| 1. |
- af Sillén, Ulrika, et al.
(författare)
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Self-rated health in relation to age and gender: influence on mortality risk in the Malmö Preventive Project.
- 2005
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 33:3, s. 9-183
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Tidskriftsartikel (refereegranskat)abstract
- Aims: A study was undertaken to examine whether poor self-rated health (SRH) can independently predict all-cause mortality during 22-year follow-up in middle-aged men and women. Subjects and methods: Data are derived from a population-based study in Malmo¨ , Sweden. This included baseline laboratory testing and a self-administered questionnaire. The question on global SRH was answered by 15,590 men (mean age 46.4 years) and 10,089 women (49.4 years). Social background characteristics (occupation, marital status) were based on data from national censuses. Mortality was retrieved from national registers. Results: At screening 4,261 (27.3%) men and 3,085 (30.6%) women reported poor SRH. Among subjects rating their SRH as low, 1,022 (24.0%) men and 228 (7.4%) women died during follow-up. Corresponding figures for subjects rating their SRH as high were 1801 (15.9%) men and 376 (5.4%) women. An analysis of survival in subjects reporting poor SRH revealed an age-adjusted hazard risk ratio (HR, 95%CI) for men HR 1.5 (1.4–1.7), and for women HR 1.4 (1.2–1.6). The corresponding HR after adjusting for possible social confounders was for men HR 1.3 (1.1–1.4), and women HR 1.1 (0.9–1.4). When additional adjustment was made for biological risk factors the association for men was still significant, HR 1.2 (1.1–1.3). Conclusion: Poor SRH predicts increased long-term mortality in healthy, middle-aged subjects. For men the association is independent of both social background and selected biological variables. The adjustment for biological variables can be questioned as they might represent mediating mechanisms in a possible causal chain of events.
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| 2. |
- Johnell, K, et al.
(författare)
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Neighborhood social participation, use of anxiolytic-hypnotic drugs, and women's propensity for disability pension: a multilevel analysis
- 2006
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 34:1, s. 41-48
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The increasing number of people on disability pension in Sweden is of concern for Swedish policy-makers, and there is a need for a better understanding of the mechanisms behind disability pension. We investigated ( i) whether women living in the same neighborhood have a similar propensity for disability pension that relates to neighborhood social participation, and ( ii) whether there is an association between anxiolytic-hypnotic drug ( AHD) use and disability pension in women that is modified by the neighborhood context. Methods: We used multilevel logistic regression with 12,156 women aged 45 to 64 ( first level) residing in 95 neighborhoods ( second level) in the city of Malmo ( 250,000 inhabitants), Sweden, who participated in the Malmo Diet and Cancer Study ( 1991 - 96). Results: Both AHD use ( OR=2.09, 95% CI 1.65, 2.65) and neighborhood rate of low social participation ( OR=11.85, 95% CI 5.09, 27.58) were associated with higher propensity for disability pension. The interval odds ratio indicated that the influence of neighborhood social participation was large compared with the unexplained variance between the neighborhoods. The association between AHD use and disability pension was not modified by the neighborhood context. The median odds ratio was 1.44 after adjusting for individual characteristics and 1.27 after the additional adjusting for neighborhood social participation. Conclusions: Women living in the same neighborhood appear to have a similar propensity for disability pension, beyond individual characteristics, and this contextual effect seems largely explained by neighborhood social participation. In addition, AHD use might increase the propensity for disability pension in women.
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| 3. |
- Månsson, Nils-Ove, et al.
(författare)
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Is there an interaction between self-rated health and medication with analgesics and hypnotics in the prediction of disability pension?
- 2002
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 30:4, s. 267-273
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Several studies have shown that self-rated health (SRH ) is associated with drug use. The aim of this study was to investigate the possible interaction between SRH and use of analgesics and hypnotics and its ability to predict disability pension. Methods: In 1974-78, complete birth-year cohorts of middle-aged male residents in Malmö, Sweden, were invited to a health screening, and the cohort in this study comprised 5,798 men with complete data followed up for 11 years. Results: At inclusion, 27% rated their health as less than perfect, 11% used analgesics, 3% used hypnotics and, during follow-up, 12% received a disability pension. The adjusted hazard ratios of disability pension were 3.1 (CI: 2.6, 3.6) for those who had rated their health as less than perfect and 2.7 (2.3, 3.2) for subjects who used analgesics and/or hypnotics. For subjects with the combined risk of poor SRH and medication, the hazard ratio was 5.5 (4.6, 6.5). The granting of disability pension attributable to the interaction between poor SRH and medication was estimated at 47%, which was statistically significant. Conclusions: Disability pension among middle-aged men was associated with self-rated health as well as medication and clear evidence of synergism between the two factors was found, while there were no indications of medication acting as a causal link between poor SRH and disability pension. Several mechanisms may contribute to the findings, but the information gained may be used as means to identify those at risk for disability pension.
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| 4. |
- Månsson, Nils-Ove, et al.
(författare)
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Self-rated health as a predictor of disability pension and death--a prospective study of middle-aged men
- 2001
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 29:2, s. 151-158
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Self-rated health (SRH) is increasingly attracting attention as a predictor of morbidity and mortality while its relation to impaired function has been given less momentum. The aim of this study was to assess the relation between SRH and the risk of being awarded a disability pension and premature death. METHODS: Five birth-year cohorts of middle-aged men were invited to a screening programme and were followed for approximately 11 years. Of the 718 (12%) men with a disability pension granted during follow-up, 46% had perceived their health as perfect on inclusion. The corresponding figure for the remaining 5,082 men was 77%. RESULTS: The crude relative risk (RR) of disability pension for men with SRH less than perfect was 3.7 (3.2-4.2). After adjustment for premorbidity/medication, the RR declined to 3.3 (2.8-3.8). The crude RR of death associated with SRH less than perfect was 1.6 (1.3-2.0), unchanged after adjustment. CONCLUSION: The results showed that SRH is a strong and independent predictor of disability and, to a lesser degree, of mortality.
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| 5. |
- Månsson, Nils-Ove, et al.
(författare)
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The use of analgesics and hypnotics in relation to self-rated health and disability pension - A prospective study of middle-aged men
- 2001
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 29:2, s. 133-139
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Tidskriftsartikel (refereegranskat)abstract
- Aims: This cohort study on urban middle-aged men investigates the association between the use of analgesics and hypnotics, self-rated health (SRI-I) and disability pension. Methods: Five birth-year cohorts of middle-aged, urban, Swedish men were invited to a screening programme and were followed for approximately 11 years. Results: Out of all the subjects (n = 5798), 12.4% received a disability pension during follow-up, 27.0% rated their health as less than perfect, 10.6% used analgesics and 2.9% used hypnotics. Compared with non-users of analgesics and hypnotics, the adjusted hazard ratio of disability pension for the simultaneous use of both drugs was 7.0 (95% CI: 4.3, 11.6) and the adjusted odds ratio of poor SRH was 16.5 (6.3, 43.5). Thus, the use of analgesics and hypnotics was positively related to poor SRH and predicted award of a disability pension within an Ii-year follow-up. This may reflect that the use of analgesics and hypnotics is a proxy of disease but an independent negative effect on health cannot be excluded. Conclusions: Information on the use of these drugs could be used to predict the award of a disability pension, such as in different geographical areas or population groups.
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| 6. |
- Sundbeck, Mats, et al.
(författare)
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Snuff use associated with abdominal obesity in former smokers.
- 2009
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 37:5, s. 487-93
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe the consumption of snuff in a rural male population and to explore associations between snuff use and obesity. Participants and METHODS: Tobacco use was explored in 834 men aged 30-75 years old who participated in a cross-sectional population survey in the municipality of Vara (participation rate was 81%). Self-reported questionnaires assessed the habits of smoking and snuff use. Anthropometric measures were obtained during a health examination. RESULTS: Of these men 21% (n = 179) were snuff users, 13% (n = 109) current smokers, and 65% (n = 546) were non-users. Of all snuff users 65% (n = 116) were former smokers, and 35% (n = 63) were exclusive snuff users (current users who never smoked). Among non-users 65% (n = 357) were never users and 35% (n = 189) had quit smoking without nicotine substitution. These men were characterized by abdominal obesity; OR 1.84 (1.08-3.12) (p = 0.002) (WHR 41.0) and OR 1.71 (1.08-2.72) (p = 0.022) (waist circumference 4102 cm). One can/week use of snuff among ex-smokers was associated with a 1.21 cm wider (0.05-2.36) (p = 0.041) waist circumference and 0.01 (0.00-0.02) units higher (p = 0.021) WHR. There were statistically significant associations between former smoking without current nicotine substitute and both general and abdominal obesity. No similar association with abdominal obesity was seen among exclusive snuff users. CONCLUSIONS: Abdominal obesity in current snuff users is limited to former smokers. The remaining effect of previous smoking has to be considered in future studies on obesity and related disorders in snuff users. Counselling among people who substitute snuff for smoking should include measures to prevent weight gain.
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