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Purpose and aims: We aim to contribute to a better understanding of the role of psychosocial factors in the etiology and prognosis of heart failure (HF) and of patterns and predictors of work disability in HF patients of working age. The specific questions are:Are psychosocial factors, namely adverse life events in childhood and adulthood, work stress, social support, anger-behavior and a wider range of psychiatric disorders than depression associated with incident HF?Are psychosocial factors, namely stress and a wider range of psychiatric disorders than depression associated with HF prognosis?What are the patterns of work disability in HF patients of working age compared to healthy controls and what factors predict length of work disability?Project organization, time plan and methods: In this four-year project, we will analyze data from a register cohort involving all born in Denmark (1973-2020) and Sweden (1973-2014) (N=7.2 million) and their parents (N=6.7 million), the Norwegian Nord-Trøndelag Health Study conducted in 1995-97 (N=65237) and 2006-08 (N=50807) (aim 1), a register-based cohort of HF patients in the National Patient Register (1987-2019) and/or patients in the HF quality registry (2003-2019) (aim 2) and Insurance Medicine All Sweden database (aim 3).Relevance: A better understanding of the role of psychosocial factors in the etiology and prognosis of HF and the patterns and predictors of work disability will be informative for HF prevention strategies.

Temperature extremes negatively affect public health and well-being. These detrimental impacts are unevenly distributed, and affect most those who are already vulnerable. Moreover, they are projected to increase under future climate change.Taking Sweden as a case-in-point, this project aims to address the following questions, of key relevance for ensuring a socially just adaptation to future temperatures: (1) which groups are most vulnerable to non-optimal and extreme temperatures? (2) what is the interplay between environmental drivers, societal processes, adaptation strategies and the resulting health impacts? and (3) how can adaptation strategies mitigate the health impacts of plausible future temperatures?These questions will be addressed by quantifying the excess risk of adverse health outcomes related to exposure to non-optimal and extreme temperatures including an analysis of historical trends and drivers of the adaptation process. Leveraging available climate projections, we will also develop scenarios of health impacts of future temperatures incorporating different adaptation strategies.This effort is timely, as the expectation of continued large impacts of temperature extremes points to the urgency of reducing their uneven distribution and designing a long-term adaptation process. Sweden offers highly spatially and temporally resolved registers of health data, unique in the international context, that can be rapidly and effectively leveraged towards this goal.