| 1. |
- Bruckner, Tim .A., et al.
(författare)
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Cold ambient temperature in utero and birth outcomes in Uppsala, Sweden, 1915 to 1929
- 2014
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Ingår i: Annals of Epidemiology. - : Elsevier BV. - 1047-2797 .- 1873-2585. ; 24:2, s. 116-121
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Tidskriftsartikel (refereegranskat)abstract
- PurposeAlthough the literature reports adverse birth outcomes following ambient heat, less work focuses on cold. We, moreover, know of no studies of cold that examine stillbirth. We tested the relation between cold ambient temperature during pregnancy in Sweden and four outcomes: stillbirth, preterm, birth weight for gestational age, and birth length. We examined births from 1915 to 1929 in Uppsala, Sweden, which—unlike most societies today—experienced substandard indoor-heating and fewer amenities to provide shelter from cold.MethodsWe retrieved data on almost 14,000 deliveries from the Uppsala Birth Cohort Study. We linked a validated, daily ambient temperature series to all pregnancies and applied Cox proportional hazards (stillbirth and preterm) and linear regression models (birth weight and length). We tested for nonlinearity using quadratic splines.ResultsThe risk of stillbirth rose as ambient temperature during pregnancy fell (hazard ratio for a 1°C decrease in temperature, 1.08; 95% confidence interval, 1.00 to 1.17). Cold extremes adversely affected preterm and birth length, whereas warm extremes increased preterm risk. We observed no relation between cold and birth weight for gestational age.ConclusionIn historical Sweden, cold temperatures during pregnancy increased stillbirth and preterm risk and reduced birth length among live births.
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| 2. |
- Carlsson, Sofia, et al.
(författare)
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Late retirement is not associated with increased mortality, results based on all Swedish retirements 1991-2007
- 2012
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 27:6, s. 483-486
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In their recent paper based on German old-age pensioners, Kühntopf and Tivig [1] show that early retirement is associated with considerably higher mortality in men. This is in line with previous reports from British, Danish, US, German and Greek populations showing an increased mortality risk related to retirement, especially in the case of early retirement [2–6]. As pointed out by Kühntopf and Tivig, interpretation of these results is complicated, since a “Healthy worker selection effect” may be operating. To reduce this bias, they used information on credited periods of disease in the public insurance system [1]. Other strategies include adjustment for baseline medical problems [2, 6], using a time lag during follow up [5] or exclusion of subjects retiring for health reasons [3, 4]. It is however questionable, whether these strategies have been sufficient to eliminate the effect of health on retirement.
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| 3. |
- Fors, Stefan, et al.
(författare)
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Socioeconomic inequalities in circulatory and all-cause mortality after retirement : the impact of mid-life income and old-age pension. Evidence from the Uppsala Birth Cohort Study
- 2012
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 66:7, s. e16-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to explore the impact of mid-life income and old-age pensions on the risk of mortality in later life. Furthermore, the study explored whether income inequalities in old-age mortality can be explained by differences in early childhood development, social class during childhood, education or marital status.Methods: The study sample comprises all individuals born at Uppsala Academic Hospital during the period 1915–1924 who had retired but not died or emigrated by 1991 (n=4156). Information on social and biological conditions was retrieved from national registries.Results: The results show that income during mid-life and income during retirement were associated with old-age mortality. However, mutually adjusted models showed that income in mid-life was more important for women's late-life mortality and that income during retirement was more important for men's late-life mortality. Furthermore, differences in education and marital status seemed to explain a substantial part of income inequalities in late-life mortality.Conclusions: It is unlikely that egalitarian social policies aimed at older populations can eradicate health inequalities accumulated over the life course. However, retirement income appears to have an effect on late-life mortality that is independent of the effect of income in mid-life, suggesting that egalitarian pension schemes could affect health inequalities in later life or, at the very least, slow down further accumulation of inequalities.
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| 4. |
- Garcy, Anthony M., et al.
(författare)
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The length of unemployment predicts mortality, differently in men and women, and by cause of death : A six year mortality follow-up of the Swedish 1992-1996 recession
- 2012
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Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 74:12, s. 1911-1920
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Tidskriftsartikel (refereegranskat)abstract
- This study examines the relationship between the total amount of accumulated unemployment during the deep Swedish recession of 1992-1996 and mortality in the following 6 years. Nearly 3.4 million Swedish men and women, born between 1931 and 1965 who were gainfully employed at the time of the 1990 census were included. Almost 23% of these individuals were unemployed at some point during the recession. We conduct a prospective cohort study utilizing Cox proportional hazard regression with a mortality follow-up from January 1997 to December 2002. We adjust for health status (1982-1991), baseline (1991) social, family, and employer characteristics of individuals before the recession. The findings suggest that long-term unemployment is related to elevated all-cause mortality for men and women. The excess mortality effects were small for women and attributable to a positive, linear increase in the hazard of alcohol disease-related mortality and external causes-of-death not classified as suicides or transport accidents. For men, the excess hazard of all-cause mortality was best represented by a cubic, non-linear shape. The predicted hazard increases rapidly with the shortest and longest accumulated levels of unemployment. However, the underlying pattern differed by cause-of-death. The cancer, circulatory, and alcohol disease-related analyses suggest that mortality peaks with mid-levels of accumulated unemployment and then declines with longer duration unemployment. For men, we observed a positive, linear increase in the hazard ratios associated with transport and suicide mortality, and a very steep non-linear increase in the excess hazard ratio associated with other external causes of death that were not classified as suicide or transport accidents. In conclusion, mortality risk increases with the duration of unemployment among men and women. This was best described by a cubic function for men and a linear function for women. Behind this pattern, different causes-of-death varied in their relation to the accumulation of unemployment.
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| 5. |
- Garcy, Anthony M., et al.
(författare)
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Unemployment and suicide during and after a deep recession : a longitudinal study of 3.4 million Swedish men and women
- 2013
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Ingår i: American Journal of Public Health. - 0090-0036 .- 1541-0048. ; 103:6, s. 1031-1038
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. We tested 2 hypotheses found in studies of the relationship between suicide and unemployment: causal (stress and adversity) and selective interpretation (previous poor health).Methods. We estimated Cox models for adults (n = 3 424 550) born between 1931 and 1965. We examined mortality during the recession (1993–1996), postrecession (1997–2002), and a combined follow-up. Models controlled for previous medical problems, and social, family, and employer characteristics.Results. During the recession there was no excess hazard of mortality from suicide or events of undetermined intent. Postrecession, there was an excess hazard of suicide mortality for unemployed men but not unemployed women. However, for unemployed women with no health-problem history there was a modest hazard of suicide. Finally, there was elevated mortality from events of undetermined intent for unemployed men and women postrecession.Conclusions. A small part of the relationship may be related to health selection, more so during the recession. However, postrecessionary period findings suggest that much of the association could be causal. A narrow focus on suicide mortality may understate the mortality effects of unemployment in Sweden.
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| 6. |
- Helgertz, Jonas, et al.
(författare)
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Small for gestational age and adulthood risk of disability pension : the contribution of childhood and adulthood conditions
- 2014
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Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 119, s. 249-257
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Tidskriftsartikel (refereegranskat)abstract
- Early exiting from the labor force and into disability pension (DP) represents a major social problem in Sweden and elsewhere. We examined how being asymmetric (A-SGA) or symmetric (S-SGA) small for gestational age predicts transitioning into DP. We analyzed a longitudinal sample of 8125 men and women from the Stockholm Birth Cohort (SBC), born in 1953 and not on DP in 1990. The SBC consists of data from various sources, including self-reported information and data from administrative registers. The follow-up period was from 1991 to 2009. Yearly information on the receipt of DP benefits from register data was operationalized as a dichotomous variable. 13 percent of the sample moved into DP during follow-up. Cox proportional hazards regression was used to examine whether disadvantageous fetal growth - A-SGA and S-SGA - predicted DP. Men and women born A-SGA had a substantially increased hazard of DP. The full model suggested a hazard ratio of 1.68 (CI: 1.11-2.54), only being affected slightly by adulthood conditions. Several childhood conditions were also associated with DP. Such factors, however, mainly affected DP risk through adulthood conditions. The effect of SGA on DP appeared particularly strong among individuals from socioeconomically disadvantaged backgrounds. The evidence presented suggests that being A-SGA influences the risk of DP, independent of childhood and adulthood conditions, and similarly for men and women. Due to A-SGA being rather infrequent, reducing the occurrence of A-SGA would, however, only have a marginal impact on the stock of DP pensioners. For the individual affected, the elevation in the risk of DP was nevertheless substantial. Other childhood conditions exercised a larger influence on the stock of DP recipients, but they mostly operated through adulthood attainment. The importance of socioeconomic resources in childhood for the long term health consequences of SGA is interesting from a policy perspective and warrants further research.
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| 7. |
- Jasilionis, Domantas, et al.
(författare)
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L’avant-garde en matière d’espérance de vie montre-t-elle la voie au reste de la population?
- 2014
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Ingår i: Population. - : CAIRN. - 0032-4663 .- 1957-7966. ; 69:4, s. 589-615
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Tidskriftsartikel (refereegranskat)abstract
- Do vanguard populations open new frontiers of survival and longevity that will eventually be reached by others? The main aim of this study is to identify the extent to which the non-vanguard populations in Finland, Norway, and Sweden might follow the mortality trajectories of the vanguard groups in these countries for different age ranges and for the major causes of death. The results show no systematic convergence between vanguard and non-vanguard sub-populations. On the contrary, they confirm the theory whereby each major epidemiological development initially gives rise to divergence in mortality trends. Our study found that at the sub-national level, rather than simply following (with a certain time lag) the same path as the vanguard groups, non-vanguard groups have their own pathways to low mortality which are related to specific determinants of mortality change. The study also found that a long time is needed for the non-vanguard group to attain the mortality levels already reached by the vanguard group at the start of the observation period. This is notably the case for the treatment and prevention of cardiovascular diseases.
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| 8. |
- Khanolkar, Amal, et al.
(författare)
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Social determinants of cardiac disease biomarkers : Investigating a Swedish male cohort at ages 50 and 70
- 2012
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Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 19:3, s. 523-533
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate relationships between socioeconomic position (SEP) and common CVD biomarkers including adiponectin not previously investigated in a Swedish-population sample, and to assess if these associations changed with age. Design: Population-based longitudinal cohort study of men born 1920-24 with clinical measurements, blood samples, questionnaire data, and register-based information on SEP and cause of death. Methods: A total of 2322 men attended an investigation at age 50 of which 1221 attended a reinvestigation at age 70. Association between SEP and CVD biomarkers [cholesterol, low-density lipoprotein/high-density lipoprotein (LDL/HDL), apolipoprotein (Apo) ApoB/ApoA1, and adiponectin] were analysed by linear regression (adjusted for age, body mass index, and physical activity). SEP was measured as occupational class and educational level. CVD mortality over 36 years of follow-up was analysed by Cox regression. Results: At age 50, we found a significant inverse association of education with cholesterol level, LDL/HDL ratio and ApoB/ApoA1 ratio. Cholesterol was also associated with occupational class, statistically significant after adjustment for all covariates. At age 70, no significant associations were found between either measurement of SEP and any of the biomarkers studied. Highest educated men had decreased risk for CVD mortality during follow-up. Conclusions: Associations of SEP with cholesterol levels and LDL/HDL ratio that exist at age 50 are no longer apparent in the same group of men at age 70. We found no significant association between SEP and adiponectin levels at age 70.
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| 9. |
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| 10. |
- Lager, Anton, et al.
(författare)
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Social origin, schooling and individual change in intelligence during childhood influence long-term mortality : a 68-year follow-up study
- 2011
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Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 41:2, s. 398-404
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Tidskriftsartikel (refereegranskat)abstract
- Background Intelligence at a single time-point has been linked to health outcomes. An individual's IQ increases with longer schooling, but the validity of such increase is unclear. In this study, we assess the hypothesis that individual change in the performance on IQ tests between ages 10 and 20 years is associated with mortality later in life.Methods The analyses are based on a cohort of Swedish boys born in 1928 (n = 610) for whom social background data were collected in 1937, IQ tests were carried out in 1938 and 1948 and own education and mortality were recorded up to 2006. Structural equation models were used to estimate the extent to which two latent intelligence scores, at ages 10 and 20 years, manifested by results on the IQ tests, are related to paternal and own education, and how all these variables are linked to all-cause mortality.Results Intelligence at the age of 20 years was associated with lower mortality in adulthood, after controlling for intelligence at the age of 10 years. The increases in intelligence partly mediated the link between longer schooling and lower mortality. Social background differences in adult intelligence (and consequently in mortality) were partly explained by the tendency for sons of more educated fathers to receive longer schooling, even when initial intelligence levels had been accounted for.Conclusions The results are consistent with a causal link from change in intelligence to mortality, and further, that schooling-induced changes in IQ scores are true and bring about lasting changes in intelligence. In addition, if both these interpretations are correct, social differences in access to longer schooling have consequences for social differences in both adult intelligence and adult health.
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