| 21. |
- Gustafsson, Klas, et al.
(författare)
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Future risk for disability pension among people with sickness absence due to otoaudiological diagnoses: a population-based cohort study with a 12-year follow-up
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : Sage. - 1403-4948 .- 1651-1905. ; 39:5, s. 501-507
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Tidskriftsartikel (refereegranskat)abstract
- Hearing difficulties is a growing public health problem and more knowledge of consequences of those difficulties in working life is warranted. Aims: To study the future risk of being granted a disability pension (DP) among people with sickness absence with an otoaudiological diagnoses (OAD) compared to other sickness absentees. Methods: A population-based prospective cohort study of all 40,786 people in a Swedish county who in 1985 were aged 16-64 and had a new sick-leave spell greater than 7 days. Those were followed for 12 years with regard to DP. Hazard ratios (HR) + 95% confidence intervals (CI) of being granted DP was calculated among those with sick leave due to OAD compared to people with sickness absence with other diagnoses. Results: In 1985, 515 people had a new sick-leave spell with an OAD. Twelve years later, 36% of those had been granted DP, compared to 24% of all other sickness absentees. Their HR for DP was 1.42 (95% CI 1.23-1.64) adjusting for gender and age. Compared to men, women with an OAD had a HR of DP of 1.24 (95% CI 0.90-1.71), when adjusted for age. The HR for DP regarding those aged greater than 45 years and sickness absent with OAD was 2.63 (95% CI 1.95-3.55) compared to the sickness absentees with OAD below 45 years of age, adjusted for gender. Conclusions: The risk for future DP was more than 40% higher among those initially on sickness absence due to OAD than among other sickness absentees.
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| 22. |
- Hammarström, Anne, et al.
(författare)
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It´s no surprise! Men are not hit more than women by the health consequences of unemployment in the Northern Swedish Cohort
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:2, s. 187-193
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Research often fails to ascertain whether men and women are equally hit by the health consequences of unemployment. The aim of this study was to analyze whether men’s self-reported health and health behaviour were hit more by unemployment than women’s in a follow-up of the Northern Swedish Cohort.Methods: A follow-up study of a cohort of all school leavers in a middle-sized industrial town in northern Sweden was performed from age 16 to age 42. Of those still alive of the original cohort, 94% (n = 1,006) participated during the whole period. A sample was made of participants in the labour force and living in Sweden (n = 916). Register data were used to assess the length of unemployment from age 40 to 42, while questionnaire data were used for the other variables.Results: In multivariate logistic regression analyses significant relations between unemployment and mental health/smoking were found among both women and men, even after control for unemployment at the time of the investigation and indicators of health-related selection. Significant relations between unemployment and alcohol consumption were found among women, while few visits to a dentist was significant among men.Conclusions: Men are not hit more by the health consequences of unemployment in a Swedish context, with a high participation rate of women in the labour market. The public health relevance is that the study indicates the need to take gendered contexts into account in public health research.
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| 23. |
- Hansson, Anders, 1953-, et al.
(författare)
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Working together--primary care doctors' and nurses' attitudes to collaboration.
- 2010
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38:1, s. 78-85
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Tidskriftsartikel (refereegranskat)abstract
- Multidisciplinary teamwork is recommended for various disorders and it has been suggested that it is a way to meet the new challenges and demands facing general practitioners (GPs) in modern society. Attempts to introduce the method in primary care have failed partly due to GPs' unwillingness to participate. The aim of this study was to measure attitudes towards collaboration among GPs and district nurses (DN) and to investigate whether there is a correlation between a positive attitude toward collaboration and high self-esteem in the professional role.
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| 24. |
- Hansson, LM, et al.
(författare)
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Perceived discrimination among men and women with normal weight and obesity. A population-based study from Sweden
- 2010
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38:6, s. 587-596
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Tidskriftsartikel (refereegranskat)abstract
- Aims: We examined whether men and women with obesity reported different types of discrimination to a greater extent than those with normal weight, and explored whether these associations were modified by socioeconomic position. Method: National representative sample of men and women, with normal weight (n = 2,000), moderate obesity (n = 2,461) and severe obesity (n = 557). Participants were identified in a yearly population-based survey (1996—2006) and data on perceived discrimination and potential confounding factors were measured in 2008. Logistic regression models tested whether obesity was associated with perceived lifetime, workplace, healthcare and interpersonal discrimination. Results: The overall response rate was 56%. For men, moderate obesity was associated with workplace discrimination, while severely obese women were more likely to report this sort of discrimination than normal weight women. Severely obese individuals were twice as likely to report healthcare discrimination than normal weight individuals. Women, regardless of weight status group, were in turn twice as likely to report healthcare discrimination as men. Women with severe obesity were significantly more likely to report interpersonal discrimination compared with normal weight women. Socioeconomic position modified the association between weight status and healthcare discrimination. Highly educated individuals with moderate and severe obesity were more likely to report healthcare discrimination than their normal weight counterparts, whereas low educated individuals with normal weight, moderate and severe obesity were equally likely to report discrimination. Conclusions: In this large, population-based study, discrimination was more likely to be reported by obese individuals compared with those of normal weight. The associations, however, varied according to gender and socioeconomic position.
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| 25. |
- Hedberg, Charlotte, et al.
(författare)
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Can evidence-based medicine become counter-productive?
- 2010
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Ingår i: Scandinavian Journal of Public Health. - London, United Kingdom : Sage Publications. - 1403-4948 .- 1651-1905. ; 38:5, s. 553-4
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Tidskriftsartikel (refereegranskat)
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| 26. |
- Hubicka, B, et al.
(författare)
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Psychosocial characteristics of drunk drivers assessed by the Addiction Severity Index, prediction of relapse
- 2010
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38:1, s. 71-77
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate psychosocial characteristics and problems of a representative sample of Swedish drunk drivers with special consideration of the gender of the driver; analyze criminal records of the drivers before and after enrolment in the study; identify psychosocial predictors of relapse to drunk driving. Methods: Psychosocial characteristics were assessed by the Addiction Severity Index (ASI). Alcohol problems were additionally assessed by the Alcohol Use Disorders Identification Test (AUDIT). Criminal records were collected for the five year period before the enrolment, and for the subsequent two years, from Sweden’s official crime statistics. Results: About half of the investigated drivers had other psychosocial problems besides the drink driving offence. Female drivers had more alcohol, drug, psychiatric and relational problems, including with parents when growing up, than male drivers, but less previous and subsequent criminality. Heavily drunk drivers (blood alcohol concentration ≥0.1%) had more problems with alcohol, legal status and employment and support than the other drunk drivers. Problems with legal status, family and social relations and alcohol use increased the risk of relapse in drunk driving, while medical problems seemed to be a protective factor. Different ASI risk factors were identified for relapse in either traffic offences or other crimes. Conclusions: As well as the drunk driving offence, drunk drivers often have other psychosocial problems, female drivers in particular. Already the blood alcohol concentration per se gives some indication of the psychosocial problem profile of a drunk driver and the ASI profile has some prognostic value for relapse in drunk driving.
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| 27. |
- Højgaard, B, et al.
(författare)
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The potential of smoking cessation programmes and a smoking ban in public places: comparing gain in life ex-pectancy and cost effectiveness.
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 39:8, s. 785-796
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Interventions aimed at reducing the number of smokers are generally believed to be cost effective. However as the cost of the interventions should be paid up front whereas the gains in life years only appear in the future--the budgetary consequences might be a barrier to implementing such interventions. AIMS: The aim of the present paper was to assess the long-term cost effectiveness as well as the short-term (10 years) budget consequences of cessation programmes and a smoking ban in enclosed public places. METHODS: We develop a population-based Markov model capable of analyzing both interventions and assess long-term costs effectiveness as well as short-term budgetary consequences and outcome gains. The smoking cessation programme model was based on data from the Danish National Smoking Cessation Database (SCDB), while the model of the smoking ban was based on effect estimates found in the literature. RESULTS: On a population level the effect of a smoking ban has the largest potential compared with the effect of smoking cessation programmes. Our results suggest that smoking cessation programmes are cost saving and generate life-years, whereas the costs per life-year gained by a smoking ban are 40,645 to 64,462 DKK (100 DKK = €13.4). These results are conservative as they do not include the healthcare cost saving related to reduced passive smoking. CONCLUSIONS: Our results indicate that smoking cessation programmes and a smoking ban in enclosed public places both in the short term and the long term are cost-effective strategies compared with the status quo.
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| 28. |
- Irestig, R, et al.
(författare)
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How are homeless people treated in the healthcare system and other societal institutions? Study of their experiences and trust
- 2010
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38:3, s. 225-231
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To elucidate the perceived treatment that the homeless have received from the healthcare and other societal organisations and to present homeless persons’ trust in the healthcare system and suggestions of necessary changes for improving it. Methods: Homeless individuals in special houses and institutions in the County of Stockholm were asked to answer a short version of a public health survey, including added questions about how they experienced the healthcare providers’ attitudes towards them and how much trust they had in the healthcare system. A total of 155 homeless persons (123 male and 32 female) were interviewed. Results: Three-quarters of the participants stated that they had fairly or very high trust in healthcare services and also felt that they had been fairly or very well treated. Fewer females than males reported being treated well and they declared a lower degree of trust in the healthcare system. The homeless suggest that extra resources be set aside to organise their healthcare, including a higher level of knowledge of the medical problems prevailing in the group. Those who felt badly treated also asked for less neglect and disrespect from the healthcare staff. Conclusions: Even though a majority experience that they are being well treated within the healthcare system, the study also indicated disadvantages in the treatment of homeless persons in Sweden. The study also reveals an imbalance between the official ethical framework in Sweden and of the specific moral of some individual healthcare providers. One way to facilitate their entry into the healthcare system might be to create special surgeries for the homeless.
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| 29. |
- Johansson, Gunnar, 1956-
(författare)
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Overweight and obesity in Sweden : A five year follow-up, 2004-2008
- 2010
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Ingår i: Scandinavian Journal of Public Health. - Oslo : Scandinavian University Press. - 1403-4948 .- 1651-1905. ; 38:8, s. 803-809
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The number of overweight and obese persons increased through the 1980s and 1990s in Sweden, for instance for men from 35% in 1980 to 52% in 2007. This study investigated whether this trend continued over the past 5 years, including trends for diet and physical activity.MATERIALS AND METHODS:The sampling frame in these surveys was established from the Swedish National Registry where all people registered in Sweden between 18 and 84 years in 2004 and 16-84 years in 2005-08 were included.RESULTS:There were no changes in the number of overweight (approximately 42% for men and 27% for women) and obese (approximately 11% for both men and women) persons between 2004 and 2008. Approximately 65% of the men and 64% of the women were physically active for an average of 30 minutes per day in 2008. Thirteen percent of women and 5% of men reported consuming at least five servings of fruit and vegetables per day during the 5-year period.CONCLUSIONS:Sweden seems to have reached a steady state regarding overweight and obesity. It would probably be fruitful to further discuss life-style issues, such as diet and physical activity, in the Swedish healthcare system and how to deal with the social gradient.
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| 30. |
- Johansson, Pia, et al.
(författare)
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Financing intersectoral health promotion programmes : some reasons why collaborators are collaborating as indicated by cost-effectiveness analyses
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39, s. 26-32
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Intersectoral collaboration is an important part of many health promotion programmes. The reasons for the local organisations to collaborate, i.e. to finance programmes, are presumably based on benefits they derive from the collaboration. The aim of this study is to discuss whether subsector financial analyses based on data from cost-effectiveness analyses reflect incentives of collaborating organisations in two intersectoral health promotion programmes. Methods: Within economics, financial incentives are important reasons for actions. The financial incentives of collaborators are exemplified with two subsector financial analyses containing avoided disease-related costs as estimated in two cost-effectiveness analyses, on an elderly safety promotion programme (Safe Seniors in Sundbyberg) and on a diabetes prevention programme (Stockholm Diabetes Prevention Program, SDPP) from Stockholm, Sweden. Results: The subsector financial analyses indicate that there are financial incentives for the key local community organisation, i.e. the local authority, to collaborate in one of the programmes but not the other. There are no financial benefits for other important community organisations, such as non-governmental organisations. Conclusions: The reasons for collaborating organisations to collaborate within intersectoral health promotion programmes extend beyond financial benefits from averted disease. Thus, the reported subsector financial analyses are only partial reflections of the incentives of collaborators, but they might be used as a starting point for discussions on cost sharing among potential intersectoral collaborators.
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