| 1. |
- Bostrom, G, et al.
(författare)
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Measuring social inequalities in health--politics or science?
- 2003
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 31:3, s. 211-215
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The methods chosen for seeking the answers to questions on social inequalities in health may heavily influence the results and thereby the formulation of appropriate public health policies. This study aims at identifying methodological problems in analysing trends about socio-economic differences in health. The focus is on whether the results may be influenced by the choice of outcome measure, the choice of social groups or by changes in the composition of social groups over time. Methods: Data sets on socio-economic differences in mortality in Europe presented by Kunst et al. and also data sets from the Swedish Survey of Living Conditions have been used. Results: The choice of outcome measures influences the results. Mortality trend comparisons between European countries for different socio-economic groups give completely different pictures whether using relative or absolute figures. The generally lower death rate in Sweden means that even small absolute differences give higher relative differences than in countries with higher death rates. Using socio-economic group or educational level as indicators of social position showed quite different results when analysing social inequalities in smoking and overweight in Sweden. The structure of social groups changes over time making trend analysis more difficult to interpret. In Sweden the group of poorly-educated people has halved in size during the past two decades, and the group of highly-educated people has increased. These changes most likely make the poorly-educated group a more homogenous and -healthwise - a more negatively selected group than it was twenty years ago. Conclusions: The most appropriate scientific approach to this problem is to present basic data in terms of absolute figures per population before presenting relative or absolute differences.
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| 2. |
- Haglund, B, et al.
(författare)
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Is moist snuff use associated with excess risk of IHD or stroke? A longitudinal follow-up of snuff users in Sweden
- 2007
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 35:6, s. 618-622
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Tidskriftsartikel (refereegranskat)abstract
- Background: The potential risks of Swedish moist snuff (snus) are debated and studies have shown diverging results. Aims: The aim of this study is to investigate whether there is any excess risk of ischaemic heart disease (IHD) and stroke from snuff use. Methods: The Swedish Survey of Living Conditions from 1988—89 was record-linked to the Swedish Cause of Death Register and the Swedish Hospital Discharge Register to investigate excess mortality and hospitalization from IHD and stroke. A Poisson regression model was used and incidence rate ratios (IRRs) for snuff and smoking were calculated controlling for age, physical activity, self-reported health, number of longstanding illnesses, residential area, and socioeconomic position. Results: Among snuff users there were no excess risks of mortality or hospitalization from IHD (IRR 0.8; 0.5—1.2,) or stroke (IRR 1.1; 0.7—1.8), but, as expected, clear excess risks were found for smokers (IRR 1.7; 1.4—2.1 for IHD, and IRR 1.4; 1.0—1.9 for stroke). Conclusions: This study has not shown any excess risk among users of snuff for IHD or stroke. If there is a risk associated with snuff it is evidently much lower than those associated with smoking.
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| 3. |
- Rosen, M, et al.
(författare)
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Follow-up of an age-period-cohort analysis on alcohol-related mortality trends in Sweden 1970-2015 with predictions to 2025
- 2019
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 47:4, s. 446-451
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Several studies have indicated that birth cohorts are important in explaining trends in alcohol-related mortality. An earlier study from Sweden with data up to 2002 showed that birth cohorts that grew up under periods of more liberal alcohol policies had higher alcohol-related mortality than those cohorts growing up under more restrictive time periods. In spite of increasing alcohol consumption, predictions in 2002 also indicated lower alcohol-related mortality in the future. The aim of this study is to follow-up whether the effects of birth cohorts and the predictions made for Sweden still holds using data up to 2015. Method: The study comprised an age-period-cohort analysis and predictions based on population predictions from Statistics Sweden. The analysis was based on all alcohol-related deaths in the Swedish population between 1969 and 2015 for the cohorts born in the decades 1920 through 1990. Data were restricted to people 15–84 years of age. In total, the analysis covered 68,341 deaths and more than 284 million person-years. Results: Male and female cohorts born in the 1940s to 1950s exhibited the highest alcohol-related mortality, while those born in the 1970s continued to have the lowest alcohol-related mortality rates. The predicted mortality rates for males are still anticipated to decrease somewhat through 2025. Conclusions: The updated age-period-cohort analysis further supports the importance of focusing on restrictive alcohol policies targeting adolescents.
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| 4. |
- Rosen, M, et al.
(författare)
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Interventions to suppress the coronavirus pandemic will increase unemployment and lead to many premature deaths
- 2021
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 49:1, s. 64-68
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Tidskriftsartikel (refereegranskat)abstract
- Interventions to suppress the coronavirus pandemic have led to economic recession and higher unemployment, which will increase mortality and decrease quality of life. The aim of this article is to estimate the consequences on mortality and life expectancy of increased unemployment rates due to the coronavirus pandemic in Sweden and other countries. Methods: Based on recent increases and expected future unemployment rates due to the coronavirus pandemic, results from a systematic review and data from vital statistics in Sweden, the number of premature deaths due to unemployment in Sweden have been estimated. Results: Based on our assumptions, the calculations show that if the number of unemployed persons in Sweden increases by 100,000, one may expect some 1800 more premature deaths during the following 9 years. If the duration of the recession is limited to 4 years, excess deaths due to unemployment may be around 800. On average, the unemployed will lose 2 years of their remaining life expectancy. In many other countries unemployment rates have or are estimated to rise more than in Sweden, sometimes two- or threefold, suggesting hundreds of thousands of excess deaths due to unemployment. Conclusions: Interventions to suppress the coronavirus pandemic include the shut-down of economic activities and lead to increased all-cause mortality. These public health effects must be considered in the decision-making process and should be added to overall estimates of the effects of the pandemic on public health.
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| 5. |
- Rosen, M, et al.
(författare)
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The one-sided explanations of a multifactorial coronavirus disease
- 2022
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 50:1, s. 19-21
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Tidskriftsartikel (refereegranskat)abstract
- Short-term interventions to suppress COVID-19 completely dominate the public, political and even the professional discussion on what explains observed differences in mortality and morbidity across countries. This leads to an exaggerated view of what such measures can accomplish. Factors such as housing and social conditions as well as travel patterns are equally important but neglected aspects of the COVID-19 development. A multifactorial disease needs a multivariate analytical approach.
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| 6. |
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