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  • 201. Fransson, Eleonor I.
    et al.
    Nyberg, Solja T.
    Heikkilä, Katriina
    Alfredsson, Lars
    De Bacquer, Dirk
    Batty, G. David
    Bonenfant, Sebastien
    Casini, Annalisa
    Clays, Els
    Goldberg, Marcel
    Kittel, France
    Koskenvuo, Markku
    Knutsson, Anders
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Nordin, Maria
    Singh-Manoux, Archana
    Suominen, Sakari
    Vahtera, Jussi
    Westerholm, Peter
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University College London, UK.
    Zins, Marie
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kivimäki, Mika
    Comparison of alternative versions of the job demand-control scales in 17 European cohort studies: the IPD-Work consortium2012In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, article id 62Article in journal (Refereed)
    Abstract [en]

    Background: Job strain (i.e., high job demands combined with low job control) is a frequently used indicator of harmful work stress, but studies have often used partial versions of the complete multi-item job demands and control scales. Understanding whether the different instruments assess the same underlying concepts has crucial implications for the interpretation of findings across studies, harmonisation of multi-cohort data for pooled analyses, and design of future studies. As part of the 'IPD-Work' (Individual-participant-data meta-analysis in working populations) consortium, we compared different versions of the demands and control scales available in 17 European cohort studies. Methods: Six of the 17 studies had information on the complete scales and 11 on partial scales. Here, we analyse individual level data from 70 751 participants of the studies which had complete scales (5 demand items, 6 job control items). Results: We found high Pearson correlation coefficients between complete scales of job demands and control relative to scales with at least three items (r > 0.90) and for partial scales with two items only (r = 0.76-0.88). In comparison with scores from the complete scales, the agreement between job strain definitions was very good when only one item was missing in either the demands or the control scale (kappa > 0.80); good for job strain assessed with three demand items and all six control items (kappa > 0.68) and moderate to good when items were missing from both scales (kappa = 0.54-0.76). The sensitivity was > 0.80 when only one item was missing from either scale, decreasing when several items were missing in one or both job strain subscales. Conclusions: Partial job demand and job control scales with at least half of the items of the complete scales, and job strain indices based on one complete and one partial scale, seemed to assess the same underlying concepts as the complete survey instruments.

  • 202.
    Fransson, Emma
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Barn i växelvis boende – en forskningsöversikt2015Report (Other academic)
    Abstract [sv]

    Varje år separerar föräldrar till ungefär 50 000 barn i Sverige. Sedan 1980-talet bor en ökande andel av dessa barn växelvis efter separationen. Växelvis boende innebär att barnen flyttar regelbundet mellan sina föräldrars respektive hem och bor ungefär lika mycket hos båda. En högre andel barn bor i växelvis boende i Sverige än i något annat land, ca 35-40 procent av de barn som har särlevande föräldrar, totalt cirka 200 000 barn.

    Denna rapport har skrivits av forskare i Elvis-projektet på CHESS vid Stockholms Universitet/Karolinska institutet på uppdrag av Socialstyrelsen. Den ger en sammanfattning av den forskningsbaserade kunskapen om hälsa och välbefinnande hos barn i växelvis boende. När det gäller barn under sex år, där kunskapsläget är mest osäkert, ger rapporten en heltäckande bild av den internationella forskningen, inklusive en översikt av den psykologiska teoribildningen på området. För skolbarnen finns det ett ganska stort antal svenska studier och därför har vi här valt att lägga fokus på dessa och endast komplettera med särskilt relevant forskning från andra länder. Att det finns mer forskning kring skolbarn beror delvis på att växelvis boende är vanligare för de åldersgrupperna, men främst på att man lättare kan ta in deras egna åsikter och erfarenheter, medan forskning kring de yngre barnen är mer komplicerad metodologiskt sett, och därför mer resurskrävande.

    Anknytningsteorins betoning av kvaliteten i interaktionen mellan små barn och deras vårdgivare ger anledning att särskilt skärskåda konsekvenserna av växelvist boende för de yngsta barnen. Resultaten från studierna av barn 0-3 år ger inte en entydig bild av barns välbefinnande och anknytningsrelationer. Flera av de få studierna håller låg vetenskaplig kvalitet och studerar små grupper. En tillräcklig empirisk bas för de yngsta barnen i växelvis boende saknas därmed. Sammantaget visar studierna att föräldrars samarbetsförmåga, sätt att hantera konflikter och lyhördhet för barnets behov spelar större roll än boendeform.

    I rapporten presenteras tio svenska tvärsnittsstudier av skolbarn från 10 års ålder i stora nationellt eller regionalt representativa surveyundersökningar samt en studie med biologiska data. I en majoritet av studierna rapporteras barn i växelvis boende ha mindre psykisk ohälsa och bättre välbefinnande än jämnåriga som bor med bara en förälder. Detta mönster är likartat hos pojkar och flickor. Tvärsnittsdesignen i samtliga studier gör dock att man bör vara försiktig med alltför definitiva slutsatser, eftersom denna design inte gör det möjligt att fullt ut ta hänsyn till skillnader i bakomliggande faktorer som t ex föräldrars hälsa, sociala situation och kommunikation sinsemellan.

    Studier pekar på olika faktorer som kan tänkas förklara att barn i växelvis boende överlag verkar ha en större chans till god psykisk hälsa än barn som bor med enbart en förälder. Barn i växelvis boende har genomsnittligt bättre materiella resurser än barn som bor med bara en förälder. Även med god kontroll för socioekonomiska skillnader mellan olika slags familjer visar dock merparten av studierna att skolbarn och tonåringar i växelvis boende mår bättre än de som bor enbart med en förälder, varför det är rimligt att spekulera i andra fördelar med växelvis boende. En möjlig förklaring skulle kunna vara att barn i växelvis boende har tillgång till, och stöd från, båda sina föräldrar. Barn i växelvis boende har också oftare en god relation till båda sina föräldrar än de som bor med enbart eller mest med en förälder.

    En rad kunskapsluckor identifieras i rapporten. Studier av god metodologisk kvalitet som fokuserar på de yngsta barnen, framför allt 0-3 år, saknas i särskilt hög grad. Longitudinella studier som har förutsättningar att mäta förändringar i psykisk hälsa och välbefinnande före och efter att föräldrar separerar är också mycket angelägna, liksom studier med ett individperspektiv som kan ge vägledning för beslut om boendeform för särskilt sårbara barn när föräldrar separerar. Ökningen av andelen barn som bor växelvis är en av de största förändringarna i barns livsvillkor i Sverige under de senaste åren. Det är också en förändring som är en uppenbart påverkbar faktor i barns liv. Det är således angeläget att resurser görs tillgängliga för att fylla de kunskapsluckor som identifieras.

    Avslutningsvis kan konstateras att det saknas forskning som kan ge ett definitivt svar på vilka konsekvenser växelvis boende har för barns hälsa och välbefinnande efter att föräldrar separerat. Med denna begränsning är det ändå värt att notera är att inte finns någon studie som tyder på att barns hälsa skulle vara sämre i växelvis boende än i boende med enbart en förälder från 4 års ålder, men att avsaknaden av kunskap om barn 0-3 år gör att några slutsatser inte alls bör dras om denna åldersgrupp.

  • 203.
    Fransson, Emma
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Brolin Låftman, Sara
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    The Living Conditions of Children with Shared Residence – the Swedish Example2018In: Child Indicators Research, ISSN 1874-897X, E-ISSN 1874-8988, Vol. 11, no 3, p. 861-883Article in journal (Refereed)
    Abstract [en]

    Among children with separated parents, shared residence–i.e., joint phys-ical custody where the child is sharing his or her time equally between two custodialparents’homes–is increasing in many Western countries and is particularly commonin Sweden. The overall level of living among children in Sweden is high; however, thepotential structural differences between children in various post-separation familyarrangements have not been sufficiently studied. Potential risks for children with sharedresidence relate to the daily hassles and stress when having two homes. This study aimsat investigating the living conditions of children with shared residence compared withchildren living with two custodial parents in the same household and those living withone custodial parent, respectively. Swedish national survey data collected from childrenaged 10–18 years (n≈5000) and their parents were used. The outcomes were groupedinto: Economic and material conditions, Social relations with parents and peers, Healthand health behaviors, Working conditions and safety in school and in the neighbor-hood, and Culture and leisure time activities. Results from a series of linear probabilitymodels showed that most outcomes were similar for children with shared residence andthose living with two custodial parents in the same household, while several outcomeswere worse for children living with one parent. However, few differences due to livingarrangements were found regarding school conditions. This study highlights the in-equalities in the living conditions of Swedish children, with those living with oneparent having fewer resources compared with other children.

  • 204.
    Fransson, Emma
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Folkesson, Lisa
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Exploring salivary cortisol and recurrent pain in mid-adolescents living in two homes2014In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 21, no Suppl. 1, p. S23-S23Article in journal (Refereed)
    Abstract [en]

    Introduction: Every year, around 50.000 children in Sweden experience a separation between their parents. Joint physical custody (JPC), where the child alternates homes between the parents for about equal amount of time, has become a common living arrangement after parental separation. Children living in two homes can benefit from everyday contact with both parents and access to both parents’ financial resources. However, children can also experience stress from constantly moving and from exposure to any parental conflict. Yet, research on JPC and stress-related biological functioning is limited. The aimof this study was to investigate how living arrangements (intact family/JPC) relate toHPA-axis activity and recurrent pain in mid-adolescents. Methods: Mid-adolescents (106 girls and 51 boys) provided demographic details, self-reports of recurrent pain (headache, stomachache, neck/shoulder and back pain) and salivary samples. Salivary cortisol samples were collected: 1) immediately at awakening, 2) +30 minutes, 3) +60 minutes, and 4) at 8 p.m. Results: Hierarchical regressions showed that living arrangements did not predict morning cortisol levels, the diurnal cortisol rhythm nor recurrent pain. However, sex was significantly associated with both morning cortisol and recurrent pain. Conclusion: Living arrangements were not linked to HPA-axis activity or recurrent pain in this group of well-functioning mid-adolescents. Although this is the first study investigating how living arrangements relate to HPA-axis functioning, which means that additional research is needed, the findings suggest that these mid-adolescents have adapted to their living arrangements and that other factors seem more pertinent for HPA-functioning and subjective health complaints.

  • 205.
    Fransson, Emma
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Sarkadi, Anna
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska University Hospital, Sweden.
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Why should they live more with one of us when they are children to us both?: Parents' motives for practicing equal joint physical custody for children aged 0–42016In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 66, p. 154-160Article in journal (Refereed)
    Abstract [en]

    Joint physical custody, i.e., children spending an equal amount of time in both parents' home after a separation or divorce, is increasing in many countries. In line with the national policy to promote paternal involvement in parenting, two-thirds of Swedish preschoolers with non-cohabiting parents live in two homes. Internationally, there has been a debate regarding the benefits or risks with joint physical custody for infants and toddlers. The aim of this qualitative study was to explore the reasons given by divorced parents for sharing joint physical custody of children 0-4 years of age. Interviews were conducted with 46 parents (18 fathers and 28 mothers) and analyzed using systematic text condensation. Two themes emerged in response to the research question. In the theme Same rights and responsibilities, parents described that joint physical custody was 'a given' as both parents were seen to have equal rights to and responsibility for the children. Both men and women described involved fatherhood as an ideal goal. In the theme For the sake of the child, parents emphasized that joint physical custody was in the best interest of the child. Some parents had conflicts with their ex-spouses, but were still convinced of the benefits of joint physical custody and strove to make it work.

  • 206.
    Fransson, Emma
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Turunen, Jani
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Psychological complaints among children in joint physical custody and other family types: Considering parental factors2016In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, no 2, p. 177-183Article in journal (Refereed)
    Abstract [en]

    Aims: Increasing proportions of Scandinavian children and children in other Western countries live in joint physical custody, moving between parents’ homes when parents live apart. Children and parents in non-intact families are at risk of worse mental health. The potential influence of parental ill-health on child well-being in the context of differing living arrangements has not been studied thoroughly. This study investigates the psychological complaints of children in joint physical custody in comparison to children in sole parental care and nuclear families, while controlling for socioeconomic differences and parental ill-health. Methods: Data were obtained from Statistics Sweden’s yearly Survey of Living Conditions 2007–2011 and child supplements with children 10–18 years, living in households of adult participants. Children in joint physical custody (n=391) were compared with children in sole parental care (n=654) and children in nuclear families (n=3,639), using a scale of psychological complaints as the outcome measure. Results: Multiple regression modelling showed that children in joint physical custody did not report higher levels of psychological complaints than those in nuclear families, while children in sole parental care reported elevated levels of complaints compared with those in joint physical custody. Adding socioeconomic variables and parental ill-health only marginally attenuated the coefficients for the living arrangement groups. Low parental education and parental worry/anxiety were however associated with higher levels of psychological complaints. Conclusions: Psychological complaints were lower among adolescents in joint physical custody than in adolescents in sole parental care. The difference was not explained by parental ill-health or socioeconomic variables.

  • 207.
    Fresk, Henrik
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Övelius, Martin
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Folkhälsa i förändring: En komparativ studie av hälsoutvecklingen i de postkommunistiska staterna Tjeckien, Polen, Estland och Ryssland2005Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Denna uppsats avser att utreda om och i så fall varför folkhälsan i de postkommunistiska staterna Ryssland, Polen, Tjeckien och Estland har utvecklats olika sedan Sovjetunionens sammanbrott. Huvudsyftet med uppsatsen är att undersöka och förklara skillnaden i hälsoläget efter den så kallade rubelkrisen 1998. Skillnader i hälsoutveckling ställs mot å ena sidan ekonomiska - och å andra sidan sociala faktorer. Tänkbara samband mellan bland annat förväntad livslängd och bruttonationalprodukten (BNP) per capita samt inkomstfördelning prövas. Dödlighet och förväntad livslängd undersöks i respektive land för perioden 1989-2002. Mortalitetens eventuella samband med sjukdomen levercirros samt alkoholkonsumtion över samma tidsperiod analyseras. Datamaterialet är sekundärdata och en kvantitativ komparativ metod används för analysen. Data är konstruerad främst som medelvärden för ett specifikt årtal för respektive land. Materialet består således av ett populationsurval.

    Två olika teoretiska utgångspunkter gör anspråk på att försöka förklara problematiken med transformationen från kommunism till demokrati. Det är den nyliberala - samt den mer socialorienterade ekonomiska teorin. Dessa ställs mot varandra i början av denna uppsats. Tidigare forskningsresultat tyder på en kraftig försämring av folkhälsan efter 1989 i främst Ryssland och Estland medan Tjeckien och Polen uppvisat en positiv hälsoutveckling. Våra resultat visar att det troligtvis är sociala och psykosociala faktorer, såsom hur en familje- och arbetssituation exempelvis kan påverka en persons hälsotillstånd, som verkar vara avgörande för förståelsen av ökad ohälsa. Analysen visar vidare att en ojämn ekonomisk fördelningspolitik tillsammans med en svag institutionell infrastruktur har en stark inverkan på ovannämnda faktorer. Ryssland presenterar ett avvikande resultat i jämförelse med de tre övriga länderna för flertalet av undersökta variabler. Vi har funnit att Tjeckien och Polen står för den mest hoppingivande förändringen beträffande dödlighet och förväntad livslängd. Estland har dragits med svårigheter att komma tillrätta med landets hälsoproblematik, men har under senare år uppvisat mer positiva siffror. Ryssland representerar däremot fortsatt negativ hälsoutveckling trots en liknande ekonomisk tillväxt. Att landet så sent som år 2002 redovisar en mycket hög dödlighetsfrekvens och låg förväntad livslängd ser vi som anmärkningsvärt. Skillnader i dödlighet och förväntad livslängd mellan könen och mellan de olika länderna visade sig vara mycket stora. Det bör noteras att denna uppsats endast är inriktad på att belysa den skillnad i förväntad livslängd och dödlighet som uppkommit sedan sammanbrottet 1989 fram till 2002.

  • 208.
    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)
  • 209.
    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.

  • 210.
    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)
  • 211.
    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.

  • 212. 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)
  • 213. 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.

  • 214. Fröberg, Frida
    et al.
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Rosendahl, Ingvar K
    Tengström, Anders
    Hallqvist, Johan
    The association between compulsory school achievement and problem gambling among Swedish young people2015In: Journal of Adolescent Health, ISSN 1054-139X, E-ISSN 1879-1972, Vol. 56, no 4, p. 420-428Article in journal (Refereed)
    Abstract [en]

    Purpose: We aimed to examine the association between school grades at the age of 16 years and problem gambling at the age of 17-25 years among Swedish females and males. Methods: In a cohort design, we followed the 16-to 24-year-old participants in the representative Swedish Longitudinal Gambling Study for 2 years, 2008/2009 and 2009/2010, generating 3,816 person-years of follow-up time. The outcome, incidence of mild and moderate/severe gambling problems, was measured by the Problem Gambling Severity Index in telephone interviews. The exposure was register-linked information about final grades in compulsory school. The association between school grades and problem gambling was estimated in multinomial logistic regressions. Results: Low and average school grades were associated with increased incidence of mild and moderate/severe problem gambling compared to high grades, adjusted for sociodemographic characteristics, psychological distress, and alcohol use. Low grades, compared to high grades, were associated with a higher risk of mild gambling problems for adolescent males, whereas the incidence proportion of moderate/severe problem gambling was high for males aged 20-25 years with low grades, among whom unemployment was also very high. Furthermore, we found a strong and graded association between school grades and moderate/severe problem gambling for women in both age groups, despite a low prevalence of gambling participation among females compared to males. Conclusions: Our findings show that Swedish youth with low school achievement have an increased risk of gambling problems up to 8 years after school graduation, after control for confounding from sociodemographic characteristics, psychological distress, and alcohol use, and that this association is stronger for females than males.

  • 215. Gao, M.
    et al.
    Goodman, Anna
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Mishra, Gita
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Koupil, Ilona
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Developmental origins of perimenopausal disorders: evidence from a Swedish cohort2017In: Journal of Developmental Origins of Health and Disease, ISSN 2040-1744, E-ISSN 2040-1752, Vol. 8, no Suppl. 1Article in journal (Refereed)
  • 216.
    Gao, Menghan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Exposure to out-of-home care in childhood and adult all-cause mortality: A life-course perspective2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: The experience of childhood out-of-home care (OHC) has been linked to

    adverse health outcomes in young adulthood. However, less is known about the long-term

    influence of OHC on alumni’s mortality risk, or about the mechanisms from a life-course

    perspective.

    Objectives: This study aimed to examine the gender-specific association between exposure to

    OHC in childhood and all-cause mortality in adulthood, while taking into account different

    placement characteristics. Additionally, mechanisms based on different life-course models

    were analysed.

    Methods: A longitudinal study of the 1953 Stockholm birth cohort (n=14,294). Sex-stratified

    Cox regression analyses were used to examine all-cause mortality during 1981 to 2009.

    Results: Male and female OHC alumni had around three times higher risk of all-cause

    mortality in adulthood, compared to the majority population. Mortality risks were particularly

    pronounced among those who were placed during adolescence because of behavioural

    problems, who experienced both family foster care and residential care, and who spend more

    than one year in care. The associations were reduced but remained significant after

    adjustments for life-course socioeconomic factors.

    Conclusions: Adults with OHC experience constitute a high-risk group for earlier death. In

    terms of being a social intervention, OHC does not seem to improve this vulnerable group’s

    life chances.

  • 217.
    Gao, Menghan
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Almquist B., Ylva
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Exposure to out-of-home care in childhood and adult all-cause mortality: a cohort study2017In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 46, no 3, p. 1010-1017Article in journal (Refereed)
    Abstract [en]

    Background: Children placed in out-of-home care (OHC) have exceedingly high rates of health problems. Their poor health tends to persist across adolescence and into young adulthood, resulting in increased risks of mortality. Yet, very little is known about this group’s mortality risks later in life. The aim of this study was to investigate whether OHC was associated with the risk of all-cause mortality across adulthood, and whether these risks varied across different placement characteristics. Moreover, the study addressed potential confounding by including two comparison groups with children who grew up under similarly adverse living conditions but did not experience placement.

    Methods: Data were derived from a 60-year follow-up of a Stockholm cohort born in 1953 (n = 15 048), of whom around 9% have had experiences of OHC. The associations between OHC and subsequent all-cause mortality were analysed by means of Cox’s proportional hazards regression models.

    Results: Individuals who were placed in OHC at any point during their formative years had increased mortality risks across ages 20 to 56 years. Elevated risk of mortality was particularly pronounced among those who were placed in adolescence and/or because of their own behaviours. Children who were exposed to OHC had increased risks of mortality also when compared with those who grew up under similar living conditions but did not experience placement.

    Conclusions: Children in OHC constitute a high-risk group for subsequent mortality. In order to narrow the mortality gap, interventions may need to monitor not only health aspects but also to target the cognitive and social development of these children.

  • 218.
    Garcy, Anthony
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Whitehead, M
    The relationship between school quality, educational quality, and health inequalities: A critical review. In: Developing Methodologies to Reduce Inequalities in the Determinants of Health (DEMETRIQ),2014Report (Other academic)
  • 219.
    Garcy, Anthony M.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Extending the Uppsala Birth Cohort Multigenerational Study Database With a New Collection From Archival Sources: Collection and Error Correction Strategies When Problems Arise2018Other (Refereed)
    Abstract [en]

    This case study is an account of the 2014-2016 effort to expand a Swedish research database called the Uppsala Birth Cohort Multigenerational Study. The research project collected and photographed available data on school quality from local, regional, and national Swedish archives. The discovery of a widespread data quality issue in the existing database ultimately prevented the completion of the data collection and the execution of the planned research. A narrative is given about the challenges of conducting a complex, multistage archival data collection. Some of the problems that were encountered are mentioned. Practical methods and strategies that were used to collect the relevant data from the archival material are discussed. The methods used in the conversion and entry of some of this material into an electronic, numerical database format are also reviewed.

  • 220.
    Garcy, Anthony M.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    The Effects of Health Insurance Coverage on the Math Achievement Trajectories of School Children in Yuma County, Arizona: Implications for Education Accountability Policy2013In: Education Policy Analysis Archives, ISSN 1068-2341, E-ISSN 1068-2341, Vol. 21, no 80, p. 1-28Article in journal (Refereed)
    Abstract [en]

    U.S. Federal and state education policies place considerable emphasis on assessing the effects that schools and teachers have on student test score performance. It is important for education policy makers to also consider other factors that can affect student achievement. This study finds that an exogenous school factor, discontinuous health insurance coverage, leads to a deficit in math achievement over time. A sample of Yuma County, Arizona public school students who experienced an illness or injury and whose health insurance coverage status was known were selected for inclusion into the study over five consecutive school years (1999 – 2003). The longitudinal math achievement trajectory of students who had private health insurance coverage was compared to students who had discontinuous coverage. Net of a student’s poverty status and other background characteristics the findings suggest that students who experienced a health event when they had no healthcare insurance had the same growth rate but lower overall math achievement. The average achievement gap was a constant -8.84 scale score points. However, separate analyses for specific types of illness/injury suggest the achievement deficit varied considerably and is typically larger.

  • 221.
    Garcy, Anthony M.
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Berliner, David C.
    A critical review of the literature on the relationship between school quality and health inequalities2018In: Review of Education/Pedagogy/Cultural Studies, ISSN 1071-4413, E-ISSN 1556-3022, Vol. 6, no 1, p. 40-66Article, review/survey (Refereed)
    Abstract [en]

    Robust evidence suggesting a strong association between greater educational attainment, betterhealth and lower mortality, has led to speculation that the quality of schooling can also have effectson health. This review critically summarises findings from 15 studies in a growing area of researchconcerning the effects of school quality on health. Findings suggested positive, long-term benefits ofhigh-quality pre-school. Other findings suggested that higher teacher wages, lower pupil–teacherratios, a longer school year, and higher college selectivity had mostly positive long-term effects onhealth and mortality. Several studies found that school quality modified the effect of years of completededucation on various health outcomes. Some measures of school quality including smallerclass size in relation to mortality, and higher college selectivity in the case of smoking were not consistentlyrelated to better health. While studies varied in their consistency and significance, theweight of the evidence together, suggests that some health inequalities over the life course wereexplained partly by differences in school quality. This may be related to improved cognition, occupationalcharacteristics, and the incomes of those exposed to better quality schooling. Direct healthknowledge and behaviour may also play a role.

  • 222.
    Garcy, Anthony M.
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Berliner, David C.
    Context and Implications Document for: A critical review of the literature on the relationship between school quality and health inequalities2018In: Review of Education, ISSN 2049-6613, Vol. 6, no 1, p. 67-68Article in journal (Other academic)
  • 223.
    Garcy, Anthony M.
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Vågerö, Denny
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    The length of unemployment predicts mortality, differently in men and women, and by cause of death: A six year mortality follow-up of the Swedish 1992-1996 recession2012In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 74, no 12, p. 1911-1920Article in journal (Refereed)
    Abstract [en]

    This study examines the relationship between the total amount of accumulated unemployment during the deep Swedish recession of 1992-1996 and mortality in the following 6 years. Nearly 3.4 million Swedish men and women, born between 1931 and 1965 who were gainfully employed at the time of the 1990 census were included. Almost 23% of these individuals were unemployed at some point during the recession. We conduct a prospective cohort study utilizing Cox proportional hazard regression with a mortality follow-up from January 1997 to December 2002. We adjust for health status (1982-1991), baseline (1991) social, family, and employer characteristics of individuals before the recession. The findings suggest that long-term unemployment is related to elevated all-cause mortality for men and women. The excess mortality effects were small for women and attributable to a positive, linear increase in the hazard of alcohol disease-related mortality and external causes-of-death not classified as suicides or transport accidents. For men, the excess hazard of all-cause mortality was best represented by a cubic, non-linear shape. The predicted hazard increases rapidly with the shortest and longest accumulated levels of unemployment. However, the underlying pattern differed by cause-of-death. The cancer, circulatory, and alcohol disease-related analyses suggest that mortality peaks with mid-levels of accumulated unemployment and then declines with longer duration unemployment. For men, we observed a positive, linear increase in the hazard ratios associated with transport and suicide mortality, and a very steep non-linear increase in the excess hazard ratio associated with other external causes of death that were not classified as suicide or transport accidents. In conclusion, mortality risk increases with the duration of unemployment among men and women. This was best described by a cubic function for men and a linear function for women. Behind this pattern, different causes-of-death varied in their relation to the accumulation of unemployment.

  • 224. Garde, Anne Helene
    et al.
    Karlson, Berndt
    Hansen, Åse Marie
    Persson, Roger
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Sleep and salivary cortisol2012In: The role of saliva cortisol measurement in health and disease / [ed] Margareta Kristenson, Peter Garvin, Ulf Lundberg, Bentham Science , 2012, p. 116-128Chapter in book (Refereed)
    Abstract [en]

    The aim of the present chapter was to analyze whether measures of cortisol in saliva were associated with measures of sleep and to explore if divergent results were related to underlying differences in theoretic assumptions and methods. Measures of sleep quality included sleep duration, overall sleep quality, difficulty falling asleep, disturbed sleep, and sleep deprivation. Twenty-three papers were found to fulfil the inclusion criteria. Cortisol measures were grouped into single time points at different times during the day, deviations at different time periods during the day, reactivity and recovery after a standardized laboratory test, area under the curve and response to dexamethasone test. A large proportion of the studies included showed nonsignificant findings, which, in several cases, may be a result of low power. The most consistent results were a positive association between sleep duration and single measures of salivary cortisol at awakening, which was observed in 3 studies. In these studies, sleep duration was also associated with low evening cortisol levels, steep diurnal deviation of cortisol and/or high area under the curve. Together these findings suggest that longer sleep duration is related to a more dynamic cortisol secretion. Two of the 6 studies on disturbed or restless sleep showed relations to flat diurnal deviation and low laboratory stress test reactivity. This to some extent corroborates the findings on sleep duration. However, the many nonsignificant findings as well as the theoretical and methodological differences (e.g., heterogeneity in measures) complicate comparisons. Conflicting results may be at least partially due to differences in methods and underlying assumptions.

  • 225.
    Garefelt, Johanna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Sverke, Magnus
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Work and sleep – a prospective study of psychosocial work factors, physical work factors and work scheduling2014In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 23, no S1, p. 218-218, article id P706Article in journal (Refereed)
  • 226.
    Gauffin, Karl
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Björkenstam, Emma
    Childhood Household Dysfunction, Social Inequality and Alcohol Related Illness in Young Adulthood. A Swedish National Cohort Study2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 3, article id e0151755Article in journal (Refereed)
    Abstract [en]

    The aim of this paper is to estimate the cumulative effect of childhood household dysfunction (CHD) on alcohol related illness and death later in life and to test the interaction between CHD and socioeconomic background. The study utilised Swedish national registers including data of a Swedish national cohort born 1973-82 (n = 872 912), which was followed from age 18 to 29-40 years. Cox regression analyses were used to calculate hazard ratios (HR) for alcohol related illness or death in young adulthood. The CHD measure consisted of seven indicators: parental alcohol/drug misuse, mental health problems, criminality, death, divorce, social assistance, and child welfare interventions. Childhood socioeconomic position (SEP) was indicated by parental occupational status. Outcomes were alcohol related inpatient hospital care, specialised outpatient care or deaths. Using the highest socioeconomic group without CHD experience as a reference, those in the same socioeconomic group with one indicator of CHD had HRs of 2.1 [95% CI: 1.7-2.5], two CHD indicators 5.6 [4.4-7.1], three or more indicators 9.4 [7.1-12.4] for retrieving inpatient care. Socioeconomic disadvantage further increased the risks-those with low socioeconomic background and three CHD indicators or more had a HR of 12.5 [10.9-14.3]. Testing for interaction suggests that the combined HRs deviates from additivity [Synergy index: 1.6, 95% CI: 1.4-1.9]. The results for outpatient care were similar, but not as pronounced. In conclusion, this Swedish national cohort study shows that childhood household dysfunction is strongly and cumulatively associated to alcohol related illness later in life and that it interacts with socioeconomic disadvantage.

  • 227.
    Gauffin, Karl
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    School performance and alcohol-related disorders in early adulthood: a Swedish national cohort study2015In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 44, no 3, p. 919-927Article in journal (Refereed)
    Abstract [en]

    Background Alcohol misuse is an important global health determinant and a major contributor to health inequalities. We aimed to investigate the association between school performance and alcohol-related disorders in early adulthood in a longitudinal register-based national cohort study. Methods We followed a register-based national cohort of Swedish citizens born 1973-1984 (N = 948 440) from compulsory school graduation at age 15-16 to 2009. We divided the population into five groups: high school marks (> mean+1 SD); high average (between mean and mean - 1 SD); low average (between mean and mean - 1 SD); low (< mean - 1SD); and missing. Cox proportional hazard models were used to investigate the relation between school marks at time of graduation and hospital care for alcohol-related disorders in early adulthood. Results There was a steep gradient in the risk of alcohol-related disorders related to school performance. In comparison with peers in the top category of school marks, students with low marks had adjusted hazard ratios of 8.02 [95% confidence interval (CI) 7.20 to 8.91], low average 3.02 (2.72 to 3.35) and high average 1.55 (1.39 to 1.73). The risk associated with low school marks was stronger in the male population and in the group from high socioeconomic background. Conclusions The study demonstrated a strong graded relation between low school performance and alcohol-related disorders in young adulthood. School performance should be taken into account when developing prevention programmes/policies targeting alcohol misuse among teenagers and young adults, especially if the aim is to reach high-risk groups.

  • 228.
    Ghamari, Vanessa
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Work strain in midlife and old age disability: A longitudinal study with 23 years of follow up.2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Increasing parts of the world are facing ageing societies with growing figures of morbidity and disability. Focus of attention for European countries is directed towards prevention of old age impairment. As considerable time is spent at work, preventative psychosocial work environment measures could be entry points for a healthier ageing. The aims of this study are to i) explore the impact of mid-life work strain on old age disability ii) to examine the independent effects of the work strain components on disability, iii) to analyse the relation between education and disability and whether work strain mediates parts of this association. Work strain and baseline data will be collected from Level of Living Survey (LNU) 1981 and disability data from Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) 2004 (n=626). Multiple logistic regression analysis showed that persons in high strain work had the lowest odds of being IADL disabled compared to the passive group. Low demand was not associated to disability, low control group had more than twice the odds of being ADL disabled. Further results indicated that work strain may mediate the association between education and disability. Finally the results support that psychosocial work environment plays a part in the health of individuals at old age.

  • 229.
    Ghilagaber, Gebrenegus
    Stockholm University, Faculty of Social Sciences, Department of Statistics.
    Advances in modelling maternal and child health in Africa: what have we learned and what is next?2014In: Advanced techniques for modelling maternal and child health in Africa / [ed] Ngianga-Bakwin Kandala; Gebrenegus Ghilagaber, Dordrecht: Springer Netherlands, 2014, p. 321-325Chapter in book (Refereed)
  • 230.
    Ghilagaber, Gebrenegus
    Stockholm University, Faculty of Social Sciences, Department of Statistics.
    Analysis of grouped survival data: a synthesis of various traditions and application to modeling childhood mortality in Eritrea2014In: Advanced techniques for modelling maternal and child health in Africa / [ed] Ngianga-Bakwin Kandala, Gebrenegus Ghilagaber, Dordrecht: Springer, 2014, p. 107-122Chapter in book (Refereed)
  • 231.
    Ghilagaber, Gebrenegus
    Stockholm University, Faculty of Social Sciences, Department of Statistics.
    Disentangling selection and causality in assessing the effects of health inputs on child survival: case studies from east Africa2014In: Advanced Techniques for Modelling Maternal and Child Health in Africa / [ed] Ngianga-Bakwin Kandala, Gebrenegus Ghilagaber, Dordrecht: Springer Netherlands, 2014, p. 11-28Chapter in book (Refereed)
  • 232.
    Ghilagaber, Gebrenegus
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Statistics.
    Elisa, Woldeyesus
    A Family of Flexible Parametric Duration Functions and their Applications to Modeling Child-Spacing in Sub-Saharan Africa2014In: Advanced techniques for modelling maternal and child health in Africa / [ed] Ngianga-Bakwin Kandala, Gebrenegus Ghilagaber, Springer, 2014, p. 185-209Chapter in book (Refereed)
    Abstract [en]

    Examining the dynamics of child spacing is of interest for several reasons. First, several inferences are consistent with the view that in much of the developing world, women with large families have shorter birth intervals than those with smaller families. There is thus an indication of an inverse relationship between spacing and completed or cumulative fertility. The spacing of births also has a significant bearing on maternal and child health through the dynamics of sibling competition, maternal depletion and interval effect hypotheses.

  • 233. Giordano, Guiseppe Nicola
    et al.
    Mewes, Jan
    Miething, Alexander
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Trust and all-cause mortality: a multilevel study of US General Social Survey data (1978–2010)2018In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738Article in journal (Refereed)
    Abstract [en]

    Background Within public health research, generalised trust has been considered an independent predictor of morbidity and mortality for over two decades. However, there are no population-based studies that have scrutinised both contextual-level and individual-level effects of generalised trust on all-cause mortality. We, therefore, aim to investigate such associations by using pooled nationally representative US General Social Survey (GSS) data linked to the National Death Register (NDI).

    Methods The combined GSS–NDI data from the USA have 90 contextual units. Our sample consisted of 25 270 respondents from 1972 to 2010, with 6424 recorded deaths by 2014. We used multilevel parametric Weibull survival models reporting HRs and 95% CI (credible intervals for Bayesian analysis). Individual-level and contextual-level generalised trust were the exposures of interest; covariates included age, race, gender, marital status, education and household income.

    Results We found a robust, significant impact of individual-level and contextual-level trust on mortality (HR=0.92, 95% CI 0.88 to 0.97; and HR=0.96, 95% CI 0.93 to 0.98, respectively). There were no discernible gender differences. Neither did we observe any significant cross-level interactions.

    Conclusion High levels of individual and contextual generalised trust protect against mortality, even after considering numerous individual and aggregated socioeconomic conditions. Its robustness at both levels hints at the importance of psychosocial mechanisms, as well as a trustworthy environment. Declining trust levels across the USA should be of concern; decision makers should consider direct and indirect effects of policy on trust with the view to halting this decline.

  • 234. Goisis, Alice
    et al.
    Remes, Hanna
    Barclay, Kieron
    Stockholm University, Faculty of Social Sciences, Department of Sociology. London School of Economics and Political Science, United Kingdom; Max Planck Institute for Demographic Research, Germany.
    Martikainen, Pekka
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Myrskylä, Mikko
    Advanced Maternal Age and the Risk of Low Birth Weight and Preterm Delivery: a Within-Family Analysis Using Finnish Population Registers2017In: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 186, no 11, p. 1219-1226Article in journal (Refereed)
    Abstract [en]

    Advanced maternal age at birth is considered a major risk factor for birth outcomes. It is unclear to what extent this association is confounded by maternal characteristics. To test whether advanced maternal age at birth independently increases the risk of low birth weight (< 2,500 g) and preterm birth (< 37 weeks' gestation), we compared between-family models (children born to different mothers at different ages) with within-family models (children born to the same mother at different ages). The latter procedure reduces confounding by unobserved parental characteristics that are shared by siblings. We used Finnish population registers, including 124,098 children born during 1987-2000. When compared with maternal ages 25-29 years in between-family models, maternal ages of 35-39 years and a parts per thousand<yen>40 years were associated with percentage increases of 1.1 points (95% confidence intervals: 0.8, 1.4) and 2.2 points (95% confidence intervals: 1.4, 2.9), respectively, in the probability of low birth weight. The associations are similar for the risk of preterm delivery. In within-family models, the relationship between advanced maternal age and low birth weight or preterm birth is statistically and substantively negligible. In Finland, advanced maternal age is not independently associated with the risk of low birth weight or preterm delivery among mothers who have had at least 2 live births.

  • 235. Goldblatt, Peter
    et al.
    Siegrist, Johannes
    Lundberg, Olle
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Marinetti, Claudia
    Farrer, Linden
    Costongs, Caroline
    Improving health equity through action across the life course: summary of evidence and recommendations from the drivers project2015Report (Other academic)
  • 236. Gomes de Matos, Elena
    et al.
    Hannemann, Tessa-Virginia
    Atzendorf, Josefine
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institute for Therapy Research, Germany.
    Piontek, Daniela
    The Consumption of New Psychoactive Substances and Methamphetamine Analysis of Data From 6 German Federal States2018In: Deutsches Ärzteblatt International, ISSN 1866-0452, E-ISSN 1866-0452, Vol. 115, no 4, p. 49-55Article in journal (Refereed)
    Abstract [en]

    Background: The abuse of new psychoactive substances (NPS) and methamphet amine has severe adverse effects. Here we provide the first report of regional patterns in NPS and methamphetamine consumption in Germany, on the basis of epidemiologic data from six federal states (Bavaria, Hamburg, Hesse, North Rhine-Westphalia, Saxony, and Thuringia). Methods: Data were derived from the 2015 Epidemiological Survey of Substance Abuse (Epidemiologischer Suchtsurvey) and supplemented with additional cases from the federal states that were studied. The numbers of persons included in the representative samples of persons aged 18 to 64 in each state were 1916 (Bavaria), 1125 (Hamburg), 1151 (Hesse), 2008 (North Rhine-Westphalia), 1897 (Saxony), and 1543 (Thuringia). Potential risk factors for the lifetime prevalence of consumption were studied by logistic regression. Results: The lifetime prevalence of methamphetamine consumption in the individual states ranged from 0.3% (North Rhine-Westphalia) to 2.0% (Saxony). Thuringia and Saxony displayed values that were significantly higher than average. For NPS, the figures ranged from 2.2% (Bavaria) to 3.9% (Hamburg), but multivariate analysis revealed no statistically significant differences between the states. Higher age and higher educational level were associated with lower consumption of NPS and methamphetamine, while smoking and cannabis use were each associated with higher consumption. Conclusion: NPS consumption is equally widespread in all of the federal states studied. Methamphetamine is rarely consumed; its consumption appears to be higher in Saxony and Thuringia. The risk factor analysis reported here should be interpreted cautiously in view of the low case numbers with respect to consumption.

  • 237. Gomes de Matos, Elena
    et al.
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institute for Therapeutic Research, Germany.
    Hannemann, Tessa-Virginia
    Soellner, Renate
    Piontek, Daniela
    Cross-cultural variation in the association between family's socioeconomic status and adolescent alcohol use2017In: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 36, no 6, p. 797-804Article in journal (Refereed)
    Abstract [en]

    Introduction and Aims. This study estimates cross-country variation in socioeconomic disparities in adolescent alcohol use and identifies country-level characteristics associated with these disparities. Design and Methods. The association between socioeconomic status (family wealth and parental education) and alcohol use (lifetime use and episodic heavy drinking) of 15- to 16-year-olds from 32 European countries was investigated. Country-level characteristics were national income, income inequality and per capita alcohol consumption. Multilevel modelling was applied. Results. Across countries, lifetime use was lower in wealthy than in less wealthy families (odds ratio [OR]((girls))=0.95, OR(boys)=0.94). The risk of episodic heavy drinking, in contrast, was higher for children from wealthier families (OR(girls)=1.04, OR(boys)=1.08) and lower when parents were highly educated (ORs=0.95-0.98). Socioeconomic disparities varied substantially between countries. National wealth and income inequality were associated with cross-country variation of disparities in lifetime use in few comparisons, such that among girls, the (negative) effect of family wealth was greatest in countries with unequally distributed income (OR=0.86). Among boys, the (negative) effect of family wealth was greatest in low-income countries (OR=1.00), and the (positive) effect of mothers' education was greatest in countries with high income inequality (OR=1.11). Discussion and Conclusions. Socioeconomic disparities in adolescent alcohol use vary across European countries. Broad country-level indicators can explain this variation only to a limited extent, but results point towards slightly greater socioeconomic disparities in drinking in countries of low national income and countries with a high income inequality. [Gomes de Matos E, Kraus L, Hannemann T-V, Soellner R, Piontek D. Cross-cultural variation in the association between family's socioeconomic status and adolescent alcohol use.

  • 238. Gonçalves, MA
    et al.
    Amici, R
    Peigneux, P
    Luckas, R
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Cirignotta, FC
    Horne, J
    Léger, D
    McNicholas, W
    Partinen, M
    Téran Santos, J
    Grote, L
    The wake-up bus sleep study: falling asleep at the wheel in 19 European countries2014Conference paper (Other academic)
  • 239. Goodman, Anna
    et al.
    Gisselmann, Marit
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Koupil, Ilona
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Size at birth and early life social characteristics predict educational outcomes: consistency across Swedish cohorts born 1915-1929 and 1973-1980 (abstract)2010In: Longitudinal and Life Course Studies, Vol. 1, no 3 Supplemebt, p. 210-Article in journal (Refereed)
  • 240.
    Goodman, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). London School of Hygiene and Tropical Medicine, United Kingdom.
    Heshmati, Amy
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Koupil, Ilona
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Family history of education predicts eating disorders across multiple generations: a study of one million Swedish females born 1973-19982013In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 23, p. 108-108Article in journal (Other academic)
  • 241. Grape Viding, Christina
    et al.
    Osika, Walter
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kowalski, Jan
    Hallqvist, Johan
    Bojner Horwitz, Eva
    "The culture palette" – a randomized intervention study for women with burnout symptoms in Sweden2015In: British Journal of Medical Practitioners, ISSN 1757-8515, Vol. 8, no 2, article id a813Article in journal (Refereed)
    Abstract [en]

    Burnout is common among women in Sweden. Cultural activities, i.e. arts, have benefitted different patient populations and may have potential for treating this group as well. Aim: To evaluate possible health effects of regular cultural activities for women with burnout symptoms with focus on exhaustion level.Methods: 48 women (mean age 54) were randomly assigned either to a cultural activity group (intervention group) or to a control group. Four health care centers were the settings for a “Culture Palette” comprised of six different cultural activity packages: interactive theater, movie, vocal improvisation and drawing, dance, mindfulness training and musical show. The activity packages were offered once a week over a period of three months. Standardized questionnaires; the Karolinska Exhaustion Disorder Scale ( KEDS), Sense of Coherence (SOC), Toronto Alexithymia Scale (TAS)  and Self-rated health  were used at baseline, in month three and at follow-up in month six. Qualitative interviews with patients, cultural producers and health care staff were conducted at month three and month six.Results: Burnout symptoms/exhaustion (P< .001) and alexithymia (P=0.007) as well as self-rated health (P<0.001) improved more in the intervention group than in the control group with clinically relevant effect variances. There was no statistical evidence of any difference in the development of SOC between the intervention and the control group. The healthcare staff were also positively affected although they did not participate in the cultural activities. Conclusion: Regular cultural activities affected this group of women beneficially with enhanced health and decreased levels of exhaustion.

  • 242.
    Griep Härter, Rosane
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bastos S., Leonardo
    da Fonseca, Maria de Jesus Mendes
    Silva-Costa, Aline
    Portela, Luciana Fernandes
    Toivanen, Susanna
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Rotenberg, Lucia
    Years worked at night and body mass index among registered nurses from eighteen public hospitals in Rio de Janeiro, Brazil2014In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 14, p. 603-Article in journal (Refereed)
    Abstract [en]

    Background: Employees working night shifts are at a greater risk of being overweight or obese. Few studies on obesity and weight gain analyze the years of exposure to night work. The aim of this study was to determine the relationship between the years of exposure to night work and body mass index (BMI) among registered nurses. Methods: A cross-sectional analysis was performed in 18 largest public hospitals in Rio de Janeiro, Brazil. A total of 2,372 registered nurses ( 2,100 women) completed a comprehensive questionnaire concerning sociodemographic, professional, lifestyle, and health behavioral data. Current and past exposures to night shifts as well as BMI values were measured as continuous variables. A gamma regression model was used with an identity link function to establish the association. Results: The association between years of exposure to night work and BMI was statistically significant for both women and men after adjusting for all covariates [beta = 0.036; CI95% = 0.009-0.063) and beta = 0.071 (CI95% = 0.012-0.129), respectively]. The effect of night work was greater among men than women. For example, for those women who have worked at night for 20 years the estimated average BMI was 25.6 kg/m(2) [range, 25.0-26.2]. In relation to men, after 20 years of exposure to night work the estimated average BMI was 26.9 kg/m(2) [range, 25.6-28.1]. Conclusions: These findings suggest that night shift exposure is related to BMI increases. Obesity prevention strategies should incorporate improvements in work environments, such as the provision of proper meals to night workers, in addition to educational programs on the health effects of night work.

  • 243. Griep, Yannick
    et al.
    Magnusson Hanson, Linda
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Vantilborgh, Tim
    Janssens, Laurens
    Jones, Samantha K.
    Hyde, Martin
    Can volunteering in later life reduce the risk of dementia? A 5-year longitudinal study among volunteering and non-volunteering retired seniors2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 3, article id e0173885Article in journal (Refereed)
    Abstract [en]

    We propose that voluntary work, characterized by social, physical and cognitive activity in later life is associated with fewer cognitive problems and lower dementia rates. We test these assumptions using 3-wave, self-reported, and registry data from the 2010, 2012, and 2014 Swedish National Prescribed Drug Register. We had three groups of seniors in our data: 1) no volunteering (N = 531), 2) discontinuous volunteering (N = 220), and 3) continuous volunteering (N = 250). We conducted a path analysis in Mplus to investigate the effect of voluntary work (discontinuously and continuously) on self-reported cognitive complaints and the likelihood of being prescribed an anti-dementia treatment after controlling for baseline and relevant background variables. Our results indicated that seniors, who continuously volunteered, reported a decrease in their cognitive complaints over time, whereas no such associations were found for the other groups. In addition, they were 2.44 (95%CI [1.86; 3.21]) and 2.46 (95%CI [1,89; 3.24]) times less likely to be prescribed an anti-dementia treatment in 2012 and 2014, respectively. Our results largely support the assumptions that voluntary work in later life is associated with lower self-reported cognitive complaints and a lower risk for dementia, relative to those who do not engage, or only engage episodically in voluntary work.

  • 244. Griswold, Max G.
    et al.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Gakidou, Emmanuela
    Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 20162018In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 392, no 10152, p. 1015-1035Article in journal (Refereed)
    Abstract [en]

    Background

    Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.

    Methods

    Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health.

    Findings

    Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5–3·0) of age-standardised female deaths and 6·8% (5·8–8·0) of age-standardised male deaths. Among the population aged 15–49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2–4·3) of female deaths and 12·2% (10·8–13·6) of male deaths attributable to alcohol use. For the population aged 15–49 years, female attributable DALYs were 2·3% (95% UI 2·0–2·6) and male attributable DALYs were 8·9% (7·8–9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0–1·7] of total deaths), road injuries (1·2% [0·7–1·9]), and self-harm (1·1% [0·6–1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2–33·3) of total alcohol-attributable female deaths and 18·9% (15·3–22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0–0·8) standard drinks per week.

    Interpretation

    Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.

    Funding

    Bill & Melinda Gates Foundation.

  • 245.
    Grossi, Giorgio
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. The Stress Clinic Foundation, Sweden.
    Jeding, Kerstin
    Söderström, Marie
    Osika, Walter
    Levander, Maria
    Perski, Aleksander
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. The Stress Clinic Foundation, Sweden.
    Self-reported sleep lengths ≥ 9 hours among Swedish patients with stress-related exhaustion: associations with depression, quality of sleep and levels of fatigue2015In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 69, no 4, p. 292-299Article in journal (Refereed)
    Abstract [en]

    Background: Insomnia-type sleep disturbances are frequent among patients suffering from stress-related exhaustion disorder. However, clinical observations indicate that a subgroup suffer from sleep lengths frequently exceeding 9 hours, coupled with great daytime sleepiness. Aims: The aim of the present study was to investigate differences in socio-demographic variables, use of medications, sleep parameters, anxiety, depression and fatigue, between individuals with varying sleep lengths, in a sample of 420 Swedish patients (mean age 42 ± 9 years; 77% women) referred to treatment for exhaustion disorder. Patients were allocated to the groups: "never/seldom ≥ 9 hours" (n = 248), "sometimes ≥ 9 hours" (n = 115) and "mostly/always ≥ 9 hours" (n = 57), based on their self-rated frequency of sleep lengths ≥ 9 hours. Methods: The design was cross-sectional and data was collected by means of questionnaires at pre-treatment. Results: Univariate analyses showed that patients in the "mostly/always ≥ 9 hours" group were more often on sick leave, and reported more depression and fatigue, better sleep quality and more daytime sleepiness, than patients in the other groups. Multivariate analyses showed that these patients scored higher on measures of fatigue than the rest of the sample independently of gender, use of antidepressants, sick leave, depression and quality of sleep. Conclusions: Patients suffering from exhaustion disorder and reporting excessive sleep seem to have a generally poorer clinical picture but better quality of sleep than their counterparts with shorter sleep lengths. The mechanisms underlying these differences, together with their prognostic value and implications for treatment remain to be elucidated in future studies.

  • 246.
    Gustafsson, Jan-Eric
    et al.
    Göteborgs universitet.
    Allodi Westling, Mara
    Stockholm University, Faculty of Social Sciences, Department of Special Education.
    Alin Åkerman,, Britta
    Stockholm University, Faculty of Social Sciences, Department of Special Education.
    Eriksson, Charli
    Örebro universitet.
    Eriksson, Lilly
    Folkhälsoinstitutet.
    Fischbein, Siv
    Stockholm University, Faculty of Social Sciences, Department of Special Education.
    Granlund, Mats
    Högskolan i Jönköping.
    Gustafsson, Per
    Linköpings universitet.
    Ljungdahl, Sophia
    Folkhälsoinsitutet.
    Ogden, Terje
    Universitetet i Oslo.
    Persson, Roland S.
    Högskolan i Jönköping.
    School, Learning and Mental Health: A systematic review2010Report (Other academic)
    Abstract [sv]

    Rapporten presenterar resultaten från en systematisk översikt av forskning om skola, lärande och barns psykiska hälsa. Kungliga Vetenskapsakademiens Hälsoutskottet har givit uppdraget att genomföra en sådan översikt till en arbetsgrupp som har arbetat med uppdraget från hösten 2008 till mars 2009.

    Det första syftet med översikten är att genomföra en kartläggning av forskning inom det breda fält som behandlar frågor om skola, lärande och barns och ungdomars psykiska hälsa. Det andra syftet är att genomföra en narrativ syntes av forskning som undersökt orsaksförhållanden mellan psykisk hälsa å ena sidan och skolresultat och lärande å den andra sidan. Det tredje syftet är att redovisa resultat från forskning som har studerat svenska barns och ungdomars erfarenheter och upplevelser av skola och undervisningssituationer. För att uppnå de första två syftena genomfördes systematiska litteratursökningar i bibliografiska databaser av artiklar publicerade i vetenskapliga internationella tidskrifter inom olika discipliner. Det tredje syftet undersöktes med litteratursökningar av kvalitativa svenska studier i bibliografiska databaser.

    Slutsatser

    På grundval dels av kartläggningen av forskning om skola, lärande och psykisk hälsa, dels av de två fördjupade översikterna kan följande slutsatser dras:

    • Omfattningen av forskning som undersöker relationerna mellan olika aspekter av skola och psykisk hälsa är begränsad och i synnerhet gäller detta forskning som undersöker organisationsfaktorer och undervisnings-faktorer, aktiviteter, läroplaners utformning, resurser, specialpedagogiskt stöd, och olika former av betyg och bedömning.

    • Tidiga svårigheter i skolan och i synnerhet läs- och skrivsvårigheter kan orsaka internaliserande och externaliserande psykiska problem.

    • Svårigheter i skola och psykiska problem tenderar att vara stabila över tid.

    • Skolrelaterade hälsoproblem tenderar att minska när eleverna börjar på gymnasiet och får tillgång till nya områden av aktiviteter, roller och valmöjligheter.

    • Att genomföra stora ansträngningar utan att detta leder till resultat är relaterat till utveckling av depression.

    Problem i skolan med skolresultat och prestationer orsakar inter-naliserande symptom för flickor under tonåren.

    • Det finns samband mellan olika typer av psykiska problem och de är också relaterade till ett brett spektrum av somatiska och psykosomatiska symptom.

    • Internaliserande och externaliserande psykiska problem har negativa effekter på skolprestationer genom mekanismer som är delvis ålders- och genusspecifika.

    • Kompetenser och prestationer i skolan är relaterade till psykisk hälsa.

    • Goda resultat i skolan har en positiv effekt på självuppfattning.

    • En god självuppfattning bidrar inte direkt till bättre resultat, men andra faktorer som är relaterade till självuppfattning (motivation och upplevd inre/yttre kontroll) påverkar lärande och resultat

    • Relationer med klasskamrater och lärare bidrar till processer som kopplar skolmisslyckande till psykisk ohälsa. Relationer med kamrater och lärare kan också skydda mot utvecklingen av psykiska problem.

    • Jämförelser med klasskamrater påverkar självuppfattningen, med effekter som varierar beroende på gruppsammansättning och typ av skola.

  • 247. Gustafsson, Klas
    et al.
    Marklund, Staffan
    Aronsson, Gunnar
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Wikman, Anders
    Floderus, Birgitta
    Interaction Effects of Social Isolation and Peripheral Work Position on Risk of Disability Pension: A Prospective Study of Swedish Women and Men2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 6, article id e0130361Article in journal (Refereed)
    Abstract [en]

    Purpose The study examines various combinations of levels of social isolation in private life and peripheral work position as predictors of disability pension (DP). A second aim was to test the potential interaction effects (above additivity) of social isolation and peripheral work position on the future risk of DP, and to provide results for men and women by age. Method The study was based on a sample of 45567 women and men from the Swedish population who had been interviewed between 1992 and 2007. Further information on DP and diagnoses was obtained from the Swedish Social Insurance Agency's database (1993-2011). The studied predictors were related to DP using Cox's proportional hazard regression. The analyses were stratified on sex and age (20-39 years, 40-64 years), with control for selected confounders. Results Increased risks of DP were found for most combinations of social isolation and peripheral work position in all strata. The hazard ratios (HRs) for joint exposure to high degree of social isolation and a peripheral work position were particularly strong among men aged 20-39 (HR 5.70; CI 95% 3.74-8.69) and women aged 20-39 (HR 4.07; CI 2.99-5.56). An interaction effect from combined exposure was found for women in both age groups as well as a tendency in the same direction among young men. However, after confounder control the effects did not reach significance. Conclusions Individuals who were socially isolated and in a peripheral work position had an increased risk of future DP. The fact that an interaction effect was found among women indicates that a combination of social isolation and peripheral work position may reinforce adverse health effects. There was no evidence that a peripheral work position can be compensated by a high degree of social intergration in private life.

  • 248.
    Gustafsson, Nina-Katri
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Alcohol-related problems in southern Sweden before and after major changes in availability of cheap alcohol2007Conference paper (Other academic)
  • 249.
    Gustafsson, Nina-Katri
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Mäns och kvinnors alkoholvanor i en tid av förändring: förväntade resultat och utvecklingen decennierna efter det svenska EU-medlemsskapet2014In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 91, no 6, p. 35-42Article in journal (Refereed)
    Abstract [en]

    Several large changes which were assumed to have a large impact on Swedes drinking have been implemented since 1995. The first studies showed increases in consumption levels. This article discusses the later changes and focuses in particular on men’s and women’s drinking after 2004 and how these were affected by the changes. It was expected that population groups known to drink large amounts, i.e. men, young and high consumers, would be the ones who would increase their drinking the most. Looking back, those were rather the groups which decreased their drinking. Instead an increase could be noted among those traditionally known as low consumers, e.g. older women. The article ends with a discussion on what could explain the unexpected results.

  • 250. Gustafsson, Per E.
    et al.
    Janlert, Urban
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Hammarström, Anne
    Social and material adversity from adolescence to adulthood and allostatic load in middle-aged women and men: results from the Northern Swedish Cohort2012In: Annals of Behavioral Medicine, ISSN 0883-6612, E-ISSN 1532-4796, Vol. 43, no 1, p. 117-28Article in journal (Refereed)
    Abstract [en]

    Background

    Little is known about the theoretically assumed association between adversity exposure over the life course and allostatic load in adulthood.

    Purpose

    This study aims to examine whether social and material adversity over the life course is related to allostatic load in mid-adulthood.

    Methods

    A 27-year prospective Swedish cohort (N = 822; 77% response rate) reported exposure to social and material adversities at age 16, 21, 30 and 43 years. At age 43, allostatic load was operationalized based on 12 biological parameters.

    Results

    Social adversity accumulated over the life course was related to allostatic load in both women and men, independently of cumulative socioeconomic disadvantage. Moreover, social adversity in adolescence (in women) and young adulthood (in men) was related to allostatic load, independently of cumulative socioeconomic disadvantage and also of later adversity exposure during adulthood.

    Conclusion

    Exposure to adversities involving relational threats impacts on allostatic load in adulthood and operates according to life course models of cumulative risk and a sensitive period around the transition into adulthood.

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