The Greenland population health survey 2018 – methods of a prospective study of risk factors for lifestyle related diseases and social determinants of health amongst Inuit

Abstract

Since 1993, regular population health surveys in Greenland have supported and monitored the public health strategy of Greenland and have monitored cardiometabolic and lung diseases. The most recent of these surveys included 2539 persons aged 15+ from 20 communities spread over the whole country. The survey instruments included personal interviews, self-administered questionnaires, blood sampling, anthropometric measurements, blood pressure, ECG, oral glucose test, pulmonary function, hand grip strength and chair stand test. Blood samples were analysed for glucose, glycated haemoglobin (HbA1c), insulin, incretin hormones, cholesterol, kidney function, fatty acids in erythrocyte membranes and mercury, urine for albumin-creatinine ratio, and aliquots were stored at −80°C for future use. Data were furthermore collected for studies of the gut microbiome and diabetes complications. Survey participants were followed up with register data. The potential of the study is to contribute to the continued monitoring of risk factors and health conditions as part of Greenland’s public health strategy and to study the epidemiology of cardiometabolic diseases and other chronic diseases and behavioural risk factors. The next population health survey is planned for 2024. The emphasis of the article is on the methods of the study and results will be presented in other publications.

Analysis of admixed Greenlandic siblings shows that the mean genotypic values for metabolic phenotypes differ between Inuit and Europeans

“…We included Greenlanders from the population health surveys B99 (sample size 1953, recruited 1998–2001) [ 19 ], Inuit Health in Transition (IHIT; sample size 2807, recruited 2005–2010) [ 20 ] and B2018 (sample size 1236, recruited 2017–2019) [ 21 ]. All these cohorts were collected as part of a general population health survey of the adult (18+ years of age) Greenlandic population based on random population samples.…”

“…Anthropometric and biochemical data collection in the Greenlandic cohorts (B99, IHIT, B2018) and the Danish Inter99 cohort have been described previously [ 19 – 21 , 23 , 24 ]. In brief, body weight, height and waist and hip circumference were measured, and body mass index (BMI) and waist-to-hip ratio calculated in both the Greenlandic and the Danish cohorts, and in the Greenlanders also visceral and subcutaneous adipose tissue were measured and lean body mass and fat percentage calculated.…”

Reproducibility and validity of a 45 item food-frequency questionnaire for inuit in Greenland

“…Data was collected from 2016 to 2019 as part of a countrywide survey of health and risk factors for health [ 4 ]. The participants were selected through a stratified random sample of adults in Greenland, who had been born in Greenland or Denmark.…”

“…In Greenland, a 66-item FFQ with portion sizes and seasonal variation of locally harvested food was developed for the Inuit Health in Transition study in 2005–2010 [ 3 ]. This FFQ was considered to be too lengthy for a general health survey and was subsequently reduced to an FFQ with 45 food items with portion sizes but not seasonal variation [ 4 ]. [ 5 ] This is now considered the standard FFQ in Greenland.…”

Increasing health inequality among Inuit in Greenland from 1993 to 2018: Different patterns for household assets, urbanization and a sociocultural index as indicators of social position

“…The four surveys were conducted in 1993–1994 in 38 communities (acronym: B1993; n = 1513 Inuit; 57% participation) ( Bjerregaard & Young, 1998 ); in 2005–2010 in 22 communities (acronym IHIT; n = 3059 Inuit; 67% participation) ( Bjerregaard, 2011 ); in 2014 in 19 communities (acronym B2014; n = 2096 Inuit; 63% participation) ( Dahl-Petersen, Olesen, Jørgensen, Larsen, & Bjerregaard, 2016 ); and in 2016–2019 in 20 communities (acronym B2018; n = 2356 Inuit; 52% participation) ( Bjerregaard et al, 2022 ). Fig.…”