Multisite musculoskeletal pain in adolescence as a predictor of medical and social welfare benefits in young adulthood: The Norwegian Arctic Adolescent Health Cohort Study.

BACKGROUND: Pain in adolescence is associated with mental health problems, the main reason for work disability in young adults. This study explores the relationship between multisite musculoskeletal pain in adolescence and later medical (sickness and medical rehabilitation benefits) and social welfare benefits, adjusted for sociodemographic, adolescent psychosocial and mental health problems. METHODS: Data were obtained by linkage between the National Insurance Registry (2003-11) and the Norwegian Arctic Adolescent Health Study, a school-based survey in North Norway (2003-05), accepted by 3987 fifteen- to sixteen-year-olds (68% of the total population). The start of the follow-up time was July 1st of the corresponding year the participants responded to the health study. Musculoskeletal pain was measured by the number of musculoskeletal pain sites. RESULTS: We found a positive linear relationship between adolescent musculoskeletal pain sites and the occurrence of medical and social welfare benefits in young adulthood (p ≤ 0.001). Adolescent musculoskeletal pain was a significant predictor of sickness (p < 0.001) and social welfare benefits in females (p = 0.036), when adjusted for adolescent psychosocial and mental health problems. The most important adolescent psychosocial predictors were externalizing problems, less parental involvement and adverse life events. CONCLUSION: Adolescent multisite musculoskeletal pain was found to be an important predictor of later sickness and social welfare benefit receipt from adolescence to young adulthood. SIGNIFICANCE: Adolescents with multisite musculoskeletal pain are at substantially increased risk of health and social difficulties into young adulthood. Identification and interventions for these adolescent problems could alleviate this risk and be a sound socioeconomic investment.

An Australian model of the First 1000 Days: an Indigenous-led process to turn an international initiative into an early-life strategy benefiting indigenous families.

Internationally, the 1000 days movement calls for action and investment in improving nutrition for the period from a child's conception to their second birthday, thereby providing an organising framework for early-life interventions. To ensure Australian Indigenous families benefit from this 1000 days framework, an Indigenous-led year-long engagement process was undertaken linking early-life researchers, research institutions, policy-makers, professional associations and human rights activists with Australian Indigenous organisations and families. The resultant model, First 1000 Days Australia, broadened the international concept beyond improving nutrition. The First 1000 Days Australia model was built by adhering to Indigenous methodologies, a recognition of the centrality of culture that reinforces and strengthens families, and uses a holistic view of health and wellbeing. The First 1000 Days Australia was developed under the auspice of Indigenous people's leadership using a collective impact framework. As such, the model emphasises Indigenous leadership, mutual trust and solidarity to achieve early-life equity.

Substance use in young indigenous Sami: an ethnocultural and longitudinal perspective.

The cross-sectional and prospective influences of ethnocultural factors on substance use were explored among indigenous Sami in northern Norway. Longitudinal data was collected in 1994/95 (school-based survey; N = 675; RR: 85%; late adolescence: 15-19; 54% females) and 1997/98 (combined school-based and postal questionnaire study; N = 360; RR: 57%; young adulthood; 18-22; 62% females). When controlled for sociodemographics, logistic regression analyses indicated that favoring assimilation, residing in assimilated contexts, and having a weaker ethnic identity were associated with more drinking in late adolescence. Prospectively, favoring assimilation in late adolescence predicted the respondents' perception of excessive drinking in young adulthood. In late adolescence, the effect of assimilation on current smoking was moderated by living in an assimilated context and associated with stronger ethnic group identification. Prospectively, favoring assimilation in late adolescence predicted current smoking in young adulthood. Generally, less Sami oriented individuals were more likely to use substances. The implications and limitations of the findings along with recommendations for future research were discussed.

Suicide among Indigenous Sami in Arctic Norway, 1970-1998.

Suicide mortality was examined between 1970 and 1998 in a cohort of 19,801 persons categorized as indigenous Sami in Arctic Norway. Standardized mortality ratios (SMR) were calculated using the suicide rates of the rural population of Arctic Norway as reference. There was a significant moderate increased risk for suicide among indigenous Sami (SMR = 1.27, 95% Confidence interval (CI): 1.02-1.56). In the study period, 89 suicides occurred in the cohort (70 men and 19 women) with increased suicide mortality both for indigenous Sami males (SMR = 1.27; 95% CI: 0.99-1.61) and females (SMR = 1.27; 95% CI: 0.77-1.99). Significant increased suicide mortality was found for young Sami aged 15-24 for both males (SMR = 1.82; 95% CI: 1.13-2.78) and females (SMR = 3.17; 95% CI: 1.17-6.91). Significant increased suicide mortality was found for indigenous Sami males residing in Sami core area (SMR = 1.54; 95% CI: 1.04-2.20) and for indigenous Sami males not belonging to semi-nomadic reindeer herding (SMR = 1.30; 95% CI: 1.00-1.65). Clusters of suicides in Sami core area may explain the increased suicide mortality found in subgroups among indigenous Sami.

Influence of ethnic factors on behavior problems in indigenous Sami and majority Norwegian adolescents.

OBJECTIVE: To explore the relationship between behavior problems and ethnic factors in indigenous minority Sami and Norwegian majority adolescents in northern Norway. METHOD: The Youth Self-Report (YSR) was completed by 249 Sami and 210 Norwegian students in junior high school, aged 13 to 16 years. Parents completed the Child Behavior Checklist (CBCL). Behavior problems were assessed in relation to ethnicity and ethnic context (geographic region and family context). RESULTS: Rates of behavior problems (CBCL and YSR) were generally high in both ethnic groups and were highest among girls. Sami adolescents, particularly those living in assimilated ethnic communities, reported more behavior problems than Norwegian adolescents. CONCLUSION: Ethnic factors have significant impact on behavior problems in indigenous minority adolescents living in a multiethnic context.

Ethnic identity in aboriginal Sami adolescents: the impact of the family and the ethnic community context

The influence of parentage and ethnic community context on ethnic self-identification and ethnic attitudes and behaviour were examined in 245 indigenous Sami adolescents in northern Norway. Ethnic identity was strongly related to both parentage and type of ethnic community. Monoethnic adolescents at the coast (with great integration and assimilation) identified themselves mostly as bicultural or Norwegian, but in the highland (with strong ethnic support), they identified strongly as Samis. Adolescents with mixed parentage identified strongly as Norwegian at the coast but mostly as bicultural in the highland. Ethnic behaviour and attitudes were significantly associated with both family and regional context; ethnic self-identification was related to other components of ethnic identity.

Preventive health programs among Sami adolescents in a Sami community.

The town of Karasjok had during the eighties one of the highest prevalence of suicide among young men with a cluster of deaths in 1987 and 1988. This situation highlighted the life situation of the Sami adolescents in this area and a special suicide prevention program was established. Health and social workers from the primary health care in the town, the psychiatric outpatient clinics, the school, the church among others, worked together in an emergency interventional service for suicidal patients and postventional for the survival relatives and friends. In addition the preventive aspects of health services for the youth were focused. Firmer health services in the primary care in the town were reorganized to recognize and treat children and adolescents with special problems and needs. The school nurses got a central role in the schools available for children and teachers both in treatment, counselling and teaching. A special health service for youth, "the Youth office," was established one evening in the week staffed with a doctor and a nurse. All consultations are free and to make a data is not necessary. Everyone who wants a consultation gets it on the same evening. The Youth office runs evenings with films and discussions on special topics which the youth themselves want to learn more about as contraceptives, AIDS, abortion, friendship, the relationship between a boy and a girl and so on. This offer is very popular, but mostly among girls. The staff also organizes courses for other professionals in cooperation with the youth.(ABSTRACT TRUNCATED AT 250 WORDS)