| 1. |
- Bastola, K, et al.
(author)
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Pre-pregnancy body mass index and inter-pregnancy weight change among women of Russian, Somali and Kurdish origin and the general Finnish population
- 2017
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In: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 45:3, s. 314-321
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Journal article (peer-reviewed)abstract
- Objectives: We studied the differences in the mean pre-pregnancy body mass index (BMI) and mean inter-pregnancy weight change in women of Russian, Somali and Kurdish origin and women in the general Finnish population. Methods: The population-based samples were from the Migrant Health and Wellbeing Study and the Health 2011 Survey conducted in six cities in Finland in 2010–2012. This study included women with at least one birth in Finland. Data on their previous pregnancies in Finland were obtained from the National Medical Birth Register for 318 Russian, 584 Somali and 373 Kurdish origin women and for 243 women in the general Finnish population (reference group). Data on pre-pregnancy weight and height were self-reported in early pregnancy. Linear logistic regression was the main method of analysis. Results: The unadjusted mean pre-pregnancy BMI was higher in Somali (27.0 kg/m2, p<0.001) and Kurdish (25.8 kg/m2, p<0.001) women, but lower in Russian (22.2 kg/m2, p<0.001) women than in the reference group (24.1 kg/m2). The adjusted coefficients for the difference in the mean pre-pregnancy BMI were −1.93 (95% CI −2.77 to −1.09) for Russian, 1.82 (95% CI 0.89–2.75) for Somali and 1.30 (95% CI 0.43–2.17) for Kurdish women compared with the reference group. Among women with at least two births, no statistically significant difference was observed in the mean inter-pregnancy weight change between the migrant groups and the reference group. Conclusions: Somali and Kurdish women had higher mean pre-pregnancy BMIs than women in the general Finnish population and may need special support and health promotion strategies for weight management.
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| 2. |
- Gissler, M, et al.
(author)
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Sex differences in child and adolescent mortality in the Nordic countries, 1981--2000
- 2009
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In: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 37:4, s. 340-346
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Journal article (peer-reviewed)abstract
- Aims: Unlike the situation for infant and adult mortality, there are only a few studies on child and adolescent mortality. The purpose of this study was to examine sex differences in child and adolescent mortality by age and cohort in four Nordic countries over a 20-year period. Methods: Data on all live-born children were received from national population-covering birth registries from 1981 to 2000 (Denmark, n = 1,184,926; Finland, n = 841,470 (from 1987 to 2000); Norway, n = 1,090,127; and Sweden, n = 1,961,911). Data on mortality and causes of death until the age of 20 years were received from the national cause-of-death registers. Results: The overall mortality rates were higher in Denmark and Norway than in Finland and Sweden, among both boys and girls, and the difference between countries increased over time. In all countries, boys had higher mortality rates than girls. Overall, the sex difference was larger in Denmark and Norway (36% and 33% higher, respectively) than in Finland and Sweden (both 24%). The sex differences were more pronounced for deaths of those aged 5—19 years than for those aged 0—4 years. Twelve per cent of all deaths among boys and 10% of those among girls were due to external causes, mainly unintentional injury deaths or intentional deaths. For children and adolescents aged 5—19 years, the corresponding figures were 43% for boys and 35% for girls. Conclusions: Boys have excess mortality, but the sex difference is lower in countries with lower mortality. Boys' excess mortality was only partly accounted for by deaths from external causes. Avoidable deaths and causes of death need further investigation.
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| 3. |
- Hallgren, J, et al.
(author)
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Mortality trends in external causes of death in people with mental health disorders in Sweden, 1987-2010
- 2019
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In: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 47:2, s. 121-126
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Journal article (peer-reviewed)abstract
- Aim: We investigated mortality from external causes in Swedish people who had been hospitalised with a severe mental disorder. Methods: Hospitalisations in people aged 15 years or older admitted to hospital with a main diagnosis of schizophrenia, bipolar mood disorder or unipolar mood disorder between 1987 and 2010 were linked to their causes of death. Results: The mortality rate from all external causes was 20-fold higher in those with unipolar mood disorder, 15-fold higher in those with bipolar disorder and 12-fold higher in those with schizophrenia than in the general population. Over the study periods, the mortality rate declined more for people with unipolar mood disorder (−35%) and schizophrenia (−29%) than the total population (−25%) and those with bipolar mood disorder (−15%). The suicide rate declined most for those with unipolar mood disorder and schizophrenia (−42% for both) and less for the general population (−37%) and those with bipolar mood disorder (−21%). For external causes other than suicide, the mortality rate declined in the general population (−17%) but increased in people with schizophrenia (14%), bipolar mood disorder (30%) and unipolar mood disorder (52%). Conclusions: People with mental disorders have high but declining excess mortality from suicide. Mortality from other external causes has increased, as has the gap in mortality rates between psychiatric patients and the general population.
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| 4. |
- Heino, AE, et al.
(author)
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Induced abortions by woman's country of origin in Finland 2001-2014
- 2020
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In: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 48:1, s. 88-95
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Journal article (peer-reviewed)abstract
- Aims: Understanding the differences in reproductive-health behaviours between native and migrant populations helps provide good reproductive-health services. We investigate the differences in induced abortion rates, pregnancy histories and use of contraceptives between native and migrant populations in Finland. Methods: The Finnish Register on Induced Abortions was linked with Population Register data from years 2001–2014 to identify first- and second-generation immigrants. The data included 142,708 induced abortions. Results: Abortion and contraceptive use varied between women of Finnish and foreign origins. Native women had a lower abortion rate than women born abroad. Women born in Somalia and India had the highest likelihood for having an abortion shortly after birth. The highest risk for having an abortion soon after previous induced abortion was among women born in Iran, Iraq, Somalia and former Yugoslavia. The risk for having more than two induced abortions was the highest for women born in Russia/the former Soviet Union and Estonia. Second-generation immigrants had a lower abortion rate than first-generation immigrants. Lack of contraceptive use prior to abortion was more common among women born abroad. Conclusion: There were differences in pregnancy histories and in the use of reliable contraceptive methods before an induced abortion by country of birth. The higher likelihood for abortion after a recent birth among first-generation immigrants highlights the need for more targeted counselling immediately after childbirth. Although the abortion rate is lower among second-generation immigrants, the neglect of contraceptive use calls for additional education in sexual and reproductive health.
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| 5. |
- Lehti, V, et al.
(author)
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Use of benzodiazepine and related drugs in migrants and Finnish-born persons: a nationwide register-based study
- 2023
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In: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 51:8, s. 1222-1230
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Journal article (peer-reviewed)abstract
- Benzodiazepines and related drugs (BZDR) are often used longer than generally recommended. The aim is to study patterns of use among migrant and Finnish-born users of BZDR, and to identify factors that are associated with long-term use and BZDR polytherapy. Methods: This register-based study includes a nationwide sample of migrants ( n=8729) and their Finnish-born controls ( n=11 388) who had purchased BZDR in 2011–2014, but not in 2009–2010. Information on drug purchases was obtained from the National Prescription Register and the duration of drug use was estimated using PRE2DUP method. The main outcomes were long-term use of BZDR, polytherapy and time until discontinuation of BZDR use. Sociodemographic variables and information on preceding psychiatric diagnoses were included as covariates. Logistic and Cox regression analyses were the statistical methods used. Results: Only migrants from Sub-Saharan Africa were more likely to discontinue the medication once initiated than Finnish-born users. Migrants were significantly less likely to be long-term users (adjusted odds ratio 0.79, 95% CI 0.70–0.89) or polytherapy users (aOR 0.90, 95% CI 0.84–0.97) of BZDR compared with Finnish-born participants. Conclusions: Migrants had less long-term and concomitant use of several BZDR than Finnish-born participants. The pattern of use is more optimal among migrants, but it may also reflect poorer access to mental health treatment.
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| 6. |
- Merikukka, M, et al.
(author)
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Association between parental hospital-treated somatic illnesses in childhood and later mental disorders among offspring up to early adulthood: An explorative study in the 1987 Finnish Birth Cohort
- 2020
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In: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 48:2, s. 214-223
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Journal article (peer-reviewed)abstract
- Aims: Earlier studies on the associations between parental somatic illnesses and children’s psychological wellbeing have focused on the most common somatic illnesses or on specific groups of illnesses. In this study, we aimed to systematically examine whether parental somatic illnesses, diagnosed during an offspring’s childhood, are associated with later mental disorders of the offspring and, if so, identify which parental somatic illnesses in particular increase the likelihood for later mental disorders among the offspring. Methods: The 1987 Finnish Birth Cohort study yields longitudinal nationwide follow-up data that include a complete census of children born in a single year. Children have been followed over time through to the year 2012 using official registers maintained by the Finnish authorities. Parental diagnoses of specialised hospital inpatient care were identified from the Hospital Discharge Register after children’s birth and followed up until the end of 1995. Children’s psychiatric diagnoses from specialised hospital care were identified from the same register for the periods 1996/1998–2012. Logistic regression analyses were used to calculate sex-specific odds ratios for associations of mental disorders with maternal and paternal somatic illnesses using parental death, education, social assistance and psychiatric inpatient care as covariates. Results: Parental somatic illnesses during an offspring’s childhood seem to increase the risk for later mental disorders. Several previously unreported somatic parental illnesses were found to be significantly associated with offspring’s later mental health. Conclusions: Parental somatic illnesses should be considered as a significant adverse childhood life event, calling for preventive actions and child-centred support in adult healthcare.
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| 7. |
- Roustaei, Z, et al.
(author)
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Socioeconomic differences in the association between maternal age and maternal obesity: a register-based study of 707,728 women in Finland
- 2023
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In: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 51:6, s. 963-971
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Journal article (peer-reviewed)abstract
- To examine the association between maternal age and maternal obesity across socioeconomic groups and to determine whether socioeconomic status modifies the association between maternal age and maternal obesity with a view to informing public health policies. Methods: Data for this register-based study were sourced from the Finnish Medical Birth Register and Statistics Finland, using the information of 707,728 women who gave birth in Finland from 2004 to 2015. We used multivariable regression models to assess the association between maternal age and maternal obesity across socioeconomic groups. We further assessed interactions on both multiplicative and additive scales. Results: Across all socioeconomic groups, the adjusted odds ratio for the association between maternal age and maternal obesity increased, peaking for women 35 years or older. Using women below 20 years of age in the category of upper-level employees as a single reference group, in the category of upper-level employees, the adjusted odds ratio and 95% confidence intervals among women 35 years or older was 1.92 (1.39–2.64) for maternal obesity. Equally, the adjusted odds ratio and 95% confidence intervals in the category of long-term unemployed was 4.35 (3.16–5.98). Synergistic interactions on both multiplicative and additive scales were found across age and socioeconomic groups. Conclusions: The association between maternal age and maternal obesity was strongest among women 35 years or older with lower socioeconomic status. Population-level interventions that address maternal risk factors from teenage years are needed alongside individual-level interventions that target high-risk mothers in areas of low socioeconomic status and maternal obesity.
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| 8. |
- Rumrich, IK, et al.
(author)
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Smoking during pregnancy in Finland - Trends in the MATEX cohort
- 2019
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In: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 47:8, s. 890-898
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Journal article (peer-reviewed)abstract
- Aims: In Finland, smoking rates in the general population are decreasing due to increased awareness of the adverse effects and tightened tobacco legislation. However, previous studies have shown that smoking in pregnant Finnish women remained as high as in the general Finnish female population at around 15% in 2010. Our aim was to describe temporal and spatial trends in smoking behaviour, and determinants of changes in smoking behaviour between first and second pregnancy. Methods: Self-reported smoking from the Finnish Medical Birth Register covered the years 1991–2015 ( N=1,435,009). The association of maternal age and socioeconomic status with smoking rate was analysed. Spatial trends were assessed at municipality level. Results: The overall smoking rate during early pregnancy remained fairly stable at around 15% from 1991 to 2015, but increased in teenage and young women below 25 years of age. The mean smoking rate (36%) was higher in these age groups than in older pregnant women (11%). Through the study period the smoking rate remained higher in blue collar workers compared with higher socioeconomic groups. Between the first and second child, on average only 4% of women started to smoke and 41% quitted. Smoking rates developed less favourably in Eastern Finland. Conclusions: The observed increase in smoking rate during pregnancy in teenage and young women is concerning. Pregnancy is a trigger point for smoking cessation in a big fraction of pregnant women. More studies are needed to explain the opposite trends of smoking rates in Northern and Western Finland compared with Eastern Finland.
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| 9. |
- Saloranta, T, et al.
(author)
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Use of universally offered family planning services - a cohort study in the city of Vantaa, Helsinki metropolitan area, Finland
- 2022
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In: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 50:4, s. 454-462
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Journal article (peer-reviewed)abstract
- Aims: Knowledge about the women reached by public family planning services is scarce. The means for provision of these services that are pivotal for women’s health and empowerment varies globally. In Finland, family planning services are offered free of charge, but often separately for different age groups. City of Vantaa offers these services for all female residents without age limit. The aim of this study was to describe the characteristics of the women using public family planning services. Methods: We assessed the sociodemographic and reproductive characteristics of women aged 15–44 using ( n = 11,790) and not using ( n = 42,931) these services in 2013–2014. We obtained adjusted odds ratios (AORs) and 95% confidence intervals (95%CIs) for service use by multivariate logistic regression. Results: Women under 35 years of age had higher odds of service use compared with those over 35 (AORs ranging from 2.79 [95%CI 2.54–3.07] for 15–19 year-olds to 1.81 [95%CI 1.69–1.95] for 30–34 year-olds). Women speaking a foreign native language used services less when aged under 30 and more when aged 35–44 compared with women speaking the national languages. Women with a history of delivery, induced abortion or sexually transmitted infections, or with a lower socioeconomic or educational status were more likely to use the services. Conclusions: Young women in general were more likely to use free-of-charge family planning services. In contrast, young women speaking a foreign native language were underrepresented among service users. It is important to recognise and actively reach underrepresented groups, such as young women with a foreign background, to optimise equal access to family planning services.
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| 10. |
- Stenius-Ayoade, A, et al.
(author)
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Duration of homelessness and its relationship to use of hospital and emergency department services in Helsinki, Finland
- 2020
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In: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 48:3, s. 259-266
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Journal article (peer-reviewed)abstract
- Aims: Homelessness is associated with poor health outcomes and increased use of hospital and emergency department (ED) services. Little is known about the duration of homelessness in relation to health care service use. The aim of this study was to examine the use of hospital and ED services among the homeless in Helsinki, Finland, and for the first time, to examine the relationship between service use and duration of homelessness. Methods: Six hundred and eighty-three persons staying at least one night in a shelter between September 2009 and September 2010 were followed until the end of 2014. Using negative binominal regression analysis we calculated the use of hospital and ED services and compared the use with that of a matched control group ( N = 1361). We also analyzed service use in relation to the time spent homeless during follow-up. Results: The mean time spent homeless during the follow-up was 8.5 months, one third was temporarily homeless (less than 2% of the follow-up time), but recurrent episodes of homelessness were also common. The study group’s incidence rate ratios for medical-surgical hospital days was 6.23 (95% CI: 4.73 to 8.21), for psychiatric hospital days 43.11 (95% CI: 23.02 to 80.74) and for ED visits 10.21 (95% CI: 8.77 to 11.90), compared with controls. The number of medical-surgical hospital days and ED visits/person-year increased as homelessness was prolonged, but the pattern was opposite for psychiatric hospital days. Conclusions: Homeless persons are heavy users of hospital and ED services, and there is also increased use among those temporarily homeless.
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