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- Bigert, Carolina, et al.
(författare)
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Myocardial infarction among professional drivers.
- 2003
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Ingår i: Epidemiology. - 1044-3983 .- 1531-5487. ; 14:3, s. 333-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Professional drivers are at an increased risk of myocardial infarction but the underlying causes for this increased risk are uncertain. METHODS: We identified all first events of myocardial infarction among men age 45-70 years in Stockholm County for 1992 and 1993. We selected controls randomly from the population. Response rates of 72% and 71% resulted in 1067 cases and 1482 controls, respectively. We obtained exposure information from questionnaires. We calculated odds ratios (ORs), with and without adjustment for socioeconomic status, tobacco smoking, alcohol drinking, physical inactivity at leisure time, overweight status, diabetes and hypertension. RESULTS: The crude OR among bus drivers was 2.14 (95% confidence interval = 1.34-3.41), among taxi drivers 1.88 (1.19-2.98) and among truck drivers 1.66 (1.22-2.26). Adjustment for potential confounders gave lower ORs: 1.49 (0.90-2.45), 1.34 (0.82-2.19) and 1.10 (0.79-1.53), respectively. Additional adjustment for job strain lowered the ORs only slightly. An exposure-response pattern (by duration of work) was found for bus and taxi drivers. CONCLUSIONS: The high risk among bus and taxi drivers was partly explained by unfavorable life-style factors and social factors. The work environment may contribute to their increased risk. Among truck drivers, individual risk factors seemed to explain most of the elevated risk.
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- Wamala, Sarah, et al.
(författare)
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Perceived discrimination, socioeconomic disadvantage and refraining from seeking medical treatment in Sweden
- 2007
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Ingår i: Journal of Epidemiology and Community Health. - Natl Inst Publ Hlth, S-10367 Stockholm, Sweden. Lund Univ, Dept Clin Sci, Malmo, Sweden. Karolinska Inst, Stockholm, Sweden. : BMJ PUBLISHING GROUP. - 0143-005X .- 1470-2738. ; 61:5, s. 409-415
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Tidskriftsartikel (refereegranskat)abstract
- Study objective: To analyse the association between perceived discrimination and refraining from seeking required medical treatment and the contribution of socioeconomic disadvantage. Design and setting: Data from the Swedish National Survey of Public Health 2004 were used for analysis. Respondents were asked whether they had refrained from seeking required medical treatment during the past 3 months. Perceived discrimination was based on whether respondents reported that they had been treated in a way that made them feel humiliated ( due to ethnicity/race, religion, gender, sexual orientation, age or disability). The Socioeconomic Disadvantage Index ( SDI) was developed to measure economic deprivation ( social welfare beneficiary, being unemployed, financial crisis and lack of cash reserves). Participants: Swedish population-based survey of 14 736 men and 17 115 women. Main results: Both perceived discrimination and socioeconomic disadvantage were independently associated with refraining from seeking medical treatment. Experiences of frequent discrimination even without any socioeconomic disadvantage were associated with three to nine-fold increased odds for refraining from seeking medical treatment. A combination of both frequent discrimination and severe SDI was associated with a multiplicative effect on refraining from seeking medical treatment, but this effect was statistically more conclusive among women ( OR = 11.6, 95% CI 8.1 to 16.6; Synergy Index ( SI) = 2.0 ( 95% CI 1.2 to 3.2)) than among men ( OR = 12, 95% CI 7.7 to 18.7; SI = 1.6 ( 95% CI 1.3 to 2.1)). Conclusions: The goal of equitable access to healthcare services cannot be achieved without public health strategies that confront and tackle discrimination in society and specifically in the healthcare setting.
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- Wamala, Sarah, et al.
(författare)
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Socioeconomic disadvantage and primary non-adherence with medication in Sweden
- 2007
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Ingår i: International Journal for Quality in Health Care. - Karolinska Inst, Stockholm, Sweden. Lund Univ, Fac Med, S-22100 Lund, Sweden. Swedish Natl Inst Publ Hlth, Stockholm, Sweden. : OXFORD UNIV PRESS. - 1353-4505 .- 1464-3677. ; 19:3, s. 134-140
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Lack of adherence with pharmacological therapy is a public health concern that compels tremendous costs for the health care system and the community. To analyse the association between socioeconomic disadvantage and primary nonadherence with medication, and to explore possible mediating effects of trust in health care and lifestyle profile. Design. Cross-sectional population-based study based on data from the Swedish national public health surveys 2004-2005. Participants. The study comprised 13603 men and 18292 women aged 21-84 years who had any contact with a physician at a hospital or primary care centre. Measures. Primary non-adherence with medication based on whether respondents reported that they refrained from purchasing at the pharmacy prescribed medication. Socioeconomic Disadvantage Index was based on four different indicators of economic deprivation. Results. Socioeconomic disadvantage was associated with primary non-adherence with medication independent of long-term illness, risky lifestyle, low education, living alone and low trust for health care. This association increased with older age, particularly among women. Among individuals aged 21-34 years, severe compared with no socioeconomic disadvantage, was associated with two-fold increased odds for non-adherence with medication. The: corresponding odds among individuals aged 65-84 years were three-fold increase among elderly men (OR = 3.3, 95% CI: 1.4-7.8) and six-fold increase among elderly women (OR = 6.2, 95% CI: 2.5-15.3). Yet every seventh elderly woman aged 65-84 years suffered from long-term illness. Conclusions. Results indicate that health policies for 'care on equal terms' in Sweden have been less successful in relation to equitable access to prescribed medication, especially among the elderly.
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