How eight health risks and chronic conditions relate: identifying associations and profiling characteristics of multiple health risk factors among 14 disease groups and 30 common chronic conditions in Denmark

AIMS: To identify associations between chronic conditions and eight key health risks (stress, loneliness, sleep, obesity/body mass index, smoking, exercise, alcohol consumption, and fruit intake) and provide a practical descriptive profile of the distribution of health risks within chronic conditions.

METHODS: The sample involved 56,988 Danish residents aged over 16 years from three national health surveys (2010/2013), one sociodemographic register, and seven national health registers. Linear and logistic regression models adjusting for socioeconomic variables were used to analyse associations with 14 disease groups and 30 common conditions.

RESULTS: The regression analyses revealed that stress, obesity, and physical inactivity were the most consistently associated health risk factors across disease groups. We identified three groups of health risks with similar strengths of associations. Firstly, one group comprising obesity, stress, and sleep troubles, was significantly linked to 27, 23, and 22 chronic conditions, respectively. Secondly, a group of physical inactivity/loneliness showed moderate associations, linked to 19 and five chronic conditions, particularly mental health conditions; and thirdly, a group of smoking, drinking, and low fruit intake showed the weakest and fewest associations. A descriptive profile showed that anxiety, schizophrenia, attention deficit hyperactivity disorder, headaches and chronic obstructive pulmonary disease were conditions with high proportions of patients experiencing more than four health risks.

CONCLUSIONS: The current study provides comparable, hierarchical information on the strength of associations between eight health risks and chronic conditions adjusted for socioeconomic factors. The findings suggest that healthcare professionals, policymakers and public health strategies should place less emphasis on classic behavioural health risks such as smoking and more attention on psychological factors such as stress, sleep problems, and loneliness.