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- Fritzell, S., et al.
(författare)
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Inequalities in determinants and mental health in Sweden : results from a governmental initiative
- 2018
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Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 28, s. 124-124
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Mental health is an increasing concern in all European countries. Social inequalities may appear both in the distribution of mental health and the social and economic consequences. In 2016, the government commissioned The Public Health Agency of Sweden (PHAS) to increase knowledge on socioeconomic determinants of mental health problems. The present study addresses the social distribution of mental health problems and what mediates this.Drawing on patient registry data of the population from 2014 and a national survey representative of the population aged 16-84, years 2013-2016 (n = 155339) we analyze how mental health is distributed in social groups and what determinants mediate poor mental health. Outcomes include psychiatric in- and outpatient care (numbers and cases/1000), and for self-reported measures (ie. GHQ, stress, anxiety) odds ratios (OR) from multivariate logistic regression, adjusting for social and economic determinants.Preliminary results show that most outcomes in self-reported poor mental health and psychiatric diagnoses were more common among women. Social patterns differed between diagnoses.Among working ages in- and outpatient care, low educated showed fourfold increased risk of psychotic disorders, while neurotic stress related disorders showed a doubled risk among low educated. Care for any mental disorder (excluding dementia) was more common among lower educated men and women aged 65+ but had a reverse social gradient. In analyses modelling the risk of poor mental health (GHQ12), controlling for background-, social and economic factors in particular financial strain (OR 2.42, CI 2.11-2.77) mediated poor mental health among women 25-64.An educational gradient was found in most mental health outcomes with more pronounced gradient in more severe outcomes. Patterns differ by age groups, social group, and outcome. Results will be used to inform practitioners and policy makers at national and regional level to decrease inequalities in mental health.Key messages:Social inequalities in mental health and its’ determinants are found in most age groups, and most outcomes studied.Focusing on living conditions, particularly economic strain is essential for achieving equity in mental health.
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- Fritzell, S., et al.
(författare)
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Scoping the evidence on mental health inequalities and underlying determinants in Sweden
- 2018
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Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 28, s. 316-316
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Mental health is an increasing concern in all European countries. Social inequalities may appear in both the distribution of mental health and the social and economic consequences. In 2016, the government commissioned The Public Health Agency of Sweden (PHAS) to increase the knowledge on mental health inequalities and their underlying determinants. In all, 18 research projects were initiated within different universities in Sweden and PHAS.Research questions addressed dimensions of inequality such as age, gender, SES, sexual orientation and disability. PHAS involved researchers from the fields of social medicine, epidemiology and economics to explore all levels of social determinants, different mechanisms, interacting forces of inequalities and consequences of disease. Evidence from scoping literature reviews were coupled with analyses of Swedish data on a range of outcomes; from positive mental health to in-patient care.Preliminary results have been discussed in joint workshops and show social inequalities in mental health in all age groups in Sweden, including small children, with a more pronounced gradient in severe outcomes. Generally, the results points towards policy actions focusing girls and women, low income earners, those experiencing financial strain, hbtq persons and persons with disability. Also, the interaction of different dimensions of inequality need consideration.The project is a collaboration between PHAS and a range of research disciplines all joining to discuss mental health and inequalities. Though challenging as interpretations may differ due to field of research, overall it has allowed for a broad approach and joint learning as experts have collaborated. This is a step towards understanding country specific determinants of mental health inequalities. Combined, the results make up a knowledge base that will guide policy makers and practitioners to develop efficient policies and practices in order to decrease inequalities in mental health.Key messages:Combining evidence from international literature with context specific secondary data analyses improves its local relevance.Collaboration between research fields enables a more comprehensive basis for decision making.
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- Agren, G, et al.
(författare)
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Mortality trends for young adults in Sweden in the years 2000-2017
- 2022
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 50:4, s. 448-453
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Tidskriftsartikel (refereegranskat)abstract
- Mental health problems in young people seem to be on the rise and more so in Sweden than in other locations. The aim was to compare the development of mortality rates for young adults in Sweden with Western Europe in total. Methods: Young adults were defined as individuals aged 20–34 years and the study period was 2000–2017. Mortality data were derived from the Institute of Health Metrics and Evaluation. Results: During the period 2000–2017, the mortality rate in young adults in Sweden stayed about the same, while in Western Europe as a whole the mortality rate decreased by 42%. The leading explanation for the unfavourable Swedish development was deaths due to drug use, mainly opioids, which increased by 60% during this period. The other major causes of death decreased both in Sweden and Western Europe, but decreased more slowly in Sweden. The differences in the rate of decrease between Sweden and Western Europe were for self-harm (27%), transport injuries (12%), unintentional injuries (31%) and for neoplasms (23%). The unfavourable development in Sweden resembled the development in the USA. Conclusions: The risks of four of the five leading causes of death in this age group were affected by the individuals’ social conditions. The unfavourable mortality development in young adults in Sweden was mainly due to substance use. A contributing cause might be the change in the Swedish healthcare system that introduced competition between providers, which might have encouraged providers to prescribe opioids.
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- Bartelink, VHM, et al.
(författare)
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Unemployment among young people and mental health: A systematic review
- 2020
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 48:5, s. 544-558
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this systematic review is to obtain a better understanding of the association between unemployment among young people and mental health. Methods: After screening the title and abstract of 794 articles drawn from four electronic databases, 52 articles remained for full-text reading. Of these, 20 studies met the inclusion criteria and were assessed on methodological quality. All steps were performed independently by two reviewers. Finally, a total of 17 articles were included in the systematic review. Results: Analysis of cross-sectional studies ( N = 5) showed an association between unemployment among young people and mental health. An effect of unemployment on mental health was found when considering cohort studies ( N = 12) that did not control for confounders (7/7). When controlling for confounders except mental health at baseline, this effect decreased in most studies leading to mixed results, although the majority (6/8) still found an effect. However, when taking mental health at baseline into account as one of the confounders, only a minority of studies (3/8) found a significant effect of unemployment on mental health. Conclusions: This systematic review showed an association between unemployment among young people and mental health. However, whether there is a causal relationship is less clear. More evidence from, for example, natural experiments and longitudinal studies that control for confounding variables, especially mental health at baseline, is required to better understand the association and potential causation between unemployment among young people and mental health.
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