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  • 1.
    Agahi, Neda
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Fors, Stefan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Shaw, Benjamin A.
    Smoking and Physical Inactivity as Predictors of Mobility Impairment During Late Life: Exploring Differential Vulnerability Across Education Level in Sweden2018In: The journals of gerontology. Series B, Psychological sciences and social sciences, ISSN 1079-5014, E-ISSN 1758-5368, Vol. 73, no 4, p. 675-683Article in journal (Refereed)
    Abstract [en]

    Objectives: To test whether older adults from high and low educational groups are differentially vulnerable to the impact of smoking and physical inactivity on the progression of mobility impairment during old age.

    Methods: A nationally representative sample of older Swedish adults (n = 1,311), aged 57-76 years at baseline (1991), were followed for up to 23 years (2014). Multilevel regression was used to estimate individual trajectories of mobility impairment over the study period and to test for differences in the progression of mobility impairment on the basis of smoking status, physical activity status, and level of education.

    Results: Compared to nonsmokers, heavy smokers had higher levels and steeper increases in mobility impairment with advancing age. However, there were only small and statistically nonsignificant differences in the impact of heavy smoking on mobility impairment in high versus low education groups. A similar pattern of results was found for physical inactivity.

    Discussion: Differential vulnerability to unhealthy behaviors may vary across populations, age, time-periods, and health outcomes. In this study of older adults in Sweden, low and high education groups did not differ significantly in their associations between heavy smoking or physical inactivity, and the progression of mobility impairment.

  • 2.
    Bryngelson, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Bacchus Hertzman, Jennie
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Institute for Futures Studies, Sweden.
    The relationship between gender segregation in the workplace and long-term sickness absence in Sweden2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 6, p. 618-626Article in journal (Refereed)
    Abstract [en]

    Background: The aim of the study is to investigate whether the gender composition in workplaces is related to long-term sickness absence (LSA). We start off with Kanter’s theory on ‘‘tokenism,’’ suggesting an increased risk of stress among minority groups (tokens), which, in turn, might increase the risk of ill health and LSA. Methods: The dataset consists of information obtained from the Swedish level of Living Survey (LNU) and the Swedish Establishment Survey (APU), linked to register-based data from the Swedish Social Insurance Agency. The longitudinal data is representative for the Swedish population and consists of 496 women and 566 men, aged 20—55 at baseline. Our study group consisted of employed persons in 1991 and we analyze, by means of piecewise constant intensity regressions, the first entry into LSA with a follow-up period of nine years. Results: Compared with women in gender-integrated workplaces, women’s risk of LSA is most elevated at both extremely male-dominated (0—20% females) and extremely female-dominated workplaces (80—100% females), although the result among women in the most male-dominated group did not reach statistical significance at the 5% level. Men’s risk seems less varied by gender composition. Conclusions: The present study suggests that the gender composition in the workplace has an impact on the risk of LSA, especially among women. Our findings lend no support for Kanter’s theory on the effects of being a token. Most likely, women’s and men’s different status positions have an impact on the different associations found.

  • 3. Bryngelson, Anna
    et al.
    Mittendorfer-Rutz, Ellenor
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Åsberg, Marie
    Nygren, Åke
    Reduction in personnel and long-term sickness absence for psychiatric disorders among employees in Swedish county councils: an ecological population-based study.2011In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 53, no 6, p. 658-62Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    The aim was to examine whether staff downsizing was related to long-term psychiatric sickness absence.

    METHODS:

    We used aggregate data on sickness absence from AFA insurance, as well as information on staff numbers from the Swedish Association of Local Authorities and Regions. Bootstrap regression analyses were used to elucidate whether there was a relationship between reduction in personnel and changes in sickness rates.

    RESULTS:

    A staff reduction of 1% increased the sickness rate, on average, by 9%. The associations were similar in men and women as well as in different age groups, although statistical significance was only reached in the groups of women and middle-aged employees.

    CONCLUSIONS:

    Our findings suggest that downsizing may be related to subsequent increases in psychiatric sickness absence. The association appeared after a time-delay of several years.

  • 4. Bäckman, O.
    et al.
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hälsa - en fördelningsfråga2008In: Framtider, Vol. 1, p. 18-23Article in journal (Other (popular science, discussion, etc.))
  • 5.
    Bäckman, Olof
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Nilsson, Anders
    Stockholm University, Faculty of Social Sciences, Department of Criminology.
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Marginalisering och uppväxtvillkor2008In: Framtider, ISSN 0281-0492, no 4, p. 21-23Article in journal (Other (popular science, discussion, etc.))
  • 6. Celeste, R. K.
    et al.
    Nadanovsky, P.
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Trends in socioeconomic disparities in oral health in Brazil and Sweden2011In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 39, no 3, p. 204-212Article in journal (Refereed)
    Abstract [en]

    Objectives: To describe the dynamics of trends in socioeconomic disparities in oral health in Brazil and Sweden among adults, to assess whether trends follow expected patterns according to the inverse equity hypothesis.

    Methods:  In Sweden, we obtained nationally representative data for the years 1968, 1974, 1981, 1991 and 2000, and in Brazil, for 16 state capitals in 1986 and in 2002. Trends in the prevalence of ‘edentulism’ and of ‘teeth in good conditions’ were described in two groups aged 35–44 with lower and higher economic standards, respectively.

    Results:  There was an annual decline in disparities in ‘edentulism’ of 0.4 percentage points (pp) (95% CI = 0.2–0.7) in Brazil and 0.7pp (95% CI = 0.5–0.9) in Sweden, as a result of improvements in both income groups. Concerning ‘teeth in good conditions’, in Brazil, there was improvement only in the higher income group and absolute disparities have increased (0.5pp annually), while in Sweden, there was a nonsignificant decrease (0.3pp annually) with improvements in both groups. Since 1991 in Sweden and in 2002 in Brazil, our measures of socioeconomic disparities in ‘edentulism’ were not statistically significant. Trends did not differ by sex or dental visit.

    Conclusions:  Despite improvements in both income groups and a decrease in disparities in ‘edentulism’, the poorer group in Brazil has seen no improvement in ‘teeth in good conditions’ and disparities have increased. It appears that Brazil and Sweden reflect different stages of trend for ‘teeth in good conditions’ and the same stages for ‘edentulism’, represented by the inverse equity hypothesis.

  • 7. Celeste, R. K.
    et al.
    Nadanovsky, P.
    Ponce de Leon, A.
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    The individual and contextual pathways between oral health and income inequality in Brazilian adolescents and adults2009In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 69, no 10, p. 1468-1475Article in journal (Refereed)
    Abstract [en]

    We evaluate the association between incomeinequality (Gini index) and oralhealth and in particular the role of alternative models in explaining this association. We also studied whether or not income at the individual level modifies the Gini effect. We used data from an oralhealth survey in Brazil in 2002–2003. Our analysis included 23,568 15–19 and 22,839 35–44 year-olds nested in 330 municipalities. Different models were fitted using multilevel analysis. The outcomes analysed were the number of untreated dental caries (count), having at least one missing tooth (dichotomous) and being edentulous (dichotomous). To assess interaction as a departure from additivity we used the Synergy Index. For this, we dichotomized the Gini coefficient (high vs low inequality) by the median value across municipalities and the individualincome in the point beyond which it showed roughly no association with oralhealth. Adjusted rate ratio of mean untreated dental caries, respectively for the 15–19 and 35–44 age groups, was 1.12 and 1.16 for each 10 points increase in Gini scale. Adjusted odds ratio of a 15–19 year-old having at least one missing tooth or a 35–44 year-old being edentulous was, respectively, 1.19 and 1.01. High incomeinequality had no statistically significant synergistic effect with being poor or living in a poor municipality. Higher levels of incomeinequality at the municipal level were associated with worse oralhealth and there was an unexplained residual effect after controlling for potential confoundings and mediators. Municipal level incomeinequality had a similar, detrimental effect, among individuals with lower or higher income.

  • 8. Celeste, Roger Keller
    et al.
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Nadanovsky, Paulo
    The relationship between levels of income inequality and dental caries and periodontal diseases2011In: Cadernos de Saúde Pública, ISSN 0102-311X, E-ISSN 1678-4464, Vol. 27, no 6, p. 1111-1120Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to evaluate the association between income inequality at a lagged time of 2 and 11 years with two short latency outcomes (untreated dental caries and gingivitis) and two long latency outcomes (edentulism and periodontal attachment loss > 8mm). We used data from the Brazilian oral health survey in 2002-2003. Our analysis included 13,405 subjects aged 35-44 years. Different lagged Gini at municipal level were fitted using logistic and negative binomial multilevel analyses. Covariates included municipal per capita income, equivalized income, age, sex, time since last dental visit and place of residence (rural versus urban). Crude estimates showed that only untreated dental caries was associated with current and lagged Gini, but in adjusted models only current Gini remained significant with a ratio of 1.19 (95%CI: 1.09-1.30) for every ten-point increase in the Gini coefficient We conclude that lagged Gini showed no association with oral health; and current income Gini was associated with current dental caries hut not with periodontal disease.

  • 9. Celeste, Roger Keller
    et al.
    Nadanovsky, Paulo
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Trends in socioeconomic disparities in the utilization of dental care in Brazil and Sweden2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 6, p. 640-648Article in journal (Refereed)
    Abstract [en]

    Aims: To describe trends in socioeconomic disparities in utilization of dental care. Methods: We obtained cross-sectional data from Sweden in the period 1968-2000 and from Brazil in 1986 and 2002 for 16 state capitals. The outcome was the percentage of people who reported that they had visited the dentist in the last 12 months, calculated for a higher and a lower income group and stratified by sex, age (two groups: young and adults) and dental status. Adjusted prevalence differences and prevalence ratios were produced using Poisson regression. Results: In Brazil, there was a decline in use of dental care among the 15-19 year olds in the period 1986-2002, but not among the 35-44 year olds. In Sweden, there was a decline among the young and adults between 1991 and 2000. Overall, socioeconomic disparities in use of dental services between the higher and the lower economic groups showed a decline in both countries. The reduction in disparities among young Brazilians was 1.1 percentage points per year (p < 0.01), but among the other age groups the decline was not significant (p>0.01). In the last surveys, the gap remained in both countries and age groups (p < 0.01). Conclusions: The recent decline in utilization of dental care and in the socioeconomic gap may mirror improvements in oral health. However, there are still relevant and persistent disparities in utilization of dental care in both countries, with a higher proportion of people of higher socioeconomic status visiting the dentist.

  • 10.
    Eklund, Jenny M.
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Keeping delinquency at bay: the role of the school context for impulsive and sensation-seeking adolescents2014In: European Journal of Criminology, ISSN 1477-3708, E-ISSN 1741-2609, Vol. 11, no 6, p. 682-701Article in journal (Refereed)
    Abstract [en]

    Previous research shows that a disadvantaged school setting is associated with increased risk of adolescent delinquency. However, there is limited research on individual differences in such contextual effects. In this study, we investigated whether the association between impulsive and sensation-seeking traits and delinquency is modified by the school setting, focusing on schools’ socioeconomic and ethnic composition and average school performance. We also examined whether the association between gender and delinquency varies by school context. Participants were adolescents in ninth grade from the Stockholm School Survey (5619 pupils in 89 schools). The findings showed an attenuating effect of school advantage on adolescents’ individual risk of delinquency. Impulsive and sensation-seeking adolescents, and boys in particular, committed less crime if they attended more advantaged schools.

  • 11.
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fattig och rik i Sverige2011In: Utanförskap / [ed] Alm S, Bäckman O, Gavanas, A & Nilsson A, Dialogos Förlag, 2011Chapter in book (Other academic)
  • 12.
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    HEALTH INEQUALITY AND SOCIAL JUSTICE2014In: Routledge International Handbook of Social Justice / [ed] Reisch, M, LONDON: ROUTLEDGE , 2014, p. 339-352Chapter in book (Refereed)
  • 13.
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Socioekonomiska skillnader i hälsa2012In: Den orättvisa hälsan: Om socioekonomiska skillnader i hälsa och livslängd / [ed] Mikael Rostila, Susanna Toivanen, Stockholm: Liber, 2012Chapter in book (Other academic)
  • 14.
    Fritzell, Johan
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bacchus Hertzman, Jennie
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bäckman, Olof
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Borg, Ida
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Ferrarini, Tommy
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Nelson, Kenneth
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Sweden: Increasing income inequalities and changing social relations2014In: Changing Inequalities and Societal Impacts in Rich Countries. Thirty Countries' Experiences / [ed] Brian Nolan, Wiemer Salverda, Daniele Checchi, Ive Marx, Abigail McKnight, István György Tóth, Herman G. van de Werfhorst, Oxford: Oxford University Press, 2014Chapter in book (Refereed)
    Abstract [en]

    From an all-time low around 1980, income inequality substantially increased, reflecting a strong rise in top incomes and income from capital, more recently also a widening gap between bottom and middle incomes. Behind this are the dual income tax system, established in the early 1990s, the introduction of earned income tax credits, and a diminished coverage of social insurance programmes, which widened the income gap between employed and non-employed during the 2000s. The benefit and tax systems became less redistributive and thereby contributed to increased income inequalities. Another important element is the deep recession in the early 1990s with skyrocketing unemployment and subsequent cutbacks in welfare provision. Income inequalities, however, increased first and foremost in the aftermath of the recession. The chapter finds no unambiguous trend in social, cultural, and political conditions corresponding to the increased inequalities. There is increased polarization for many indicators between different socio-economic groups.

  • 15.
    Fritzell, Johan
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bäckman, Olof
    Ritakallio, Veli-Matti
    Income inequality and poverty: do the Nordic countries still constitute a family of their own?2012In: Changing Social Equality: The Nordic welfare model in the 21st century / [ed] Kvist, Fritzell, Hvinden & Kangas, Bristol: Policy Press, 2012, p. 165-185Chapter in book (Other academic)
  • 16. Fritzell, Johan
    et al.
    Gähler, Michael
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Nermo, Magnus
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Vad hände med 1990-talets stora förlorargrupper? Välfärd och ofärd under 2000-talet2007In: Socialvetenskaplig Tidskrift, Vol. 14, no 2-3, p. 110-133Article in journal (Other academic)
  • 17.
    Fritzell, Johan
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Kangas, O.
    Bacchus Hertzman, Jennie
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Blomgren, J.
    Hiilamo, H.
    Dynamics of cross-national poverty and mortality rates.2011In: EUROPEAN JOURNAL OF PUBLIC HEALTH:: 4TH EUROPEAN PUBLIC HEALTH CONFERENCE: ABSTRACT SUPPLEMENT / [ed] Torben Jørgensen, Finn Kamper-Jørgensen, Dineke Zeegers Paget, 2011, Vol. 21, no suppl 1, p. 202-202Conference paper (Refereed)
  • 18.
    Fritzell, Johan
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Kangas, Olli
    Bacchus Hertzman, Jennie
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Blomgren, Jenni
    Hiilamo, Heikki
    Cross-Temporal and Cross-National Poverty and Mortality Rates among Developed Countries2013In: Journal of Environmental and Public health, ISSN 1687-9805, E-ISSN 1687-9813, Vol. 2013, article id 915490Article in journal (Refereed)
    Abstract [en]

    A prime objective of welfare state activities is to take action to enhance population health and to decrease mortality risks. For several centuries, poverty has been seen as a key social risk factor in these respects. Consequently, the fight against poverty has historically been at the forefront of public health and social policy. The relationship between relative poverty rates and population health indicators is less self-evident, notwithstanding the obvious similarity to the debated topic of the relationship between population health and income inequality. In this study we undertake a comparative analysis of the relationship between relative poverty and mortality across 26 countries over time, with pooled cross-sectional time series analysis. We utilize data from the Luxembourg Income Study to construct age-specific poverty rates across countries and time covering the period from around 1980 to 2005, merged with data on age- and gender-specific mortality data from the Human Mortality Database. Our results suggest not only an impact of relative poverty but also clear differences by welfare regime that partly goes beyond the well-known differences in poverty rates between welfare regimes.

  • 19.
    Fritzell, Johan
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Kangas, Olli
    Bacchus Hertzman, Jennie
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Blomgren, Jenni
    Hiilamo, Heikki
    Cross-Temporal and Cross-National Poverty and Mortality Rates among Developed Countries2012Report (Other academic)
  • 20.
    Fritzell, Johan
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Rehnberg, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Bacchus Hertzman, Jennie
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Blomgren, Jenni
    Absolute or relative? A comparative analysis of the relationship between poverty and mortality2015In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 60, no 1, p. 101-110Article in journal (Refereed)
    Abstract [en]

    We aimed to examine the cross-national and cross-temporal association between poverty and mortality, in particular differentiating the impact of absolute and relative poverty. We employed pooled cross-sectional time series analysis. Our measure of relative poverty was based upon the standard 60 % of median income. The measure of absolute, or fixed, poverty was based upon the US poverty threshold. Our analyses were conducted on data for 30 countries between 1978 and 2010, a total of 149 data points. We separately studied infant, child, and adult mortality. Our findings highlight the importance of relative poverty for mortality. Especially for infant and child mortality, we found that our estimates of fixed poverty is close to zero either in the crude models, or when adjusting for gross domestic product. Conversely, the relative poverty estimates increased when adjusting for confounders. Our results seemed robust to a number of sensitivity tests. If we agree that risk of death is important, the public policy implication of our findings is that relative poverty, which has close associations to overall inequality, should be a major concern also among rich countries.

  • 21.
    Fritzell, Johan
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Ritakallio, Veli-Matti
    Societal shifts and changed patterns of poverty2010In: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 19, no s1, p. s25-s41Article in journal (Refereed)
    Abstract [en]

    This article uses data from the Luxembourg Income Study to analyse cross-national and cross-temporal poverty risks in 11 Western countries. We show that poverty risks have tended to increase from the early 1980s to 2000. In line with what we would expect based on the welfare state literature, the Nordic countries tend to have the lowest poverty rates. However, the proportion of the national population with a market income below the poverty threshold has increased in all countries and the cross-national variation in market income poverty is not apparently related to the type of welfare state regime. We perform a simulation analysis to test whether structural factors, that is, compositional differences in age, family and labour market behaviour, could account for the cross-national variation found. Our results demonstrate the increasing importance of household labour market attachment for alleviating poverty risks, as well as for explaining the cross-national variation in these risks.

  • 22.
    Fritzell, Johan
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Strömblad, P.
    Segregation och social tillit2011In: Utanförskap / [ed] Alm S, Bäckman O, Gavanas, A & Nilsson A, Dialogos Förlag, 2011Chapter in book (Other academic)
  • 23. Fritzell, Sara
    et al.
    Bakshi, A.-S.
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Burström, B.
    Lone mothers talking money and health: A discourse analysis of focus groups with Swedish lone mothers with financial difficulties.2011In: EUROPEAN JOURNAL OF PUBLIC HEALTH: 4TH EUROPEAN PUBLIC HEALTH CONFERENCE: ABSTRACT SUPPLEMENT / [ed] Torben Jørgensen, Finn Kamper-Jørgensen, Dineke Zeegers Paget, 2011, Vol. 21, no suppl 1, p. 62-62Conference paper (Refereed)
  • 24. Fritzell, Sara
    et al.
    Vannoni, Francesca
    Whitehead, Margaret
    Burström, Bo
    Costa, Giuseppe
    Clayton, Stephen
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Institute for Futures Studies, Sweden.
    Does non-employment contribute to the health disadvantage among lone mothers in Britain, Italy and Sweden? Family policy and synergy effects2012In: Health and Place, ISSN 1353-8292, E-ISSN 1873-2054, Vol. 18, no 2, p. 199-208Article in journal (Refereed)
    Abstract [en]

    This study analyses self-rated health and non-employment and potential synergy effects among lone and couple mothers aged 25–59 in Britain, Sweden and Italy, representing different family policy categories using data from national surveys (2000–2005). Synergy effects on health were calculated by synergy index. Non-employment only marginally contributed to the excess risk of poor health among lone mothers but there were synergy effects between lone motherhood and non-employment in all three countries, producing a higher risk of poor health than would be expected from a simple addition of these exposures. Results are discussed in relation to the different family policy and living contexts.

  • 25.
    Heap, Josephine
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work. Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Lennartsson, Carin
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Associations between and coexistence of disadvantages in the oldest old people in Sweden: Patterns of change between 1992 and 2011Manuscript (preprint) (Other academic)
  • 26.
    Heap, Josephine
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Lennartsson, Carin
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Associations between and coexistence of disadvantages in the oldest old people in Sweden: Patterns of change between 1992 and 20112018In: Journal of European Social Policy, ISSN 0958-9287, E-ISSN 1461-7269, Vol. 28, no 3, p. 197-210Article in journal (Refereed)
    Abstract [en]

    This study explored changes in the associations between and coexistence of disadvantages in several dimensions of living conditions in the oldest old people in Sweden. We used nationally representative data from 1992 (n = 537), 2002 (n = 621) and 2011 (n = 931). Indicators of limited social resources, limited political resources, limited financial resources, psychological health problems, physical health problems and functional limitations were used. The probability of reporting coexisting disadvantages tended to increase and was particularly elevated in 2002. Physical health problems became more common, and functional limitations, limited financial resources and limited political resources became less common during the studied period. Associations between health-related disadvantages remained fairly stable, whereas associations including other kinds of disadvantages varied somewhat over the studied period. These changes suggest that in general, the composition of coexisting disadvantages is likely to have altered over time. Consequently, the challenges faced by disadvantaged groups in 2011 may have been different from those in 1992. Moreover, the healthcare and social care services directed to older people have undergone significant changes during the past decades. These changes to the system accentuate the vulnerability of people experiencing coexisting disadvantages.

  • 27.
    Honkaniemi, Helena
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Bacchus-Hertzman, Jennie
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Rostila, Mikael
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Mortality by country of birth in the Nordic countries – a systematic review of the literature2017In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, article id 511Article, review/survey (Refereed)
    Abstract [en]

    Background: Immigration to the Nordic countries has increased in the last decades and foreign-born inhabitants now constitute a considerable part of the region’s population. Several studies suggest poorer self-reported health among foreign-born compared to natives, while results on mortality and life expectancy are inconclusive. To date, few studies have summarized knowledge on mortality differentials by country of birth. This article aims to systematically review previous results on all-cause and cause-specific mortality by country of birth in the Nordic countries.Methods: The methodology was conducted and documented systematically and transparently using a narrative approach. We identified 43 relevant studies out of 6059 potentially relevant studies in August 2016, 35 of which used Swedish data, 8 Danish and 1 Norwegian.Results: Our findings from fully-adjusted models on Swedish data support claims of excess mortality risks in specific categories of foreign-born. Most notably, immigrants from other Nordic countries, especially Finland, experience increased risk of mortality from all causes, and specifically by suicide, breast and gynaecological cancers, and circulatory diseases. Increased risks in people from Central and Eastern Europe can also be found. On the contrary, decreased risks for people with Southern European and Middle Eastern origins are found for all-cause, suicide, and breast and gynaecological cancer mortality. The few Danish studies are more difficult to compare, with conflicting results arising in the analysis. Finally, results from the one Norwegian study suggest significantly decreased mortality risks among foreign-born, to be explored in further research.Conclusions: With new studies being published on mortality differentials between native and foreign-born populations in the Nordic countries, specific risk patterns have begun to arise. Regardless, data from most Nordic countries remains limited, as does the information on specific causes of death. The literature should be expanded in upcoming years to capture associations between country of birth and mortality more clearly.

  • 28. Hökerberg, Yara Hahr Marques
    et al.
    Reichenheim, Michael Eduardo
    Faerstein, Eduardo
    Lambert Passos, Sonia Regina
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Toivanen, Susanna
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Cross-cultural validity of the demand-control questionnaire: Swedish and Brazilian workers2014In: Revista de Saude Publica, ISSN 0034-8910, E-ISSN 1518-8787, Vol. 48, no 3, p. 486-496Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE

    To evaluate the cross-cultural validity of the Demand-Control Questionnaire, comparing the original Swedish questionnaire with the Brazilian version.

    METHODS

    We compared data from 362 Swedish and 399 Brazilian health workers. Confirmatory and exploratory factor analyses were performed to test structural validity, using the robust weighted least squares mean and variance-adjusted (WLSMV) estimator. Construct validity, using hypotheses testing, was evaluated through the inspection of the mean score distribution of the scale dimensions according to sociodemographic and social support at work variables.

    RESULTS

    The confirmatory and exploratory factor analyses supported the instrument in three dimensions (for Swedish and Brazilians): psychological demands, skill discretion and decision authority. The best-fit model was achieved by including an error correlation between work fast and work intensely (psychological demands) and removing the item repetitive work (skill discretion). Hypotheses testing showed that workers with university degree had higher scores on skill discretion and decision authority and those with high levels of Social Support at Work had lower scores on psychological demands and higher scores on decision authority.

    CONCLUSIONS

    The results supported the equivalent dimensional structures across the two culturally different work contexts. Skill discretion and decision authority formed two distinct dimensions and the item repetitive work should be removed.

  • 29.
    Keller Celeste, Roger
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Federal University of Rio Grande do Sul, Brazil.
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Do socioeconomic inequalities in pain, psychological distress and oral health increase or decrease over the life course? Evidence from Sweden over 43 years of follow-up2018In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 72, no 2, p. 160-167Article in journal (Refereed)
    Abstract [en]

    Background Inequalities over the life course may increase due to accumulation of disadvantage or may decrease because ageing can work as a leveller. We report how absolute and relative socioeconomic inequalities in musculoskeletal pain, oral health and psychological distress evolve with ageing. Methods Data were combined from two nationally representative Swedish panel studies: the Swedish Level-of-Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old. Individuals were followed up to 43 years in six waves (1968, 1974, 1981, 1991/1992, 2000/2002, 2010/2011) from five cohorts: 1906-1915 (n=899), 1925-1934 (n=906), 1944-1953 (n=1154), 1957-1966 (n=923) and 1970-1981 (n=1199). The participants were 15-62 years at baseline. Three self-reported outcomes were measured as dichotomous variables: teeth not in good conditions, psychological distress and musculoskeletal pain. The fixed-income groups were: (A) never poor and (B) poor at least once in life. The relationship between ageing and the outcomes was smoothed with locally weighted ordinary least squares, and the relative and absolute gaps were calculated with Poisson regression using generalised estimating equations. Results All outcomes were associated with ageing, birth cohort, sex and being poor at least once in live. Absolute inequalities increased up to the age of 45-64 years, and then they decreased. Relative inequalities were large already in individuals aged 15-25years, showing a declining trend over the life course. Selective mortality did not change the results. The socioeconomic gap was larger for current poverty than for being poor at least once in life. Conclusion Inequalities persist into very old age, though they are more salient in midlife for all three outcomes observed.

  • 30. Kroger, Hannes
    et al.
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Hoffmann, Rasmus
    The Association of Levels of and Decline in Grip Strength in Old Age with Trajectories of Life Course Occupational Position2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 5, article id e0155954Article in journal (Refereed)
    Abstract [en]

    Background The study of the influence of life course occupational position (OP) on health in old age demands analysis of time patterns in both OP and health. We study associations between life course time patterns of OP and decline in grip strength in old age. Methods We analyze 5 waves from the Survey of Health Ageing and Retirement in Europe (n = 5108, ages 65-90). We use a pattern-mixture latent growth model to predict the level and decline in grip strength in old age by trajectory of life course OP. We extend and generalize the structured regression approach to establish the explanatory power of different life course models for both the level and decline of grip strength. Results Grip strength declined linearly by 0.70 kg (95% CI -0.74;-0.66) for men and 0.42 kg (95% CI -0.45;-0.39) for women per year. The level of men's grip strength can best be explained by a critical period during midlife, with those exposed to low OP during this period having 1.67 kg (95% CI -2.33;-1.00) less grip strength. These differences remain constant over age. For women, no association between OP and levels of or decline in grip strength was found. Conclusions Men's OP in midlife seems to be a critical period for the level of grip strength in old age. Inequalities remain constant over age. The integration of the structured regression approach and latent growth modelling offers new possibilities for life course epidemiology.

  • 31. Kvist, Jon
    et al.
    Fritzell, JohanStockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).Hvinden, BjørnKangas, Olli
    Changing Social Equality: The Nordic welfare model in the 21st century2012Collection (editor) (Other academic)
    Abstract [en]

    Changing social equality through state policies was perhaps the greatest legacy of the twentieth century. The Nordic countries in particular have been able to raise living standards and curb inequalities without compromising economic growth. But with social inequalities on the rise, how do they fare when compared with countries with alternative welfare models, such as the UK, the Netherlands and Germany? Taking a comparative perspective, this book casts light on the changing inequalities in Europe. Contributions from experts in a range of fields examine the causes, direction and impact of changes, investigating whether support for egalitarian policies is diminishing and whether policies are becoming less effective at reducing inequalities. The book demonstrates how the Nordic countries seem to be on a track that will eventually lead to a welfare model where ‘some are more equal than others’.

  • 32. Kvist, Jon
    et al.
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hvinden, Bjørn
    Kangas, Olli
    Equality and the Nordic welfare model: principles, pressures and perspectives2012In: Changing Social Equality: The Nordic welfare model in the 21st century / [ed] Jon Kvist, Johan Fritzell, Bjørn Hvinden, Olli Kangas, Bristol: Policy Press, 2012Chapter in book (Other academic)
  • 33. Kvist, Jon
    et al.
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hvinden, Bjørn
    Kangas, Olli
    Nordic responses to rising inequalities: still pursuing a distinct path or joining the rest?2012In: Changing Social Equality: The Nordic welfare model in the 21st century / [ed] Jon Kvist, Johan Fritzell, Bjørn Hvinden, Olli Kangas, Bristol: Policy Press, 2012, p. 201-205Chapter in book (Other academic)
    Abstract [en]

    Whether the Nordic countries have stemmed the international tide of inequality better, worse or merely different from other Western countries is the question addressed in this final chapter. Applying the results of the analysis in the previous chapters, this chapter prepares trends across different aspects of inequality and the Nordic welfare model. The findings point towards a complex transformation of the Nordic welfare model. The overall aim of motivating individuals and helping them find work, form families and excel in society may be intact. However, the mix of policies has become ambiguous in relation to the aims of promoting individuals' agency and protecting their level of living outside work. At the same time, rewarding employment is becoming more dominant.

  • 34. Kölegård Stjärne, M.
    et al.
    Fritzell, Johan
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Estrada, F.
    Nilsson, A.
    Boendesegregationens utveckling och konsekvenser2007In: Socialvetenskaplig tidskrift, no 2-3, p. 153-178Article in journal (Other academic)
  • 35.
    Lennartsson, Carin
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Eyjólfsdóttir, Harpa Sif
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Celeste, Roger Keller
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Social class and infirmity. The role of social class over the life-course2018In: SSM - Population Health, ISSN 2352-8273, Vol. 4, p. 169-177Article in journal (Refereed)
    Abstract [en]

    In an aging society, it is important to promote the compression of poor health. To do so, we need to know more about how life-course trajectories influence late-life health and health inequalities. In this study, we used a life-course perspective to examine how health and health inequalities in late-midlife and in late-life are influenced by socioeconomic position at different stages of the life course. We used a representative sample of the Swedish population born between 1925 and 1934 derived from the Swedish Level of Living Survey (LNU) and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) to investigate the impact of socioeconomic position during childhood (social class of origin) and of socioeconomic position in young adulthood (social class of entry) and late-midlife (social class of destination) on infirmity in late-midlife (age 60) and late-life (age 80). The results of structural equation modelling showed that poor social class of origin had no direct effect on late-midlife and late-life infirmity, but the overall indirect effect through chains of risks was significant. Thus, late-midlife and late-life health inequalities are the result of complex pathways through different social and material conditions that are unevenly distributed over the life course. Our findings suggest that policies that break the chain of disadvantage may help reduce health inequalities in late-midlife and in late-life.

  • 36.
    Lennartsson, Carin
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Silverstein, Merril
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Institute for Futures Studies, Stockholm, Sweden.
    Time-for-Money Exchanges Between Older and Younger Generations in Swedish Families2010In: Journal of family issues, ISSN 0192-513X, E-ISSN 1552-5481, Vol. 31, no 2, p. 189-210Article in journal (Refereed)
    Abstract [en]

    Despite the maturation of welfare states, family solidarity continues to be strong and a growing body of research has shown that substantial financial transfers are passed from older to younger generations within the family. At the same time, family solidarity in terms of instrumental and social support is found to be mutual. This study examines eventual reciprocity in time-for-money exchanges, by combining two large-scale Swedish representative longitudinal studies. It analyzes how earlier social contacts (time) are related to financial transfers (money) and to what extent social class and gender differentials are visible. The findings indicate that parents provide economic transfers if they have more frequent social contact with any of their children, and that these time investments pay off for children who were of higher social class origins. In contrast, no support for gender-specific patterns is found. In conclusion, family solidarity seems to have different bases in different social strata.

  • 37.
    Lundberg, Olle
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Dahl, E.
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Palme, J.
    Sjöberg, O.
    Social Protection, Income and Health Inequalities: Final Report from TG4–GDP, Taxes, Income and Welfare to the Review of Social Determinants and the Health Divide in the WHO Euro Region. WHO2013Report (Other academic)
  • 38.
    Lundberg, Olle
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Åberg Yngwe, Monica
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Kölegård, Maria L.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    The potential power of social policy programmes: income redistribution, economic resources and health2010In: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 19, no s1, p. s2-s13Article in journal (Refereed)
    Abstract [en]

    This Supplement includes a number of articles dealing with the role of social policy schemes for public health across the life course. As a key social determinant of health, poverty and its consequences have historically been at the forefront of the public health discussion. But also in rich countries today, economic resources are likely to be important for health and survival, both on an individual and an aggregate level. This introductory article serves as a background for the more specific analyses that follow. The focus is on why income and income inequality could have an effect on individual and population health. We discuss relationships between the individual and population levels and between income and health, and some of the possible mechanisms involved. We also present arguments for why welfare state institutions may matter.

  • 39.
    Lundberg, Olle
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Åberg Yngwe, Monica
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bacchus Hertzman, Jennie
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bergqvist, Kersti
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Ferranini, Tommy
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Nelson, Kenneth
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Rehnberg, Johan
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Sjöberg, Ola
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    The effect of social protection and income maintenance policies on health and health inequalities2013In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 23, no Suppl. 1Article in journal (Other academic)
    Abstract [en]

    Background

    As a starting point we review the existing evidence on welfare states, health and health inequalities, from 2005 onwards. Three different approaches emerge in these previous studies – the welfare regime approach, the welfare institutions approach and the social spending approach. While no clear picture emerges for the welfare regime approach, summarising findings regarding the institutional and expenditure approach suggest that a higher degree of generosity and social spending benefits public health. These are therefore approaches we follow to arrive at a better understanding of what type of policies are linked to smaller inequalities in health across the life-course.

    Methods

    A starting point in the analyses is the relation between income, poverty and mortality. The cross-national variation in poverty rates, both absolute (poverty threshold) and relative (60 per cent of median income) measure, and mortality rates in European 26 countries will be considered.

    The second step in the analysis focuses on the relationship between social rights and subjective health in Europe, with a focus on national variations and changes in social rights to levels and changes in subjective health outcomes across several countries. The data holds information regarding social rights and social expenditure, including individual data from EU-SILC.

    Results

    Preliminary results indicate that it is the totality of social protection that is important rather than individual policies. A sub-study regarding social rights and health among youth highlight also the importance of active and passive labour market policy in the 16 included countries.

    Conclusions

    In sum our diverse approach to analysing welfare state efforts and their links to health inequalities suggest that there is a clear relationship between more ambitious policies and smaller inequalities in health. These results are discussed in relation to previous findings.

  • 40.
    Lundberg, Olle
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Åberg Yngwe, Monica
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Kölegård Stjärne, Maria
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Björk, Lisa
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    The Nordic Experience: Welfare States and Public Health (NEWS)2008Book (Other academic)
  • 41.
    Lundberg, Olle
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Åberg Yngwe, Monica
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Kölegård Stjärne, Maria
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Elstad, Jon Ivar
    Ferrarini, Tommy
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Kangas, Olli
    Norström, Thor
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Palme, Joakim
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    The role of welfare state principles and generosity in social policy programmes for public health: an international comparative study2008In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 372, no 9650, p. 1633-1640Article in journal (Refereed)
    Abstract [en]

     Background Many important social determinants of health are also the focus for social policies. Welfare states contribute to the resources available for their citizens through cash transfer programmes and subsidised services. Although all rich nations have welfare programmes, there are clear cross-national differences with respect to their design and generosity These differences are evident in national variations in poverty rates, especially among children and elderly people. We investigated to what extent variations in family and pension policies are linked to infant mortality and old-age excess mortality. Methods Infant mortality rates and old-age excess mortality rates were analysed in relation to social policy characteristics and generosity. We did pooled cross-sectional time-series analyses of 18 OECD (Organisation for Economic Co-operation and Development) countries during the period 1970-2000 for family policies and 1950-2000 for pension policies. Findings Increased generosity in family policies that support dual-earner families is linked with lower infant mortality rates, whereas the generosity in family policies that support more traditional families with gainfully employed men and homemaking women is not. An increase by one percentage point in dual-earner support lowers infant mortality by 0.04 deaths per 1000 births. Generosity in basic security type of pensions is linked to lower old-age excess mortality, whereas the generosity of earnings-related income security pensions is not. An increase by one percentage point in basic security pensions is associated with a decrease in the old age excess mortality by 0.02 for men as well as for women. Interpretation The ways in which social policies are designed, as well as their generosity, are important for health because of the increase in resources that social policies entail. Hence, social policies are of major importance for how we can tackle the social determinants of health.

  • 42.
    Modin, Bitte
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    The long arm of the family: Are parental and grandparental earnings related to young men’s body mass index and cognitive ability?2009In: International Journal of Epidemiology, Vol. 38, no 3, p. 733-744Article in journal (Refereed)
  • 43. Mortensen, Laust H.
    et al.
    Rehnberg, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Dahl, Espen
    Diderichsen, Finn
    Elstad, Jon Ivar
    Martikainen, Pekka
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). University of Helsinki, Finland; Max Planck Institute for Demographic Research, Germany.
    Rehkopf, David
    Tarkiainen, Lasse
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Shape of the association between income and mortality: a cohort study of Denmark, Finland, Norway and Sweden in 1995 and 20032016In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 12, article id e010974Article in journal (Refereed)
    Abstract [en]

    Objectives: Prior work has examined the shape of the income-mortality association, but work has not compared gradients between countries. In this study, we focus on changes over time in the shape of income-mortality gradients for 4 Nordic countries during a period of rising income inequality. Context and time differentials in shape imply that the relationship between income and mortality is not fixed. Setting: Population-based cohort study of Denmark, Finland, Norway and Sweden. Participants: We collected data on individuals aged 25 or more in 1995 (n=12.98 million individuals, 0.84 million deaths) and 2003 (n=13.08 million individuals, 0.90 million deaths). We then examined the household size equivalised disposable income at the baseline year in relation to the rate of mortality in the following 5 years. Results: A steep income gradient in mortality in men and women across all age groups except the oldest old in Denmark, Finland, Norway and Sweden. From the 1990s to 2000s mortality dropped, but generally more so in the upper part of the income distribution than in the lower part. As a consequence, the shape of the income gradient in mortality changed. The shift in the shape of the association was similar in all 4 countries. Conclusions: A non-linear gradient exists between income and mortality in most cases and because of a more rapid mortality decline among those with high income the income gradient has become steeper over time.

  • 44.
    Nelson, Kenneth
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Welfare states and population health: the role of minimum income benefits for mortality2014In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 112, p. 63-71Article in journal (Refereed)
    Abstract [en]

    The causes of cross-national differences in population health are subject for intense discussion, often focusing on the role of structural economic factors. Although population health is widely believed to reflect the living conditions in society, surprisingly few comparative studies systematically assess policy impacts of anti-poverty programs. In this paper we estimate the influence of minimum income benefits on mortality using international data on benefit levels in 18 countries 1990-2009. Included are all major non-contributory benefits that low-income households may receive. Our analyses, based on fixed effects pooled time-series regression, show that minimum income benefits improve mortality, measured in terms of age-standardized death rates and life expectancy. The results on country-level links between minimum income benefits and mortality are remarkably robust in terms of measured confounding effects.

  • 45.
    Nilsen, Charlotta
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Andel, Ross
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Kåreholt, Ingemar
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Jönköping University, Sweden.
    Work-related stress in midlife and all-cause mortality: can sense of coherence modify this association?2016In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 26, no 6, p. 1055-1061Article in journal (Refereed)
    Abstract [en]

    Background: Survival reflects the accumulation of multiple influences experienced over the life course. Given the amount of time usually spent at work, the influence of work may be particularly important. We examined the association between work-related stress in midlife and subsequent mortality, investigating whether sense of coherence modified the association. Methods: Self-reported work-related stress was assessed in 1393 Swedish workers aged 42-65 who participated in the nationally representative Level of Living Survey in 1991. An established psychosocial job exposure matrix was applied to measure occupation-based stress. Sense of coherence was measured as meaningfulness, manageability and comprehensibility. Mortality data were collected from the Swedish National Cause of Death Register. Data were analyzed with hazard regression with Gompertz distributed baseline intensity. Results: After adjustment for socioeconomic position, occupation-based high job strain was associated with higher mortality in the presence of a weak sense of coherence (HR, 3.15; 1.62-6.13), a result that was stronger in women (HR, 4.48; 1.64-12.26) than in men (HR, 2.90; 1.12-7.49). Self-reported passive jobs were associated with higher mortality in the presence of a weak sense of coherence in men (HR, 2.76; 1.16-6.59). The link between work stress and mortality was not significant in the presence of a strong sense of coherence, indicating that a strong sense of coherence buffered the negative effects of work-related stress on mortality. Conclusions: Modifications to work environments that reduce work-related stress may contribute to better health and longer lives, especially in combination with promoting a sense of coherence among workers.

  • 46.
    Olsson, Gabriella
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    A Multilevel Study on Ethnic and Socioeconomic School Stratification and Health-Related Behaviors Among Students in Stockholm2015In: Journal of School Health, ISSN 0022-4391, E-ISSN 1746-1561, Vol. 85, no 12, p. 871-879Article in journal (Refereed)
    Abstract [en]

    BACKGROUND

    This study examines the extent to which high alcohol consumption, drug use, and delinquency vary between schools with different socioeconomic characteristics, over and above the pupil's own sociodemographic background.

    METHODS

    Analyses are based on data on 5484 ninth-grade students distributed over 93 schools in Stockholm, from the 2010 Stockholm School Survey. School-level information was retrieved from the Swedish National Agency for Education. School disadvantage was determined by combining information on the level of education among parents and the share of pupils with a nonnative background, 2 aspects that have been shown to be central to school segregation in Sweden.

    RESULTS

    Results indicate significant school-to-school differences in relation to all outcomes. The risk for high alcohol consumption and drug use is greater in more advantaged school settings, adjusting for individual characteristics, whereas the opposite is true in relation to criminal behavior. The school's level of collective efficacy also seems to play an important, albeit not mediating, role.

    CONCLUSIONS

    Regardless of an adolescent's own background, the risk of having adverse health behaviors is higher at certain schools compared to others. However, school socioeconomic factors do not influence health behaviors consistently; instead, it seems as if the association varies depending on the behavior under study.

  • 47.
    Olsson, Gabriella
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    A multilevel study on ethnic and socio-economic school stratification and risk behaviors among students in Stockholm2014In: Growing Up and Growing Old: Health Transitions Throughout the Lifecourse: Abstract Book / [ed] Jane Raimes, 2014Conference paper (Refereed)
  • 48.
    Olsson, Gabriella
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Family Composition and Youth Health Risk Behaviors: the Role of Patental Relation and the School Context2017In: Child Indicators Research, ISSN 1874-897X, E-ISSN 1874-8988, Vol. 10, no 2, p. 403-421Article in journal (Refereed)
    Abstract [en]

    Children not residing with both parents have been shown to be more at risk of negative developmental outcomes than children residing in two-parent families. Few studies have explored how other central contexts may interact with family characteristics to hinder or facilitate youth adjustment. This study examines how aspects of family structure and family processes are associated with youth health risk behaviors and interact with the structural characteristics of schools. The analyses are based on data from the Stockholm School Survey and consist of 5 002 ninth-grade students distributed over 92 schools in the Stockholm area in 2010. School information has been gathered from the Swedish National Agency for Education. Random intercept and fully random models have been used. Results show that adolescents not living with both their parents are more involved in health risk behaviors than adolescents that do. Poor parent–child relations accounts for more of the disadvantage associated with non-traditional family structures than differences in socioeconomic background. Results further suggest that health risk behaviors are more prevalent in more advantaged school settings, net the effect of individual background characteristics. Moreover, advantage school settings are found to accentuate the detrimental effects of poor parent–child relations on health risk behaviors. In conclusion, the study suggests that the effect of family type and family processes on youth behavior is susceptible to contextual effects of the school environment and that more advantage school settings have detrimental direct and indirect effects on youth health risk behaviors.

  • 49.
    Olsson, Gabriella
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    School stratification and risk behaviours among students in Stockholm2012In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 19, no suppl 1, p. 285-286Article in journal (Refereed)
  • 50.
    Olsson, Gabriella
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hemström, Örjan
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Identifying factors associated with good and ill health. Not just opposite sides of the same coin2009In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 16, no 4, p. 323-330Article in journal (Refereed)
    Abstract [en]

    Background  Work-related health research has traditionally focused on identifying risks rather than determinants of good health. Our knowledge of variation in ill health is thus greater than our understanding of such variations in good health. Purpose  In this study, the associations between work-environment exposures and good health are examined. We are especially interested in contrasting our indices of ill health with a narrow measure of good health. Moreover, the salutary effect of sense of coherence (SOC) is explored, focusing particularly on its moderating role. Method  Data stem from the panel of Swedish level of living surveys for 1991 and 2000. The analysis is based on a sample of 2,334 employed men and women. Logistic regressions are used. Results  Assessed work-environment factors are to a large extent related, in a mirrored way, to good health and ill health. The models' fit are, however, generally better for the latter. Our findings also indicate that SOC has a protective role for individuals exposed to work risks such as stress and high physical demands. Conclusion  To improve our understanding of what promotes good health, research needs to focus on salutary factors. One such salutary factor explored in this paper is sense of coherence.

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