| 1. |
- Ali, Sadiq Mohammad, et al.
(författare)
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Gender differences in daily smoking prevalence in different age strata: A population-based study in southern Sweden.
- 2009
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 37:2, s. 146-152
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate gender differences in daily smoking prevalence in different age groups in southern Sweden. Methods: The 2004 public-health survey in Skåne is a cross-sectional study. A total of 27,757 persons aged 18-80 years answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model was used to investigate the associations between gender and daily smoking according to age. The multivariate analysis was performed to investigate the importance of possible confounders (country of origin, education, snus use, alcohol consumption, leisure-time physical activity, and BMI) on the gender differences in daily smoking in different age groups. Results: 14.9% of the men and 18.1% of the women were daily smokers. Middle-aged respondents were daily smokers to a significantly higher extent than young and old respondents. The prevalence of daily smoking also varied according to other demographic, socioeconomic, health related behaviour, and BMI characteristics. The crude odds ratios of daily smoking were 1.79 (1.42-2.26) among women compared to men in the 18-24 years age group, and 0.95 (0.80-1.12) in the 65-80 years age group. These odds ratios changed to 2.00 (1.49-2.67) and 0.95 (0.76-1.18), respectively, when all confounders were included. CONCLUSIONS: For the first time in Sweden women have a higher prevalence of daily smoking than men. The odds ratios of daily smoking are highest among women compared to men in the youngest age group of 18-24 years and the odds ratios decrease with increasing age. The findings point to a serious public health problem. Strategic interventions targeting young women's tobacco smoking are needed.
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| 2. |
- Cantarero Arevalo, Lourdes, et al.
(författare)
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Ethnic differences in asthma treatment among Swedish adolescents: A multilevel analysis of individual heterogeneity.
- 2016
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 44:2, s. 94-184
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Tidskriftsartikel (refereegranskat)abstract
- Adolescents with immigrant or ethnic minority background suffering from asthma receive on average less appropriate anti-asthmatic medication (AAM) than the majority population. However, those findings are based on analyses of differences between group averages which prevents our understanding of individual heterogeneity around the averages. Taking into account individual socioeconomic factors and medical needs, we performed multilevel analysis in order to evaluate if maternal country of birth (MCOB) accurately identifies adolescents with inappropriate AAM use.
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| 3. |
- Carlsson, Frida, et al.
(författare)
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Representativity of a postal public health questionnaire survey in Sweden, with special reference to ethnic differences in participation
- 2006
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 34:2, s. 132-139
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Non-participation in health surveys is a common phenomenon. When differences between participants and non-participants are considerable, the external validity of the sample survey may decrease and false conclusions might be drawn about the health status of the population. For this reason, the authors aimed to investigate the representativity of a postal questionnaire survey performed in the county of Scania, Sweden, in 1999-2000. The survey, which was based on an 18- to 80-year-old population sample, had a 58% response rate (n = 13 604).METHODS: For some variables, the information obtained using the questionnaire was compared with information obtained from a population register that covers all the population in the county (for the 18- to 80-year-old group, n = 850 476). The population register includes, among other data, information on age, gender, educational level, country of birth, and healthcare expenditure.RESULTS: Men, individuals with a low level of education, and immigrants were under-represented in the survey. However, except for immigrants, the under-representation was not large. Among immigrants, particularly those born in former Yugoslavia, the Arabic-speaking countries, and Poland were very significantly under-represented in the study. By contrast, immigrants born in other Nordic countries had responded to almost the same extent as respondents born in Sweden. The survey sample had about the same healthcare utilization costs as did the general population.CONCLUSIONS: In summary, the "Health Survey for Scania, 2000" seems largely representative of the total Scanian population. A major concern, however, is the under-representation of the immigrant population.
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| 4. |
- Ericsson, Lovisa, et al.
(författare)
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Revisiting socio-economic inequalities in sedentary leisure time in Sweden : An intersectional analysis of individual heterogeneity and discriminatory accuracy (AIHDA)
- 2023
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 51:4, s. 570-578
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Swedish public health reports have repeatedly provided information about socio-economic inequalities in sedentary leisure time, despite that, in the interest of health equity, physical activity should be equally distributed in the population. Such public health reports, however, neither consider the intersection of multiple socio-demographic factors nor the individual heterogeneity around group averages. Drawing on intersectionality theory, this study aimed to revisit previous findings on sedentary leisure time from Swedish public health surveys and demonstrate how the analysis of individual heterogeneity and discriminatory accuracy (AIHDA) can be used for analysing complex health inequalities.Methods: Using data from Swedish national public health surveys (2004–2015), we applied the AIHDA to define 72 intersectional groups by categories of age, gender, educational achievement, migration status and household composition. We then calculated (a) the absolute and relative risk of sedentary leisure time and (b) the discriminatory accuracy (DA) of the intersectional grouping.Results: The average risk of sedentary leisure time ranged from 5.8% among native-born, highly educated, young women living alone to 41.0% among immigrated young men, living alone, with low education. The risk was higher in strata comprising immigrated people with low education and lower in strata including native-born, highly educated people. However, the DA of the grouping was poor, indicating a substantial overlap of individual risk between groups.Conclusions: Using the AIHDA and drawing on intersectionality, this study provides an improved mapping of the socio-economic distribution of sedentary leisure time in Sweden, with the poor DA suggesting universal rather than targeted physical activity interventions.
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| 5. |
- Hedblad, Bo, et al.
(författare)
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Incidence of cardiovascular disease, cancer and death in postmenopausal women affirming use of hormone replacement therapy.
- 2002
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 30:1, s. 12-19
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The goal of this study was to evaluate the incidence of myocardial infarction, cancer and death in relation to use of hormone replacement therapy (HRT). METHODS: Nine years' follow up of an urban cohort of peri-/postmenopausal women was undertaken. Local and national registers were used for retrieval of events. RESULTS: The incidence of myocardial infarction per 1.000 person-years in users and non-users was 0.61 (5/962) and 2.20 (92/4759) respectively, adjusted relative risk (RR) 0.37; 95% confidence interval 0.15-0.90. Rates of mortality from cardiovascular disease and cancer were 0.36 and 1.10, p= 0.058, and 2.60 and 2.09, p=0.360 respectively. In terms of all-cause mortality the adjusted RR was 1.02; 0.69-1.52, incidence of cancer 1.28; 1.01-1.64, breast cancer 1.52; 1.01-2.28 and endometrial cancer 3.61; 1.54-8.46. CONCLUSIONS: Women affirming use of HRT had a lower incidence of myocardial infarction. Further studies are needed to assess whether the absence of effect on total mortality may be accounted for by an increased cancer risk.
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| 6. |
- 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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| 7. |
- Lindström, Martin, et al.
(författare)
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Individual and contextual determinants of self-reported poor psychological health: A population-based multilevel analysis in southern Sweden.
- 2006
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 34:4, s. 397-405
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the influence of contextual and individual factors on self-reported psychological health. Design/setting/participants/measurements: The 2000 public health survey in Scania is a cross-sectional postal questionnaire study with a 59% participation rate. A total of 13,715 persons aged 18-80 answered the questionnaire. A multilevel logistic regression model, with individuals at the first level and municipalities/city quarters at the second, was performed. The effect (intra-class correlation, cross-level modification, and odds ratios) of individual and municipality/city quarter factors on self-reported psychological health was analysed. Results: The crude variance between municipalities/city quarters was small but significant. It was particularly affected and lowered by individual civil status, country of origin, economic stress, and social participation. The inclusion of all individual factors age, sex, civil status, country of origin, education, economic stress, and social participation lowered the between municipality variance to not-significant levels, which is the reason why no contextual variables were included in the calculations. Conclusions: The results of this study suggest that poor self-reported psychological health is affected mainly by individual characteristics of the population and not by contextual factors at the municipality/city quarter level.
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| 8. |
- Lindström, Martin, et al.
(författare)
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Social participation, social capital and daily tobacco smoking: a population-based multilevel analysis in Malmö, Sweden.
- 2003
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 31:6, s. 444-450
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of this study was to investigate the influence of contextual and individual factors on daily tobacco smoking. Methods: The public-health survey in Malmö 1994 is a cross-sectional study. A total of 5,600 individuals aged 20 - 80 years were invited to answer a postal questionnaire. The participation rate was 71%. A multilevel logistic regression model, with individuals at the first level and neighbourhoods at the second, was performed. We analysed the effect (intra-area correlation, cross-level modification and odds ratios) of individual and neighbourhood factors on smoking after adjustment for individual factors. Results: Neighbourhood factors accounted for 2.5% of the crude total variance in daily tobacco smoking. This effect was significantly reduced when the individual factors such as education were included in the model. However, individual social capital, measured by social participation, only marginally affected the total neighbourhood variance in daily tobacco smoking. In fact, no significant variance in daily tobacco smoking remained after the introduction of the individual factors other than individual social capital in the model. Conclusion: In Malmö, the neighbourhood variance in daily tobacco smoking is mainly affected by individual factors other than individual social capital, especially socioeconomic status measured as level of education.
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| 9. |
- Ljungman, Hanna, et al.
(författare)
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Antidepressant use in Sweden : an intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA)
- 2021
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 50:3, s. 395-403
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Antidepressants are among the most commonly prescribed drugs in Sweden. However, we lack detailed knowledge on the socioeconomic and demographic distribution of antidepressant use in the population. To fill this gap, we performed an intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy.Methods: Analysing all Swedish residents older than 10 years (n=8,190,990), we measured the absolute risk of antidepressant use across 144 intersectional strata defined by combinations of age, gender, income, country of birth and psychiatric diagnosis. We calculated the strata-specific absolute risk of antidepressant use in a series of multilevel logistic regression models. By means of the variance partitioning coefficient and the area under the receiver operating characteristic curve, we quantified the discriminatory accuracy of the intersectional contexts (i.e. strata) for discerning those who use antidepressants from those who do not.Results: The absolute risk of antidepressant use ranged between 0.93% and 24.78% among those without a psychiatric diagnosis, and between 21.41% and 77.56% among those with a psychiatric diagnosis. Both the variance partitioning coefficient of 41.88% and the area under the receiver operating characteristic curve of 0.81 were considerable.Conclusions: Besides overt psychiatric diagnoses, our study shows that antidepressant use is mainly conditioned by age, which might express the embodiment of socioeconomic conditions across the individual life course. Our analysis provides a detailed and highly discriminatory mapping of the heterogeneous distribution of antidepressant use in the Swedish population, which may be useful in public health management.
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| 10. |
- 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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