| 1. |
- Corell, Maria, et al.
(författare)
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Socioeconomic inequalities in adolescent mental health in the Nordic countries in the 2000s-A study using cross-sectional data from the Health Behaviour in School-aged Children study
- 2024
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Ingår i: ARCHIVES OF PUBLIC HEALTH. - 0778-7367 .- 2049-3258. ; 82:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAdolescents in Sweden experience more mental health problems and lower mental well-being than adolescents in other Nordic countries. According to the literature, one possible explanation may be differences in income inequality. The at-risk-of-poverty rate varies significantly across the Nordic countries, and the highest rate is found in Sweden. The aims of the study were to examine socioeconomic inequalities in subjective health complaints and life satisfaction among adolescents in the Nordic countries during 2002 - 2018 and to explore whether subjective health complaints and life satisfaction were related to income inequality in terms of the at-risk-of-poverty rate at the country level.MethodsData regarding 15-year-olds from the Health Behaviour in School-aged Children study from five survey rounds (2002 - 2018) were used (n = 41,148). The HBSC Symptoms Checklist and Cantril's ladder were used as measures of subjective health complaints and life satisfaction, respectively. The Family Affluence Scale, the Perceived Family Wealth item and the at-risk-of-poverty rate in each country were used as measures of individual-level socioeconomic conditions and country-level income inequality. Statistical methods involved ANOVA, multiple linear regressions and multilevel regression analyses.ResultsAbsolute and relative socioeconomic inequalities in both subjective health complaints and life satisfaction were found in all countries. Sweden showed average socioeconomic inequalities, Iceland the largest and Denmark the smallest. Country-level income inequality in terms of the at-risk-of-poverty rate was associated with a higher prevalence of subjective health complaints and lower levels of life satisfaction in all countries.ConclusionSocioeconomic inequalities in adolescent mental health and well-being persisted in Nordic countries in the 2000s. Increasing income inequality may have contributed to higher levels of SHC and lower LS in Sweden compared to the other Nordic countries. Policies improving families' socioeconomic conditions and reducing income inequality at the country level are needed to improve and reduce inequalities in mental health and well-being among adolescents.
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| 2. |
- Chen, Yun, 1966, et al.
(författare)
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Association between childhood BMI trajectories and cardiometabolic risk and mental health problems at the age of 13 years: the cohort STudy of Adolescence Resilience and Stress (STARS)
- 2023
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Ingår i: The Lancet. Global health. - 2214-109X. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Research on BMI trajectories has been focused mainly on childhood and adolescence, missing birth and infancy, which are also relevant in the development of cardiometabolic disease in adulthood. We aimed to identify trajectories of BMI from birth throughout childhood, and to examine whether BMI trajectories predict health outcomes at the age of 13 years; and, if so, whether differences exist among trajectories regarding timeframes during which BMI in early life influences health outcomes. METHODS: Participants recruited from schools in the Västra Götaland region of Sweden completed questionnaires of perceived stress and psychosomatic symptoms and were examined for the following cardiometabolic risk factors: BMI, waist circumference, systolic blood pressure, pulse-wave velocity, and white blood cell counts. We collected ten retrospective measures of weight and height, from birth to the age of 12 years. Participants with at least five measures (at birth, one at age 6-18 months, two at age 2-8 years, and one at age 10-13 years) were included in the analyses. We used group-based trajectory modelling to identify BMI trajectories, ANOVA to compare different trajectories, and linear regression to assess associations. FINDINGS: We recruited 1902 participants (829 [44%] boys and 1073 [56%] girls, median age 13·6 years (IQR 13·3-13·8). We identified and named three BMI trajectories, and categorised participants accordingly: normal gain (847 [44%] participants), moderate gain (815 [43%] participants), and excessive gain (240 [13%] participants). Differences distinguishing these trajectories were established before the age of 2 years. After adjustments for sex, age, migrant background, and parental income, respondents with excessive gain had a higher waist circumference (mean difference 19·2 cm [95% CI 18·4-20·0]), higher systolic blood pressure (mean difference 3·6 mm Hg [95% CI 2·4-4·4]), more white blood cells (mean difference 0·7×10⁹ cells per L [95% CI 0·4-0·9]), and higher stress scores (mean difference 1·1 [95% CI 0·2-1·9]), but similar pulse-wave velocity compared with adolescents with normal gain. Higher waist circumference (mean difference 6·4 cm [95% CI 5·8-6·9]), higher systolic blood pressure (mean difference 1·8 mm Hg [95% CI 1·0-2·5]), and a higher stress score (mean difference 0·7 [95% CI 0·1-1·2]) were also found in adolescents with moderate gain, compared with adolescents with normal gain. Regarding timeframes, we observed that a significant positive correlation of early life BMI with systolic blood pressure started approximately at the age 6 years for participants with excessive gain, much earlier than for participants with normal gain and moderate gain, for which it started at the age of 12 years. For waist circumference, white blood cell counts, stress, and psychosomatic symptoms, the timeframes were similar across the three BMI trajectories. INTERPRETATION: Excessive gain BMI trajectory from birth can predict both cardiometabolic risk and stress and psychosomatic symptoms in adolescents before the age of 13 years.
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| 3. |
- Chen, Yun, 1978, et al.
(författare)
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Childhood BMI trajectories predict cardiometabolic risk and perceived stress at age 13 years: the STARS cohort
- 2023
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Ingår i: Obesity. - 1930-7381 .- 1930-739X.
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to examine BMI trajectories from birth throughout childhood, associations with health outcomes at age 13 years, and time frames during which early-life BMI influenced adolescent health. Methods: Participants (1902, 44% male) reported perceived stress and psychosomatic symptoms and were examined for waist circumference (WC), systolic blood pressure (SBP), pulse wave velocity, and white blood cell counts (WBC). BMI trajectory was analyzed using group-based trajectory modeling of retrospective data of weight/height from birth throughout childhood. The authors performed linear regression to assess associations between BMI trajectories and health outcomes at age 13 years, presented as estimated mean differences with 95% CI among trajectories. Results: Three BMI trajectories were identified: normal; moderate; and excessive gain. Adjusting for covariates, adolescents with excessive gain had higher WC (19.2 [95% CI: 18.4–20.0] cm), SBP (3.6 [95% CI: 2.4–4.4] mm Hg), WBC (0.7 [95% CI: 0.4–0.9] × 109/L), and stress (1.1 [95% CI: 0.2–1.9]) than adolescents with normal gain. Higher WC (6.4 [95% CI: 5.8–6.9] cm), SBP (1.8 [95% CI: 1.0–2.5] mm Hg), and stress (0.7 [95% CI: 0.1–1.2]) were found in adolescents with moderate versus normal gain. The association of early-life BMI with SBP started around age 6 years with the excessive gain group, which was earlier than in the normal and moderate gain groups, in which it started at age 12 years. Conclusions: An excessive gain BMI trajectory from birth predicts cardiometabolic risk and stress in 13-year-old individuals.
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| 4. |
- Dahlstrand, Johan, et al.
(författare)
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Move for Your Heart, Break a Sweat for Your Mind: Providing Precision in Adolescent Health and Physical Activity Behaviour Pattern.
- 2023
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Ingår i: The Journal of adolescent health : official publication of the Society for Adolescent Medicine. - 1879-1972. ; 73:1, s. 29-36
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Tidskriftsartikel (refereegranskat)abstract
- Adolescent health benefits of different physical activity (PA) intensities, especially of lower intensities, are debated due to challenges in accelerometer data processing and analyses. Using a new accelerometer data processing method and multivariate pattern analysis, this study investigated the association of PA intensities with indicators of cardiovascular and mental health.Adolescents (n= 1,235, mean age 13.6years, 41% males) were examined for cardiovascular health: body mass index (BMI) z-score, waist circumference (WC), resting heart rate and blood pressure, white blood cell count (WBC), pulse wave velocity (PWV), and answered questionnaires assessing stress and psychosomatic symptoms. Sex, age, and socioeconomic status were confounders. Hip-worn accelerometer data were processed with 10Hz frequency extended method and a spectrum of 22 PA intensity categories was analyzed for association with health using partial least squares regression.Total explained variances for BMI z-score, WC, resting heart rate, stress, and psychosomatic symptoms were higher (3.3%-8.7%) compared to diastolic blood pressure, WBC, and PWV (0.9%-1.4%). We found positive associations of high-end moderate PA and vigorous PA with cardiovascular and mental health indicators. More sedentary time and lower level of light PA were associated with higher BMI z-score, WC, resting heart rate, diastolic blood pressure, WBC, and PWV, but not with mental health indicators. Very vigorous PA was negatively associated with resting heart rate, stress, and psychosomatic symptoms.In adolescents, PA of varying intensities were generally found to be positively associated with better cardiovascular health, but only higher intensity PA was associated with better mental health.
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| 5. |
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| 6. |
- Smith, Michael, et al.
(författare)
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A field investigation on associations between environmental noise and adolescent physiological sleep: An Equal-Life study
- 2023
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Ingår i: 14th ICBEN Congress on Noise as a Public Health Problem.
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Konferensbidrag (refereegranskat)abstract
- There is a need for field studies incorporating objective measures of both noise and sleep. Within the EU project Equal-Life we performed an in-depth field study to investigate associations between nocturnal noise exposure and physiological sleep. Participants (n=109; 68 female) were adolescents/young adults (18-19 years) recruited from within the longitudinal birth cohort STARS, around Gothenburg, Sweden. The noise exposure and sleep of each subject was investigated for four consecutive nights, from Tuesday night to Saturday morning. Outdoor noise was measured with sound level meters mounted outside bedroom windows. Indoor noise measurements and audio recordings were made in the bedrooms. Sleep was measured with a headband (DREEM3) incorporating dry EEG electrodes. Questionnaires were administered every evening and morning, and included items on daytime activities, sleepiness (Karolinska Sleepiness Scale), sleep quality, sleep disturbance by noise, and the bedroom environment. Outdoor noise measurements were obtained for 465 days and nights. Nighttime levels ranged from 35.8 to 73.7 dB Lnight (mean±SD 47.6±5.5 dB Lnight). Twenty-four hour levels ranged from 39.5 to 69.1 dB LAEq,24h (mean±SD 51.3±5.4 dB LAEq,24h). Data analysis is ongoing, and results will be presented at the congress. We will determine associations between average noise levels (Lnight, and LAEq during the EEG-derived sleep period) and sleep structure. We will also determine acute effects of discrete noise events on sleep fragmentation including noise-induced awakenings and changes of sleep stage.
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| 7. |
- Chen, Yun, 1966, et al.
(författare)
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Hair glucocorticoid concentration, self-perceived stress and their associations with cardiometabolic risk markers in Swedish adolescents
- 2022
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 0306-4530. ; 146
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Tidskriftsartikel (refereegranskat)abstract
- Background: While hair cortisol is proposed as a biomarker for chronic stress and a possible mediator linking chronic stress and cardiovascular risk in adults, studies in adolescents are scarce. We explored the associations between self-perceived stress, hair cortisol (HairF) and cortisone (HairE), and cardiometabolic risk markers in adolescents. Further, we examined whether association between self-perceived stress and HairF may depend on the use of the coping strategies "shift-persist ". Methods: Participants were 7th grade pupils recruited to the STudy of Adolescence Resilience and Stress (STARS) and data from the baseline examinations were used. Adolescents (n = 1553, 26 % boys, Mage=13.6, SD = 0.4) completed questionnaires assessing perceived stress and coping strategies "shift-persist ", provided hair sample, and examined for cardiometabolic risk factors including waist circumference (WC), body mass index (BMI) z -score, blood pressure, and white blood cell counts (WBC). HairF and HairE were analysed using liquid chro-matography with tandem mass spectrometry. We conducted descriptive analyses (Student's t-test, Wilcoxon Signed Ranks test, Chi-square test) and linear regression analyses. Results: Perceived stress was not associated with HairF, neither had the use of coping strategies "shift-persist " any influence on this association. Both HairF and HairE were positively associated with BMI z-score (beta coefficients (8): 0.178 (p < 0.001) and 0.119 (p < 0.001) for boys; 0.123 (p < 0.001) and 0.089 (p < 0.01) for girls) and WC (8: 0.089 (p > 0.05) and 0.098 (p < 0.05) for boys; 0.103 (p < 0.01) and 0.076 (p < 0.05) for girls). Perceived stress was also positively associated with BMI z-score and WC. Perceived stress, but not HairF, remained asso-ciated with WC in boys (8 = 0.200, p < 0.001) in the models with HairF and perceived stress presented simultaneously. Modest association between HairE and WBC was found in boys (8 = 0.149, p < 0.01). Conclusions: The study supports the association between chronic stress and overweight/obesity in adolescents. Hair cortisol and self-perceived stress capture different aspects of how chronic stress is related to overweight/ obesity in adolescents.
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| 8. |
- Chen, Yun, 1966, et al.
(författare)
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Impact of COVID-19 pandemic on mental health and health behaviors in Swedish adolescents
- 2022
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 50, s. 26-32
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Tidskriftsartikel (refereegranskat)abstract
- Aims: There is an urgent need to explore the impact of the COVID-19 pandemic on adolescent mental health and health behaviours. To date, there are no such studies on Swedish adolescents. As COVID-19 emerged in the middle of our ongoing 2-year follow-up examination of the Study of Adolescence Resilience and Stress, we had the unique opportunity to use the corona outbreak as a 'natural experiment' to study the impact of COVID-19 on 15-year-old adolescents in Sweden. Methods: Adolescents (baseline age 13.6 +/- 0.4 years) were recruited from schools in western Sweden (during the COVID-19 outbreak schools were kept open for those under 16 years of age). The COVID-19 pandemic reached Sweden on 31 January 2020. A total of 1316 adolescents answered the 2-year follow-up survey before (unexposed to COVID-19 pandemic, controls) and 584 after 1 February 2020 (COVID19-exposed). Data on stress, psychosomatic symptoms, happiness, relationships with parents and peers, school and health behaviours were collected. Results: Adolescents reported higher levels of stress and psychosomatic symptoms and lower levels of happiness at follow-up compared to baseline. These changes occurred to a similar extent in both the control and COVID-19-exposed groups. Likewise, the COVID-19-exposed group showed no deterioration in peer relations or relations with parents versus controls. We did not find any significant differences between groups regarding sleep duration and physical activity. Conclusions: Swedish adolescents exposed to COVID-19 during most of 2020 showed no differences in longitudinal changes in mental health, relationships with parents and peers, and health behaviours compared to those not exposed to COVID-19.
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| 9. |
- Corell, Maria, et al.
(författare)
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Subjective health complaints in early adolescence reflect stress: A study among adolescents in Western Sweden
- 2022
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 50:4, s. 516-523
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Mental health problems are common among Swedish adolescents and are sometimes referred to as 'stress-related'. The overall aim of this study is to do an analysis of subjective health complaints (SHCs) and perceived general stress among adolescents in Sweden, both their prevalence and association, by gender, migration background, family structure and socioeconomic conditions. Methods: Data from the baseline (comprising 2283 adolescents aged 13) of the STudy of Adolescence Resilience and Stress (STARS) study in Vastra Gotaland in Sweden were used. SHCs were measured by the Psychosomatic Problems Scale (PSP-scale) and self-reported stress was measured by Cohen's Perceived Stress Scale (PSS-10). Socioeconomic conditions were measured with the Family Affluence Scale (FAS) and the MacArthur Scale of Subjective Social Status (SSS). Statistical analyses included Student's t-tests and ANOVAs of means, linear and logistic regression analyses and Pearson's correlations. Results: Social inequalities in both SHCs and self-reported stress were found; levels were higher among girls, adolescents living with one parent or in families with less favourable socioeconomic conditions. Self-reported stress and SHCs were found to be strongly correlated (r=0.70). Correlations with self-reported stress were stronger for psychological complaints (r=0.71) than for somatic complaints (r=0.52). Correlations did not vary with socioeconomic conditions of the family. Conclusions: SHCs do reflect general stress among adolescents, and it is appropriate to address the complaints as 'stress-related'. Measures to improve adolescents' mental health by reducing levels of SHCs should pay special attention to stressors in adolescents' daily lives and strengthening adolescent's coping resources and strategies.
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| 10. |
- Dasandi, N., et al.
(författare)
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The inclusion of health in major global reports on climate change and biodiversity
- 2022
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Ingår i: Bmj Global Health. - : BMJ. - 2059-7908. ; 7:6
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Tidskriftsartikel (refereegranskat)abstract
- This article argues that human health has become a key consideration in recent global reports on climate change and biodiversity produced by various international organisations; however, greater attention must be given to the unequal health impacts of climate change and biodiversity loss around the world and the different health adaptation measures that are urgently required.
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