the gain in life expectancy is expected to be lived with or without functional limitations (physical, cognitive etc.) or other health conditions by estimating trends in health expectancy (disability-free life expectancy, disease-free life expectancy etc.) We will analyze gender and social inequalities in health expectancy using register data, SHARE and other surveys and linkage between registers and surveys.
- Copenhagen Aging and Midlife Biobank (CAMB)
- The Metropolit 1953 Cohort (in Danish only)
- The Danish Longitudinal Study on Work, Unemployment and Health (DALWUH)
- The Copenhagen Perinatal Cohort (CPC)
- The Danish Intervention Study on Preventive Home Visits
- The Danish Conscription Database (DCD)
- The 1914 Birth Cohort Copenhagen School Health Records Register (Reference: J. Baker et al. Cohort Profile: The Copenhagen School Health Records Register)
- The Danish Longitudinal Study of Ageing (DLSA)
- Survey of Health Ageing and Retirement in Europe (SHARE)
- Women’s Health Initiative
- The Level of Living Surveys (LNU)
- Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD)
- Danish National Registries
AHEAD is an acronym for Arbejdsmiljø, Hovedpine og Evnen til at Arbejde i Danmark (Working environment, Headache and the Ability to Work in Denmark)
Headache disorders are the most prevalent neurological disorders, and among primary headaches migraine and tension-type headache are the most frequent. Among occupationally active individuals in Denmark, 10% of the men and 24% of the women report migraine or frequent headache.
Despite the high number of people with headache disorders, surprisingly few studies have investigated the causes and consequences of headache in an occupational health perspective. Consequently, the adverse effects of headache on sickness absence, work ability and—not least—quality of life are often unnoticed.
Together with our collaborators, we are investigating causes and consequences of headache, and how these consequences can be mitigated among employees in Denmark.
Currently, with support from Helsefonden we are studying the demand-specific work ability among people with from migraine or frequent headache and among people with possible medication-overuse headache.
Publications from the project
Appel et al., Journal of Aging and Health 2022: Socioeconomic Position and Late-Onset Dementia: A Nationwide Register-Based Study
Islamoska et al., Public Health 2022: The association between migraine and dementia - a national register-based matched cohort study
Steenberg et al., International Journal of Industrial Ergonomics 2022: Demand-specific work ability among employees with migraine or frequent headache
Urhammer et al., J Occup Environ Med 2020: The effect of psychosocial work factors on headache: results from the PRISME cohort study
Appel et al. Int Arch Occup Environ Health 2020: The longitudinal association between shift work and headache: results from the Danish PRISME cohort
Jakobsen et al., Ergonomics 2017: The association between shift work and treatment-seeking migraine in Denmark
Collaboration
- The Danish Knowledge Center for Headache
- The National Research Centre for the Working Environment
- The Danish Committee for Health Education
The overall aim of our research is to investigate the effect of the COVID-19 pandemic on emotional reactions to the pandemic, social relations at work, and social stigmatization among frontline employees.
Currently, we are investigating teachers at public schools and employees, working within eldercare, ambulance service, psychiatry, childcare, and rehabilitation.
COLLABORATION
This research is carried out as a collaboration between researchers at the Section of Social Medicine, Department of Public Health, University of Copenhagen and labor unions (FOA and Danmarks Lærerforening).
PUBLICATIONS
Danish reports
Kirsten Nabe-Nielsen, Vivian Rueskov, Inge Larsen, Nina Vibe Fuglsang, Charlotte Juul Nilsson: CLASS – En analyse af bæredygtigheden af tiltag til begrænsning af smittespredning i folkeskolen, Københavns Universitet, København april 2021.
Kirsten Nabe-Nielsen, Inge Larsen, Nina Vibe Fuglsang, Charlotte Juul Nilsson: CLASS – Folkeskolelæreres arbejdsmiljø under COVID-19: Udfordringer og mulige løsninger baseret på erfaringer fra juni 2020, Københavns Universitet, København, februar 2021.
Kirsten Nabe-Nielsen, Nina Vibe Fuglsang, Inge Larsen, Charlotte Juul Nilsson: CLASS – Folkeskolelæreres arbejdsmiljø under anden bølge af COVID-19-pandemien i Danmark, Københavns Universitet, København, januar 2021.
Kirsten Nabe-Nielsen, Inge Larsen, Nina Vibe Fuglsang, Charlotte Juul Nilsson: CLASS – et forskningsprojekt om COVID-19’s betydning for Læreres Arbejdsmiljø, Sammenhold og Smitteoplevelse, Københavns Universitet, København, oktober 2020.
Scientific papers
Kirsten Nabe-Nielsen, Nina Vibe Fuglsang, Inge Larsen, and Charlotte Juul Nilsson: COVID-19 Risk Management and Emotional Reactions to COVID-19 Among School Teachers in Denmark. Results From the CLASS Study, Journal of Occupational and Environmental Medicine, Volume 63, Number 5, May 2021, pp 357-362.
Kirsten Nabe-Nielsen, Charlotte Juul Nilsson, Maria Juul-Madsen, Charlotte Bredal, Lars Ole Preisler Hansen, Åse Marie Hansen: COVID-19 risk management at the workplace, fear of infection and fear of transmission of infection among frontline employees, Occupational and Environmental Medicine 2020.
OTHER DISSEMINATION
Podcasts
Børn&Unge Podcast, May 2021: Veras brev blev et lys i en mørk tid (in Danish, podcast about the consequences of COVID-19 for the working environment among pedagogues)
Radio4, December 2021: Psykologi i coronaens tid (in Danish, podcast about fear of infection and “zoom fatigue”)
Webinars
Arbejdsmiljørådet, May 2021: Arbejdsmiljø i en coronatid – hvad har vi lært?
Fagbevægelsens Hovedorganisation, October 2020: FH døgnet (the effect of COVID-19 on the working environment from minute 2:02:00)
Selected articles in magazines
Folkeskolen, April 2021: Folkesundhedsforsker: Corona-opgaver tærer på lærernes resurser
Folkeskolen, January 2021: Forsker: Husk lærernes psykiske arbejdsmiljø, når I åbner skolerne
Fagbladet FOA, October 2021: Adgang til tests og værnemidler afgørende for det mentale helbred
Mit Arbejdsmiljø, August 2020: Med COVID-19 på skoleskemaet
Mit Arbejdsmiljø, August 2020: COVID-19 påvirker frontlinjemedarbejdere følelsesmæssigt
Folkeskolen, 4 June 2020: Halvdelen af lærerne frygter at tage corona-smitte med hjem
Fagbladet FOA, May 2020: Forsker undersøger coronaens effekt på FOA-faggruppers arbejdsmiljø
Funding
- Nordeafonden STRIT 8.8 mio DKK (STRIT)
- Nordeafonden Center for Sund Aldring 3 mio. DKK (CAMB2)
- Nordforsk (Social inequalities in Ageing)
- Beckettfonden 100.000 kr. (CAMB2)
- Ensomme gamles værn 300.000 kr. (STRIT)
- VELUX (CAMB)
Research Group Leader
Rikke Lund
Professor
Email: rilu@sund.ku.dk
Phone: +45 35 32 79 92
Mobile: +45 24 66 05 35
Internal researchers
| Name | Title | Phone | |
|---|---|---|---|
| Foverskov, Else | Assistant Professor | +4535328974 | |
| Jørgensen, Terese Sara Høj | Associate Professor | +4535335886 | |
| Kalvåg, Cecilie Kivikoski | Student | +4535332751 | |
| Lund, Rikke | Professor, Head of Section | +4535327992 | |
| Malling, Gritt Marie Hviid | PhD Fellow | +4535327715 | |
| Molbo, Drude | Data Administrator | +4535326736 | |
| Nilsson, Charlotte Juul | Associate Professor | +4535327122 |