| 1. |
- Bolin, Kristian, et al.
(författare)
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Investments in social capital - implications of social interactions for the production of health
- 2003
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Ingår i: Social Science and Medicine. - 1873-5347 .- 0277-9536. ; 56:12, s. 2379-2390
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Tidskriftsartikel (refereegranskat)abstract
- This paper develops a theoretical model of the family as producer of health- and social capital. There are both direct and indirect returns on the production and accumulation of health- and social capital. Direct returns (the consumption motives) result since health and social capital both enhance individual welfare per se. Indirect returns (the investment motives) result since health capital increases the amount of productive time, and social capital improves the efficiency of the production technology used for producing health capital. The main prediction of the theoretical model is that the amount of social capital is positively related to the level of health; individuals with high levels of social capital are healthier than individuals with lower levels of social capital, ceteris paribus. An empirical model is estimated, using a set of individual panel data from three different time periods in Sweden. We find that social capital is positively related to the level of health capital, which supports the theoretical model. Further, we find that the level of social capital (1) declines with age, (2) is lower for those married or cohabiting, and (3) is lower for men than for women. (C) 2003 Elsevier Science Ltd. All rights reserved.
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| 2. |
- Clarke, PM, et al.
(författare)
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On the measurement of relative and absolute income-related health inequality
- 2002
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Ingår i: Social Science and Medicine. - : Elsevier Ltd. - 1873-5347 .- 0277-9536. ; 55:11, s. 1923-1928
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Tidskriftsartikel (refereegranskat)abstract
- In recent work on international comparisons of income-related inequalities in health, the concentration index has been used as a measure of health inequality. A drawback of this measure is that it is sensitive to whether it is estimated with respect to health or morbidity. An alternative would be to use the generalized concentration index that is based on absolute rather than relative health differences. In this methodological paper, we explore the importance of the choice of health inequality measure by comparing the income-related inequality in health status and morbidity between Sweden and Australia. This involves estimating a concentration index and a generalized concentration index for the eight-scale health profile of the Short Form 36 (SF-36) health survey. We then transform the scores for each scale into a measure of morbidity and show that whether the concentration index is estimated with respect to health or morbidity has an impact on the results. The ranking between the two countries is reversed for two of the eight dimensions of SF-36 and within both countries the ranking across the eight SF-36 scales is also affected. However, this change in ranking does not occur when the generalized concentration index is compared and we conclude with the implications of these results for reporting comparisons of income-related health inequality in different populations. (C) 2002 Elsevier Science Ltd. All rights reserved.
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| 3. |
- Dozet, Alexander, et al.
(författare)
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Health care for the elderly: two cases of technology diffusion.
- 2002
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Ingår i: Social Science and Medicine. - 1873-5347 .- 0277-9536. ; 54:1, s. 49-64
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Tidskriftsartikel (refereegranskat)abstract
- Diffusion of medical technology and the growing proportion of elderly people in the population are generally regarded as major contributors to the increasing health care expenditure in the industrialised world. This study explores the importance of one specific factor in this process, the change in the use of technology among elderly patients. In some instances, a new technology is first used among younger patients and then gradually extended to the elderly. Two such cases are studied, both representing costly procedures: coronary bypass surgery (treatment of coronary heart disease) and dialysis (treatment of uraemia). In both cases, we demonstrate significant diffusion to older age groups. It is also tentatively concluded that the diffusion of technology could have an important effect on per capita health care expenditure among the oldest of the old.
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| 4. |
- Pudaric, Sonja, et al.
(författare)
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Country of birth, instrumental activities of daily living, self-rated health and mortality: a Swedish population-based survey of people aged 55-74.
- 2003
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Ingår i: Social Science and Medicine. - 1873-5347 .- 0277-9536. ; 56:12, s. 2493-2503
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Tidskriftsartikel (refereegranskat)abstract
- There is scant knowledge of the effects of country of birth on the health of individuals in the years prior to and after retirement. The aim of this study was to consider country of birth in relation to health status, instrumental activities of daily living (IADL) and all-cause mortality when adjusted for socioeconomic status (SES). Cross-sectional data were collected between 1986 and 1991 on 8959 individuals between the ages of 55 and 74. Self-reported data were analysed using a logistic regression model while the mortality data were analysed by means of a proportional hazard model. In the present study, immigrants from Southern Europe, Eastern Europe and Finland carried significantly increased risks of poor health even after adjustment for SES. Southern Europeans, refugees from Developing countries and Finns exhibited an increased risk of impaired IADL compared to Swedes, even after adjustment for SES. In conclusion, country of birth was associated with poor health status and impaired IADL. This association remained after adjustment for SES. In accordance with pre-study expectations, mortality was predicted by impaired IADL and male gender. Country of birth was not associated with all-cause mortality.
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| 5. |
- Sundquist, K, et al.
(författare)
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Social participation and coronary heart disease: a follow-up study of 6900 women and men in Sweden
- 2004
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Ingår i: Social Science and Medicine. - 1873-5347 .- 0277-9536. ; 58:3, s. 615-622
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Tidskriftsartikel (refereegranskat)abstract
- Few studies have examined the relationship between social, cultural and religious participation, political empowerment and coronary heart disease (CHD). The aim of this study was to examine whether low social participation, as described in a social participation index, predicted incidence rates of CHD. This is a follow-up study, from 1990-91 to 31 December 2000, of 6861 Swedish women and men, who were interviewed about their social participation, education, housing tenure and smoking habits. A social participation index was constructed, based on 18 variables from the survey. The outcome measure was CHD morbidity and mortality. Respondents with a CHD incident from 1986 until interview were excluded from the study. Data were analysed using Cox' regression and the results are presented as hazard ratios (HR) with 95% confidence intervals (Q. In the sex- and age-adjusted model there was a gradient between the social participation index and CHD, so that persons with low social participation had the highest risk of CHD with HR = 2.15; CI = 1.57-2.94, followed by HR = 1.67; Cl = 1.23-2.27 for those with middle social participation. In the full model, when education, housing tenure and smoking habits were included, the increased risk of CHD for persons with low social participation remained high, with HR = 1.69, CI = 1.21-2.37. We conclude that persons with low social participation in the social participation index exhibited an increased risk of CHD that remained after adjustment for education, housing tenure and smoking habits. (C) 2003 Elsevier Science Ltd. All rights reserved.
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| 6. |
- Andersen, Ronald, et al.
(författare)
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Cost containment, solidarity and cautious experimentation : Swedish dilemmas
- 2001
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Ingår i: Social Science and Medicine. - 0277-9536 .- 1873-5347. ; 52, s. 1195-1204
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Tidskriftsartikel (refereegranskat)abstract
- This paper uses secondary data analysis and a literature review to explore a “Swedish Dilemma”: Can Sweden continue to provide a high level of comprehensive health services for all regardless of ability to pay — a policy emphasizing “solidarity” — or must it decide to impose increasing constraints on health services spending and service delivery — a policy emphasizing “cost containment?” It examines recent policies and longer term trends including: changes in health personnel and facilities; integration of health and social services for older persons; introduction of competition among providers; cost sharing for patients; dismantling of dental insurance; decentralization of government responsibility; priority settings for treatment; and encouragement of the private sector. It is apparent that the Swedes have had considerable success in attaining cost containment — not primarily through “market mechanisms” but through government budget controls and service reduction. Further, it appears that equal access to care, or solidarity, may be adversely affected by some of the system changes.
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| 7. |
- Brenner, Sven-Olof, et al.
(författare)
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Long-term unemployment among women in Sweden
- 1987
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Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 25:2, s. 153-161
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Tidskriftsartikel (refereegranskat)abstract
- Vulnerability at long-term unemployment is discussed and the results of a study of the effects of job loss and long-term unemployment among Swedish women are presented. Psychological and physiological data for the unemployed were sampled repeatedly over a two year period. Some of the unemployed were subject to an intervention programme aiming at buffering for the possibly negative effects of unemployment. Health data from matched control groups of employed were gathered over the same period. The results indicate a strong negative stress reaction at the job loss period, followed by a gradual adaptation to the conditions of unemployment as measured by biochemical and physiological health indicators. However, a substantial proportion of the unemployed compared to the employed showed a lower degree of psychological well-being and more severe depressive reactions. Recommendations are given concerning further research approaches on long-term unemployment. Policy implications to reduce vulnerability at long-term unemployment are discussed
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| 8. |
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| 9. |
- Carlson, Per
(författare)
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Self-perceived health in east and west Europe. : Another European health divide
- 1998
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Ingår i: Social Science and Medicine. - 0277-9536 .- 1873-5347. ; 46:10, s. 1355-1366
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Tidskriftsartikel (refereegranskat)abstract
- There is a great, and possibly also a growing, difference in public health between the central, eastern (CEE) and western European countries. Several suggestions have been put forward as explanations for this health divide. A broader framework than one focusing on medical care systems or behavioural patterns is necessary to examine this difference. It will be more fruitful to try to identify social and economic factors at large, as well as specific explanatory factors. The aim of this study is to find out to what extent "The East-West Mortality Divide" was apparent in people's perception of their own health in 1990-1991, as a division in self-perceived health across Europe. If there were indeed differences, the aim is to examine whether or not they can be explained by specific economic and social conditions present in the early 1990s. Data from "World Values Survey 1990" reveal a striking east west divide in self-perceived health among people in the age group 35-64 yr, one of greater size than the gender gap in self-perceived health. The importance of a number of circumstances for people's self-perceived health in the 25 European countries was estimated. The assumption was that any resulting difference between eastern and western European countries could help to explain the health divide. An attempt was made to estimate how much the east-west health divide would be reduced if some of these circumstances were similar in CEE to those in the west. The results indicate that people's participation in civic activities has a positive effect on their health. This effect is recognised especially on a societal level. This supports theories about civic activities and community performance. In western Europe the tradition of the active citizen is more developed than in eastern Europe. People's life control was important for their self-perceived health in almost every European country, both in the west and the east. In the former communist countries, however, people did not feel that they had the same control over their lives as did people in the west. People's economic satisfaction was the most powerful predictor of self-perceived health, both in the eastern and western parts of Europe. The average level of economic satisfaction in 1990 1991 was considerably lower in CEE. If people's influence and economic resources were the same in the former communist countries as in the west, the health divide, according to my estimations, would decrease by something between 10-30%.
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| 10. |
- Dong, Hengjin, et al.
(författare)
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Drug policy in China : pharmaceutical distribution in rural areas.
- 1999
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Ingår i: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 48:6, s. 777-786
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Tidskriftsartikel (refereegranskat)abstract
- In 1978, China decided to reform its economy and since then has gradually opened up to the world. The economy has grown rapidly at an average of 9.8% per year from 1978 to 1994. Medical expenditure, especially for drugs, has grown even more rapidly. The increase in medical expenditure can be attributed to changing disease patterns, a higher proportion of older people in the population and fee-for-service incentives for hospitals. Due to the changing economic system and higher cost of health care, the Chinese government has reformed its health care system, including its health and drug policy. The drug policy reform has led to more comprehensive policy elements, including registration, production, distribution, utilization and administration. As a part of drug policy reform, the drug distribution network has also been changed, from a centrally controlled supply system (push system) to a market-oriented demand system (pull system). Hospitals can now purchase drugs directly from drug companies, factories and retailers, leading to increased price competition. Patients have easier access to drugs as more drugs are available on the market. At the same time, this has also entailed negative effects. The old drug administrative system is not suitable for the new drug distribution network. It is easy for people to get drugs on the market and this can lead to overuse and misuse. Marketing factors have influenced drug distribution so strongly that there is a risk of fake or low quality drugs being distributed. The government has taken some measures to fight these negative effects. This paper describes the drug policy reform in China, particularly the distribution of drugs to health care facilities.
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