Medical benefits in young adulthood: A population-based longitudinal study of health behaviour and mental health in adolescence and later receipt of medical benefits
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Original versionBMJ Open 2015, 5(5) 10.1136/bmjopen-2014-007139
Objectives: To examine the extent to which smoking,alcohol, physical activity and mental health problems in15–16-year-olds are associated with receipt of medicalbenefits in young adulthood, after adjustment forconfounders.Design: Prospective population-based cohort surveylinked to national registers.Participants: In the ‘Youth studies’ from theNorwegian Institute of Public Health, 15 966 10thgraders in 6 Norwegian counties answered a healthbehaviour and mental health questionnaire; 88% werelinked to National Insurance Administration Registers(FD-Trygd).Outcome measure: Time to receipt of medicalbenefits, based on FD-Trygd. Follow-up was from age18 years until participants were aged 22–26 years.Method: We performed Cox regression analyses toexamine the extent to which variations in healthbehaviour and mental health problems during 10thgrade were associated with receipt of medical benefitsduring follow-up.Results: Daily smoking at age 15–16 years wasassociated with a significant increase in hazard ofreceiving health benefits at follow-up compared with notsmoking for boys, HR (95% CI) 1.56 (1.23 to 1.98),and for girls 1.47 (1.12 to 1.93). Physical activity wasassociated with a decrease in hazard compared withinactivity from 23% to 53% in boys and from 21% to59% in girls, while use of alcohol showed a mixedpattern. The hazard for benefits use rose with increasinglevels of emotional symptoms, peer problems, conductproblems and hyperactivity–inattention problems(Strengths and Difficulties Questionnaire) at15–16 years among both genders.Conclusions: Health behaviour and mental healthproblems in adolescence are independent risk factorsfor receipt of medical benefits in young adulthood.