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  • 51. Malmberg, Gunnar
    et al.
    Nilsson, Lars-Goran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Weinehall, Lars
    Longitudinal data for interdisciplinary ageing research. Design of the Linnaeus Database2010Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, nr 7, s. 761-767Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: To allow for interdisciplinary research on the relations between socioeconomic conditions and health in the ageing population, a new anonymized longitudinal database - the Linnaeus Database - has been developed at the Centre for Population Studies at Umea University. This paper presents the database and its research potential. Design: Using the Swedish personal numbers the researchers have, in collaboration with Statistics Sweden and the National Board for Health and Welfare, linked individual records from Swedish register data on death causes, hospitalization and various socioeconomic conditions with two databases - Betula and VIP (Vasterbottens Intervention Programme) - previously developed by the researchers at Umea University. Whereas Betula includes rich information about e. g. cognitive functions, VIP contains information about e. g. lifestyle and health indicators. Population and sample size: The Linnaeus Database includes annually updated socioeconomic information from Statistics Sweden registers for all registered residents of Sweden for the period 1990 to 2006, in total 12,066,478. The information from the Betula includes 4,500 participants from the city of Umea and VIP includes data for almost 90,000 participants. Both datasets include cross-sectional as well as longitudinal information. Potential: Due to the coverage and rich information, the Linnaeus Database allows for a variety of longitudinal studies on the relations between, for instance, socioeconomic conditions, health, lifestyle, cognition, family networks, migration and working conditions in ageing cohorts. Conclusions: By joining various datasets developed in different disciplinary traditions new possibilities for interdisciplinary research on ageing emerge.

  • 52. Mather, Lisa
    et al.
    Blom, Victoria
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Arbets- och organisationspsykologi. Karolinska Institutet, Sweden; The Swedish School of Sport and Health Sciences, Sweden.
    Bergström, Gunnar
    Svedberg, Pia
    Adverse outcomes of sick leave due to mental disorders: A prospective study of discordant twin pairs2019Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 47, nr 2, s. 127-136Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: The aim of this study was to investigate whether sick leave due to different mental disorders increased the risk of reoccurring sick-leave, disability pension and unemployment, taking genetics and shared environment into account. Methods: This register-based cohort study contains 2202 discordant twin pairs 18-64 years old, where one twin had sick leave due to a mental disorder 2005-2006. The end of the sick-leave spell was the start of follow-up for both twins. The twins were followed up for reoccurring sick-leave, disability pension and unemployment (> 180 days in a year), until December 2012. Analyses were censored for disability pension, death, emigration and old-age pension. Cox proportional hazards models with time-varying covariates were used to calculate hazard ratios with 95% confidence intervals (CI). Results: Those with sick leave due to mental disorders had a 3.64 (CI: 3.24-4.08) times higher risk of reoccurring sick-leave within the first two years; after that, hazard ratios were attenuated and explained by genetic factors. The first year, they had 12.24 (CI: 8.11-18.46) times the risk of disability pension. The risk was attenuated but remained at 2.75 (CI: 2.07-3.65) after one year. The risk of unemployment was 1.99 (CI: 1.72-2.31) during the whole follow-up period. The risk of unemployment and disability pension was lower for those with stress-related than other mental disorders, this was less clear for recurrent reoccuring sick-leave. Conclusions: Sick leave due to mental disorders increased the risk of reoccurring sick-leave within two years, disability pension and unemployment, independent of genetics and shared environment.

  • 53.
    Miething, Alexander
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Almquist B., Ylva
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Edling, Christofer
    Rydgren, Jens
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Rostila, Mikael
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Friendship trust and psychological well-being from late adolescence to early adulthood: A structural equation modeling approach2017Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, nr 3, s. 244-252Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: This study explored the sex-specific associations between friendship trust and the psychological well-being of young Swedes from late adolescence to early adulthood. Methods: A random sample of native Swedes born in 1990 was surveyed at age 19 years and again at age 23 years regarding their own well-being and their relationships with a maximum of five self-named peers. The response rate was 31.3%, resulting in 782 cases to be analysed. We used sex-stratified structural equation models to explore the associations between trust and well-being. Psychological well-being was constructed as the latent variable in the measurement part. The structural part accounted for the autocorrelation of trust with respect to well-being over time and incorporated the cross-lagged effects between late adolescence and early adulthood. Results: It was found that trust increased while well-being decreased for young men and remained stable for young women from 19 to 23 years of age. The young women reported lower well-being at both time points, whereas no sex difference was found for trust. Based on model fit comparisons, a simple model without forward or reward causation was accepted for young men, whereas reversed causation from well-being to trust was suggested for young women. Subsequent analysis based on these assumptions confirmed the reversed effect for young women. Conclusions: The findings suggest that young people do not benefit from trustful social relations to the same extent as adult populations. Young women who express impaired well-being run a greater risk of being members of networks characterized by low friendship trust over time.

  • 54.
    Miething, Alexander
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Lundberg, Olle
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Geyer, Siegfried
    Income and health in different welfare contexts: A comparison of Sweden, East and West Germany2013Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, nr 3, s. 260-268Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The aim of the present study is to explore whether the association between income and self-rated health in Sweden is similar to that in Germany. Both countries represent relatively similar economic contexts, but also different welfare traditions and historic experiences. Thus, the study compares Sweden with East Germany and West Germany in order to incorporate the aftereffects of reunification in East Germany. Methods: The association between adjusted disposable household income and self-rated health is investigated by exploring cross-sectional survey data for the year 2000. In a sequence of logistic regression models, the risk for poor self-rated health across income quintiles is analysed, controlling for educational status and occupational position. Data sources are the Swedish Level-of-Living Survey and the German Socio-Economic Panel. Results: A relationship between income and health was observed for Sweden, East Germany and West Germany, before as well as after controlling for education and occupational position. The associations were somewhat stronger for women than for men. Similar magnitudes of income-related poor health were detected across the investigated subsamples, but patterns were distinct in the three regions. The highest estimates were not always found in groups with the lowest income position. Conclusions: Given the variation in the results, we found neither advantages nor disadvantages that can be linked to the effectiveness of the welfare contexts under study. We could also not identify an income threshold for poor health across the investigated countries and settings. Nevertheless, the association between income and health persists, although the patterns vary across regional contexts.

  • 55. Modig, Karin
    et al.
    Virtanen, Suvi
    Ahlbom, Anders
    Agahi, Neda
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Stable or improved health status in the population 65 years and older in Stockholm, Sweden - an 8-year follow-up of self-reported health items2016Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, nr 5, s. 480-489Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Previous studies have reached different conclusions about whether health is improving in the ageing population. More studies with narrow age groups analyzed separately for men and women will contribute to the literature. Aim: To describe trends in self-reported indicators of health and health-related quality of life between 2002 and 2010, focusing on differences between gender and age groups. A population-based survey of individuals 65+ in the Stockholm County was used. Results: Prevalence of health problems increased with age both among men and women. Men generally reported having no health problems to a larger extent than women, but the proportions reporting severe problems were similar. The larger picture is one of stability in health-related quality of life, even if several items developed for the better, especially among women. While the proportions reporting no health/functional problems increased for many items, the proportions reporting severe problems remained unchanged among men and improved only for two items among women. Conclusions: Overall, improvements were seen in many of the health-related quality of life items as well as for self-rated health among women. The proportions reporting long-term illness or persistent health problems increased, but fewer seem to be limited in their daily activities by these problems. The stable proportions of poor self-rated health indicates that while health and functioning seem to be improving for the majority of the older population, some groups may be lagging behind. Future studies should pay attention to changes both in the upper and lower ends of the health spectrum.

  • 56.
    Nelson, Kenneth
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutet för social forskning (SOFI).
    Tøge, Anne Grete
    Health trends in the wake of the financial crisis—increasing inequalities?2017Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, nr 18, s. 22-29Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The financial crisis that hit Europe in 2007–2008 and the corresponding austerity policies have generated concern about increasing health inequalities, although impacts have been less salient than initially expected. One explanation could be that health inequalities emerged first a few years into the crisis. This study investigates health trends in the wake of the financial crisis and analyses health inequalities across a number of relevant population subgroups, including those defined by employment status, age, family type, gender, and educational attainment. Methods: This study uses individual-level panel data (EU-SILC, 2010–2013) to investigate trends in self-rated health. By applying individual fixed effects regression models, the study estimates the average yearly change in self-rated health for persons aged 15–64 years in 28 European countries. Health inequalities are investigated using stratified analyses. Results: Unemployed respondents, particularly those who were unemployed in all years of observation, had a steeper decline in self-rated health than the employed. Respondents of prime working age (25–54 years) had a steeper decline than their younger (15–24) and older (55–64) counterparts, while single parents had a more favorable trend in self-rated health than dual parents. We did not observe any increasing health inequalities based on gender or educational attainment. Conclusions: Health inequalities increased in the wake of the financial crisis, especially those associated with employment status, age, and family type. We did not observe increasing health inequalities in terms of levels of educational attainment and gender.

  • 57.
    Norström, Thor
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutet för social forskning (SOFI).
    Rossow, Ingeborg
    Cannabis use and violence: is there a link?2014Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, nr 4, s. 358-363Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: While several studies suggest that cannabis users are at increased risk of interpersonal violence, it is not clear to what extent the association is causal. Our paper aims to assess the association between cannabis use and violence by using a method that diminishes the risk of confounding. Methods: We analysed data on cannabis use and violent behaviour from the second (1994) and third (1999) waves of the Young in Norway Longitudinal Study (cumulative response rate: 68.1%, n = 2681). We applied fixed-effects modelling to estimate the association between these behaviours, implying that changes in the frequency of violence were regressed on changes in the frequency of cannabis use. The effects of time-invariant confounders were hence eliminated. In addition, we included two time-varying covariates. Results: The elasticity estimate implies that a 10% increase in cannabis use frequency is associated with a 0.4% increase in frequency of violence (p=.024). Conclusions: Analyses of panel data on Norwegian youths reveals a statistically significant association between cannabis use and violence.

  • 58.
    Norström, Thor
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutet för social forskning (SOFI).
    Sundin, Erica
    Müller, Daniel
    Leifman, Håkan
    Hazardous drinking among restaurant workers2012Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, nr 7, s. 591-595Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background/aims: We address three research questions pertaining to Swedish restaurant workers: (i) What is the prevalence of hazardous drinking? (ii) How is the consumption of alcohol distributed? (iii) Does the prevention paradox apply? Methods: Data were collected by administering the Alcohol Use Disorders Identification Test (AUDIT) among restaurant workers who attended a 2-day Responsible Beverage Service training in Stockholm during the period from October 2008 to December 2009. The control group comprised a sample representative of the general Swedish population. We restricted the analyses to the age span 18-59 years, which yielded a sample size of 579 for restaurant workers and 434 for the general population. Results: The prevalence of hazardous drinking as measured by AUDIT (8+ for men and 6+ for women) was markedly higher among restaurant workers than in the general population. The difference was especially pronounced among females below 30 years of age. We found no difference between restaurant workers and the general population in the distribution of alcohol consumption. About 76% of the drinking problems were found in the lower part of the consumption distribution (bottom 88%), which supports the prevention paradox. Conclusions: Restaurant workers comprise a high-risk group with respect to drinking.

  • 59.
    Nyberg, Anna
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Magnusson Hanson, Linda L.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Leineweber, Constanze
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Hammarström, Anne
    Theorell, Töres
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Occupational gender composition and mild to severe depression in a Swedish cohort: The impact of psychosocial work factors2018Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, nr 3, s. 425-432Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: The aim of the present study was to investigate associations between occupational gender composition, psychosocial work factors and mild to severe depression in Swedish women and men with various educational backgrounds.

    Methods: The study included 5560 participants from two waves of the Swedish Longitudinal Occupational Survey of Health, an approximately representative sample of the Swedish working population. Odds ratios (OR) and 95% confidence intervals of mild to severe depression in 2014 were estimated for five strata of occupational gender composition with >20-40%, >40-60%, >60-80% and >80-100% women, using 0-20% women as the reference. Analyses were stratified by gender and education. Job strain, organisational injustice, poor social support and effort-reward imbalance in 2012 were added in separate models, and changes in OR of mild to severe depression for strata of occupational gender composition were evaluated.

    Results: Among women, the odds of mild to severe depression did not vary by occupational gender composition. Among men with low to intermediate education, the odds were higher in the stratum with >80-100% women, and among men with high education, the odds were higher in strata with >20-40% and >60-80% women. Psychosocial work factors affected the odds ratios of mild to severe depression, but most of the variation remained unexplained.

    Conclusions: Odds of mild to severe depression appeared to vary by occupational gender composition among Swedish men but not women. This variation seemed only to a small extent to be explained by psychosocial work factors.

  • 60. Palm, Anna
    et al.
    Olofsson, Niclas
    Danielsson, Ingela
    Skalkidou, Alkistis
    Wennberg, Peter
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD).
    Högberg, Ulf
    Motivational interviewing does not affect risk drinking among young women: A randomised, controlled intervention study in Swedish youth health centres2016Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, nr 6, s. 611-618Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The aim of this study was to analyse risk and binge drinking at 12-month follow-up in young women with risk drinking who received motivational interviewing compared with controls.

    Methods: Young women attending Swedish youth health centres were randomised into intervention or control groups. The intervention group members were asked about their alcohol consumption by a midwife/social worker using the Alcohol Use Disorders Identification Test Consumption. A score of 5 was used as the cut-off value for risk drinking. Participants with risk drinking in the intervention group received motivational interviewing within the same visit. Participants in the control group had a regular visit with a midwife/social worker and answered the same questions about alcohol consumption in a questionnaire after their visit. A questionnaire with the same questions was administered to participants 12 months after baseline.

    Results: Of 1445 eligible young women, 1051 (73%) consented to randomisation and were enrolled in the study. The follow-up rate was 54%. There was a significant decrease in risk- and binge drinking, from baseline to follow-up, in both the intervention and the control groups. Generalised estimating equation analyses demonstrated no significant effect between groups. Of participants who did not have risk drinking at baseline, about 20% in both groups had developed high-risk drinking by the 12-month follow-up.

    Conclusions: No significant differences in risk drinking between young women who received motivational interviewing and controls were found. There was a large intra-individual mobility in young women's risk drinking behaviour. This highlights the importance of finding reliable screening tools that can capture the mobility in drinking behaviour in youth. More research is needed before recommendations can be made.

  • 61.
    Rajaleid, Kristiina
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Hallqvist, Johan
    Koupil, Ilona
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    The effect of early life factors on 28 day case fatality after acute myocardial infarction2009Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 37, nr 7, s. 720-727Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To study the association of size at birth and social circumstances at birth with 28 day case fatality of acute myocardial infarction (AMI). Methods: Based on 1,776 first cases of AMI occurring in Uppsala Birth Cohort (men and women born 1915—1929) between 1964 and 2002. Data on circumstances at birth retrieved from archived obstetric records; data on social characteristics in adulthood, hospitalizations, and date of death obtained through linkage to Censuses, Hospital Discharge Register, and Cause of Death Register. Results: We found a U-shaped association between standardized birth weight and case fatality of AMI in men (p = 0.045 for age and period adjusted quadratic trend over quintiles of standardized birth weight) that was driven by cases of AMI occurring during the early years of follow-up. We found no association between standardized birth weight and case fatality of AMI in women. There was a statistically non-significant inverse association of AMI case fatality with social class at birth as well as with social class and household income in adulthood in the cohort. Marital status was a strong determinant of case fatality in men. Conclusions: Standardized birth weight for gestational age was associated with case fatality of AMI in men. Social class at birth was weakly inversely associated with case fatality of AMI in the cohort.

  • 62. Rooth, Hetty
    et al.
    Forinder, Ulla
    Söderbäck, Maja
    Viitasara, Eija
    Piuva, Katarina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Trusted and doubted: Discourses of parenting training in two Swedish official inquiries, 1947 and 20082018Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, nr Suppl. 20, s. 59-65Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The aim of this study was to analyse discourses of parenting training in official inquires in Sweden that explicitly deal with the bringing up of children and parental education and how the representations of the problems and their solutions affect parental subject positions in the early welfare state and at the onset of the 21st century. Method: We carried out a discourse analysis of two public inquiries of 1947 and 2008, drawing on theories about governmentality and power regimes. Tools from political discourse analysis were used to investigate the objectives of political discourse practices. Results: Both inquiries referred to a context of change and new life demands as a problem. Concerning suggestions for solutions, there were discrepancies in parents' estimated need of expert knowledge and in descriptions of parental capacity. In a discourse of trust and doubt, the parents in 1947 were positioned as trusted welfare partners and secure raisers of future generations, and in 2008, as doubted adults, feared to be faltering in their child-rearing tasks. Conclusions: The analysis revealed how governmental problem descriptions, reasoning about causes and suggestions of solutions influenced parents' subject positions in a discourse of trust and doubt, and made way for governmental interventions with universal parenting training in the 21st century.

  • 63. Saarela, Jan
    et al.
    Weber, Rosa
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Assessment of educational misclassification in register-based data on Finnish immigrants in Sweden2017Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, s. 20-24Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: In population registers, information on completed schooling is either missing or misclassified for a large proportion of newly arrived immigrants. It is unclear how quickly the information is updated and whether misclassification, i.e., that the wrong level of education is recorded, biases empirical estimates. Methods: We use unique linked Swedish and Finnish register data to determine the extent of such mismeasurement. By running logistic regressions on zero earnings, we also illustrate how mismeasurement might influence the estimated effects of education on health or labour market outcomes. Results: We find a considerable bias in estimates based on Swedish records of educational attainment during immigrants' first few years in the country. Misclassification is additionally very common, even when information on educational attainment exists. Conclusions: These findings suggest that research and policies using recently arrived immigrants' completed schooling as a determinant of socioeconomic integration need to be interpreted with care.

  • 64. Sandahl, Hinuga
    et al.
    Norredam, Marie
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Asher, Henry
    Smith Nielsen, Signe
    Policies of access to healthcare services for accompanied asylum-seeking children in the Nordic countries2013Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, nr 6, s. 630-636Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: Asylum-seeking children constitute a vulnerable group with high prevalence and risk for mental health problems. The aim of this study was to compare policies of access to healthcare services, including physical examination and screening for mental health problems on arrival, for accompanied asylum-seeking children in the Nordic countries. Methods: This study was based on the national reports “Reception of refugee children in the Nordic countries” written by independent national experts for the Nordic Network for Research on Refugee Children, supplemented by information from relevant authorities. Results: In Sweden, Norway and Iceland, asylum-seeking children had access to healthcare services equal to children in the general population. On a policy level, Denmark imposed restrictions on non-acute hospitalisations and prolonged specialist treatments. Regarding health examinations, Sweden deviated from the Nordic pattern by not performing these systematically. In Denmark, Iceland, and some counties in Sweden, but not in Norway, screening for mental health problems was offered to asylum-seeking children. Conclusion: Access to healthcare services for asylum-seeking children differs in the Nordic countries; the consequences of these systematic differences for the individual asylum-seeking child are unknown. For asylum-seeking children, access to healthcare has to be considered in a wider context that includes the core conditions of being an asylum-seeker. A comparative study at policy level needs to be supplemented with empirical follow-up studies of the well-being of the study population to document potential consequences of policies in practice.

  • 65.
    Sonmark, Kristina
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Modin, Bitte
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Psychosocial work environment in school and students’ somatic health complaints: An analysis of buffering resources2017Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, nr 1, s. 64-72Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: This study explores the association between the psychosocial work environment in school and students’ somatic health complaints. With its point of departure from the Demand–Control–Support (DCS) model, the aim was to examine how aspects of decision control and social support can moderate stress-related health implications of high psychological demands. Methods: Data come from two cross-sectional waves of the Swedish version of Health Behaviour in School-aged Children (HBSC 2005/2006 and 2009/2010), which consists of a total of 9427 11-, 13- and 15-year-old students. A two-level random intercept model was applied, with school class as the level 2 unit. Results: Findings showed significant associations between school demands and somatic health complaints for all studied age groups, with a slight increase in strength with age. Decision control as well as social support from teachers, parents and peers consistently predicted a favorable association with health. An age pattern emerged in the analyses of stress-moderating resources. For 11 year olds parental support was the only resource that displayed a significant interaction with demands in relation to somatic health complaints, whereas for 13 year olds, decision control and support from teachers and parents all demonstrated moderating effects on student health. For 15 year olds, however, it was peer support that acted as a buffering resource in the studied relationship. Conclusions: The psychosocial work environment is an important predictor of students’ health complaints. Overall, social support was a better stress-moderating resource than decision control, but some “buffers” were more important at certain ages than others.

  • 66.
    Theorell, Töres
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Karolinska Institutet, Sweden .
    De Manzano, Örjan
    Lennartsson, Anna-Karin
    Pedersen, Nancy L.
    Ullén, Fredrik
    Self-reported psychological demands, skill discretion and decision authority at work: A twin study2016Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, nr 4, s. 354-360Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To examine the contribution of genetic factors to self-reported psychological demands (PD), skill discretion (SD) and decision authority (DA) and the possible importance of such influence on the association between these work variables and depressive symptoms.

    METHODS: 11,543 participants aged 27-54 in the Swedish Twin Registry participated in a web survey. First of all, in multiple regressions, phenotypic associations between each one of the three work environment variables and depressive symptoms were analysed. Secondly, by means of classical twin analysis, the genetic contribution to PD, SD and DA was assessed. After this, cross-twin cross-trait correlations were computed between PD, SD and DA, on the one hand, and depressive symptom score, on the other hand.

    RESULTS: The genetic contribution to self-reported PD, DS and DA ranged from 18% for decision authority to 30% for skill discretion. Cross-twin cross-trait correlations were very weak (r values < .1) and non-significant for dizygotic twins, and we lacked power to analyse the genetic architecture of the phenotypic associations using bivariate twin modelling. However, substantial genetic contribution to these associations seems unlikely.

    CONCLUSIONS: Genetic contributions to the self-reported work environment scores were 18-30%.

  • 67.
    Toivanen, Susanna
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Income differences in stroke mortality: a follow-up study of the Swedish working population2011Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, nr 8, s. 797-804Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: This study explored the association between income and stroke mortality in the total working population in Sweden and examined whether the associations differ by gender or for stroke subtypes intracerebral haemorrhage (ICH) or brain infarction (BI).

    Methods: This was a register-based study among nearly 3 million working women and men (30–64 years in 1990) with a 12-year follow up (1991–2002) for mortality from stroke (4886 deaths). Income was measured as annual registered income from work in 1990. Gender-specific Cox regressions were applied with adjustments for sociodemographic covariates.

    Results: The age-adjusted hazard ratio (95% confidence interval) of lowest versus highest income quartile was 1.80 (1.482.19) for any stroke, 1.68 (1.292.17) for ICH and 2.23 (1.533.22) for BI in women, and the corresponding figures for men were 2.12 (1.922.34), 2.02 (1.772.31), and 2.09 (1.772.46). Adjustment for covariates attenuated these associations to 1.69 (1.332.15) for any stroke and 1.56 (1.142.14) for ICH in women and to 1.98 (1.742.24) for any stroke and 1.77 (1.442.19) for BI in men. In contrast, adjustment for covariates amplified the estimates to 2.36 (1.523.66) for BI in women and to 2.05 (1.732.44) for ICH in men.

    Conclusions: Risk of stroke mortality was highest in the lowest income group, with a gradient for the intermediate groups, in both women and men. The risk of mortality from BI was highest in women with the lowest income and the risk of ICH was highest in men with the lowest income. 

  • 68. van der Wel, Kjetil A.
    et al.
    Östergren, Olof
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap.
    Lundberg, Olle
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap.
    Korhonen, Kaarina
    Martikainen, Pekka
    Nybo Andersen, Anne-Marie
    Kjaer Urhoj, Stine
    A gold mine, but still no Klondike: Nordic register data in health inequalities research2019Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 47, nr 6, s. 618-630Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: Future research on health inequality relies on data that cover life-course exposure, different birth cohorts and variation in policy contexts. Nordic register data have long been celebrated as a 'gold mine' for research, and fulfil many of these criteria. However, access to and use of such data are hampered by a number of hurdles and bottlenecks. We present and discuss the experiences of an ongoing Nordic consortium from the process of acquiring register data on socio-economic conditions and health in Denmark, Finland, Norway and Sweden. Methods: We compare experiences of data-acquisition processes from a researcher's perspective in the four countries and discuss the comparability of register data and the modes of collaboration available to researchers, given the prevailing ethical and legal restrictions. Results: The application processes we experienced were time-consuming, and decision structures were often fragmented. We found substantial variation between the countries in terms of processing times, costs and the administrative burden of the researcher. Concerned agencies differed in policy and practice which influenced both how and when data were delivered. These discrepancies present a challenge to comparative research. Conclusions: We conclude that there are few signs of harmonisation, as called for by previous policy documents and research papers. Ethical vetting needs to be centralised both within and between countries in order to improve data access. Institutional factors that seem to facilitate access to register data at the national level include single storage environments for health and social data, simplified ethical vetting and user guidance.

  • 69.
    Wastesson, Jonas W.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Fors, Stefan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Parker, Marti G.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Johnell, Kristina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Inequalities in health care use among older adults in Sweden 1992-2011: A repeated cross-sectional study of Swedes aged 77 years and older.2014Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, nr 8, s. 795-803Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: In the last decades, the Swedish health care system was reformed to promote free choice; however, it has been questioned whether older adults benefit from these reforms. It has also been proposed that reforms promoting free choice might increase inequalities in health care use. Thus, the aim of this study is to investigate socioeconomic differences in health care use among older adults in Sweden, from 1992 to 2011.

    METHODS: The Swedish Panel Study of the Living Conditions of the Oldest Old (SWEOLD) is a nationally representative study of Swedes over 76 years old, including both institutionalized and community-dwelling persons. We analyzed cross-sectional data from SWEOLD waves in 1992, 2002 and 2011 (n ≈ 600/wave); and performed multivariate analyses to investigate whether socioeconomic position was associated with health care use (inpatient, outpatient and dental services) after need was accounted for.

    RESULTS: For the period of 1992-2011, we found that higher education was associated with more use of outpatient and dental care, both before and after adjustment for need. The association between education and inpatient or outpatient care use did not change over time. There was an increase in the proportion of older adults whom used dental care over the 19-year period, and there was a tendency for the socioeconomic differences regarding dentist visits to decrease over time.

    CONCLUSIONS: Our study covering 19 years showed relatively stable findings for socioeconomic differences in health care use among older adults in Sweden. We found there was a slight decrease in inequality in dental care; but unchanged socioeconomic differences in outpatient care, regardless of the changes that occurred in the Swedish health care system.

  • 70.
    Östergren, Olof
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Growing gaps: the importance of income and family for educational inequalities in mortality among Swedish men and women 1990–20092015Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, nr 6, s. 563-570Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: Although absolute levels of mortality have decreased among Swedish men and women in recent decades, educational inequalities in mortality have increased, especially among women. The aim of this study is to disentangle the role of income and family type in educational inequalities in mortality in Sweden during 1990-2009, focusing on gender differences. Methods: Data on individuals born in Sweden between the ages of 30 and 74 years were collected from total population registries, covering a total of 529,275 deaths and 729 million person-months. Temporary life expectancies (age 30-74 years) by education were calculated using life tables, and rate ratios were estimated with Poisson regression with robust standard errors. Results: Temporary life expectancy improved among all groups except low educated women. Relative educational inequalities in mortality (RRs) increased from 1.79 to 1.98 among men and from 1.78 to 2.10 among women. Variation in family type explained some of the inequalities among men, but not among women, and did not contribute to the trend. Variation in income explained a larger part of the educational inequalities among men compared to women and also explained the increase in educational inequalities in mortality among men and women. Conclusions: Increasing educational inequalities in mortality in Sweden may be attributed to the increase in income inequalities in mortality.

  • 71.
    Östergren, Olof
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap.
    Pekka, Martikainen
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. University of Helsinki, Finland .
    The contribution of smoking-related deaths to the gender gap in life expectancy in Sweden between 1997 and 20162019Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: In recent decades, smoking-related mortality has declined among men and increased among women in Sweden. We estimate the contribution of smoking-related deaths to the narrowing of the gender gap in life expectancy in Sweden between 1997 and 2016.

    Methods: We extracted population data on deaths and population under risk on the entire Swedish population aged 25 years and over for the period 1997–2016. Smoking-related mortality was assessed using an indirect method based on lung cancer mortality. We then estimated the contribution of smoking to the gender gap in life expectancy by comparing the observed life expectancies to life expectancies excluding smoking-related deaths.

    Results: The gender gap in life expectancy was 5.0 years in 1997 and 3.4 years in 2016. The gender gap narrowed by 1.6 years, of which 0.6 years were attributable to smoking-related deaths.

    Conclusions: The combination of decreasing smoking-related mortality among men and increasing smoking-related mortality among women in Sweden accounted for almost 40% of the narrowing of the gender gap in life expectancy during the period 1997–2016.

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