| 1. |
- Brydsten, Anna, et al.
(författare)
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Does contextual unemployment matter for health status across the life course?
- 2016
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Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 26:Suppl 1, s. 142-142
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Tidskriftsartikel (refereegranskat)abstract
- Background: Individual health is affected by one’s individual life conditionsand by the context in which individuals live, interact anddevelop. Research shows that living in a neighbourhood withhigh levels of unemployment might affect residents’ health, atleast partially independent of own labour market status.However, how such contextual-individual transactions playout across the life course is unknown. The present study aims:(i) to examine whether neighbourhood unemployment isrelated to health status across the life course independently ofthe individual employment from adolescence to middle age(age 16 to 42); and (ii) to analyse whether this relationship isobservable at four specific life course periods from adolescenceto middle age (age 16, 21, 30 and 42).Methods: A 26-year prospective Swedish cohort (n = 1010), linked toregister data on neighbourhood unemployment. Individualemployment and functional somatic symptoms were measuredby self-reported questionnaire data. Two models of hierarchallinear regressions were built: a longitudinal analysis, and a setof age-specific cross-sectional analyses at each age.Results: The longitudinal analysis showed an independent contributionof neighbourhood unemployment and individual employmenton FSS across the life course. The cross-sectional analysisshowed an association at age 30, when accounting forindividual employment, but no association was found at age21 and 42.Conclusions: Neighbourhood unemployment has a significant relationshipwith functional somatic symptoms across the life course. Thereseems to be an age-specific pattern where neighbourhoodunemployment may have stronger implications in earlyadulthood than in other phases of the life courseKey messages:High neighbourhood unemployment predicts higher levelsof individual FSS across the life course, independently ofown labour market position, socioeconomic status andeducationThese findings stress the importance of neighbourhoodunemployment for current health status as well as development of health status across the life course, particular duringearly adulthood
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| 2. |
- Brydsten, Anna, et al.
(författare)
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Does contextual unemployment matter for health status across the life course? A longitudinal multilevel study exploring the link between neighbourhood unemployment and functional somatic symptoms
- 2017
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Ingår i: Health and Place. - : Elsevier BV. - 1353-8292 .- 1873-2054. ; 43, s. 113-120
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Tidskriftsartikel (refereegranskat)abstract
- This study examines whether neighbourhood unemployment is related to functional somatic symptoms, independently of the individual employment, across the life course and at four specific life course periods (age 16, 21, 30 and 42). Self-reported questioner data was used from a 26-year prospective Swedish cohort (n=1010) with complementary neighbourhood register data. A longitudinal and a set of age-specific cross-sectional hierarchal linear regressions was carried out. The results suggest that living in a neighbourhood with high unemployment has implications for residents' level of functional somatic symptoms, regardless of their own unemployment across time, particularly at age 30.
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| 3. |
- Brydsten, Anna, 1984-
(författare)
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Yesterday once more? Unemployment and health inequalities across the life course in northern Sweden
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- AbstractBackground. It is relatively well established in previous research that unemployment has direct health consequences in terms of mental and physical ill health. Recently, knowledge has emerged indicating that unemployment can lead to economic consequences that remain long after re-establishment in the labour market. However, few empirical studies have been able to apply a life course perspective asking whether there are also long-term health consequences of unemployment, and, when and in which context unemployment may affect the individual health status across the life course. The aim of this thesis was to analyse the relationship between unemployment and illness across the life course, and how it relates to individual and structural factors in the geographical setting of northern Sweden. In particular, three main areas have been explored: youth unemployment and illness in adulthood (Paper I and Paper II), contextual unemployment of national unemployment rate and neighbourhood unemployment (Paper II and Paper III) and lastly, social determinants of health inequality between employment statuses (Paper IV).Methods. This thesis is positioned in Sweden between the early 1980s and the mid-2010s, following two comparable cohorts sampled from northern Sweden (26 and 19 years follow-up time respectively from youth to midlife) and a cross-sectional sample from 2014 of the four northernmost counties in Sweden. The two longitudinal cohorts comprised the Northern Swedish Cohort and the Younger Northern Swedish Cohort, consisting of all pupils in the 9th grade of compulsory school in Luleå municipality in 1981 and 1989. The participants responded to an extensive questionnaire on socioeconomic factors, work and health, in 5 and 2 waves respectively of data collections. Neighbourhood register data from Statistics Sweden was also collected for all participants in the Northern Sweden Cohort. At the latest data collection, 94.3% (n=1010) participated in the Northern Sweden Cohort and 85.6% (n=686) in the Younger Northern Sweden Cohort. The cross-sectional study Health on Equal Terms is a national study, administered by the Public Health Agency together with Statistics Sweden and county councils with the aim of mapping public health and living conditions in the country over time. In this thesis, material from 2014 has been used for northern Sweden with a response rate of around 50% (effective sample n=12769). The statistical analyses used were linear regression, multilevel analysis and difference-in-difference analysis to estimate the concurrent and long-term health consequences of unemployment, and a decomposition analysis to disentangle the inequality in health between different labour market positions. The health outcomes in focus were functional somatic symptoms (the occurrence of relatively common physical illnesses such as head, muscle and stomach ache, insomnia and palpitation) and psychological distress.Results. Among men only, as little as one month of youth unemployment was related to increased levels of functional somatic symptoms in midlife, regardless of previous ill health or unemployment later in life, although only during relatively low national unemployment (pre-recession) when comparing with youth unemployment during high national unemployment (recession). This was explained by the health promoting effect of more time spent in higher education during the recession period. Furthermore, the health impact of neighbourhood unemployment highlights the importance of the contextual setting for individuals’ health both across the life course and at specific periods of life. Lastly, employment-related mental health inequalities exist for both men and women in all life phases (youth, adulthood and midlife). Economic and social deprivation related to unemployment and illness varied across different phases in life and across genders.Conclusion. The key findings of this thesis paint a rather pessimistic vision of the future: one’s own and others’ unemployment may cause not only ill health today but also ill health later in life. Importantly, the responsibility of unemployment and the associated ill health should not be placed on the already marginalised individuals and communities. Instead, the responsibility should be directed towards the structural aspects of society and the political choices that shape these. In other words, health inequality manifested by the position in the labour market is socially produced, unfair and changeable through political decisions. The results of this study therefore cannot contribute to any simple or concrete solutions to the concurrent or long-term health consequences of individual or contextual unemployment, as the solution is beyond the areas of responsibility and abilities of research. However, if there are long-term health consequences of one’s own and other people’s unemployment, labour market and public health policies should be initiated from a young age and continue throughout the life course to reduce individual suffering and future costs of social insurance, sick-leave and unemployment benefits.
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| 4. |
- Gustafsson, Per, 1981-, et al.
(författare)
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Cumulative contextual and individual disadvantages over the life course and adult functional somatic symptoms in Sweden
- 2015
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 25:4, s. 592-597
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:: Disadvantage, originating in one's residential context or in one's past life course, has been shown to impact on health in adulthood. There is however little research on the accumulated health impact of both neighbourhood and individual conditions over the life course. This study aims to examine whether the accumulation of contextual and individual disadvantages from adolescence to middle-age predicts functional somatic symptoms (FSS) in middle-age, taking baseline health into account.METHODS:: The sample is the age 16, 21, 30 and 42 surveys of the prospective Northern Swedish Cohort, with analytical sample size n = 910 (85% of the original cohort). FSS at age 16 and 42, and cumulative socioeconomic disadvantage, social adversity and material adversity between 16 and 42 years were operationalized from questionnaires, and cumulative neighbourhood disadvantage between 16 and 42 years from register data.RESULTS:: Results showed accumulation of disadvantages jointly explained 9-12% of FSS variance. In the total sample, cumulative neighbourhood and socioeconomic disadvantage significantly predicted FSS at age 42 in the total sample. In women, neighbourhood disadvantage but not socioeconomic disadvantage contributed significantly, whereas in men, socioeconomic but not neighbourhood disadvantage contributed significantly. In all analyses, associations were largely explained by the parallel accumulation of social and material adversities, but not by symptoms at baseline.CONCLUSION:: In conclusion, the accumulation of diverse forms of disadvantages together plays an important role for somatic complaints in adulthood, independently of baseline health.
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| 5. |
- Gustafsson, Per E., et al.
(författare)
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Life-course accumulation of neighborhood disadvantage and allostatic load : empirical integration of three social determinants of health frameworks
- 2014
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Ingår i: American Journal of Public Health. - : American Public Health Association. - 0090-0036 .- 1541-0048. ; 104:5, s. 904-910
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: We examined if the accumulation of neighborhood disadvantages from adolescence to mid-adulthood were related to allostatic load, a measure of cumulative biological risk, in mid-adulthood, and explored whether this association was similar in women and men.METHODS: Data were from the participants in the Northern Swedish Cohort (analytical n = 818) at ages 16, 21, 30, and 43 years in 1981, 1986, 1995, and 2008. Personal living conditions were self-reported at each wave. At age 43 years, 12 biological markers were measured to operationalize allostatic load. Registered data for all residents in the cohort participants' neighborhoods at each wave were used to construct a cumulative measure of neighborhood disadvantage. Associations were examined in ordinary least-squares regression models.RESULTS: We found that cumulative neighborhood disadvantage between ages 16 and 43 years was related to higher allostatic load at age 43 years after adjusting for personal living conditions in the total sample (B = 0.11; P = .004) and in men (B = 0.16; P = .004), but not in women (B = 0.07; P = .248).CONCLUSIONS: Our findings suggested that neighborhood disadvantage acted cumulatively over the life course on biological wear and tear, and exemplified the gains of integrating social determinants of health frameworks.
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| 6. |
- Gustafsson, Per E., et al.
(författare)
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Residential Selection across the Life Course : Adolescent Contextual and Individual Determinants of Neighborhood Disadvantage in Mid-Adulthood
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:11, s. e80241-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Numerous cross-sectional studies have examined neighborhood effects on health. Residential selection in adulthood has been stressed as an important cause of selection bias but has received little empirical attention, particularly its determinants from the earlier life course. The present study aims to examine whether neighborhood, family, school, health behaviors and health in adolescence are related to socioeconomic disadvantage of one's neighborhood of residence in adulthood. Methods: Based on the prospective Northern Swedish Cohort (analytical N = 971, 90.6% retention rate), information was collected at age 16 years concerning family circumstances, school adjustment, health behaviors and mental and physical health. Neighborhood register data was linked to the cohort and used to operationalize aggregated measures of neighborhood disadvantage (ND) at age 16 and 42. Data was analyzed with linear mixed models, with ND in adulthood regressed on adolescent predictors and neighborhood of residence in adolescence as the level-2 unit. Results: Neighborhood disadvantage in adulthood was clustered by neighborhood of residence in adolescence (ICC = 8.6%). The clustering was completely explained by ND in adolescence. Of the adolescent predictors, ND (b =.14 (95% credible interval =.07-.22)), final school marks (b =-.18 (-.26--.10)), socioeconomic disadvantage (b =.07 (.01-.14)), and, with borderline significance, school peer problems (b =-.07 (-.00-.13)), were independently related to adulthood ND in the final adjusted model. In sex-stratified analyses, the most important predictors were school marks (b =-.21 (-.32--.09)) in women, and neighborhood of residence (ICC = 15.5%) and ND (b =.20 (.09-.31)) in men. Conclusions: These findings show that factors from adolescence - which also may impact on adult health - could influence the neighborhood context in which one will live in adulthood. This indicates that residential selection bias in neighborhood effects on health research may have its sources in early life.
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| 7. |
- Gustafsson, Per E., et al.
(författare)
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What role does adolescent neighborhood play for adult health? : A cross-classified multilevel analysis of life course models in Northern Sweden
- 2017
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Ingår i: Health and Place. - : Elsevier. - 1353-8292 .- 1873-2054. ; 46, s. 137-144
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Tidskriftsartikel (refereegranskat)abstract
- This study examined whether, and by which life course models, adolescent neighborhood environment relate to health in mid-adulthood. Data came from the Northern Swedish Cohort (n=1001), surveyed at age 16, 21, 30 and 42 years including functional somatic symptoms at age 42, and individual disadvantage neighborhood disadvantage at all four ages. Results from cross-classified multilevel models showed that 12.7% of age 42 health variance was explained by an interaction of age 16 and age 42 neighborhood of residence. Our study thus suggests that health variation by neighborhood in mid-adulthood may partly depend on neighborhood of residence in adolescence.
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| 8. |
- Johansson, Klara, et al.
(författare)
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Neighbourhood disadvantage and individual adversities in adolescence and total alcohol consumption up to mid-life : Results from the Northern Swedish Cohort
- 2015
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Ingår i: Health and Place. - : Elsevier BV. - 1353-8292 .- 1873-2054. ; 33, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- This study tests if neighbourhood socioeconomic disadvantage and family social and material adversities during adolescence are independently related to total alcohol consumption from adolescence through to mid-life. Self-reports from the Northern Swedish Cohort (effective sample=950) at ages 16, 18, 21, 30 and 42 was combined with register data on the socioeconomic composition of neighbourhoods at age 16. Total volume of alcohol consumed between age 16-42 was estimated based on the five survey waves, and self-reported social and material adversities were computed as composite variables. Neighbourhood socioeconomic disadvantage at age 16 was associated with alcohol consumption age 16-42 for men but not for women. Social adversities at age 16 were associated with alcohol consumption age 16-42 for both women and men, but material adversity or parental class was not. In conclusion, neighbourhood socioeconomic disadvantage in adolescence has a significant relationship with later alcohol consumption among men, even independently from individual factors. On family level, social factors but not socioeconomic factors in adolescence independently predict later alcohol consumption.
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| 9. |
- Jonsson, Frida, et al.
(författare)
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Are neighbourhood inequalities in adult health explained by socio-economic and psychosocial determinants in adolescence and the subsequent life course in northern Sweden? : A decomposition analysis
- 2018
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Ingår i: Health and Place. - : Elsevier. - 1353-8292 .- 1873-2054. ; 52, s. 127-134
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Tidskriftsartikel (refereegranskat)abstract
- This study explains neighbourhood deprivation inequalities in adult health for a northern Swedish cohort by examining the contribution of socio-economic and psychosocial determinants from adolescence (age 16), young adulthood (age 21) and midlife (age 42) to the disparity. Self-reported information from 873 participants was drawn from questionnaires, with complementary neighbourhood register data. The concentration index was used to estimate the inequality while decomposition analyses were run to attribute the disparity to its underlying determinants. The results suggest that socio-economic and psychosocial factors in midlife explain a substantial part, but also that the inequality can originate from conditions in adolescence and young adulthood.
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| 10. |
- Jonsson, Frida, et al.
(författare)
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Intragenerational social mobility and functional somatic symptoms in a northern Swedish context : analyses of diagonal reference models
- 2017
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Ingår i: International Journal for Equity in Health. - : Springer Science and Business Media LLC. - 1475-9276. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Research indicate that social class mobility could be potentially important for health, but whether this is due to the movement itself or a result of people having been integrated in different class contexts is, to date, difficult to infer. In addition, although several theories suggest that transitions between classes in the social hierarchy can be stressful experiences, few studies have empirically examined whether such movements may have health effects, over and above the implications of "being" in these classes. In an attempt to investigate whether intragenerational social mobility is associated with functional somatic symptoms in mid-adulthood, the current study tests three partially contrasting theories.METHOD: The dissociative theory suggests that mobility in general and upward mobility in particular may be linked to psychological distress, while the falling from grace theory indicates that downward mobility is especially stressful. In contrast, the acculturation theory holds that the health implications of social mobility is not due to the movement itself but attributed to the class contexts in which people find themselves. Diagonal Reference Models were used on a sample of 924 individuals who in 1981 graduated from 9(th) grade in the municipality of Luleå, Sweden. Social mobility was operationalized as change in occupational class between age 30 and 42 (measured in 1995 and 2007). The health outcome was functional somatic symptoms at age 42, defined as a clustering self-reported physical symptoms, palpitation and sleeping difficulties during the last 12 months.RESULTS: Overall mobility was not associated with higher levels of functional somatic symptoms compared to being immobile (p = 0.653). After controlling for prior and current class, sex, parental social position, general health, civil status, education and unemployment, the association between downward mobility was borderline significant (p = 0.055) while upward mobility was associated with lower levels of functional somatic symptoms (p = 0.03).CONCLUSION: The current study did not find unanimous support for any of the theories. Nevertheless, it sheds light on the possibility that upward mobility may be beneficial to reduce stress-related health problems in mid-life over and above the exposure to prior and current class, while downward mobility can be of less importance for middle-age health complaints.
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