| 1. |
- Inoue, Yosuke, et al.
(författare)
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Neighborhood Characteristics and Cardiovascular Risk among Older People in Japan : Findings from the JAGES Project
- 2016
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:10
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies have found an association between neighborhood characteristics (i.e., aspects of the physical and social environment) and the incidence of cardiovascular disease (CVD) and elevated CVD risk. This study investigated the relationship between neighborhood characteristics and CVD risk among older people in Japan where research on this association is scarce. Data came from the Japan Gerontological Evaluation Study project; questionnaire data collected from 3,810 people aged 65 years or older living in 20 primary school districts in Aichi prefecture, Japan, was linked to a computed composite CVD risk score based on biomarker data (i.e., hemoglobin A1c, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and estimated glomerular filtration rate). A sex-stratified multilevel linear regression analysis revealed that for male participants, living in neighborhoods with a higher perceived occurrence of traffic accidents and reduced personal safety was associated with an elevated CVD risk (coefficient = 1.08 per interquartile range increase, 95% confidence interval [CI] = 0.30 to 1.86) whereas males living in neighborhoods with a higher perceived proximity of exercise facilities had a lower risk (coefficient = −1.00, 95% CI = −1.78 to −0.21). For females, there was no statistically significant association between neighborhood characteristics and CVD risk. This study suggests that aspects of the neighborhood environment might be important for CVD morbidity and mortality in Japan, particularly among men.
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| 2. |
- Kanamori, Mariko, et al.
(författare)
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Community gender norms, mental health, and suicide ideation and attempts among older Japanese adults : a cross-sectional study
- 2024
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Ingår i: International psychogeriatrics. - 1041-6102 .- 1741-203X. ; 36:5, s. 385-395
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Tidskriftsartikel (refereegranskat)abstract
- Objectives:Gender norms embedded in communities may restrict opportunities and harm the mental health of older adults, yet this phenomenon has received little attention. This study investigates the connection between older adults' perceptions of community gender norms and mental health and suicide-related outcomes.Design:Cross-sectional.Setting:This study analyzed data from the 2019 wave of the Japan Gerontological Evaluation Study.Participants:In total, 25,937 participants aged 65 years or older in 61 municipalities.Measurements:Perceptions of community gender norms were assessed by the respondents' perceptions of the gender-differentiating language used by those around them such as You should/should not do XXX, because you are a man/woman.Results:The prevalence of all mental health outcomes was higher among both men and women who perceived community gender norms as restrictive. These associations remained in fully adjusted multivariable analyses. Prevalence ratios for men were 1.36 [95% confidence interval: 1.13, 1.65] for psychological resistance to obtaining help, 1.85 [1.54, 2.23] for depressive symptoms, 1.99 [1.34, 2.96] for suicidal ideation, and 2.15 [1.21, 3.80] for suicide attempts. The corresponding figures for women were 1.39 [1.17, 1.65], 1.80 [1.55, 2.10], 2.13 [1.65, 2.74], 2.62 [1.78, 3.87]. There was a more pronounced association between perceiving community gender norms as restrictive and depressive symptoms and suicidal behaviors among those with nonconventional gender role attitudes compared to those with conventional attitudes.Conclusions:Considering the effects of community gender norms, in addition to individual gender role attitudes, may be critical in designing effective public health interventions for improving mental health.
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| 3. |
- Kanamori, Mariko, et al.
(författare)
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Does increased migration affect the rural-urban divide in suicide? A register-based repeated cohort study in Sweden from 1991 to 2015
- 2022
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Ingår i: Population, Space and Place. - : Wiley. - 1544-8444 .- 1544-8452. ; 28:1
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Tidskriftsartikel (refereegranskat)abstract
- Some countries have high suicide rates in rural areas with a potentially stronger impact of rural context on foreign-born residents. In Sweden, where immigration has been increasing, dispersion policies have directed refugees/migrants to settle in rural areas. We examined whether trends in suicide mortality vary by nativity and rurality. A repeated cohort study was designed using Swedish national register data between 1991 and 2015. Our three-level analysis found that male suicide rates in rural areas were 1.2 times higher than in urban areas, with the rate decreasing over time in both urban and rural areas. We observed fluctuations in suicide mortality among foreign-born men residing in small rural communities, with high suicide rates in the 2000s. The proportion of unemployed was linked to the excess rate of suicide in rural municipalities. Dispersion policies moving migrants to rural areas should take into account the regional characteristics both within municipalities (e.g., income distribution) and between municipalities (e.g., labour market characteristics).
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| 4. |
- Stickley, Andrew, et al.
(författare)
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Disability and loneliness in nine countries of the former Soviet Union
- 2021
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Ingår i: Disability and Health Journal. - : Elsevier. - 1936-6574 .- 1876-7583. ; 14:4
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: People with disabilities (PWD) often face structural and other barriers to community involvement and may therefore be at risk of loneliness. Yet, so far, this issue has received little attention.OBJECTIVE: This cross-sectional study aimed to examine the association between disability and loneliness in nine countries of the former Soviet Union (FSU).METHODS: Data were analyzed from 18000 respondents aged ≥18 that came from the Health in Times of Transition (HITT) survey that was undertaken in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine in 2010/11. Respondents reported on whether they had a disability (no/yes) and its severity. A single-item question was used to assess loneliness. Logistic regression analysis was used to examine the associations.RESULTS: Across the countries, 6.8% of respondents reported being disabled. In a fully adjusted combined country analysis, disability was associated with higher odds for loneliness (odds ratio: 1.30, 95% confidence interval: 1.06-1.60). In an analysis restricted to PWD, individuals in the most severe disability category (Group 1) had over two times higher odds for loneliness when compared to those in the least severe disability category (Group 3).CONCLUSIONS: Disability is associated with higher odds for reporting loneliness in the FSU countries and this association is especially strong among those who are more severely disabled. An increased focus on the relationship between disability and loneliness is now warranted given the increasing recognition of loneliness as a serious public health problem that is associated with a number of detrimental outcomes.
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| 5. |
- Stickley, Andrew, et al.
(författare)
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Disability and psychological distress in nine countries of the former Soviet Union
- 2021
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Ingår i: Journal of Affective Disorders. - : Elsevier. - 0165-0327 .- 1573-2517. ; 292, s. 782-787
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: People with disabilities (PWD) are at increased risk of poor mental health. However, this association and the pathways involved remain under-researched in many parts of the world. This study examined the association between disability and psychological distress in nine countries of the former Soviet Union (FSU).METHODS: Data were analysed from 18,000 adults aged ≥18 years collected during the Health in Times of Transition (HITT) survey undertaken in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine in 2010 and 2011. Information was obtained on disability status, the severity of the disability and psychological distress. Logistic regression analysis was used to estimate associations.RESULTS: In a fully adjusted combined country analysis, disability was associated with over two times higher odds for psychological distress (odds ratio [OR]: 2.19, 95% confidence interval [CI]: 1.86-2.58). The strength of the association varied across the individual countries. Among PWD more severe disability was associated with significantly higher odds for psychological distress (OR: 2.12, 95%CI: 1.26-3.55).LIMITATIONS: The data were cross-sectional and disability status was self-reported, possibly resulting in underreporting.CONCLUSIONS: Disability is associated with worse psychological health in FSU countries, especially among those with more severe disabilities. As poor mental health may also increase the risk of negative outcomes in PWD, this finding highlights the importance of the early detection and treatment of mental disorders in PWD in these countries.
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| 6. |
- Stickley, Andrew, et al.
(författare)
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Economic cycles and inequalities in alcohol-related mortality in the Baltic countries and Finland in 2000-2015 : a register-based study
- 2021
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Ingår i: Addiction. - : Wiley-Blackwell. - 0965-2140 .- 1360-0443. ; 16:12, s. 3357-3368
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To estimate whether large macroeconomic fluctuations in the 2000s affected inequalities in alcohol-related mortality in the Baltic countries and Finland.DESIGN: Longitudinal register-based follow up study.SETTING: Estonia, Latvia, Lithuania and Finland.PARTICIPANTS: General population in the 35-74 age group.MEASUREMENTS: Socioeconomic status was measured by the highest achieved educational level and was categorised using the International Standard Classification of Education 2011 as low (included categories 0-2), middle (3-4), and high (5-8). Educational inequalities in alcohol-related mortality in 2000-2003, 2004-2007, 2008-2011 and 2012-2015 were examined using census-linked longitudinal mortality data. We estimated age-standardised mortality rates and the relative and slope index of inequality.FINDINGS: Alcohol-related mortality increased in all countries in 2004-2007 except among Estonian women and decreased/remained the same from 2008 onwards except among Latvian men. By 2012-2015 alcohol-related mortality was still higher than in 2000-2003 in Finland, Latvia and Lithuania (women only). Relative inequalities increased across the study period in all countries (significantly in Lithuania and Latvia). The 2004-2007 increase in relative inequalities was mostly driven by a larger mortality increase among the low educated, whereas in 2008-2011 and in 2012-2015 inequalities often increased because of a larger relative mortality decline among the high educated. However, these period changes in relative inequalities and between educational groups were often not statistically significant. Absolute inequalities were larger in 2012-2015 vs. 2000-2003 in all countries except Estonia (decrease).CONCLUSION: In Estonia, Latvia, Lithuania and Finland, alcohol-related mortality tended to increase faster among the low educated during a period of economic expansion (2004-2007) and tended to decrease more among the high educated during a period of economic recession (2008-2011).
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| 7. |
- Stickley, Andrew, et al.
(författare)
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Educational inequalities in epilepsy mortality in the Baltic countries and Finland in 2000-2015
- 2022
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Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Little is known about socioeconomic differences in epilepsy mortality. This study examined educational inequalities in epilepsy mortality in the general population in the Baltic countries and Finland in 2000-2015. Education-specific mortality estimates for individuals aged 30-74 in Estonia, Latvia and Lithuania were obtained from census-linked mortality datasets while data for Finland came from the register-based population and death data file of Statistics Finland. Trends and educational inequalities in epilepsy mortality were assessed using age-standardised mortality rates (ASMRs) per 100,000 person years and age-adjusted mortality rate ratios (RRs) calculated using Poisson regression. ASMRs were higher in men than women in all countries. ASMRs reduced in 2000-2015 among all men and women except for Finnish women. Among men, an inverse educational gradient in epilepsy mortality in 2000-2007 widened in 2008-2015 with ASMRs falling among high and mid educated men in all countries but increasing among low educated men in three countries. An inverse educational gradient in female mortality remained in all countries throughout 2000-2015. Although epilepsy mortality fell in the Baltic countries and Finland (men only) in 2000-2015, this masked a clear inverse educational gradient in mortality that became steeper across the period.
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| 8. |
- Stickley, Andrew, et al.
(författare)
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Educational inequalities in hypothermia mortality in the Baltic countries and Finland in 2000-15
- 2023
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Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 33:4, s. 555-560
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite an increased focus on cold-related mortality in recent years, there has been comparatively little research specifically on hypothermia mortality and its associated factors.METHODS: Educational inequalities in hypothermia mortality among individuals aged 30-74 in the Baltic countries (Estonia, Latvia, Lithuania) and Finland in 2000-15 were examined using data from longitudinal mortality follow-up studies of population censuses (the Baltics) and from a longitudinal register-based population data file (Finland).RESULTS: Age-standardized mortality rates (ASMRs) were much higher in the Baltic countries than in Finland across the study period. From 2000-07 to 2008-15, overall ASMRs declined in all countries except among Finnish women. Although a strong educational gradient was observed in hypothermia mortality in all countries in 2000-07, inequalities were larger in the Baltic countries. Between 2000-07 and 2008-15, ASMRs declined in all educational groups except for high-educated women in Finland and low-educated women in Lithuania; the changes however were not always statistically significant. The absolute mortality decline was often larger among the low educated resulting in narrowing absolute inequalities (excepting Lithuania), whereas a larger relative decline among the high educated (excepting Finnish women) resulted in a considerable widening of relative inequalities in hypothermia mortality by 2008-15.CONCLUSION: Although some reduction was observed in absolute educational inequalities in hypothermia mortality in 2000-15, substantial and widening relative inequalities highlight the need for further action in combatting factors behind deaths from excessive cold in socioeconomically disadvantaged groups, including risky alcohol consumption and homelessness.
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| 9. |
- Stickley, Andrew, et al.
(författare)
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Macroeconomic changes and educational inequalities in traffic fatalities in the Baltic countries and Finland in 2000-2015 : a register-based study
- 2021
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Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- This study examined trends and inequalities in road traffic accident (RTA) mortality in the Baltic countries (Estonia, Latvia, Lithuania) and Finland in relation to large-scale macroeconomic changes in the 2000s. Educational inequalities in RTA mortality in 2000-2003, 2004-2007, 2008-2011 and 2012-2015 among 30-74 year olds were examined using census-linked longitudinal mortality data and by estimating the relative and slope index of inequality. Overall RTA mortality decreased substantially between 2000-2003 and 2012-2015. From 2004-2007 to 2008-2011, the RTA mortality decline accelerated but was larger in the Baltic countries. Among men the RTA mortality decline was mostly driven by a larger fall among the high and middle educated. Among women, the changes in RTA mortality by educational level had no clear pattern. From 2000-2003 to 2012-2015 relative educational inequalities in RTA mortality increased among men, although more in the Baltic countries. Among women the pattern was mixed across countries. Absolute inequalities fell in all countries among both sexes. Educational inequalities in male RTA mortality may be growing because of increasingly less access to safer cars and a more hazardous driving culture among the lower educated.
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| 10. |
- Stickley, Andrew, et al.
(författare)
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Sociodemographic inequalities in mortality from drowning in the Baltic countries and Finland in 2000-2015 : a register-based study
- 2023
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Drowning is an important public health problem. Some evidence suggests that the risk of drowning is not distributed evenly across the general population. However, there has been comparatively little research on inequalities in drowning mortality. To address this deficit, this study examined trends and sociodemographic inequalities in mortality from unintentional drowning in the Baltic countries and Finland in 2000-2015.METHODS: Data for Estonia, Latvia and Lithuania came from longitudinal mortality follow-up studies of population censuses in 2000/2001 and 2011, while corresponding data for Finland were obtained from the longitudinal register-based population data file of Statistics Finland. Deaths from drowning (ICD-10 codes W65-W74) were obtained from national mortality registries. Information was also obtained on socioeconomic status (educational level) and urban-rural residence. Age-standardised mortality rates (ASMRs) per 100 000 person years and mortality rate ratios were calculated for adults aged 30-74 years old. Poisson regression analysis was performed to assess the independent effects of sex, urban-rural residence and education on drowning mortality.RESULTS: Drowning ASMRs were significantly higher in the Baltic countries than in Finland but declined by nearly 30% in all countries across the study period. There were large inequalities by sex, urban-rural residence and educational level in all countries during 2000-2015. Men, rural residents and low educated individuals had substantially higher drowning ASMRs compared to their counterparts. Absolute and relative inequalities were significantly larger in the Baltic countries than in Finland. Absolute inequalities in drowning mortality declined in all countries across the study period except between urban and rural residents in Finland. Changes in relative inequalities were more variable during 2000-2015.CONCLUSION: Despite a sharp reduction in deaths from drowning in the Baltic countries and Finland in 2000-2015, drowning mortality was still high in these countries at the end of the study period with a substantially larger risk of death seen among men, rural residents and low educated individuals. A concerted effort to prevent drowning mortality among those most at risk may reduce drownings considerably in the general population.
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