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Health2000

Health 2000 Survey, a comprehensive combination of health interview and health examination survey, was carried out in 2000-2001. The study was based on a nationally representative sample of 8028 persons aged 30 and over living in the mainland Finland. The study was carried out by the National Institute for Health and Welfare in co-operation with researchers and experts from several different organizations. The main aim of the Health 2000 Survey was to obtain information on the most important public health problems in working-aged and the aged population, their causes and treatment as well as on the population’s functional capacity and working capacity. As a part of the study blood samples were collected and stored frozen at  -70C. In addition a sample of 1894 persons aged 18-29 and a sample of 1260 survivors from the Mini-Finland Health Examination Survey, were included in the data.

The Mini-Finland Health Examination Survey, which also was representative of the Finnish population, was carried out in 1978-1980 by The Social Insurance Institution.

The cohorts are continuously followed-up by linkage to nationwide health registers. A follow-up study of the Health 2000 Survey was conducted in 2011, in which extensive data was collected using physiological measurements, interviews, and questionnaires. For 2130 individuals, selected as case-control study for metabolic syndrome (GenMets study), genome-wide SNP data is available (see GWAS table for details).

http://www.terveys2000.fi/indexe.html

THL – The National Institute for Health and Welfare
Principal Investigator: Seppo Koskinen, firstname.lastname (at) thl.fi
Contact person: Pirkko Alha, firstname.lastname (at) thl.fi

Key reference:
http://www.terveys2000.fi/julkaisut/baseline.pdf

HEALTH 2000 - Detailed Information:

Background
Health 2000 was a health interview and examination survey carried out in Finland from fall 2000 to spring 2001. KTL (which became a part of THL in 1 January 2009) had the main responsibility for the survey. Also other Finnish social and health care organizations participated. The main partners comprise THL and the Central Pension Institute, the Social Insurance Institution, the Municipal Pension Institute, Statistics Finland, The National Research and Development Centre for Welfare and Health, the Institute of Occupational Health and the UKK-institute for Health Promotion.
The Social Insurance Institution carried out a comparable study 20 years ago called Mini-Finland health survey. The main aim of Health 2000 is to provide an up-to-date comprehensive picture of health and functional ability in the working-aged and aged population by studying the prevalence and determinants of most important health problems and associated need for care, rehabilitation and help.
A nationally representative sample of 10,000 persons was drawn of the population aged 18 and over. Targets of the study are general health, major chronic conditions, functional ability and limitations, determinants of health, health needs and service needs and their satisfaction.

Study protocol
The study comprised questionnaires filled in at home, home interviews, interviews during the health examination as well as measurements, tests and clinical examinations by nurses, a medical doctor and a dentist. The initial stage was a health interview at home or in an institution. At that time the interviewer made an appointment for the examination and after one to six weeks the subjects received an invitation to attend a health examination. This examination included several interviews, clinical tests and drawing blood samples (about 4 hours, see below).
The field work consisted of the following phases:
1. An interview at home (or institution; one to six weeks prior to the health examination).
2. A health examination in the local health centre or comparable premises.
3. An interview and a health examination of non-respondents at home (or institution).
4. A telephone interview and/or a mail questionnaire of remaining non-respondents.
5. Gathering of register information on the whole sample both to complete baseline information and for follow-up purposes.
6. In the second phase of the health examination proper, persons aged 45 to 74 years from several regions were invited to a special investigation (cardiovascular diseases and diabetes) carried out in university hospitals. A total of 1975 individuals from Health2000 and Mini-Finland cohorts were selected for this phase of study, and 1500 participated.
 
Everything possible was done to keep non-response extremely small and at least some data was obtained on 95% of the sample. The field survey was performed simultaneously by five regional field teams in different parts of the country. More than 130 persons worked in the project organization during the implementation of the study. Interviews were carried out by more than 160 interviewers of Statistics Finland. Each of the health examination field teams comprised 16 to 17 persons, together more than 80 persons. The mean duration of the health interview was 70 to 90 minutes. The health examination comprised 10 measurement and observation stations. It lasted on an average four hours. All participants gave written informed consent, and the study was approved by the Ethics Committee for Epidemiology and Public Health of the Hospital District of Helsinki and Uusimaa, Finland.

Questionnaire and interview data
All questionnaires and clinical examination forms are available from the project website.

Home interview
Determinants of health and functional ability, symptoms, diseases and their care, use of medicines, living conditions in childhood and adulthood, work, working conditions and work demands, living habits and life styles, hobbies, leisure time activities, exercise, and alcohol use.

Mental Interview (CIDI)
Addictions, anxiety, mood disorders, psychosis

Other interviews and questionnaires
Complementary data were obtained at various stages of the survey by self-completed questionnaires and symptom interviews. These comprised specific symptoms, living habits, quality of life, infectious diseases and vaccinations, and diet and nutrition.

Final Interview
Quality checks, information about forthcoming examina¬tions.

Laboratory measurements and reserve sampling
Measurements: blood pressure, height, weight, hip girth, waist girth, abdominal breadth, sagittal abdominal diameter, ECG (Minnesota coding), ultrasound examination of heel, spirometry, bioimpedance.
Samples: blood sample (DNA from 8758) and saliva sample.

Laboratory measurements from all: cholesterol, HDL-cholesterol, LDL cholesterol (direct assay), triglycerides, ApoA1, ApoB, C-Reactive Protein, Rheumatoid Factor, s-urate, GGT, vitamin D, homocysteine, cotinine.

Laboratory measurements from participants aged 45 to 74y (N=1500, see Study Protocol section 6): cholesterol, triglycerides, ApoA1, ApoB, Lewis blood group, 2 h oral glucose tolerance test results for glucose and insulin (0, 30, 120 minutes), TNF-alpha, IL-6 and CRP (and carotid ultrasound).

Oral Health Examination Dentist’s clinical examinantion, Digital Panoramic Intraoral X-ray

Testing of functional ability near vision acuity, distance acuity, dark vision, audiometry, cognitive function, psychomotor speed, hand grip, postural balance, static back endurance, tiptoe walking, upstairs walking, squatting, arm elevation, elbow extension, elbow flexion, wrist flexion, finger flexion, thumbs opposition, chair stand, walking speed.

Physician’s examination medical history, walking, tip toe walking, auscultation of heart (while sitting), auscultation of lungs, auscultation of carotic arteries, auscultation of heart (while lying), auscultation of femoral arteries, percussion of liver, palpation of arteria tibialis posterior, palpation of arteria dorsalis pedis, opposed dorsiflexion of foot, opposed dorsiflexion of hallux, straight leg raising, abduction of hip, adduction of hip, flexion angle of knee, external rotation of hip, internal rotation of hip, reflex of achilles tendon, vibration test of spinal processes, side bending of back, abduction of upper arm, external rotation of upper arm, external rotation and abduction of upper arm, internal rotation of upper arm, opposed abduction of upper arm, opposed flexion of elbow joint, opposed external rotation of elbow joint, opposed internal rotation of elbow joint, torsion of neck, opposed extension of wrist, opposed flexion of wrist, tenderness of humeral epicondyli, Tinell’s test, compression test of nervus medianus, strength of abductor pollicis brevis, sense of touch in fingers. Serum has been stored at -70 C for further analyses.

Registry links
Yearly: Hospital discharge register, Causes of death register, Cancer register, register for specially reimbursed medicines, register for disability pensions. The data is stored electronically in an Oracle database.