| 1. |
- Fritzell, Johan, et al.
(författare)
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Absolute or relative? A comparative analysis of the relationship between poverty and mortality
- 2015
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Ingår i: International Journal of Public Health. - : Springer Science and Business Media LLC. - 1661-8556 .- 1661-8564. ; 60:1, s. 101-110
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to examine the cross-national and cross-temporal association between poverty and mortality, in particular differentiating the impact of absolute and relative poverty. We employed pooled cross-sectional time series analysis. Our measure of relative poverty was based upon the standard 60 % of median income. The measure of absolute, or fixed, poverty was based upon the US poverty threshold. Our analyses were conducted on data for 30 countries between 1978 and 2010, a total of 149 data points. We separately studied infant, child, and adult mortality. Our findings highlight the importance of relative poverty for mortality. Especially for infant and child mortality, we found that our estimates of fixed poverty is close to zero either in the crude models, or when adjusting for gross domestic product. Conversely, the relative poverty estimates increased when adjusting for confounders. Our results seemed robust to a number of sensitivity tests. If we agree that risk of death is important, the public policy implication of our findings is that relative poverty, which has close associations to overall inequality, should be a major concern also among rich countries.
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| 2. |
- Mortensen, Laust H., et al.
(författare)
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Shape of the association between income and mortality : a cohort study of Denmark, Finland, Norway and Sweden in 1995 and 2003
- 2016
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 6:12
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Prior work has examined the shape of the income-mortality association, but work has not compared gradients between countries. In this study, we focus on changes over time in the shape of income-mortality gradients for 4 Nordic countries during a period of rising income inequality. Context and time differentials in shape imply that the relationship between income and mortality is not fixed. Setting: Population-based cohort study of Denmark, Finland, Norway and Sweden. Participants: We collected data on individuals aged 25 or more in 1995 (n=12.98 million individuals, 0.84 million deaths) and 2003 (n=13.08 million individuals, 0.90 million deaths). We then examined the household size equivalised disposable income at the baseline year in relation to the rate of mortality in the following 5 years. Results: A steep income gradient in mortality in men and women across all age groups except the oldest old in Denmark, Finland, Norway and Sweden. From the 1990s to 2000s mortality dropped, but generally more so in the upper part of the income distribution than in the lower part. As a consequence, the shape of the income gradient in mortality changed. The shift in the shape of the association was similar in all 4 countries. Conclusions: A non-linear gradient exists between income and mortality in most cases and because of a more rapid mortality decline among those with high income the income gradient has become steeper over time.
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| 3. |
- Rehnberg, Johan, et al.
(författare)
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Divergence and Convergence : How Do Income Inequalities in Mortality Change over the Life Course?
- 2019
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Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 65:3, s. 313-322
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Do inequalities in health by income increase or decrease with age? The empirical evidence is not conclusive and competing theories arrive at different conclusions.OBJECTIVE: This study examined inequality in mortality by income over the adult life course with longitudinal data on people aged 30-99 between the years 1990 and 2009. Each person was followed for 19 years.METHODS: We used Swedish total population data with 5,011,414 individual observations. We calculated the probability of having died for ages between 31 and 99. This approach to calculating death risk incorporates selective mortality during the follow-up period into the measure. Age and year standardized income positions were calculated for all individuals. Inequality was assessed by comparing the top 10% income group and the bottom 10% income group. Relative inequality was measured by risk ratios (RR) and absolute inequality by percentage point differences.RESULTS: The results showed that the highest relative income inequality in mortality was at age 56 for men (RR: 4.7) and at age 40 for women (RR: 4.1) with differing patterns across the younger age categories between the sexes. The highest absolute income inequality in mortality was found at age 78 for men (19% difference) and at age 89 for women (14% difference) with similar patterns for both sexes. Both measures of inequality decreased after the peak, with small or no inequalities above age 95. Income inequality in mortality remained in advanced age, with larger absolute inequalities in older ages and larger relative inequalities in younger ages.CONCLUSION: The results for absolute and relative measures of inequality differed substantially; this highlights the importance of discussing and making an active choice of inequality measure. To explain and understand the patterns of inequality in mortality over the adult life course, we conclude that the "age-as-leveler" and "cumulative disadvantage" theories are best applied to an absolute measure of inequality.
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| 4. |
- Rehnberg, Johan, 1986-
(författare)
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Inequalities in life and death : Income and mortality in an ageing population
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Income serves as an indicator of success relative to others, and provides individuals with resources that strengthen their capability to face challenges and benefit from opportunities. Out of all social determinants of health, income is one of the strongest predictors of health outcomes. The positive association between income and health in the working-age population is well established; those with higher income tend to have better health. Less is known about the association between income and health among older persons. Several studies have observed that in old age, health inequalities decrease and the relationship between income and health weakens. However, at what point in the ageing process the association starts to weaken, and to what extent, is debated.The ageing process highlights the need for several theoretical considerations in studies on income and health. Societies are stratified by age, as manifested through transitions in and out of education, work, and retirement. Moreover, the individual experience of the ageing process involves biological processes of decline. Many health problems, and particularly death, are uncommon events during most of adulthood. In old age, however, health decline becomes a normative experience, and in Sweden, more than 90 percent of all deaths occur among people aged 65 or older. The characteristics and magnitude of age-related changes in the association between income and mortality constitute one of the prime concerns in this thesis. I have used two contending perspectives to understand the empirical results: the cumulative (dis)advantage theory and the age-as-leveler hypothesis.In this thesis, I have investigated the association between income and mortality across ages, with a focus on later life. More specifically, I studied the shape and magnitude of the income-mortality association across the life course. Furthermore, I tested two potential mechanisms that may shape this association in old age: health decline and mortality selection. Overall, this thesis shows to what extent and in what ways the association between income and mortality is maintained in old ageThis thesis includes four empirical studies. Study I, II, and IV are based on data from Swedish national registers (n = 801,017 – 5,011,414). Study III used survey data (LNU and SWEOLD) linked with data from administrative registries (n = 2619). The results from Study I showed that the income-mortality association was curvilinear with diminishing returns of income in both mid-life and late-life. Study II showed that relative mortality inequalities in income decreased with age and absolute mortality inequalities in income increased with age up to age 85-90, after which the mortality inequalities decreased. The results from Study III showed that health decline partly explained the weakened income-mortality association among the oldest old. Finally, Study IV showed that selective mortality had a substantial impact on poverty rates in old age; poverty rates were consistently and substantially lower for those who survived than those who died. Furthermore, selective mortality had the largest influence on the surviving population when mortality rates were at their highest.
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| 5. |
- Rehnberg, Johan, et al.
(författare)
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The shape of the association between income and mortality in old age : A longitudinal Swedish national register study
- 2016
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Ingår i: SSM - Population Health. - : Elsevier BV. - 2352-8273. ; 2, s. 750-756
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Tidskriftsartikel (refereegranskat)abstract
- This study used data on the total population to examine the longitudinal association between midlife income and mortality and late-life income and mortality in an aging Swedish cohort. We specifically examined the shape of the associations between income and mortality with focus on where in the income distribution that higher incomes began to provide diminishing returns. The study is based on a total Swedish population cohort between the ages of 50 and 60 years in 1990 (n=801,017) followed in registers for up to 19 years. We measured equivalent disposable household income in 1990 and 2005 and mortality between 2006 and 2009. Cox proportional hazard models with penalized splines (P-spline) enabled us to examine for non-linearity in the relationship between income and mortality. The results showed a clear non-linear association. The shape of the association between midlife (ages 50-60) income and mortality was curvilinear; returns diminished as income increased. The shape of the association between late-life (ages 65-75) income and mortality was also curvilinear; returns diminished as income increased. The association between late-life income and mortality remained after controlling for midlife income. In summary, the results indicated that a non-linear association between income and mortality is maintained into old age, in which higher incomes give diminishing returns.
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| 6. |
- Tarkiainen, Lasse, et al.
(författare)
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Income trajectories prior to alcohol-attributable death in Finland and Sweden
- 2019
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Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 114:5, s. 807-814
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Mortality from alcohol-attributable causes is patterned by income. We study analysed the income trajectories 17-19 years prior to death in order to determine: 1) whether income levels and trajectories differ between those who die of alcohol-attributable causes, survivors with similar sociodemographic characteristics, all survivors and those dying of other causes; 2) whether the income trajectories of these groups differ by education; and 3) whether there are differences in income trajectories between Finland and Sweden - two countries with differing levels of alcohol-attributable mortality but similar welfare-provision systems.DESIGN: Retrospective cohort study using individual-level longitudinal register data including information on income, cause of death and socioeconomic position.SETTING: Finland and Sweden Participants: The subjects comprised an 11-percent sample of the Finnish population in 2006-07 and the total population of Sweden aged 45-64 in 2007-08.MEASUREMENTS: Median household income trajectories by educational group were calculated by cause of death and population alive during the respective years. Additionally, propensity score matching was used to match the surviving population to those dying from alcohol-attributable causes with regard to sociodemographic characteristics.FINDINGS: The median income 17-19 years prior to death from alcohol-attributable causes was 92% (Finland) and 91% (Sweden) of survivor income: one year prior to death the respective figures were 47% and 57%. The trajectories differed substantially. Those dying of alcohol-attributable causes had lower and decreasing incomes for substantially longer periods than survivors and people dying from other causes. These differences were more modest among the highly educated. The baseline sociodemographic characteristics of those dying of alcohol causes did not explain the different trajectories.CONCLUSIONS: In Finland and Sweden, income appears to decline substantially before alcohol-attributable death. Highly educated individuals may be able to buffer the negative effects of extensive alcohol use on their income level. Income trajectories are similar in Finland and Sweden despite marked differences in the level of alcohol-attributable mortality.
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| 7. |
- Agahi, Neda, et al.
(författare)
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Smoking and Physical Inactivity as Predictors of Mobility Impairment During Late Life : Exploring Differential Vulnerability Across Education Level in Sweden
- 2018
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Ingår i: The journals of gerontology. Series B, Psychological sciences and social sciences. - : Oxford University Press (OUP). - 1079-5014 .- 1758-5368. ; 73:4, s. 675-683
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To test whether older adults from high and low educational groups are differentially vulnerable to the impact of smoking and physical inactivity on the progression of mobility impairment during old age.Methods: A nationally representative sample of older Swedish adults (n = 1,311), aged 57-76 years at baseline (1991), were followed for up to 23 years (2014). Multilevel regression was used to estimate individual trajectories of mobility impairment over the study period and to test for differences in the progression of mobility impairment on the basis of smoking status, physical activity status, and level of education.Results: Compared to nonsmokers, heavy smokers had higher levels and steeper increases in mobility impairment with advancing age. However, there were only small and statistically nonsignificant differences in the impact of heavy smoking on mobility impairment in high versus low education groups. A similar pattern of results was found for physical inactivity.Discussion: Differential vulnerability to unhealthy behaviors may vary across populations, age, time-periods, and health outcomes. In this study of older adults in Sweden, low and high education groups did not differ significantly in their associations between heavy smoking or physical inactivity, and the progression of mobility impairment.
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| 8. |
- Dahlberg, Lena, 1970-, et al.
(författare)
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Trends in social exclusion among older women and men in Sweden
- 2018
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Konferensbidrag (refereegranskat)abstract
- Background: Social exclusion is a framework for understanding the complexity of disadvantage across various domains of life such as material resources, social relations, civic activities and services. Reviews have identified a lack of gender perspective in social exclusion research. This paper will introduce the framework of social exclusion, and examine trends over time in the levels of social exclusion across different life domains for older women and men in Sweden.Methods: Data on indicators of social exclusion were analysed from respondents aged 76+ years who participated in the 1992, 2002 and 2011 waves of the nationally representative Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD).Results: There was evidence of a gender different in exclusion from material resources and civic activities, from which women were more often excluded than men. Regardless of gender there were improvements in access to material resources, such as owning a house/apartment. Social contacts (visiting or being visited by friends) decreased over time, while engagement in cultural activities and going to restaurants increased.Conclusions: Trends in social exclusion in older adults over the last 20 years are dependent on the domain considered. Over a range of indicators, older women were more vulnerable to exclusion than men, which needs to be taken into account in policy to combat exclusion.
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| 9. |
- Eyjólfsdóttir, Harpa S., et al.
(författare)
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Prolongation of working life and its effect on mortality and health in older adults : Propensity score matching
- 2019
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Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 226, s. 77-86
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Tidskriftsartikel (refereegranskat)abstract
- Many countries are raising the age of pension eligibility because of increases in life expectancy. Given the social gradient in life expectancy and health, it is important to understand the potential late-life health effects of prolonging working life and whether any effects differ by socioeconomic position. We examined the effect of prolonging working life beyond age 65 on mortality and a series of indicators of late-life physical health (the ability to climb stairs without difficulty, self-rated health, ADL limitations, and musculoskeletal pain) in a representative sample of the Swedish population. In addition to average effects, we also examined heterogeneous effects, for instance by occupational social class. To do this, we use propensity score matching, a method suitable for addressing causality in observational data. The data came from two linked Swedish longitudinal surveys based on nationally representative samples with repeated follow-ups; The Swedish Level of Living Survey and the Swedish Panel Study of Living conditions of the Oldest Old, and from national income and mortality registries. The analytical sample for the mortality outcome included 1852 people, and for late-life physical health outcomes 1461 people. We found no significant average treatment effect on the treated (ATT) of working to age 66 or above on the outcomes, measured an average of 12 years after retirement: mortality (ATT-0.039), the ability to climb stairs (ATT -0.023), self-rated health (ATT -0.009), ADL limitations (ATT -0.023), or musculoskeletal pain (ATT -0.009) in late life. Analyses of whether the results varied by occupational social class or the propensity to prolong working life were inconclusive but suggest a positive effect of prolonging working life on health outcomes. Accordingly, more detailed knowledge about the precise mechanisms underlying these results are needed. In conclusion, working to age 66 or above did not have effect on mortality or late-life physical health.
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| 10. |
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| 11. |
- Heap, Josephine, et al.
(författare)
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Associations between and coexistence of disadvantages in the oldest old people in Sweden : Patterns of change between 1992 and 2011
- 2018
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Ingår i: Journal of European Social Policy. - : SAGE Publications. - 0958-9287 .- 1461-7269. ; 28:3, s. 197-210
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Tidskriftsartikel (refereegranskat)abstract
- This study explored changes in the associations between and coexistence of disadvantages in several dimensions of living conditions in the oldest old people in Sweden. We used nationally representative data from 1992 (n = 537), 2002 (n = 621) and 2011 (n = 931). Indicators of limited social resources, limited political resources, limited financial resources, psychological health problems, physical health problems and functional limitations were used. The probability of reporting coexisting disadvantages tended to increase and was particularly elevated in 2002. Physical health problems became more common, and functional limitations, limited financial resources and limited political resources became less common during the studied period. Associations between health-related disadvantages remained fairly stable, whereas associations including other kinds of disadvantages varied somewhat over the studied period. These changes suggest that in general, the composition of coexisting disadvantages is likely to have altered over time. Consequently, the challenges faced by disadvantaged groups in 2011 may have been different from those in 1992. Moreover, the healthcare and social care services directed to older people have undergone significant changes during the past decades. These changes to the system accentuate the vulnerability of people experiencing coexisting disadvantages.
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| 12. |
- Honkaniemi, Helena, et al.
(författare)
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Mortality by country of birth in the Nordic countries – a systematic review of the literature
- 2017
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 17
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Forskningsöversikt (refereegranskat)abstract
- Background: Immigration to the Nordic countries has increased in the last decades and foreign-born inhabitants now constitute a considerable part of the region’s population. Several studies suggest poorer self-reported health among foreign-born compared to natives, while results on mortality and life expectancy are inconclusive. To date, few studies have summarized knowledge on mortality differentials by country of birth. This article aims to systematically review previous results on all-cause and cause-specific mortality by country of birth in the Nordic countries.Methods: The methodology was conducted and documented systematically and transparently using a narrative approach. We identified 43 relevant studies out of 6059 potentially relevant studies in August 2016, 35 of which used Swedish data, 8 Danish and 1 Norwegian.Results: Our findings from fully-adjusted models on Swedish data support claims of excess mortality risks in specific categories of foreign-born. Most notably, immigrants from other Nordic countries, especially Finland, experience increased risk of mortality from all causes, and specifically by suicide, breast and gynaecological cancers, and circulatory diseases. Increased risks in people from Central and Eastern Europe can also be found. On the contrary, decreased risks for people with Southern European and Middle Eastern origins are found for all-cause, suicide, and breast and gynaecological cancer mortality. The few Danish studies are more difficult to compare, with conflicting results arising in the analysis. Finally, results from the one Norwegian study suggest significantly decreased mortality risks among foreign-born, to be explored in further research.Conclusions: With new studies being published on mortality differentials between native and foreign-born populations in the Nordic countries, specific risk patterns have begun to arise. Regardless, data from most Nordic countries remains limited, as does the information on specific causes of death. The literature should be expanded in upcoming years to capture associations between country of birth and mortality more clearly.
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| 13. |
- Keller Celeste, Roger, et al.
(författare)
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Do socioeconomic inequalities in pain, psychological distress and oral health increase or decrease over the life course? Evidence from Sweden over 43 years of follow-up
- 2018
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 72:2, s. 160-167
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Tidskriftsartikel (refereegranskat)abstract
- Background Inequalities over the life course may increase due to accumulation of disadvantage or may decrease because ageing can work as a leveller. We report how absolute and relative socioeconomic inequalities in musculoskeletal pain, oral health and psychological distress evolve with ageing. Methods Data were combined from two nationally representative Swedish panel studies: the Swedish Level-of-Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old. Individuals were followed up to 43 years in six waves (1968, 1974, 1981, 1991/1992, 2000/2002, 2010/2011) from five cohorts: 1906-1915 (n=899), 1925-1934 (n=906), 1944-1953 (n=1154), 1957-1966 (n=923) and 1970-1981 (n=1199). The participants were 15-62 years at baseline. Three self-reported outcomes were measured as dichotomous variables: teeth not in good conditions, psychological distress and musculoskeletal pain. The fixed-income groups were: (A) never poor and (B) poor at least once in life. The relationship between ageing and the outcomes was smoothed with locally weighted ordinary least squares, and the relative and absolute gaps were calculated with Poisson regression using generalised estimating equations. Results All outcomes were associated with ageing, birth cohort, sex and being poor at least once in live. Absolute inequalities increased up to the age of 45-64 years, and then they decreased. Relative inequalities were large already in individuals aged 15-25years, showing a declining trend over the life course. Selective mortality did not change the results. The socioeconomic gap was larger for current poverty than for being poor at least once in life. Conclusion Inequalities persist into very old age, though they are more salient in midlife for all three outcomes observed.
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| 14. |
- Kroger, Hannes, et al.
(författare)
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The Association of Levels of and Decline in Grip Strength in Old Age with Trajectories of Life Course Occupational Position
- 2016
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:5
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Tidskriftsartikel (refereegranskat)abstract
- Background The study of the influence of life course occupational position (OP) on health in old age demands analysis of time patterns in both OP and health. We study associations between life course time patterns of OP and decline in grip strength in old age. Methods We analyze 5 waves from the Survey of Health Ageing and Retirement in Europe (n = 5108, ages 65-90). We use a pattern-mixture latent growth model to predict the level and decline in grip strength in old age by trajectory of life course OP. We extend and generalize the structured regression approach to establish the explanatory power of different life course models for both the level and decline of grip strength. Results Grip strength declined linearly by 0.70 kg (95% CI -0.74;-0.66) for men and 0.42 kg (95% CI -0.45;-0.39) for women per year. The level of men's grip strength can best be explained by a critical period during midlife, with those exposed to low OP during this period having 1.67 kg (95% CI -2.33;-1.00) less grip strength. These differences remain constant over age. For women, no association between OP and levels of or decline in grip strength was found. Conclusions Men's OP in midlife seems to be a critical period for the level of grip strength in old age. Inequalities remain constant over age. The integration of the structured regression approach and latent growth modelling offers new possibilities for life course epidemiology.
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| 15. |
- Lennartsson, Carin, et al.
(författare)
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Social class and infirmity. The role of social class over the life-course
- 2018
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Ingår i: SSM - Population Health. - : Elsevier BV. - 2352-8273. ; 4, s. 169-177
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Tidskriftsartikel (refereegranskat)abstract
- In an aging society, it is important to promote the compression of poor health. To do so, we need to know more about how life-course trajectories influence late-life health and health inequalities. In this study, we used a life-course perspective to examine how health and health inequalities in late-midlife and in late-life are influenced by socioeconomic position at different stages of the life course. We used a representative sample of the Swedish population born between 1925 and 1934 derived from the Swedish Level of Living Survey (LNU) and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) to investigate the impact of socioeconomic position during childhood (social class of origin) and of socioeconomic position in young adulthood (social class of entry) and late-midlife (social class of destination) on infirmity in late-midlife (age 60) and late-life (age 80). The results of structural equation modelling showed that poor social class of origin had no direct effect on late-midlife and late-life infirmity, but the overall indirect effect through chains of risks was significant. Thus, late-midlife and late-life health inequalities are the result of complex pathways through different social and material conditions that are unevenly distributed over the life course. Our findings suggest that policies that break the chain of disadvantage may help reduce health inequalities in late-midlife and in late-life.
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| 16. |
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| 17. |
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| 18. |
- Nelson, Kenneth, et al.
(författare)
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ESPN Thematic Report on minimum income schemes : Sweden 2015
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Most benefits and transfers in Sweden are based on individual entitlements and are administered at the national level. In such cases, the eligibility criteria and entitlement levels are uniform throughout the country. The only scheme in Sweden that qualifies as a minimum income benefit is the social assistance programme (Ekonomiskt Bistånd/Försörjningsstöd), which targets people in households that lack sufficient means to support themselves – not just work income, but also access to contributory social insurance benefits. Unlike most other benefits and transfers, eligibility for social assistance is thus determined at the level of the household. One way or another, social assistance defines the ‘floor’ of the Swedish welfare state: its explicit purpose is to provide an economic standard below which no one, in principle, should be able to fall. In Sweden, social assistance is a true system of last resort. As such, it is not used as a passport to other benefits. Rather the opposite applies.The basic scale rates of social assistance are set nationally, but financing and administration is at the local municipality level. Sweden has 290 municipalities, and in terms of implementation, these have substantial leeway. They are allowed to pay more, but not less.People receiving social assistance are obliged to seek work (if possible) and to participate in active labour market programmes. The duration of social assistance is unlimited, and payments are made as long as eligibility conditions are met.When it comes to the adequacy of social assistance, we can note two important aspects: a) the level of adequacy compared to the at-risk-of-poverty (AROP) threshold is poor; b) viewed over the last 10 to 15 years, there has been a gradual decline in adequacy levels. The first point is evident from the fact that social assistance levels are quite far from the 60% poverty threshold for all family types analysed. The declining trend is somewhat less evident after the 2008 crisis, at least for families with children.Take-up rates have been roughly stable over the past few years, as has the number of long-term recipients – though that figure is much larger today than before the severe recession in Sweden in the early 1990s.Sweden has not implemented any so-called one-stop shops, which provide a common entry to all social benefits and services. Instead, emphasis is placed on cooperation between public authorities at different levels of government, in order to foster greater coordination. Such coordinated actions may be hindered by the fact that different benefit and service systems operate at different governance levels. We would note that back in 2012, only a small fraction of municipalities in Sweden had written guidelines for cooperation between the local Social Welfare Agency and state-organised offices and agencies. If Sweden decides to continue with its attempts to foster coordination and cooperation, rather than one-stop shops, it would seem to us to be a minimum requirement that such guidelines should be developed right across the country.
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| 19. |
- Nilsen, Charlotta, et al.
(författare)
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Work-related stress in midlife and all-cause mortality : can sense of coherence modify this association?
- 2016
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 26:6, s. 1055-1061
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Tidskriftsartikel (refereegranskat)abstract
- Background: Survival reflects the accumulation of multiple influences experienced over the life course. Given the amount of time usually spent at work, the influence of work may be particularly important. We examined the association between work-related stress in midlife and subsequent mortality, investigating whether sense of coherence modified the association. Methods: Self-reported work-related stress was assessed in 1393 Swedish workers aged 42-65 who participated in the nationally representative Level of Living Survey in 1991. An established psychosocial job exposure matrix was applied to measure occupation-based stress. Sense of coherence was measured as meaningfulness, manageability and comprehensibility. Mortality data were collected from the Swedish National Cause of Death Register. Data were analyzed with hazard regression with Gompertz distributed baseline intensity. Results: After adjustment for socioeconomic position, occupation-based high job strain was associated with higher mortality in the presence of a weak sense of coherence (HR, 3.15; 1.62-6.13), a result that was stronger in women (HR, 4.48; 1.64-12.26) than in men (HR, 2.90; 1.12-7.49). Self-reported passive jobs were associated with higher mortality in the presence of a weak sense of coherence in men (HR, 2.76; 1.16-6.59). The link between work stress and mortality was not significant in the presence of a strong sense of coherence, indicating that a strong sense of coherence buffered the negative effects of work-related stress on mortality. Conclusions: Modifications to work environments that reduce work-related stress may contribute to better health and longer lives, especially in combination with promoting a sense of coherence among workers.
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| 20. |
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| 21. |
- Olsson, Gabriella, et al.
(författare)
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A Multilevel Study on Ethnic and Socioeconomic School Stratification and Health-Related Behaviors Among Students in Stockholm
- 2015
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Ingår i: Journal of School Health. - : Wiley. - 0022-4391 .- 1746-1561. ; 85:12, s. 871-879
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDThis study examines the extent to which high alcohol consumption, drug use, and delinquency vary between schools with different socioeconomic characteristics, over and above the pupil's own sociodemographic background.METHODSAnalyses are based on data on 5484 ninth-grade students distributed over 93 schools in Stockholm, from the 2010 Stockholm School Survey. School-level information was retrieved from the Swedish National Agency for Education. School disadvantage was determined by combining information on the level of education among parents and the share of pupils with a nonnative background, 2 aspects that have been shown to be central to school segregation in Sweden.RESULTSResults indicate significant school-to-school differences in relation to all outcomes. The risk for high alcohol consumption and drug use is greater in more advantaged school settings, adjusting for individual characteristics, whereas the opposite is true in relation to criminal behavior. The school's level of collective efficacy also seems to play an important, albeit not mediating, role.CONCLUSIONSRegardless of an adolescent's own background, the risk of having adverse health behaviors is higher at certain schools compared to others. However, school socioeconomic factors do not influence health behaviors consistently; instead, it seems as if the association varies depending on the behavior under study.
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| 22. |
- Olsson, Gabriella, 1971-
(författare)
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Expressions of context : Studies of schools, families, and health risk behaviours
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis explores the health behaviours of young people. The main focus is on risk behaviours, i.e. those which may have adverse consequences for health. Two fields of interest are looked at. On the one hand, the thesis explores social determinants of such behaviours, with particular focus on the influence of schools’ structural and social environment on health risk behaviours among youth. On the other hand, the thesis addresses the role of such behaviours in the relationship between childhood social inequalities and adult health. In terms of theory, the study sets out from Coleman's view of the association between structure and agency and the assumption that macro level structures and patterns can be understood on the basis of individual actors’ actions. The thesis consists of four studies addressing different, but related, aspects of the above areas of interest. The overall conclusion of studies I-III is that the school context has direct and indirect effects on young people's risk behaviours. The results of multilevel analyses indicate, more specifically, that students who attend more advantaged schools report more risk behaviours such as smoking, alcohol- and drug use than students at more disadvantaged schools. Self-reported crime is however higher in the more disadvantaged school settings. Further analyses show that a school's social and normative climate also is important for the extent to which youth consume alcohol, smoke, or have used drugs. These risk behaviours are most prevalent in schools where a large proportion of the parents have a more permissive attitude towards alcohol and smoking, and where teacher-rated levels of trust and informal social control (collective efficacy) are high. The results show, further, that school contexts also act indirectly on youth risk behaviours. Young people who reports weak bonds with their parents tend generally to be more involved in risk behaviours than those who report strong bonds. This tendency is reinforced in more advantaged school settings. Finally, Study IV demonstrates that youth risk behaviours act accumulatively and indirectly on later health, rather than directly. Moreover, the importance of risk behaviours for later health varies between the birth cohorts. Health behaviours explain a larger part of the relationship between socioeconomic conditions in childhood and health as an adult in the younger cohort.
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| 23. |
- Olsson, Gabriella, et al.
(författare)
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Family Composition and Youth Health Risk Behaviors : the Role of Patental Relation and the School Context
- 2017
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Ingår i: Child Indicators Research. - : Springer Science and Business Media LLC. - 1874-897X .- 1874-8988. ; 10:2, s. 403-421
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Tidskriftsartikel (refereegranskat)abstract
- Children not residing with both parents have been shown to be more at risk of negative developmental outcomes than children residing in two-parent families. Few studies have explored how other central contexts may interact with family characteristics to hinder or facilitate youth adjustment. This study examines how aspects of family structure and family processes are associated with youth health risk behaviors and interact with the structural characteristics of schools. The analyses are based on data from the Stockholm School Survey and consist of 5 002 ninth-grade students distributed over 92 schools in the Stockholm area in 2010. School information has been gathered from the Swedish National Agency for Education. Random intercept and fully random models have been used. Results show that adolescents not living with both their parents are more involved in health risk behaviors than adolescents that do. Poor parent–child relations accounts for more of the disadvantage associated with non-traditional family structures than differences in socioeconomic background. Results further suggest that health risk behaviors are more prevalent in more advantaged school settings, net the effect of individual background characteristics. Moreover, advantage school settings are found to accentuate the detrimental effects of poor parent–child relations on health risk behaviors. In conclusion, the study suggests that the effect of family type and family processes on youth behavior is susceptible to contextual effects of the school environment and that more advantage school settings have detrimental direct and indirect effects on youth health risk behaviors.
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| 24. |
- Shaw, Benjamin A., et al.
(författare)
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Who Lives Alone During Old Age? Trends in the Social and Functional Disadvantages of Sweden's Solitary Living Older Adults
- 2018
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Ingår i: Research on Aging. - : SAGE Publications. - 0164-0275 .- 1552-7573. ; 40:9, s. 815-838
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Tidskriftsartikel (refereegranskat)abstract
- This study identifies specific social and functional disadvantages associated with living alone during old age in Sweden and assesses whether these associations have changed during recent decades. Data came from repeated cross-sectional surveys of Swedish adults aged 77+ during 1992-2014. Findings indicate that several types of disadvantage are consistently associated with the probability of living alone including financial insecurity and having never married for women and having never married and mobility impairment for men. Also for older men, low education has become an increasing strong determinant of living alone. These findings suggest that older adults who live alone are a subgroup that is particularly, and in some cases increasingly, vulnerable with respect to social and functional status. This has important policy implications related to addressing the needs of this growing subgroup as well as methodological implications for studies on the health effects of living alone.
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| 25. |
- Sundberg, Louise, et al.
(författare)
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Trends in health expectancies among the oldest old in Sweden, 1992-2011
- 2016
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 26:6, s. 1069-1074
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Tidskriftsartikel (refereegranskat)abstract
- Background: Information on the extent to which older people's increasing life expectancy is characterized by good or poor health is important for policy and fiscal planning. This study explores trends in health expectancies among the oldest old in Sweden from 1992 to 2011. Methods: Cross-sectional health expectancy estimates at age 77 were obtained for 1992, 2002, 2004 and 2011 by Sullivan's method. Health expectancy was assessed by severe disability, mild disability and mobility problems. Changes in health expectancies were decomposed into the contributions attributed to changes of mortality rates, and changes in disability and mobility prevalence. Mortality data were obtained from Statistics Sweden and prevalence data from two nationally representative surveys, the Swedish Panel Study of Living Conditions of the Oldest Old and the Survey of Health, Ageing and Retirement in Europe. Results: Years free from severe disability, mild disability and mobility problems increased in both men and women. Decomposition analysis indicates that the increase was mainly driven by the change in health status rather than change in mortality. In relation to total life expectancy, the general patterns suggest that women had a compression of health problems and men an expansion. Conclusion: Men's life expectancy increased more than women's; however, the increased life expectancy among men was mainly characterized by disability and mobility problems. The results suggest that the gender gap in health expectancy is decreasing.
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| 26. |
- Sundberg, Louise, et al.
(författare)
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Why is the gender gap in life expectancy decreasing? The impact of age- and cause-specific mortality in Sweden 1997-2014
- 2018
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Ingår i: International Journal of Public Health. - : Springer Science and Business Media LLC. - 1661-8556 .- 1661-8564. ; 63:6, s. 673-681
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Tidskriftsartikel (refereegranskat)abstract
- To enhance the understanding of the current increase in life expectancy and decreasing gender gap in life expectancy. We obtained data on underlying cause of death from the National Board of Health and Welfare in Sweden for 1997 and 2014 and used Arriaga's method to decompose life expectancy by age group and 24 causes of death. Decreased mortality from ischemic heart disease had the largest impact on the increased life expectancy of both men and women and on the decreased gender gap in life expectancy. Increased mortality from Alzheimer's disease negatively influenced overall life expectancy, but because of higher female mortality, it also served to decrease the gender gap in life expectancy. The impact of other causes of death, particularly smoking-related causes, decreased in men but increased in women, also reducing the gap in life expectancy. This study shows that a focus on overall changes in life expectancies may hide important differences in age- and cause-specific mortality. It also emphasizes the importance of addressing modifiable lifestyle factors to reduce avoidable mortality.
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