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1.	Macassa, Gloria, et al. (författare) Trends in infant and child mortality in Mozambique during and after a period ofconflict 2003 Ingår i: Public Health. - 0033-3506 .- 1476-5616. ; 117:4, s. 221-227 Tidskriftsartikel (refereegranskat)abstract This study describes urban and rural trends of infant, child and under-five mortality in Mozambique (1973–1997) by mother's place of residence. A direct method of estimation was applied to the 1997 Mozambican Demographic and Health Survey data. The levels of infant, child and under-five mortality were considerably higher in rural than in urban areas. The difference in mortality between urban and rural areas increased over time until 1988–1992 and thereafter diminished. Possible causes of the different trends (e.g. the impact of civil war, drought, migration, adjustment programme and HIV/AIDS) are discussed. The increase in mortality in urban areas during the last few years before the survey may have been related to the immigration to urban areas of mothers whose children had high levels of mortality. Higher levels of infant, child and under-five mortality still prevail, particularly in rural areas. Further studies are needed to investigate the differentials of infant and child mortality by mother's place of residence.
2.	Afroz, Barna, et al. (författare) The impact of economic crisis on injury mortality – the case of the ‘Asian Crisis’ 2012 Ingår i: Public Health. - Amsterdam : Elsevier. - 0033-3506 .- 1476-5616. ; 126:10, s. 836-838 Tidskriftsartikel (refereegranskat)
3.	Asp, Margareta, professor, 1958-, et al. (författare) Physical mobility, physical activity, and obesity among elderly : findings from a large population-based Swedish survey 2017 Ingår i: Public Health. - : Elsevier B.V.. - 0033-3506 .- 1476-5616. ; 147, s. 84-91 Tidskriftsartikel (refereegranskat)abstract Objective To examine how physical activity and physical mobility are related to obesity in the elderly. Study design A cross-sectional study of 2558 men and women aged 65 years and older who participated in a population survey in 2012 was conducted in mid-Sweden with an overall response rate of 67%. Methods Obesity (body mass index ≥30 kg/m2) was based on self-reported weight and height, and physical activity and physical mobility on questionnaire data. Chi-squared test and multiple logistic regressions were used as statistical analyses. Results The overall prevalence of obesity was 19% in women and 15% in men and decreased after the age of 75 years. A strong association between both physical activity and obesity, and physical mobility and obesity was found. The odds for obesity were higher for impaired physical mobility (odds ratio [OR] 2.83, 95% confidence interval [CI] 2.14–3.75) than for physical inactivity (OR 1.63, 95% CI 1.28–2.08) when adjusted for gender, age, socio-economic status and fruit and vegetable intake. However, physical activity was associated with obesity only among elderly with physical mobility but not among those with impaired physical mobility. Conclusion It is important to focus on making it easier for elderly with physical mobility to become or stay physically active, whereas elderly with impaired physical mobility have a higher prevalence of obesity irrespective of physical activity.
4.	Baburin, A., et al. (författare) Avoidable mortality in Estonia : exploring the differences in life expectancy between Estonians and non-Estonians in 2005-2007 2011 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 125:11, s. 754-762 Tidskriftsartikel (refereegranskat)abstract Objectives: A considerable increase in social inequalities in mortality was observed in Eastern Europe during the post-communist transition. This study evaluated the contribution of avoidable causes of death to the difference in life expectancy between Estonians and non-Estonians in Estonia. Study design: Descriptive study. Methods: Temporary life expectancy (TLE) was calculated for Estonian and non-Estonian men and women aged 0-74 years in 2005-2007. The ethnic TLE gap was decomposed by age and cause of death (classified as preventable or treatable). Results: The TLE of non-Estonian men was 3.53 years less than that of Estonian men, and the TLE of non-Estonian women was 1.36 years less than that of Estonian women. Preventable causes of death contributed 2.19 years to the gap for men and 0.78 years to the gap for women, while treatable causes contributed 0.67 and 0.33 years, respectively. Cardiorespiratory conditions were the major treatable causes of death, with ischaemic heart disease alone contributing 0.29 and 0.08 years to the gap for men and women, respectively. Conditions related to alcohol and substance use represented the largest proportion of preventable causes of death. Conclusions: Inequalities in health behaviours underlie the ethnic TLE gap in Estonia, rather than inequalities in access to health care or the quality of health care. Public health interventions should prioritize primary prevention aimed at alcohol and substance use, and should be implemented in conjunction with wider social policy measures
5.	Baigi, Amir, et al. (författare) Cardiovascular mortality focusing on socio-economic influence : the low-risk population of Halland compared to the population of Sweden as a whole 2002 Ingår i: Public Health. - Amsterdam : Elsevier. - 0033-3506 .- 1476-5616. ; 116:5, s. 285-288 Tidskriftsartikel (refereegranskat)abstract The aim of the study was to investigate the relationship between mortality from cardiovascular diseases (CVD) and socioeconomic status (SES) in Sweden and to estimate to what extent the difference between a province with low mortality and the rest of Sweden was dependent on socio-economic factors. A population-based retrospective study with a historical prospective approach was performed covering a 10-y period in the province of Halland, Sweden, as well as Sweden as a whole. Altogether 1654 744 men and 1592 467 women were included, of whom 45 394 men and 43 403 women were from Halland, distributed according to SES. Multivariate analysis with Poisson regression was used. Relative risks with 95% confidence intervals were calculated. Both men and women with a low SES showed a significantly higher risk of death from CVD in Sweden as a whole. The risk was 23% higher for male blue-collar workers and 44% higher for female blue-collar workers when compared to their white-collar counterparts. The level of mortality in Halland was 14% lower compared to the country as a whole when only age was taken into account. When the socio-economic variable was also included, this figure was 8%. The results show the substantial significance of social differences with respect to CVD mortality. The effect of SES seems to be more important than that of geographical conditions when the latter are isolated from socio-economic influence.
6.	Barrett, Damon (författare) Re: ‘Access to treatment with controlled medicines : rationale and recommendations for neutral, precise, and respectful language’ 2018 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 160, s. 156-156 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
7.	Bergh, Håkan, 1958, et al. (författare) Life events, social support and sense of coherence among frequent attenders in primary health care. 2006 Ingår i: Public health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 120, s. 229-236 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: The aim of this survey was to compare stressful life events, social support and sense of coherence (SOC) between frequent attenders (FAs) and normal attenders (controls) in primary health care. STUDY DESIGN: A cross-sectional study was conducted in a primary healthcare centre in the south-west of Sweden. METHODS: A postal questionnaire was sent to 263 frequent attenders and 703 normal attenders. The questionnaire comprised sociodemographic variables and scales of stressful life events, social support and SOC. The results from the questionnaire were compared between the groups, and the significance of the variables in terms of attendance was tested in a multiple regression analysis. RESULTS: More of the FAs were secondarily single, they had more chronic diseases and were more often living on a sickness/disablement pension than the controls. FAs did not report more stressful life events than the controls nor was their experience of events more negative. Social support was as strong among FAs as among controls, and it had no significant effect on their frequent attendance. FAs had a significantly weaker SOC compared with controls. The variables that significantly influenced frequent attendance were high age [odds ratio (OR) = 1.02], chronic disease (OR = 3.08), sickness/disablement pension (OR = 2.46) and SOC (OR = 0.97). CONCLUSIONS: SOC had a significant influence on frequent attendance in primary health care, but stressful life events and social support did not. FAs did not report more stressful life events. However, due to an inadequate coping strategy, indicated by a weak SOC, the life events probably caused them more symptoms and diseases, and thereby a higher consulting frequency.
8.	Brynhildsen, Jan, et al. (författare) Trends in body mass index during early pregnancy in Swedish women 1978-2001 2006 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 120:5, s. 393-399 Tidskriftsartikel (refereegranskat)abstract Objective: to study the body mass index (BMI) in women seeking maternity health care during early pregnancy in Sweden, and to show trends for a period of more than 20 years. Study design: register study. Methods: data from the maternity health programme on consecutively delivered women in two Swedish hospitals were collected for the years 1978, 1986, 1992, 1997 and 2001. All women were weighed at their first midwife visit between 8 and 10 weeks of gestation and height was also measured. Results: data on 4883 women were collected. Data on weight were available for 4490 (92%) women and data on BMI were available for 4378 (90%) women. The age-adjusted average weight increased from 59.5 kg in 1978 to 68.2 kg in 2001, and the BMI increased from 21.7 in 1978 to 24.7 in 2001. In 2001, 38.6% of the women had a BMI >25 compared with 11.2 in 1978. In 2001, 11.6% of the women were obese compared with 2.2% in 1978. Conclusions: during the last two decades, an alarming increase in weight has occurred in Swedish women of childbearing age. © 2005.
9.	Byass, Peter, et al. (författare) Motherhood, migration and mortality in Dikgale : modelling life events among women in a rural South African community 2011 Ingår i: Public Health. - London : Academic P.. - 0033-3506 .- 1476-5616. ; 125:5, s. 318-323 Tidskriftsartikel (refereegranskat)abstract Objectives: Although particular types of life events in populations are often studied separately, this study investigated the joint effects of three major event types in South African women’s lives: motherhood, migration and mortality. Study design: Data were taken from a health and demographic surveillance site (HDSS) over an 11-year period, reflecting the entire population of a defined geographic area as an open cohort, in which individuals participated in regular longitudinal surveillance for health and demographic events. This HDSS is a member of the Indepth Network. Methods: Multivariate Poisson regression models were built for each of the three life event types, in which individual person-time observed out of the total possible 11-year period was used as a rate multiplier. These models were used to calculate adjusted incidence rate ratios for each factor. Results: In the 21,587 person–years observed for women aged 15–49 years, from 1996 to 2006, adjusted rate ratios for mortality and migration increased substantially over time, while motherhood remained fairly constant. Women who migrated were less likely to bear children; temporary migrants were at greater risk of dying, while permanent in-migrants had higher survival rates. Women who subsequently died were much less likely to bear children or migrate. Conclusions: The associations between motherhood, migration and mortality among these rural South African women were complex and dynamic. Extremely rapid increases in mortality over the period studied are presumed to reflect the effects of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic. Understanding these complex interactions between various life events at population level is crucial for effective public health planning and service delivery.
10.	Byass, Peter, et al. (författare) The role of demographic surveillance systems (DSS) in assessing the health of communities : an example from rural Ethiopia 2002 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 116:3, s. 145-150 Tidskriftsartikel (refereegranskat)abstract Longitudinal demographic surveillance systems (DSSs) in selected populations can provide important information in situations where routine health information is incomplete or absent, particularly in developing countries. The Butajira Rural Health Project is one such example, initiated in rural Ethiopia in 1987. DSSs rely on regular community-based surveillance as a means of vital event registration, among a sufficient population base to draw meaningful conclusions about rates and trends in relatively rare events such as maternal death. Enquiries into specific health problems can also then use this framework to quantify particular issues or evaluate interventions. Demographic characteristics and trends for a rural Ethiopian population over a 10-y period are presented as an illustration of the DSS approach, based on 336 000 person-years observed. Overall life expectancy at birth was 50 y. Demographic parameters generally showed modest trends towards improvement over the 10-y period. The DSS approach is useful in characterising populations at the community level over a period of time, providing important information for health planning and intervention. Methodological issues underlying this approach need further exploration and development.
11.	Carlsson, Frida, et al. (författare) Prevalence of annoyance attributed to electrical equipment and smells in a Swedish population, and relationship with subjective health and daily functioning 2005 Ingår i: Public Health. - : Elsevier BV. - 1476-5616 .- 0033-3506. ; 119:7, s. 568-577 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Self-reported annoyance from electrical equipment has been in evidence since the mid-1980s, and the first reports of illness from everyday chemicals arose in the 1960s. However, the extent of the problem has not yet been fully established.AIMS: The aim of this study was to estimate the prevalence of annoyance related to electrical and chemical factors in a Swedish general population, and to assess possible relationships with subjective health and daily functioning.METHODS: In total, 13,604 subjects, representative of the population of Scania, Sweden, answered a survey containing five questions regarding annoyance from five environmental factors: fluorescent tube lighting, visual display units, other electrical equipment, air that smells of chemicals, and other smells. The survey also obtained data on self-reported health (SRH-7), mental well-being [General Health Questionnaire (GHQ)-12], work situation and daily functioning.RESULTS: Almost one-third of the respondents reported annoyance from at least one environmental factor. Annoyance was more frequent among women, subjects of working age and immigrants. Subjects who reported environmental annoyance scored higher on GHQ-12 and lower on SRH-7, indicating impaired subjective physical and mental well-being. They were also more likely to report deteriorated daily functioning.CONCLUSIONS: Annoyance related to electrical and/or chemical factors was common in a Swedish population. Subjects reporting environmental annoyance rated their overall health significantly poorer than the general population. The association with subjective health and functional capacity increased with severity of annoyance, which suggests that there is some connection between environmental annoyance, well-being and functional capacity.
12.	Clark, Kristen D., Postdoctoral Fellow, et al. (författare) Stressors in health care and their association to symptoms experienced by gender diverse people 2023 Ingår i: Public Health. - : Elsevier. - 0033-3506 .- 1476-5616. ; 217, s. 81-88 Tidskriftsartikel (refereegranskat)abstract ObjectivesMany individuals whose gender does not align with the sex they were assigned at birth (gender diverse [GD] people) report stressful health care encounters. We examined the relationship of these stressors to symptoms of emotional distress and impaired physical functioning among GD people.Study designThis study was conducted using a cross-sectional design with data from the 2015 United States Transgender Survey.MethodsComposite metrics of health care stressors and physical impairments were developed, and the Kessler Psychological Distress Scale (K-6) provided a measure of emotional distress. Linear and logistic regression were used to analyze the aims.ResultsA total of 22,705 participants from diverse gender identity subgroups were included. Participants who experienced at least one stressor in health care during the past 12 months had more symptoms of emotional distress (β = 0.14, P < .001) and 85% greater odds of having a physical impairment (odds ratio = 1.85, P < .001). Transgender men exposed to stressors were more likely than transgender women to experience emotional distress and have a physical impairment, with other gender identity subgroups reporting less distress. Black participants exposed to stressful encounters reported more symptoms of emotional distress than White participants.ConclusionsThe results suggest that stressful encounters in health care are associated with symptoms of emotional distress and greater odds of physical impairment for GD people, with transgender men and Black individuals being at greatest risk of emotional distress. The findings indicate the need for assessment of factors that contribute to discriminatory or biased health care for GD people, education of health care workers, and support for GD people to reduce their risk of stressor-related symptoms.
13.	DeKeyser, Nicholas, et al. (författare) Total cost comparison of standard antenatal care with a weight gain restriction programme for obese pregnant women 2011 Ingår i: Public Health. - : Elsevier Science B.V., Amsterdam. - 0033-3506 .- 1476-5616. ; 125:5, s. 311-317 Tidskriftsartikel (refereegranskat)abstract Objective: To perform a cost comparison of a weight gain restriction programme for obese pregnant women with standard antenatal care, and to identify if there were differences in healthcare costs within the intervention group related to degree of gestational weight gain or degree of obesity at programme entry. Study design: A comparison of mean healthcare costs for participants of an intervention study at antenatal care clinics with controls in south-east Sweden. Methods: In total, 155 women in an intervention group attempted to restrict their gestational weight gain to less than7 kg. The control group comprised 193 women. Mean costs during pregnancy, delivery and the neonatal period were compared with the costs of standard care. Costs were converted from Swedish Kronor to Euros ((sic)). Results: Healthcare costs during pregnancy were lower in the intervention group. There was no significant difference in total healthcare costs (i.e. sum of costs during pregnancy, delivery and the neonatal period) between the intervention group and the control group. Within the intervention group, the subgroup that gained 4.5-9.5 kg had the lowest costs. The total cost, including intervention costs, was (sic)1283 more per woman/ infant in the intervention group compared with the control group (P = 0.025). The degree of obesity at programme entry had no bearing on the outcome. Conclusions: The weight gain restriction programme for obese pregnant women was effective in restricting gestational weight gain to less than7 kg, but had a higher total cost compared with standard antenatal care.
14.	Ebeling, M, et al. (författare) Urban-rural disparities in old-age mortality vary systematically with age: evidence from Germany and England & Wales 2022 Ingår i: Public health. - : Elsevier BV. - 1476-5616 .- 0033-3506. ; 205, s. 102-109 Tidskriftsartikel (refereegranskat)
15.	Elo, S L, et al. (författare) Validity and utilization of epidemiological data: a study of ischaemic heart disease and coronary risk factors in a local population. 2009 Ingår i: Public health. - : Elsevier BV. - 1476-5616 .- 0033-3506. ; 123:1, s. 52-7 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: To calculate the burden of ischaemic heart disease (IHD) and coronary risk factors in a defined population using data from all public providers of health care, i.e. inpatient and outpatient care in all settings. STUDY DESIGN: Cross-sectional, 1-year retrospective study. METHODS: The main outcome measures were the number of individuals by diagnosis and by care setting, and gender- and age-specific event rates by diagnosis. RESULTS: Less than half of the individuals who visited any care provider for IHD or coronary risk factors were identified in the hospital discharge register. Calculation of the actual burden of disease in the population showed that when hospital discharge data were combined with outpatient data, there were no or slight differences in the age-specific rates of acute myocardial infarction (AMI), while the rates of angina were between two-fold and four-fold higher, and unspecified IHD was between three-fold and ten-fold higher in individuals aged > or =50 years compared with using hospital discharge data alone. The rates of hypertension, diabetes and lipid disorders increased in all age groups when outpatient data were added to hospital discharge data. The differences in the rates were more pronounced in women aged 50-79 years. However, the age-specific rates were higher in men except for hypertension which was higher in older women. CONCLUSION: Data for epidemiological analyses of diseases are often based on hospital discharge data. This study found that hospital discharge data provide limited information on patients treated for IHD and coronary risk factors, except for AMI. These findings suggest that hospital discharge data should be combined with outpatient care data to provide a more comprehensive estimate of the burden of IHD and its risk factors.
16.	Fantahun, Mesganaw, et al. (författare) Ageing of a rural Ethiopian population : who are the survivors? 2009 Ingår i: Public health. - : Elsevier. - 1476-5616 .- 0033-3506. Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: This study assessed trends in survival to old age and identified the factors associated with longevity among the elderly (age >/=65 years). STUDY DESIGN: Cohort analysis of demographic surveillance data. METHODS: The study was conducted in the Butajira Rural Health Programme Demographic Surveillance Site in Ethiopia. Using data collected between 1987 and 2004, the probability of survival to 65 years and remaining life expectancy for women and men aged 65 years were computed. Cox regression analysis was used to assess survival by different factors. RESULTS: Although the elderly represented 3% of the population, their person-time contribution increased by 48% over the 18-year period. Less than half reached 65 years of age, with remaining life expectancy at 65 years ranging from 15 years in rural men to 19 years in urban women. Rural residence, illiteracy and widowhood were associated with lower survival adjusted for other factors, whereas gender did not show a significant difference. However, the effect of these factors differed between men and women, as demonstrated by survival curves and Cox regression. Widowhood [hazard ratio (HR) 2.02, 95% confidence interval (CI) 1.59-2.57] and illiteracy (HR 2.26, 95% CI 1.86-2.73) affected males to a greater extent than females, and rural residence was associated with poorer female survival (HR 1.68, 95% CI 1.55-1.83). CONCLUSIONS: The number of elderly people is increasing in Ethiopia, with the chance of survival into older age being similar between men and women and approaching that in developed countries. However, rural women and illiterate women and men, particularly widowers, are disadvantaged in terms of survival.
17.	Fottrell, Edward, et al. (författare) Identifying humanitarian crises in population surveillance field sites : simple procedures and ethical imperatives. 2009 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 123:2, s. 151-155 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: Effective early warning systems of humanitarian crises may help to avert substantial increases in mortality and morbidity, and prevent major population movements. The Butajira Rural Health Programme (BRHP) in Ethiopia has maintained a programme of epidemiological surveillance since 1987. Inspection of the BRHP data revealed large peaks of mortality in 1998 and 1999, well in excess of the normally observed year-to-year variation. Further investigation and enquiry revealed that these peaks related to a measles epidemic, and a serious episode of drought and consequent food insecurity that went undetected by the BRHP. This paper applies international humanitarian crisis threshold definitions to the BRHP data in an attempt to identify suitable mortality thresholds that may be used for the prospective detection of humanitarian crises in population surveillance sites in developing countries. STUDY DESIGN: Empirical investigation using secondary analysis of longitudinal population-based cohort data. METHODS: The daily, weekly and monthly thresholds for crises in Butajira were applied to mortality data for the 5-year period incorporating the crisis periods of 1998-1999. Days, weeks and months in which mortality exceeded each threshold level were identified. Each threshold level was assessed in terms of prospectively identifying the true crisis periods in a timely manner whilst avoiding false alarms. RESULTS: The daily threshold definition is too sensitive to accurately detect impending or real crises in the population surveillance setting of the BRHP. However, the weekly threshold level is useful in identifying important increases in mortality in a timely manner without the excessive sensitivity of the daily threshold. The weekly threshold level detects the crisis periods approximately 2 weeks before the monthly threshold level. CONCLUSION: Mortality measures are highly specific indicators of the health status of populations, and simple procedures can be used to apply international crisis threshold definitions in population surveillance settings for the prospective detection of important changes in mortality rate. Standards for the timely use of surveillance data and ethical responsibilities of those responsible for the data should be made explicit to improve the public health functioning of current sentinel surveillance methodologies.
18.	Gillander Gådin, Katja, et al. (författare) Can school-related factors predict future health behaviour among young adolescents? 2002 Ingår i: Public Health. - 0033-3506 .- 1476-5616. ; 116:1, s. 22-29 Tidskriftsartikel (refereegranskat)abstract Although the prevention of unfavourable health behaviour among young people has high priority in public health, the possibility of finding risk factors at school has not been sufficiently studied. The objective of this study was to find predictors among young pupils for later unfavourable health behaviour, with special focus on school-related factors.A three-year prospective study was started in 1994 including 279 pupils (141 girls and 138 boys) from different socioeconomic areas. The pupils answered a comprehensive questionnaire in grade six and grade nine. The non-response rate was negligible. The best predictors for health behaviour among boys and girls in grade nine were factors related to earlier health/health behaviour. The results also indicated that school-related factors could predict future health behaviour, especially in relation to low physical activity among girls.The school has an important role to play in identification of future unfavourable health behaviour among pupils at the school, both directly through recognising school-related risk factors and also indirectly through paying special attention to pupils with unfavourable health/health behaviour. Our findings indicate the need for more research in younger ages, as negative health behaviour already seems to be established at 12 y of age.
19.	Godoy-Ramirez, K., et al. (författare) Exploring childhood immunization among undocumented migrants in Sweden - following qualitative study and the World Health Organizations Guide to Tailoring Immunization Programmes (TIP) 2019 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 171, s. 97-105 Tidskriftsartikel (refereegranskat)abstract Objectives: National vaccination coverage in Sweden is high. Recurrent outbreaks of measles and rubella however highlight some immunity gaps in the population. Current knowledge about immunization status of undocumented migrant children is scant. The World Health Organization/Europe has developed the Guide to Tailoring Immunization Programmes (TIP) to assist countries in diagnosing barriers and motivators to vaccination in communities with low vaccination coverage. Based on the TIP guide, the objective of this study was to explore determinants to vaccination among undocumented immigrants, using qualitative approach. Study design: The study consisted of three steps: (i) an initial workshop for problem statement; (ii) qualitative research for increased understanding of the vaccination practices of children in the undocumented community; and (iii) a second workshop to incorporate the qualitative interview findings together with data from key stakeholders into a conceptual framework. Methods: This was a qualitative study featuring interviews of seven undocumented parents recruited at non-governmental clinics, three nurses at Child Health Centers, and information from key stakeholders retrieved at workshops as part of the TIP process. Results: The content analysis revealed two main themes: parental fear of being questioned and parental acceptance of child immunization. Undocumented parents had a positive view and attitude toward childhood immunization but expressed strong fear of being asked for identification papers at healthcare facilities. Owing to lack of knowledge on entitlements of the undocumented among health personnel, parents were incorrectly rejected when seeking care for their children. Frequent mobility among undocumented may limit access to complete the immunization schedule. Undocumented parents mistrust healthcare providers and avoid health facilities, further delaying childrens' access to health care, including immunization services. Conclusions: The findings of this study confirm the complexity of barriers that undocumented parents face regarding childhood immunization. The TIP guide offers a valuable process for a deeper understanding of the determinants of immunization challenges among undocumented migrants. (C) 2019 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for Public Health.
20.	Granström, Fredrik, et al. (författare) Distinguishing independent and shared effects of material/structural conditions and psychosocial resources on educational inequalities in self-rated health : results from structural equation modelling 2021 Ingår i: Public Health. - : Elsevier. - 0033-3506 .- 1476-5616. ; 196, s. 10-17 Tidskriftsartikel (refereegranskat)abstract Objectives: The aim of this study was to distinguish independent and shared effects of material/structural factors and psychosocial resources in explaining educational inequalities in self-rated health (SRH) by using structural equation modelling. Study design: Cross-sectional survey. Methods: Data were derived from a questionnaire sent to a random sample of the population in five counties in Sweden in 2008. The study population (aged 25–75 years) included 15,099 men and 17,883 women. Exploratory structural equation modelling was used to analyse the pathways from educational level to SRH. Results: The pathway including both material/structural factors (e.g. financial buffer and unemployment) and psychosocial resources (e.g. sense of coherence and social participation) explained about 40% of educational differences in SRH for both men and women. The pathways including only the independent effects of psychosocial resources (14% in men and 20% in women) or material/structural factors (9% and 18%, respectively) explained substantial but smaller proportions of the differences. Conclusions: The major pathway explaining educational inequalities in SRH included both material/structural factors and psychosocial resources. Therefore, to reduce educational inequalities in SRH, interventions need to address both material/structural conditions and psychosocial resources across educational groups.
21.	Grjibovski, A M, et al. (författare) Large social disparities in spontaneous preterm birth rates in transitional Russia 2005 Ingår i: Public Health. - London : Elsevier BV. - 0033-3506 .- 1476-5616. ; 119:2, s. 77-86 Tidskriftsartikel (refereegranskat)abstract OBJECTIVE: This study estimated the effect of maternal sociodemographic, obstetric and lifestyle factors on the risk of spontaneous preterm birth in a Russian town.METHODS: All women with singleton pregnancies registered at prenatal care centres in Severodvinsk in 1999 comprised the cohort for this study (n=1559). Analysis was based on spontaneous live singleton births at the maternity home (n=1103). Multivariable logistic regression was applied to quantify the effect of the studied factors on the risk of preterm birth. Differences in gestation duration were studied using multiple linear regression.RESULTS: In total, 5.6% of all spontaneous births were preterm. Increased risks of preterm delivery were found in women with lower levels of education and in students. Placental complications, stress and a history of fetal death in previous pregnancies were also associated with elevated risks for preterm delivery. Smoking, hypertension and multigravidity were associated with reduced length of pregnancy in metric form.CONCLUSION: In addition to medical risk factors, social factors are important determinants of preterm birth in transitional Russia. Large disparities in preterm birth rates may reflect the level of inequalities in transitional Russia. Social variations in pregnancy outcomes should be monitored.
22.	Gånedahl, Hanna, et al. (författare) Work-site wellness programmes in Sweden : a cross-sectional study of physical activity, self-efficacy, and health 2015 Ingår i: Public Health. - : Elsevier. - 0033-3506 .- 1476-5616. ; 129:5, s. 525-530 Tidskriftsartikel (refereegranskat)abstract In Sweden, a work-site wellness programme implies reimbursing some of the expenses for health-promoting activities. Although work-site wellness programmes are readily available in Sweden, a large number of employees elect not to participate.OBJECTIVES: The aim of this study was to investigate the association of physical activity, self-reported general health assessment and self-efficacy with participation in a work-site wellness programme.STUDY DESIGN: A cross-sectional study design was used.METHODS: An online questionnaire was distributed to employees of a manufacturing company with 2500 employees in southwest Sweden.RESULTS: Those who took advantage of the work-site wellness programme assessed their general health as better and had higher assessment of physical activity. The study showed that being enlisted also implies a higher level of physical activity and general health; however, the effect sizes of these correlations were small. Self-efficacy, i.e. perceived behavioural control, was not associated with participation in the work-site wellness programme. However, self-efficacy was correlated with both general health assessment and physical activity. A regression analysis to determine explanatory contributions to the general health assessment score showed no significant contribution from participation in a work-site wellness programme, but was instead explained by perceived behavioural control and physical activity.CONCLUSIONS: Given the small effect size of the difference in physical activity between participators and non-participators in the work-site wellness programme, it is probable that only a small proportion of participators changed their health-promoting activities as a result of the work-site wellness programme.
23.	Hammarström, Anne, et al. (författare) Gender-related explanatory models of depression : a critical evaluation of medical articles 2009 Ingår i: Public Health. - : Elsevier. - 0033-3506 .- 1476-5616. ; 123:10, s. 689-693 Tidskriftsartikel (refereegranskat)abstract Objectives: Although research has consistently shown a higher prevalence of depression among women compared with men, there is a lack of consensus regarding explanatory factors for these gender-related differences. The aim of this paper was to analyse the scientific quality of different gender-related explanatory models of depression in the medical database PubMed.Study design: Qualitative and quantitative analyses of PubMed articles.Methods: In a database search in PubMed for 2002, 82 articles on gender and depression were selected and analysed with qualitative and quantitative content analyses. In total, 10 explanatory factors and four explanatory models were found. The ISI Web of Science database was searched in order to obtain the citation number and journal impact factor for each article.Results: The most commonly used gender-related explanatory model for depression was the biomedical model (especially gonadal hormones), followed by the sociocultural and psychological models. Compared with the other models, the biomedical model scored highest on bibliometric measures but lowest on measures of multifactorial dimensions and differences within the group of men/women.Conclusion: The biomedical model for explaining gender-related aspects of depression had the highest quality when bibliometric methods were used. However, the sociocultural and psychological models had higher quality than the biomedical model when multifactoriality and intersectionality were analysed. There is a need for the development of new methods in order to evaluate the scientific quality of research.
24.	Hammarström, Anne, et al. (författare) Mechanisms for the social gradient in health : results from a 14-year follow-up of the northern swedish cohort 2011 Ingår i: Public Health. - London : Academic P.. - 0033-3506 .- 1476-5616. ; 125:9, s. 567-576 Tidskriftsartikel (refereegranskat)abstract Objective: Although numerous studies have demonstrated a socio-economic gradient in health, there is still a lack of research about the mechanisms behind this gradient. The aim of this study was to analyse possible mechanisms from adolescence to adulthood to explain the socio-economic gradient in somatic symptoms among men and women in the Northern Swedish Cohort. Study design: A prospective cohort study was performed, in which all pupils (n = 1083) in the last year of compulsory school were followed for 14 years. The response rate was high, with 96.6% still participating after 14 years. The data were mainly collected through repeated comprehensive self-administered questionnaires.Methods: The main dependent variable was a combination of socio-economic position and somatic health at 30 years of age. Multivariate multinomial and bivariate logistic regression analyses were undertaken.Results: After controlling for parental working-class position and health-related selection, the authors identified mechanisms from adolescence to adulthood for the socio-economic gradient in health that were related to social relations (poor relationship with father and unemployed friends among men, violence among women), labour market experiences (unemployment among men and women, physically heavy work among women), economic hardship (among women) and poor health behaviour.Conclusion: These analyses contribute to the development of epidemiological methods for analysing mechanisms for the socio-economic gradient in health. (C) 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
25.	Hang, Hoang Minh, et al. (författare) Difficulties in getting treatment for injuries in rural Vietnam 2009 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 123:1, s. 58-65 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: Knowledge about the health-seeking behaviour of injury patients is important for the improvement of community health services. The aims of this study were: (1) to describe the healthcare-seeking behaviour of injury patients; (2) to examine factors associated with injury patients seeking care at health facilities; and (3) to describe the costs of health care for injury patients. STUDY DESIGN: This study took place in Bavi District, northern Vietnam within a longitudinal community surveillance site (FilaBavi). All non-fatal unintentional injuries occurring in a sample of 24,776 people during 2000 were recorded. METHOD: The injury questionnaire included information on care-seeking behaviour, severity and consequences of injury. Both univariate and multivariate logistic regression models were used to find associations between sociodemographic factors and utilization of any health services, as well as for each type of health service used, compared with the group who did not use any health services. RESULT: Of 24,776 persons living in the study area, 1917 reported 2079 new non-fatal debilitating injuries during the four 3-month periods of observation. Health-seeking behaviour relating to the first 1917 injuries was analysed. Self-treatment was most common (51.7%), even in cases of severe injury. There was low usage of public health services (23.2%) among injury patients. Long distances, poor economic status and residence in difficult geographic areas such as highlands and mountains were barriers for seeking health services. A large proportion of household income was spent on treating injury patients. Poor people spent a greater proportion of their income on health care than the rich, and often used less qualified or untrained private providers. CONCLUSIONS: These results demonstrate the logistical and financial difficulties associated with the treatment of injuries in rural Vietnam. This suggests the need to make public health subsidies available more efficiently and equitably. Whilst this study looked at the situation specifically in the context of injury treatment, it is likely that similar patterns apply in other areas of health care.
26.	Hang, Hoang Minh, et al. (författare) Unintentional injuries over a 1-year period in a rural Vietnamese community : describing an iceberg. 2005 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 119:6, s. 466-473 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: To document unintentional injuries in a rural community over a 1-year period as a basis for prioritizing preventive activities. STUDY DESIGN: Quarterly home visits over 1 year to elicit experience of injury among household members in the preceding 3 months. METHODS: In total, 24,776 people living in rural communities in the Bavi District, Northern Vietnam, were surveyed in home visits during 2000. In the home visits, injuries that needed care or disrupted normal activities were recorded, together with their circumstances. RESULTS: Overall, 2079 new non-fatal injuries were recorded over 23,338 person-years, a rate of 89/1000 person-years-at-risk. Males had a significantly higher injury rate than females for all age groups except for those aged 35-59 years and the elderly (P<0.05). The elderly were at highest risk of injury (P<0.05), particularly females. Home injuries occurred at the highest overall rate, particularly among the elderly. Road traffic injuries were most common among children. Most injuries involved contact with another object. Less than one-quarter of injury victims sought care at a health facility. CONCLUSIONS: Community-based household surveys revealed the hidden part of the injury iceberg, as well as showing high incidence rates, indicating that injury is an important public health problem which should be a priority for intervention in rural Vietnam, and probably elsewhere. This comprehensive study is intended to contribute evidence and methods to the Ministry of Health's national programme for injury prevention, and to a wider audience.
27.	Hansson, Anna, et al. (författare) Impact of changes in life circumstances on subjective well-being in an adult population over a 3-year period 2008 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 122:12, s. 1392-1398 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES:Mental health problems are a major issue worldwide, and there is a need to further explore factors that may increase or decrease people's subjective well-being (SWB). The main aim of the present study was to extend knowledge concerning changes in cohabitation, social support or financial situation and their influence on SWB, after controlling for personality (i.e. neuroticism), in a 3-year follow-up of an adult population-based sample. The change in overall well-being was also studied during the 3- year interval.STUDY DESIGN:Longitudinal design.METHODS:A random sample of Swedish citizens, aged 20-64 years, residing in Stockholm County received a questionnaire by post, comprising items pertaining to demographics, personality, social support and SWB. All the respondents received a second questionnaire 3 years later. In total, 8324 subjects were included in the present study.RESULTS:The overall well-being of the study sample was relatively stable. Separate analyses of the three life circumstances indicated that, after controlling for personality, positive and negative changes in each sphere of life still affected SWB.CONCLUSIONS:Despite personality and the stability of SWB, these results indicate that changes in financial situation, social support and cohabitation influence SWB. It is important for society and the healthcare services to be aware that a negative change in any of these life circumstances may lead to decreased well-being for a period of at least 3 years.
28.	Haraldsson, Katarina, 1958, et al. (författare) Evaluation of a school-based health promotion programme for adolescents aged 12-15 years with focus on well-being related to stress. 2008 Ingår i: Public health. - London : Elsevier BV. - 0033-3506 .- 1476-5616. ; 122:1, s. 25-33 Tidskriftsartikel (refereegranskat)abstract OBJECTIVE: The aim of this study was to evaluate a school-based adolescent health promotion programme with focus on well-being related to stress. STUDY DESIGN: Interventional and evaluative with tests before and after the intervention. The study was performed in two secondary schools in a town on the west coast of Sweden. METHODS: A health promotion programme comprising massage and mental training was implemented for a single academic year in one school (intervention school, 153 participants) in order to strengthen and maintain well-being. No intervention was implemented in the other school (non-intervention school, 287 participants). A questionnaire was developed and tested, resulting in 23 items distributed across the following six areas: self-reliance; leisure time; being an outsider; general and home satisfaction; school satisfaction; and school environment. RESULTS: A pre- and postintervention comparison of the six areas was made within each school. In the intervention school, the boys maintained a very good or good sense of well-being related to stress in all six areas, while the girls' sense of well-being was maintained in five areas and deteriorated in one area. In the non-intervention school, the boys maintained a very good or good sense of well-being related to stress in four areas and deteriorated in two areas, while the girls' sense of well-being was maintained in two areas and deteriorated in four areas. CONCLUSION: Massage and mental training helped to maintain adolescents' very good or good sense of well-being related to stress. A questionnaire with acceptable validity and reliability was developed and tested in order to evaluate the health promotional approach. However, there is a need for further study to develop both the intervention and the questionnaire for young people.
29.	Holowko, N., et al. (författare) More than time : travel time to the delivery ward and maternal outcomes – onset of labour, postpartum haemorrhage and obstetric anal sphincter injury 2023 Ingår i: Public Health. - : Elsevier. - 0033-3506 .- 1476-5616. ; 217, s. 105-114 Tidskriftsartikel (refereegranskat)abstract Background: Closing delivery units increases travel time for some women. Whether increased travel time is associated with maternal outcomes is important for understanding the consequences of such closures. Previous studies are limited in measuring travel time and restricted to the outcome of caesarean section. Methods: Our population-based cohort includes data from the Swedish Pregnancy Register for women giving birth between 2014 and 2017 (N = 364,630). We estimated travel time from home to the delivery ward using coordinate pairs of actual addresses. The association between travel time and onset of labour was modelled using multinomial logistic regression, and logistic regression was used for the outcomes postpartum haemorrhage (PPH) and obstetric anal sphincter injury (OASIS). Findings: Over three-quarters of women had ≤30 min travel time (median 13.9 min). Women who travelled ≥60 min arrived to care sooner and laboured there longer. Women with further to travel had increased adjusted odds ratio (aOR) of having an elective caesarean section (31–59 min aOR 1.11; 95% confidence interval [CI] 1.07–1.16; ≥60 min aOR 1.25; 95% CI 1.16–1.36) than spontaneous onset of labour. Women (at full term with spontaneous onset) living ≥60 min away had reduced odds of having a PPH (aOR 0.84; 95% CI 0.76–0.94) or OASIS (aOR 0.79; 95% CI 0.66–0.94). Interpretation: Longer travel time increased the odds of elective caesarean section. Women with furthest to travel arrived sooner and spent more time in care; although they had a lower risk of PPH or OASIS, they also tended to be younger, have a higher body mass index and were Nordic born.
30.	Hu, B, et al. (författare) Reliability and relative validity of three physical activity questionnaires in Taizhou population of China: the Taizhou Longitudinal Study 2015 Ingår i: Public health. - : Elsevier BV. - 1476-5616 .- 0033-3506. ; 129:9, s. 1211-1217 Tidskriftsartikel (refereegranskat)
31.	Huong, Dao Lan, et al. (författare) Socio-economic status inequality and major causes of death in adults : a 5-year follow-up study in rural Vietnam. 2006 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 120:6, s. 497-504 Tidskriftsartikel (refereegranskat)
32.	Jeetoo, J., et al. (författare) Willingness to pay to enhance pandemic preparedness in Mauritius 2022 Ingår i: Public Health. - : Elsevier. - 0033-3506 .- 1476-5616. ; 211, s. 144-148 Tidskriftsartikel (refereegranskat)abstract Objectives: The objective of this study is to assess the determinants of willingness to pay to enhance pandemic preparedness in Mauritius.Study design: A contingent valuation method is used to estimate willingness to pay to pay for enhancing pandemic preparedness using a sample of working people in Mauritius.Methods: A two-phase decision process analysis is carried out to model the willingness to pay to enhance pandemic preparedness. The first phase is to analyse the respondents' decision of whether or not to pay for enhancing pandemic preparedness using a Probit model. The second phase is to estimate the determinants of the amount of money respondents are willing to pay using a Tobit model.Results: Income earners are willing to pay an average of Rs. 1,900 (approximately USD 50) per annum to enhance pandemic preparedness. ‘Perceived Response Efficacy’, ‘Awareness of the Need and Responsibility for Paying’, ‘Subjective Obligation to Pay’ and the ‘Theory of Planned Behaviour’ are found to affect both stages of of the decision-making process. Knowledge on COVID-19 is found to have a positive impact on the decision to pay and health responsibility attitude is found to have a negative impact on the amount people are willing to pay.Conclusions: On average, the government can potentially expect to mobilise an additional Rs. 1,047,470,000 (USD 27,565,000) from taxpayers to spend on enhancing pandemic preparedness in Mauritius. To increase willingness to pay for enhanced pandemic preparedness, the government can focus on improving knowledge on a pandemic, perceived response efficacy and awareness on need and responsibility of paying.
33.	Johansson, Kjell, 1956-, et al. (författare) Factors influencing GPs' decisions regarding screening for high alcohol consumption : a focus group study in Swedish primary care 2005 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 119:9, s. 781-788 Tidskriftsartikel (refereegranskat)abstract Objective The aim of this study was to explore factors that influence general practitioners' (GPs') decisions regarding screening for high alcohol consumption.Methods GPs working at three primary healthcare centres in Sweden participated in focus group interviews. The interviews were recorded and transcribed verbatim, and a deductive framework approach was used for the analysis.Results The majority of the participating GPs did not believe in asking all patients about their alcohol consumption. Reported factors that influenced how many and which patients were questioned about alcohol consumption were time, age of the patient, consultation setting, patient–physician relationship, what symptoms the patient presented with, and knowledge of measures if patients appear to have a high alcohol consumption. Thus, alcohol screening and intervention were not performed in all patient groups as was originally intended, but were performed in limited groups of patients such as those with alcohol-related symptoms.Conclusions Although the number of participants in this study was small and the conclusions cannot be generalized, the results provide some valuable insights into why GPs are hesitant to engage in screening for high alcohol consumption. Since prevention of alcohol-related health problems is an important public health issue, many different screening and intervention strategies have to be formulated and evaluated in order to reach patients with both hazardous and harmful alcohol consumption within the healthcare system. Screening all consecutive patients for a limited period or screening patient groups known to include a fairly high frequency of high alcohol consumers are two ways of limiting the time requirements and increasing role legitimacy. Still, there is a need for a broader public health strategy involving many players in the community in alcohol preventive measures, especially in more primary preventive approaches.
34.	Kaarme, Johan, 1973-, et al. (författare) Reassuringly low carriage of enteropathogens among healthy Swedish children in day care centres 2016 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 140, s. 221-227 Tidskriftsartikel (refereegranskat)abstract Objectives: Infectious gastroenteritis is one of the most common diseases among children and has a considerable impact on health and socio-economy. Day care centres are highrisk environments for infections. The aim of this study was to investigate if asymptomatic preschool children constitute a reservoir for potential enteropathogens. Study design: In total, 438 individual diapers were collected from day care centres in Uppsala, Sweden, during spring and autumn, and molecular techniques were used to estimate the prevalence of asymptomatic carriage of multiple enteropathogens. Methods: Faecal samples were analysed with multiplex polymerase chain reaction (PCR) (xTAG® Gastrointestinal Pathogen Panel; Luminex Corporation, Toronto, Canada) targeting 21 different pathogens. Samples with a median fluorescence intensity above threshold were re-analysed with a second PCR assay. Results: Sixteen of the 438 samples were positive for enteropathogens, 1.6% for enteric adenovirus, 0.7% for Campylobacter spp., and 0.7% for norovirus. Conclusions: Preschool children in Uppsala constitute a limited reservoir for potential enteropathogens
35.	Kallin, Kristina, et al. (författare) Predisposing and precipitating factors for falls among older people in residential care 2002 Ingår i: Public Health. - 0033-3506 .- 1476-5616. ; 116:5, s. 263-271 Tidskriftsartikel (refereegranskat)abstract Falls and their consequences are serious health problems among older populations. To study predisposing and precipitating factors for falls among older people in residential care we used a cross-sectional study design with a prospective follow up for falls. Fifty-eight women and 25 men, with a mean age of 79.6 y, were included and prospectively followed up regarding falls for a period of 1 y after baseline assessments. All those who fell were assessed regarding factors that might have precipitated the fall. The incidence rate was 2.29 falls/person years. Antidepressants (selective serotonin reuptake inhibitors, SSRIs), impaired vision and being unable to use stairs without assistance were independently associated with being a 'faller'. Twenty-eight (53.8%) of the fallers suffered injuries as a result of their falls, including 21 fractures. Twenty-seven percent of the falls were judged to be precipitated by an acute illness or disease and 8.6% by a side effect of a drug. Acute symptoms of diseases or drug side effects were associated with 58% of the falls which resulted in fractures. We conclude that SSRIs seem to constitute one important factor that predisposes older people to fall, once or repeatedly. Since acute illnesses and drug side-effects were important precipitating factors, falls should be regarded as a possible symptom of disease or a side-effect of a drug until it is proven otherwise.
36.	Karim, F, et al. (författare) Community perceptions of tuberculosis: A qualitative exploration from a gender perspective 2011 Ingår i: Public health. - : Elsevier BV. - 1476-5616 .- 0033-3506. ; 125:2, s. 84-89 Tidskriftsartikel (refereegranskat)
37.	Konlaan, Boinkum Benson, et al. (författare) Leisure time activity as a determinant of survival : a 26-year follow-up of a Swedish cohort 2002 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 116:4, s. 227-230 Tidskriftsartikel (refereegranskat)abstract An individual's leisure time (pastime) engagements are in a way important for society. Irrespective of whether leisure time activities are causal determinants of health or health is a prerequisite for taking full part in society, the interaction is a challenge for Public Health. The first question is whether the sum of their influence results in coherence between enjoying good health and having leisure time activity. The aim of this study was to estimate their covariance. A random sample was drawn from the adult population of Stockholm County, Sweden. The residents were mailed a questionnaire regarding their social circumstances, their health complaints, the social repercussions of the complaints, and if they had any leisure time activity. Altogether, 7252 (about 93%) individuals responding to the questionnaire constituted our cohort, The individuals aged 18-65 y in November 1969 were followed up to the age of 65 y, or to 1996 as to mortality. The main outcome measure was mortality irrespective of cause of death. More than two-thirds of the respondents (71%) reported that they had some leisure time activity. Leisure time activity was a determinant of survival in the statistical sense. The risk ratio was 0.77 and its 95% confidence interval was 0.68-0.87 for those reporting leisure time activity when age, sex, baseline health and baseline alcohol consumption was discounted. The conclusion was that having leisure time activity, unspecified, covaried with health. Further studies should specify the pastime activities.
38.	Laine, MK, et al. (författare) Short primiparous women are at an increased risk for gestational diabetes mellitus 2018 Ingår i: Public health. - : Elsevier BV. - 1476-5616 .- 0033-3506. ; 156, s. 101-108 Tidskriftsartikel (refereegranskat)
39.	Lazarus, Jeffrey, et al. (författare) A multilevel analysis of condom use among adolescents in the European Union. 2009 Ingår i: Public Health. - : Elsevier BV. - 1476-5616 .- 0033-3506. ; 123, s. 138-144 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: This study examined which individual and national factors affect condom use among adolescents. STUDY DESIGN: Multilevel analysis. METHODS: This study reviewed the data on bullying, alcohol use and condom use provided by 18 European countries and subnational entities in the Health Behaviour in School-Aged Children survey. Another eight contextual variables were also analysed. Three multilevel logistic regression models were applied consecutively (analysing for crude geographical and school variance in condom use, adjusting for gender and adjusting all variables for one another). RESULTS: Among the 15-year-olds studied, 7.0% of the total variance in condom use was explained by school-related factors (intraschool-level correlation) and 5.8% by national/subnational factors. In the empty model, condom use was significantly associated with gender, alcohol consumption, predominant national religion and national prevalence of human immunodeficiency virus (HIV). In the full model, there was also a significant association with the Human Development Index ranking, gross domestic product, Gini coefficient and the Gender-related Development Index. CONCLUSIONS: This study suggests that while alcohol, gender, human development level, income, religion and HIV prevalence affect condom use in young Europeans, these factors do not explain all or even most of the variation. Nonetheless, since some of these factors are not traditionally associated with young people's sexual and reproductive health, these findings should enable more nuanced health policy programming.
40.	Lindqvist, Kent, 1948-, et al. (författare) A cost-benefit analysis of the community-based injury prevention programme in Motala, Sweden—a WHO Safe Community 2001 Ingår i: Public Health. - 0033-3506 .- 1476-5616. ; 115:5, s. 317-322 Tidskriftsartikel (refereegranskat)abstract The objective in this study was to calculate costs and benefits caused by a safe community injury prevention programme in Motala, Sweden. The study design was a quasi-experimental evaluation involving an intervention population and a non-random control population. All injuries were recorded before and after an intervention programme. The presented calculations show that costs of injuries in a societal perspective decreased from 116 million Swedish Crowns (SEK) to 96 million SEK, while the cost for the intervention was estimated at approximately 10 million SEK. Thus, the safe community injury prevention programme in Motala should be judged as cost-effective.
41.	Lindqvist, Kent, 1948-, et al. (författare) Evaluation of an inter-organizational prevention program against injuries among the elderly in a WHO Safe Community 2001 Ingår i: Public Health. - 0033-3506 .- 1476-5616. ; 115:5, s. 308-316 Tidskriftsartikel (refereegranskat)abstract The aim of the study was to evaluate the outcome of a participatory community-based prevention program against injuries among the elderly. A population-based quasi-experimental design was used with pre- and post-implementation measurements in an intervention and a control area. The program was based on cross-sectoral participation in detecting and taking action against injuries among the elderly. Change in the relative risk of injury was estimated by the odds ratio. Morbidity in moderately (AIS 2) severe injury in the study area was reduced from 46 per 1000 population years to 25 per 1000 population years (odds ratio 0.55, 95% confidence interval 0.46-0.65), while the minor (AIS 1) injuries increased (odds ratio 1.55, 95% confidence interval 1.21-1.91). The risk of severe or fatal (AIS 3-6) injuries remained constant. In the study area, only a slight decrease in the total morbidity rate was observed (odds ratio 0.87, 95% confidence interval 0.77-0.99). In the control area, there was no evident change in the total morbidity rates. Falls decreased or showed a tendency to decrease in the age groups 65 to 79-y-old in the study area, while they increased in the older age group. The results indicate that no sharp boundaries should be drawn between safety education, physical conditioning, environmental adjustments and secondary prevention measures when planning safety promotion among the elderly. Future studies should address these issues along with the methodological complexity associated with assessment of participatory community-based safety promotion programs.
42.	Lindström, M., et al. (författare) Economic stress in childhood and suicide thoughts and suicide attempts : a population-based study among adults 2018 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 163, s. 42-45 Tidskriftsartikel (refereegranskat)abstract Objectives: To investigate associations between economic stress in childhood and suicide thoughts and attempts. Study design: The 2012 public health survey in Scania, Sweden, is a cross-sectional postal questionnaire study including 28,029 participants, aged 18–80 years. Methods: Associations were analyzed in logistic regressions. Results: A 12.1% prevalence of men and 15.5% of women had ever experienced suicide thoughts, while 3.2% of men and 5.3% of women had experienced suicide attempt. Roughly 24% had experienced less severe and 8% severe economic problems in childhood. Significant associations between economic stress in childhood and suicide thoughts and attempts remained throughout the age-adjusted and multiple adjusted analyses. Conclusions: Economic stress in childhood is associated with self-reported suicide thoughts and suicide attempts in an adult general population.
43.	Lindström, Martin, et al. (författare) Marital status, social capital and health locus of control: A population-based study. 2012 Ingår i: Public Health. - : Elsevier BV. - 1476-5616 .- 0033-3506. ; 126:9, s. 790-795 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: To investigate the association between marital status and lack of internal health locus of control (HLC), taking economic stress and trust into account. STUDY DESIGN: Cross-sectional study. METHODS: The public health survey Skåne 2008 is a postal questionnaire study (55% participation rate). A random sample was invited to participate, and 28,198 individuals aged 18-80 years agreed. Logistic regression models were used to discern associations between marital status and lack of internal HLC. The multiple regression analyses included age, country of birth, education, economic stress and 'horizontal' trust. RESULTS: In total, 33.7% of the men and 31.8% of the women lacked internal HLC. After age-adjustments, the unmarried and divorced men and the widowed women displayed significantly higher odds ratios of lack of internal HLC. The significantly higher odds ratios only remained for unmarried men throughout the multiple analyses. In contrast, divorced women had significantly lower odds ratios of lack of internal HLC than married women after adjustments for economic stress. CONCLUSIONS: Health promotion regarding HLC and related behaviours should consider men and women who are not cohabiting. Health promotion should particularly consider unmarried men due to their higher propensity to lack internal HLC. The economic conditions and exposure to economic stress among widowed and divorced women should also be highlighted.
44.	Lindström, Martin (författare) Social capital, desire to increase physical activity and leisure-time physical activity: A population-based study. 2011 Ingår i: Public Health. - : Elsevier BV. - 1476-5616 .- 0033-3506. ; 125:7, s. 442-447 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: To investigate the associations between social capital (trust) and leisure-time physical activity. STUDY DESIGN: The 2004 Public Health Survey in Skåne is a cross-sectional study. METHODS: In total, 27,757 individuals aged 18-80 years answered a postal questionnaire (59% participation). Logistic regression models were used to investigate the associations between trust, desire to increase physical activity and leisure-time physical activity. RESULTS: The prevalence of low leisure-time physical activity was 15.3% among men and 13.2% among women. Middle-aged men and older women, respondents born abroad, those with medium/low education, those with the desire to increase physical activity but needing support, and those reporting low trust had significantly higher odds ratios of low leisure-time physical activity than their respective reference groups. The associations between low trust and desire to increase physical activity and between low trust and low leisure-time physical activity remained in the multiple models. CONCLUSIONS: The positive association between low trust and low leisure-time physical activity remained after multiple adjustments. There is a concentration of men and women with low leisure-time physical activity who report the desire to increase their physical activity but think that they need support to do so. This group also has a significantly higher prevalence of low trust.
45.	Lindström, Martin (författare) Social capital, economic conditions, marital status and daily smoking: a population-based study. 2010 Ingår i: Public Health. - : Elsevier BV. - 1476-5616 .- 0033-3506. ; 124:2, s. 71-77 Tidskriftsartikel (refereegranskat)abstract OBJECTIVE: To investigate the association between marital status and daily smoking, adjusting for economic conditions and trust. STUDY DESIGN: Cross-sectional study. METHODS: In total, 27,757 individuals aged 18-80 years answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model was used to investigate the association between marital status and daily smoking, adjusting for economic (material) conditions and trust. A multivariate analysis was performed to investigate the importance of possible confounders concerning the differences in daily smoking according to marital status. RESULTS: Smoking prevalence was 14.9% among men and 18.1% among women. The odds ratios of daily smoking for middle-aged respondents, born abroad, medium/low education, problems paying bills, low trust, and unmarried and (particularly) divorced respondents were significantly higher than those for their reference groups. Low trust was significantly higher among divorced and unmarried respondents compared with married/cohabitating respondents. Adjustment for economic conditions reduced the odds ratios of daily smoking among divorced subjects; this was not seen following adjustment for trust. CONCLUSIONS: Never-married subjects and (particularly) divorced subjects showed a significantly higher prevalence of daily smoking than married/cohabitating respondents. Economic conditions have a significant effect on the association between marital status and daily smoking, but this was not seen for trust.
46.	Lindström, Martin (författare) Social capital, political trust and daily smoking and smoking cessation: A population-based study in southern Sweden. 2009 Ingår i: Public Health. - : Elsevier BV. - 1476-5616 .- 0033-3506. ; 123:7, s. 496-501 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: To investigate the associations between vertical (institutional) political trust in the Riksdag and daily smoking and smoking cessation. STUDY DESIGN: Cross-sectional study. METHODS: In total, 27,757 individuals 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 political trust in the Riksdag and daily smoking and smoking cessation. A multivariate analysis was performed to investigate the importance of possible confounders on the differences in daily smoking and smoking cessation according to political trust. RESULTS: In total, 14.9% of the men and 18.1% of the women were daily smokers. Middle-aged respondents were significantly more likely to be daily smokers than the young. The proportion of ever smokers who had quit smoking increased with age. Respondents with low generalized trust in other people [odds ratio (OR) 1.6, 95% confidence interval (CI) 1.5-1.8 among men; OR 1.7, 95% CI 1.5-1.8 among women] and not high political trust/no political trust at all (OR 1.6, 95% CI 1.4-1.8 among men; OR 1.8, 95% CI 1.6-2.0 among women) had significantly higher ORs of daily smoking. Men and women with not particularly high political trust/no political trust at all and no opinion of the Riksdag had significantly lower ORs of smoking cessation than people with very high/high political trust. These associations remained significant after multiple adjustments. CONCLUSIONS: The results suggest that political trust is independently associated with both daily smoking and smoking cessation.
47.	Lundin, A., et al. (författare) Unemployment and suicide in the Stockholm population : A register-based study on 771,068 men and women 2012 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 126:5, s. 371-377 Tidskriftsartikel (refereegranskat)abstract Objectives: Several studies have reported a higher risk of suicide among the unemployed. Some individuals may be more prone to both unemployment and suicide due to an underlying health-related factor. In that case, suicide among the unemployed might be a consequence of health-related selection. This study aimed to investigate the relationship between unemployment and suicide, and the importance of previous sickness absence to this relationship. Study design: The study was based on 771,068 adults aged 25-58 years in Stockholm County in 1990-1991. Data on sickness absence in 1990-1991 and unemployment in 1991-1993 were collected from registers for each individual. Time and cause of death in 1994-1995 were obtained from Sweden's Cause of Death Register. Methods: The association between sickness absence in 1990-1991 and unemployment in 1992-1993, and the association between unemployment in 1992-1993 and suicide in 1994-1995 was investigated using logistic regression. Results: Unemployment lasting for >90 days in 1992-1993 was associated with suicide in men in 1994-1995 [odds ratio (OR) 2.16, 95% confidence interval (CI) 1.38-3.38], while unemployment lasting for <= 90 days in 1992-1993 was associated with suicide in women in 1994-1995 (OR 2.68, 95% CI 1.23-5.85). Higher levels of sickness absence were related to an increased risk of subsequent unemployment in both sexes. The higher prevalence of sickness absence among the unemployed attenuated the association between unemployment and suicide in both men and women. Conclusions: Unemployment is related to suicide. Individuals in poor health are at increased risk of unemployment and also suicide. The higher relative risk of suicide among the unemployed seems to be, in part, a consequence of exclusion of less healthy individuals from the labour market.
48.	Lundin, A., et al. (författare) Validity of the 12-item version of the General Health Questionnaire in detecting depression in the general population 2016 Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 136, s. 66-74 Tidskriftsartikel (refereegranskat)abstract Objectives: The 12-item version of the General Health Questionnaire (GHQ-12) is frequently used to measure common mental disorder in public health surveys, but few population-based validations have been made. We validated the GHQ-12 against structured psychiatric interviews of depression using a population-based cohort in Stockholm, Sweden. Methods: We used a population-based cohort of 484 individuals in Stockholm, Sweden (participation rate 62%). All completed the GHQ-12 and a semi-structured psychiatric interview. Last month DSM-III-R symptoms were used to classify major and minor depression. Three scoring methods for GHQ-12 were assessed, the Standard, Likert and Corrected method. Discriminatory ability was assessed with area under the receiver operating characteristic (ROC) curve. Results: A total of 9.5% had a major or minor depression. The area under the ROC curve was for the Standard method 0.73 (0.65-0.82), the Likert method 0.80 (0.72-0.87) and the Corrected method 0.80 (0.73-0.87) when using major or minor depression as standard criterion. Adequate sensitivity and specificity for separating those with or without a depressive disorder was reached at >12 Likert scored points (80.4 and 69.6%) or >6 Corrected GHQ points (78.3 and 73.7%). Sensitivity and specificity was at >= 2 Standard scored points 67.4% and 74.2%. Conclusion: When scored using the Likert and Corrected methods, the GHQ-12 performed excellently. When scored using the Standard method, performance was acceptable in detecting depressive disorder in the general population. The GHQ-12 appears to be a good proxy for depressive disorder when used in public health surveys.
49.	Majidi, A, et al. (författare) Cancer research priorities and gaps in Iran: the influence of cancer burden on cancer research outputs between 1997 and 2014 2017 Ingår i: Public health. - : Elsevier BV. - 1476-5616 .- 0033-3506. ; 144, s. 42-47 Tidskriftsartikel (refereegranskat)
50.	Makenzius, Marlene, et al. (författare) Health disparities based on neighbourhood and social conditions : Open Comparisons-an indicator-based comparative study in Sweden 2019 Ingår i: Public Health. - 0033-3506 .- 1476-5616. ; 174, s. 97-101 Tidskriftsartikel (refereegranskat)abstract OBJECTIVE: The overarching goal of the Swedish public health policy is to create the right societal conditions for good and equitable health throughout the population and to reduce avoidable health inequalities within a generation. The objective of this article is to highlight the main findings of the Open Comparisons in Public Health (OCPH) 2019 study. STUDY DESIGN: The OCPH is a longitudinal indicator-based comparative study, encompassing 39 public health indicators with results from Sweden's 21 regions and 290 municipalities. METHODS: Descriptive statistics and 95% confidence intervals were used to compare results between municipalities, regions and time points. Correlation analysis was used to study the strength of the relationship between the results of municipalities and their socio-economic conditions. RESULTS: Across the population, levels of health are good and have, in some areas, improved over recent decades. However, some significant health disparities remain according to neighbourhood, sex, age and educational background. Health disparities related to the level of education are often larger than those between women and men, and there are larger differences within a region than between regions. Health disparities have, in some cases, increased, such as for life expectancy. CONCLUSION: If health equity is to be achieved, leaders at all levels must collaborate and advocate for political action and local efficient public health interventions to eliminate health disparities as a result of neighbourhood and social conditions.

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