A life-course approach to prevent noncommunicable diseases in an ageing population - NCDNOR

The project aims to describe the development of non-communicable diseases (NCD) including mental health, musculoskeletal diseases (here: hip fractures) and the extent of having more than one NCD (multimorbidity), including drug use (polypharmacy). We will identify plausible underlying causal factors and the significance of various risk factors for the development. We will investigate the significance of different life conditions such as socioeconomic position, family situation and place of residence to establish new knowledge about how mental health, health behavior and biological markers affect the risk of developing non-communicable diseases in a life-course perspective. We have spent time on examining the quality of the data sources, establishing an infrastructure for processing data and coordinated the research group including all partners, stakeholders and users. We have involved clinical milieus to assist us in defining the various disease outcomes. In preliminary analyses, we have studied how different health registries capture people registered with NCDs during the period 2008-2020, and have elucidated on the proportion with one, two, three or more NCDs in the population. The research will provide new knowledge within the NCD field that will identify potential venues for structural and more targeted interventions and the effects of interventions at the local and national level. This will strengthen Norwegian public health work in key areas described in the Ministry of Health and Care Services's Public Health Report (2019).

The preventive potential of NCDs is traditionally estimated separately for each NCD, but the lifetime risk of NCDs, and how these diseases co-occur are uncertain, as are the role of clustering of life conditions, common risk factors, biomarkers and mental health throughout the life course. Thus, we need a novel approach to achieve new knowledge in the promotion and prevention of NCDs. Our concept include consolidation of NCD endpoints across somatic disciplines, examining joint and interacting effects of socioeconomic circumstances, life conditions, health behaviours, biological markers and mental health throughout the life-course. We will utilize the largest and most comprehensive population based long-term prospective cohorts and mandatory national registers, biobanks, and do comparable analyses to test similar hypotheses in independent datasets with individual data to elucidate plausible underlying causal mechanisms - to identify targets for prevention. Our approach, first using regional population based cohorts linked to national registers and then statistical methods will for the first time provide adjusted analyses applicable for the complete Norwegian population. Main objective: WP 1 To identify patterns of NCD occurrence, multimorbidity and polypharmacy of NCDs to recognise underlying potential causal mechanisms by integrating social contexts and biomarkers and do cost-effectiveness analysis. WP2 To contribute to a better understanding on how socioeconomic position (SEP) ultimately translates into inequalities in health. Our project will be among the first with this wider perspective taking shared risk factors among NCDs into account and make the results applicable for the complete Norwegian population.