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  • 51.
    Rajaleid, Kristiina
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Vågerö, Denny
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Stress resilience in young men mediates the effect of childhood trauma on their offspring's birth weight: An analysis of 250,000 families2019In: SSM - Population Health, ISSN 2352-8273, Vol. 8Article in journal (Refereed)
    Abstract [en]

    Experiencing the death of a parent during childhood is a severe trauma that seems to affect the next generation's birth weight. We studied the consequences of parental loss during childhood for men's psychological and physiological characteristics at age 18, and whether these were important for their first-born offspring's birth outcomes. We used a structured life-course approach and four-way decomposition analysis to analyse data for 250,427 three-generation families retrieved from nationwide Swedish registers and found that psychological resilience was impaired and body mass index was higher in men who had experienced parental death. Both characteristics were linked to offspring birth weight. This was lower by 18.0 g (95% confidence interval: 5.7, 30.3) for men who lost a parent at ages 8-17 compared to other ages. Resilience mediated 40% of this influence. Mediation by body mass index, systolic and diastolic blood pressure was negligible, as was the effect of parental loss on length of gestation. There was no mediation by the education of the men's future spouse. Previous literature has indicated that the period before puberty, the "slow growth period", is sensitive. Our evidence suggests that this may be too narrow a restriction: boys aged 8-17 appear to be particularly likely to respond to parental loss in a way which affects their future offspring's birth weight. We conclude that the observed transgenerational influence on birth weight is mediated by the father's psychological resilience but not by his body mass index or blood pressure.

  • 52. Rajmil, Luis
    et al.
    Taylor-Robinson, David
    Gunnlaugsson, Geir
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Spencer, Nick
    Trends in social determinants of child health and perinatal outcomes in European countries 2005-2015 by level of austerity imposed by governments: a repeat cross-sectional analysis of routinely available data2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 10, article id e022932Article in journal (Refereed)
    Abstract [en]

    Objective To assess whether the level of austerity implemented by national governments was associated with adverse trends in perinatal outcomes and the social determinants of children's health (SDCH) in rich countries Design Longitudinal ecological study of country-level time trends in perinatal outcomes and SDCH and from 2005 to 2015. Setting and participants 16 European countries using available data from the International Monetary Fund, the Organisation for Economic Co-operation and Development and Eurostat. Main outcome measures Trends in perinatal outcomes (low birth weight (LBW); infant mortality) and the SDCH: child poverty rates; severe material deprivation in families with primary education; preschool investment in three time periods: 2005-2007, 2008-2010 and 2012-2015. Outcomes were compared according to the cyclically adjusted primary balance (CAPB, differences between 2013 and 2009) as a measure of austerity, stratified in tertiles. Generalised estimating equation models of repeated measures were used to assess time trend differences in three periods. Results Countries with higher levels of austerity had worse outcomes, mainly at the last study period. Material deprivation increased during the period 2012-2015 in those countries with higher CAPB (interaction CAPB-period 2012-2015, B: 5.62: p<0.001), as did LBW (interaction CAPB-period 2012-2015, B: 0.25; p=0.004). Conclusions Countries that implemented more severe austerity measures have experienced increasing LBW, and for families with primary education also increasing material deprivation, worsening the negative impact of economic crisis. Reversing austerity policies that impact children is likely to improve child health outcomes.

  • 53.
    Ramberg, Joacim
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Brolin Låftman, Sara
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Almquist, Ylva B.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    School effectiveness and students' perceptions of teacher caring: A multilevel study2019In: Improving Schools, ISSN 1365-4802, E-ISSN 1475-7583, Vol. 22, no 1, p. 55-71Article in journal (Refereed)
    Abstract [en]

    The effective schools literature has shown that school-contextual aspects matter for students’ academic and social outcomes. A potential link here may be the quality of the relationships between teachers and students, but few studies have investigated whether features of school effectiveness are in fact associated with students’ perceptions of teacher caring, which is the main purpose of this study. Based on recently collected data from 150 senior-level school units in Stockholm, school effectiveness in terms of teacher-assessed ‘school leadership’, ‘teacher cooperation and consensus’, and ‘school ethos’ (n = 2073) was analyzed in relation to perceived teacher caring as reported by students (n = 8022). Two-level linear regression analyses showed that all three aspects of school effectiveness were predictive of higher levels of perceived teacher caring among students. The findings suggest that these features of school effectiveness constitute an important foundation for promoting the quality of teachers’ relationships with their students.

  • 54.
    Ramberg, Joacim
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Brolin Låftman, Sara
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Teacher Stress and Students’ School Well-being: the Case of Upper Secondary Schools in Stockholm2019In: Scandinavian Journal of Educational Research, ISSN 0031-3831, E-ISSN 1470-1170Article in journal (Refereed)
    Abstract [en]

    Stress and stress-related complaints such as fatigue and depressed mood are common among teachers. Yet, knowledge about the links between the overall level of teacher stress within a school and individual student outcomes is scarce. This study investigates if the levels of teacher-reported stress, fatigue and depressed mood within a school are associated with students’ ratings of their school satisfaction and perceived teacher caring, respectively. Data derives from two separate data collections performed in upper secondary schools in 2016, the Stockholm School Survey (SSS) and the Stockholm Teacher Survey (STS), which were linked together (5367 students and 1045 teachers in 46 schools). Two-level linear regression analyses were performed. Results showed negative associations between school-level teacher stress, fatigue, and depressed mood and students’ school satisfaction and perceived teacher caring, even when controlling for student- and school-level sociodemographic characteristics. The findings suggest that teacher stress may have negative implications for students.

  • 55.
    Ramberg, Joacim
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    School effectiveness and student cheating: Do students’ grades and moral standards matter for this relationship?2019In: Social Psychology of Education, ISSN 1381-2890, E-ISSN 1573-1928, Vol. 22, no 3, p. 517-538Article in journal (Refereed)
    Abstract [en]

    Cheating is a more or less prominent feature of all educational contexts, but few studies have examined its association with aspects of school effectiveness theory. With recently collected data from upper-secondary school students and their teachers, this study aims to examine whether three aspects of school effectiveness—school leadership, teacher cooperation and consensus, and school ethos—are predictive of student’s self-reported cheating, while also taking student- and school-level sociodemographic characteristics as well as student grades and moral standards into consideration. The study is based on combined data from two surveys: one targeting students and the other targeting teachers. The data cover upper secondary schools in Stockholm and includes information from 4529 students and 1045 teachers in 46 schools. Due to the hierarchical data, multilevel modelling was applied, using two-level binary logistic regression analyses. Results show significant negative associations between all three aspects of school effectiveness and student cheating, indicating that these conditions are important to consider in the pursuit of a more ethical, legitimate and equitable education system. Our findings also indicate that the relationship between school effectiveness and student cheating is partly mediated by student grades and moral standards.

  • 56.
    Rehnberg, Johan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    What Levels the Association Between Income and Mortality in Later Life: Age or Health Decline?2020In: The journals of gerontology. Series B, Psychological sciences and social sciences, ISSN 1079-5014, E-ISSN 1758-5368, Vol. 75, no 2, p. 426-435Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Researchers frequently use the "age-as-leveler" hypothesis to explain decreasing inequality and a weakened relationship between socioeconomic position and health in old age. This study examined whether health status can explain the age pattern in the association between income and mortality as predicted by the age-as-leveler hypothesis.

    METHOD: This study used longitudinal (1991-2002) data from the SWEOLD and LNU surveys. The analytical sample consisted of 2,619 people aged 54-92 in 2003. Mortality (2003-2014) and income (1991-2000) was collected from Swedish national registers. Poisson regression was used to estimate associations between mortality, income, age, and health status. Average marginal effects were used to visualize interaction effects between income and age.

    RESULTS: The association between income and mortality weakened in those aged 84 and older. However, health status explained a large part of the effect that age had on the association between income and mortality. Analyses done after stratifying the sample by health status showed that the association between income and mortality was strong in people who reported good health and weak or nonexistent in those who reported poor health.

    DISCUSSION: Age leveled the income-mortality association; however, health status, not age, explained most of the leveling.

  • 57.
    Rehnberg, Johan
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    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).
    Divergence and Convergence: How Do Income Inequalities in Mortality Change over the Life Course?2019In: Gerontology, ISSN 0304-324X, E-ISSN 1423-0003, Vol. 65, no 3, p. 313-322Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Do inequalities in health by income increase or decrease with age? The empirical evidence is not conclusive and competing theories arrive at different conclusions.

    OBJECTIVE: This study examined inequality in mortality by income over the adult life course with longitudinal data on people aged 30-99 between the years 1990 and 2009. Each person was followed for 19 years.

    METHODS: We used Swedish total population data with 5,011,414 individual observations. We calculated the probability of having died for ages between 31 and 99. This approach to calculating death risk incorporates selective mortality during the follow-up period into the measure. Age and year standardized income positions were calculated for all individuals. Inequality was assessed by comparing the top 10% income group and the bottom 10% income group. Relative inequality was measured by risk ratios (RR) and absolute inequality by percentage point differences.

    RESULTS: The results showed that the highest relative income inequality in mortality was at age 56 for men (RR: 4.7) and at age 40 for women (RR: 4.1) with differing patterns across the younger age categories between the sexes. The highest absolute income inequality in mortality was found at age 78 for men (19% difference) and at age 89 for women (14% difference) with similar patterns for both sexes. Both measures of inequality decreased after the peak, with small or no inequalities above age 95. Income inequality in mortality remained in advanced age, with larger absolute inequalities in older ages and larger relative inequalities in younger ages.

    CONCLUSION: The results for absolute and relative measures of inequality differed substantially; this highlights the importance of discussing and making an active choice of inequality measure. To explain and understand the patterns of inequality in mortality over the adult life course, we conclude that the "age-as-leveler" and "cumulative disadvantage" theories are best applied to an absolute measure of inequality.

  • 58. Remes, Hanna
    et al.
    Moustgaard, Heta
    Kestilä, Laura M.
    Martikainen, Pekka
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS). University of Helsinki, Finland; Max Planck Institute of Demographic Research, Germany.
    Parental education and adolescent health problems due to violence, self-harm and substance use: what is the role of parental health problems?2019In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 73, no 3, p. 225-231Article in journal (Refereed)
    Abstract [en]

    Background Adolescent health problems are more prevalent in families with low socioeconomic position, but few studies have assessed the role of parental health in this association. This study examines the extent to which parental health problems, particularly those related to high-risk health behaviour, might explain the association between parental education and adolescent health problems due to violence, self-harm and substance use.

    Methods We used longitudinal register data on a 20% representative sample of all families with children aged 0-14 years in 2000 in Finland with information on parental social background and parental and offspring health problems based on hospital discharge data. We estimated discrete-time survival models with the Karlson-Holm-Breen method on hospital admissions due to violence, self-harm and substance use among adolescents aged 13-19 years in 2001-2011 (n=145 404).

    Results Hospital admissions were 2-3 times more common among offspring of basic educated parents than tertiary educated parents. Similar excess risks were observed among those with parental mental health problems and parental health problems due to violence, self-harm and substance use. The OR for offspring of basic educated parents was attenuated from OR 2.73 (95% CI 2.34 to 3.18) to OR 2.38 (2.04 to2.77) with adjustment for parental health problems, particularly those due to violence, self-harm and substance use. Having both low parental education and parental health problems showed simple cumulative effects.

    Conclusions The excess risks of hospital admissions due to violence, self-harm and substance use among adolescents with lower educated parents are largely independent of severe parental health problems.

  • 59.
    Rostila, Mikael
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Berg, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Saarela, Jan
    Kawachi, Ichiro
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS). Harvard T.H. Chan School of Public Health, USA; Karolinska Institutet, Sweden.
    Experience of sibling death in childhood and risk of psychiatric care in adulthood: a national cohort study from Sweden2019In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 28, no 12, p. 1581-1588Article in journal (Refereed)
    Abstract [en]

    Studies have found that sibling loss is associated with an increased risk of death from external causes (i.e. suicides, accidents and homicides). Increased psychiatric health problems following bereavement could underlie such an association. We studied the influence of sibling loss during childhood on psychiatric care in young adulthood, adjusting for psychosocial covariates shared by siblings in childhood. A national cohort born in Sweden in 1973–1982 (N = 701,270) was followed prospectively until 2013. Cox proportional hazards models were used to analyse the association between sibling loss during childhood and psychiatric inpatient and outpatient care identified by the Hospital Discharge Register. After adjustment for confounders, the HRs of psychiatric care in men who experienced sibling loss were 1.17 (95% CI 1.07–1.27) while the associations turned non-significant in women after adjustment for family-related psychosocial covariates, HR 1.07 (95% CI 0.99–1.16). An increased risk was found in men bereaved in early childhood (1.22 95% CI 1.07–1.38) and adolescence (1.27 95% CI 1.08–1.48). Among women, loss of a sibling during adolescence was significantly associated with psychiatric care (1.19 95% CI 1.03–1.36). Increased psychiatric health problems following bereavement could underlie the previously found association between sibling loss and mortality from external causes. Family-related psychosocial conditions shared by siblings in childhood may account for the association between sibling death and psychiatric care in adulthood.

  • 60.
    Rostila, Mikael
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Juarez, Sol
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Honkaniemi, Helena
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Dunlavy, Andrea
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Sveriges migrationspolitik kan vara en hälsorisk2019In: Dagens samhälle, ISSN 1652-6511Article in journal (Other (popular science, discussion, etc.))
  • 61. Saarela, Jan
    et al.
    Rostila, Mikael
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Mortality after the death of a parent in adulthood: a register-based comparison of two ethno-linguistic groups2019In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29, no 3, p. 582-587Article in journal (Refereed)
    Abstract [en]

    Background: Most research on parental bereavement and health have analysed health consequences of parental loss in childhood, while collateral health in adulthood has been less studied. Methods: Using register-based population data from Finland, we analyse adult offspring aged 18-50 years with discrete-time hazard models that adjust for offspring and parental socioeconomic and demographic characteristics. In focus are adult children whose parents were alive and lived together at the beginning of the observation period. We compare two culturally distinct but otherwise similar ethno-linguistic groups, Finnish speakers and Swedish speakers. Results: The results suggest that bereaved men have an approximately 30% higher death risk than non-bereaved men, while there is practically no difference in women. Associations between parental and child deaths are, as expected, stronger for concordant causes of death than for discordant causes of death. However, some associations for discordant causes of death remain, which may indicate causality. Among Swedish speakers, who have notably higher family stability than Finnish speakers, the death of one or both parents shows a stronger association with own mortality. Conclusions: The estimated associations found are generally larger than in the neighbouring country Sweden, which may be due to a stronger obedience to traditional family values and patriarchal family roles in Finland. These findings suggest that the association between parental death and mortality in adult offspring may depend on the societal context as well as on cultural practices. These factors should be increasingly acknowledged in future studies on collateral health.

  • 62. Sanchez-Niubo, Albert
    et al.
    Egea-Cortés, Laia
    Olaya, Beatriz
    Caballero, Francisco Félix
    Ayuso-Mateos, Jose L.
    Prina, Matthew
    Bobak, Martin
    Arndt, Holger
    Tobiasz-Adamczyk, Beata
    Pająk, Andrzej
    Leonardi, Matilde
    Koupil, Ilona
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Panagiotakos, Demosthenes
    Tamosiunas, Abdonas
    Scherbov, Sergei
    Sanderson, Warren
    Koskinen, Seppo
    Chatterji, Somnath
    Haro, Josep Maria
    Cohort Profile: The Ageing Trajectories of Health - Longitudinal Opportunities and Synergies (ATHLOS) project2019In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 48, no 4, p. 1052-1053iArticle in journal (Refereed)
  • 63.
    Vågerö, Denny
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Pinger, Pia R.
    Aronsson, Vanda
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    van den Berg, Gerard J.
    Paternal grandfather's access to food predicts all-cause and cancer mortality in grandsons2018In: Nature Communications, ISSN 2041-1723, E-ISSN 2041-1723, Vol. 9, article id 5124Article in journal (Refereed)
    Abstract [en]

    Studies of animals and plants suggest that nutritional conditions in one generation may affect phenotypic characteristics in subsequent generations. A small number of human studies claim to show that pre-pubertal nutritional experience trigger a sex-specific transgenerational response along the male line. A single historical dataset, the Overkalix cohorts in northern Sweden, is often quoted as evidence. To test this hypothesis on an almost 40 times larger dataset we collect harvest data during the pre-pubertal period of grandparents (G0, n = 9,039) to examine its potential association with mortality in children (G1, n = 7,280) and grandchildren (G2, n = 11,561) in the Uppsala Multigeneration Study. We find support for the main Overkalix finding: paternal grandfather's food access in pre-puberty predicts his male, but not female, grandchildren's all-cause mortality. In our study, cancer mortality contributes strongly to this pattern. We are unable to reproduce previous results for diabetes and cardiovascular mortality.

  • 64.
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Ojämlikhet i levnadsvillkor och hälsa – resultat från Välfärdsundersökningarna för barn och ungdomar2018In: Barn och föräldrar i socialförsäkringen: Rapport från forskarseminariet i Umeå 17–18 januari 2018, Försäkringskassan , 2018, , p. 12p. 85-96Chapter in book (Other academic)
  • 65.
    Östergren, Olof
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Martikainen, Pekka
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS). University of Helsinki, Finland; The Max Planck Institute for Demographic Research, Germany.
    Tarkiainen, Lasse
    Elstad, Jon Ivar
    Brønnum-Hansen, Henrik
    Contribution of smoking and alcohol consumption to income differences in life expectancy: evidence using Danish, Finnish, Norwegian and Swedish register data2019In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 73, no 4, p. 334-339Article in journal (Refereed)
    Abstract [en]

    Background Despite being comparatively egalitarian welfare states, the Nordic countries have not been successful in reducing health inequalities. Previous studies have suggested that smoking and alcohol contribute to this pattern. Few studies have focused on variations in alcohol-related and smoking-related mortality within the Nordic countries. We assess the contribution of smoking and alcohol to differences in life expectancy between countries and between income quintiles within countries.

    Methods We collected data from registers in Denmark, Finland, Norway and Sweden comprising men and women aged 25–79 years during 1995–2007. Estimations of alcohol-related mortality were based on underlying and contributory causes of death on individual death certificates, and smoking-related mortality was based on an indirect method that used lung cancer mortality as an indicator for the population-level impact of smoking on mortality.

    Results About 40%–70% of the between-country differences in life expectancy in the Nordic countries can be attributed to smoking and alcohol. Alcohol-related and smoking-related mortality also made substantial contributions to income differences in life expectancy within countries. The magnitude of the contributions were about 30% in Norway, Sweden and among Finnish women to around 50% among Finnish men and in Denmark.

    Conclusions Smoking and alcohol consumption make substantial contributions to both between-country differences in mortality among the Nordic countries and within-country differences in mortality by income. The size of these contributions vary by country and sex.

12 51 - 65 of 65
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