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| 2. |
- Barbosa, Cristina, et al.
(författare)
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GOVERNANCE STRATEGIES TO AN AGEING SOCIETY - LOCAL ROLL IN MULTI LEVEL PROCESSES
- 2016
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Ingår i: Journal of Comparative Politics. - 1337-7477 .- 1338-1385. ; 9:1, s. 4-18
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Tidskriftsartikel (refereegranskat)abstract
- Demographic ageing marks strategic orientations and public policies. It's a challenge to societies, public and private institutions and Welfare State. The goal of this study is to understand the local governance strategies to an ageing population and the role of the local in multilevel governance processes. A qualitative methodology it was followed that supports analysis and understanding of both local ageing policies. The samples are case studies of two contexts, Portugal and Sweden, respectively city councils of Lisbon and Nacka, where stakeholders were interviewed. Different concepts and visions influence local ageing policies. Vertical coordination is easier to follow in Portugal, but without concrete laws, and in Sweden, horizontal coordination is emphasized between providers and municipalities. Local public intervention in ageing seeks renewed actions and this study allows to conclude that a perfect local policy doesn't exist. However in many aspects, can be complementary.
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| 3. |
- Heap, Josephine, 1980-
(författare)
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Living conditions in old age: Coexisting disadvantages across life domains
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to analyse coexisting disadvantages in the older Swedish population. Coexisting disadvantages are those that occur simultaneously in various life domains. A person who simultaneously experiences several disadvantages may be particularly vulnerable and less well-equipped to manage daily life and may also need support from several different welfare service providers. Concerted actions may be needed for older people who experience not only physical health problems and functional limitations, but also other problems. Research that encompasses a wide range of living conditions provides a basis for setting political priorities and making political decisions.The studies in this thesis used data from two Swedish nationally representative surveys: the Level of Living Survey, which includes people aged 18 through 75, and the Swedish Panel Study of Living Conditions of the Oldest Old, which includes people aged 77 and older.Study I showed that the probability of experiencing coexisting disadvantages was higher in people 77 and older than in those aged 18 through 76. These age differences were partly driven by a high prevalence of physical health problems in older people. In all age groups, coexisting disadvantages were more common in women than men.The longitudinal analyses in Study II indicated that coexisting disadvantages in old age persist in some people but are temporary in others. Moreover, the results suggested a pattern of accumulating disadvantages: reporting one disadvantage in young old age (in particular, psychological health problems) increased the probability of reporting coexisting disadvantages in late old age. Study III showed that physical health problems were a central component of coexisting disadvantages. The results also showed that being older; female; previously employed as a manual labourer; and divorced/separated, widowed or never married were associated with an increased probability of experiencing coexisting disadvantages. However, the experience of coexisting disadvantages differed: the groups associated with coexisting disadvantages tended to report different combinations of disadvantage.Study IV showed that the prevalence of coexisting disadvantages in those 77 and older increased slightly between 1992 and 2011. Physical health problems became more common over time, whereas limited ability to manage daily activities (ADL limitations), limited financial resources and limited political resources became less common. Associations between different disadvantages were found in all survey years, but certain associations changed over time. The results suggest that in general, the composition of coexisting disadvantages in the older population may have altered over time.In sum, results showed that coexisting disadvantages were associated with specific demographic and socio-economic groups. Physical health problems and psychological health problems were of particular importance to the accumulation and coexistence of disadvantages in old age.
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| 4. |
- Fors, Stefan, et al.
(författare)
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Enduring inequality : educational disparities in health among the oldest old in Sweden 1992-2011
- 2015
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Ingår i: International Journal of Public Health. - : Springer Science and Business Media LLC. - 1661-8556 .- 1661-8564. ; 60:1, s. 91-98
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Although the past two decades have involved changes in the living conditions of the oldest old in Sweden, little is known about how health inequalities have developed in this group during the period. This study explores the educational disparities in a wide range of health outcomes among the oldest old in Sweden between 1992 and 2011.METHODS: The study uses the repeated cross-sectional design of the SWEOLD survey, a nationally representative survey of the oldest old in Sweden with comparable data from 1992, 2002, and 2011. The development of educational disparities in health was tracked across the three waves.RESULTS: The results show that although the prevalence of most health problems increased during the period, the prevalence of disability in activities of daily living decreased. Despite these changes, educational disparities in health remained largely unaffected.CONCLUSIONS: The results of the study suggest that the association between education and health is remarkably robust. It prevailed into the oldest age groups, was consistently found for a wide range of health problems, and tended to be stable over extended periods of time.
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| 5. |
- Kelfve, Susanne, 1974-
(författare)
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Gotta survey somebody : Methodological challenges in population studies of older people
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Conducting representative surveys of older people is challenging. This thesis aims to analyze a) the characteristics of individuals at risk of being underrepresented in surveys of older people, b) the systematic errors likely to occur as a result of these selections, and c) whether these systematic errors can be minimized by weighting adjustments. In Study I, we investigated a) who would be missing from a survey that excluded those living in institutions and that did not use indirect interviews, b) how prevalence rates would be affected by these exclusions, and c) whether post-stratifying the data by sex and age (weighting adjustment) would correct for any systematic measurement error.In Study II, we compared mortality and hospitalization rates in those who responded to a postal questionnaire with rates in the target population. In addition, we tested whether a weighting variable created with a number of auxiliary variables could correct for the differences. In Study III, we followed a longitudinal cohort sample for 43 years. By recalculating baseline characteristics at each follow-up, we investigated how the sample changed after a) selective mortality and b) survey non-participation.In Study IV, we investigated whether the systematic non-participation that is likely to occur in surveys of older people affects the association between education and health.In sum, the results of these four studies show that people in the oldest age groups, women, those of low socioeconomic position, and those with the poorest health tend to be underrepresented in surveys of older people. This systematic underrepresentation might lead to an underestimation of poor health and function, a bias that is unlikely to be corrected by weighting adjustments, and to an underestimation of health inequality between educational groups. The results also show that the selective mortality that occurs in longitudinal samples might be compounded by selective non-participation among the most disadvantaged groups.
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| 6. |
- Lexomboon, Duangjai, 1965-, et al.
(författare)
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Determinants of tooth loss and chewing ability in mid- and late life in three Swedish birth cohorts
- 2015
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Ingår i: Ageing & Society. - 0144-686X .- 1469-1779. ; 35:5, s. 1304-1317
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the research presented is to determine the influence of socio-economic factors in childhood and mid-life on multiple tooth loss and chewing problems in mid- and late life in three Swedish birth cohorts (1903–1910, 1911–1920 and 1921–1925). Longitudinal national Swedish surveys were used for the analysis. Participants were interviewed in mid-life in 1968 and later in life (77–99 years of age) in 2002. Childhood socio-economic positions (SEP) did not result in different odds of multiple tooth loss and chewing problems in mid- and late life, but persons with higher mid-life SEP had lower odds. Persons born into the 1921–1925 birth cohort had significantly lower odds of multiple tooth loss in late life than the 1903–1910 birth cohort. Women had higher odds of losing multiple teeth than men in late life but not mid-life. Neither gender nor childhood and mid-life SEP predicted chewing problems late in life, but older people with multiple tooth loss had higher odds of chewing difficulty than those with mainly natural teeth. Childhood conditions may contribute to multiple tooth loss in mid-life, which subsequently contributes to multiple tooth loss in late life. Tooth loss in late life is strongly associated with difficulty chewing hard food. Prevalence of multiple tooth loss is higher in women than in men in late life but not in mid-life.
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| 7. |
- Meinow, Bettina, et al.
(författare)
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Complex health problems among the oldest old in Sweden : increased prevalence rates between 1992 and 2002 and stable rates thereafter
- 2015
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 12:4, s. 285-297
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Tidskriftsartikel (refereegranskat)abstract
- Studies of health trends in older populations usually focus on single health indicators. We include multiple medical and functional indicators, which together indicate the broader impact of health problems experienced by individuals and the need for integrated care from several providers of medical and long-term care. The study identified severe problems in three health domains (diseases/symptoms, mobility, and cognition/communication) in three nationally representative samples of the Swedish population aged 77+ in 1992, 2002, and 2011 (n a parts per thousand 1900; response rate > 85 %). Institutionalized people and proxy interviews were included. People with severe problems in two or three domains were considered to have complex health problems. Results showed a significant increase of older adults with complex health problems from 19 % in 1992 to 26 % in 2002 and no change thereafter. Changes over time remained when controlling for age and sex. When stratified by education, complex health problems increased significantly for people with lower education between 1992 and 2002 and did not change significantly between 2002 and 2011. For higher-educated people, there was no significant change over time. Among the people with severe problems in the symptoms/disease domain, about half had no severe problems in the other domains. People with severe mobility problems, on the other hand, were more likely to also have severe problems in other domains. Even stable rates may imply an increasing number of very old people with complex health problems, resulting in a need for improved coordination between providers of medical care and social services.
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| 8. |
- Larsson, Kristina, et al.
(författare)
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Care utilisation in the last years of life in Sweden: the effects of gender and marital status differ by type of care
- 2014
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 11:4, s. 349-359
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Tidskriftsartikel (refereegranskat)abstract
- The effects of gender and marital status on care utilisation in the last years of life are highly correlated. This study analysed whether gender differences in use of eldercare (home help services or institutional care) or hospital care in the last 5 years of life, and the place of death, could be attributed to differences in marital status and thereby to potential access to informal care. A longitudinal Swedish study provided register data on 567 participants (aged 83 +) who died between 1995 and 2004. A higher proportion of unmarried than married people used home help services; this was true of both men and women. The likelihood of receiving home help was lower for those living with their spouse (OR = 0.38) and for those with children (OR = 0.60). In the 2 years preceding death, the proportion receiving home help services decreased and the proportion in institutional care increased. Women were significantly more likely to die in institutional care (OR = 1.88) than men. Although men were less likely to live in institutional care than women and more likely to be inpatients in the 3 months preceding death, after controlling for residence in institutional care, neither gender nor marital status was statistically significant when included in the same model. In summary, the determining factor for home help utilisation seemed to be access to informal care, whereas gender differences in health status could explain women’s higher probability of dying in institutional care.
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| 9. |
- Lennartsson, Carin, et al.
(författare)
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Data Resource Profile : The Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD)
- 2014
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Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 43:3, s. 731-738
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Tidskriftsartikel (refereegranskat)abstract
- As the number and proportion of very old people in the population increase, there is a need for improved knowledge about their health and living conditions. The SWEOLD interview surveys are based on random samples of the population aged 77+years. The low non-response rates, the inclusion of institutionalized persons and the use of proxy informants for people unable to be interviewed directly ensure a representative portrayal of this age group in Sweden. SWEOLD began in 1992 and has been repeated in 2002, 2004 and 2011. The survey is based on another national survey, the Swedish Level of Living Survey (LNU), started in 1968 with 10-year follow-up waves. This longitudinal design provides additional data collected when SWEOLD participants were in middle age and early old age. The SWEOLD interviews cover a wide range of areas including health and health behaviour, work history, family, leisure activities and use of health and social care services. Socio-economic factors include education, previous occupation and available cash margin. Health indicators include symptoms, diseases, mobility and activities of daily living (ADL). In addition to self-reported data, the interview includes objective tests of lung function, physical function, grip strength and cognition. The data have been linked to register data, for example for income and mortality follow-ups. Data are available to the scientific community on request. More information about the study, data access rules and how to apply for data are available at the website (www.sweold.se).
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