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1.
  • Berkman, Lisa F., et al. (author)
  • Working conditions and health
  • 2014. - 2
  • In: Social epidemiology. - Oxford : Oxford University Press. - 9780199395330 ; , s. 153--181
  • Book chapter (other academic/artistic)
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3.
  • Grotta, Alessandra, et al. (author)
  • Suicide Around the Anniversary of a Parent's Death in Sweden
  • 2023
  • In: JAMA Network Open. - : American Medical Association. - 2574-3805. ; 6:4
  • Journal article (peer-reviewed)abstract
    • IMPORTANCE: Bereavement following parental death experienced in adulthood may be associated with suicide over many years, but this risk has received scant attention.OBJECTIVE: To investigate whether the risk of suicide increases among adult children around the anniversary of a parent's death.DESIGN, SETTING, AND PARTICIPANTS: This case-crossover study used Swedish register-based longitudinal data from 1990 to 2016, based on the entire national population. Participants included all adults aged 18 to 65 years who experienced parental death and subsequently died by suicide. Conditional logistic regression was used to quantify the association between the anniversary (or preanniversary and postanniversary periods) and suicide, controlling for time-invariant confounding. All analyses were stratified by sex of the offspring. The analyses were also stratified by the sex of the deceased parent, time since parental death, age, and marital status. Data analyses were performed in June 2022.EXPOSURES: Anniversary of a parent's death (or preanniversary and postanniversary periods).MAIN OUTCOMES AND MEASURES: Suicide.RESULTS: Of 7694 individuals who died by suicide (76% intentional self-harm), 2255 (29%) were women, and the median (IQR) age at suicide was 55 (47-62) years. There was evidence of an anniversary reaction among women, with a 67% increase in the odds of suicide when exposed to the period from the anniversary to 2 days after the anniversary, compared with when not being exposed (odds ratio [OR], 1.67; 95% CI, 1.07-2.62). The risk was particularly pronounced among maternally bereaved women (OR, 2.29; 95% CI, 1.20-4.40) and women who were never married (OR, 2.08; 95% CI, 0.99-4.37), although the latter was not statistically significant. An increased risk of suicide from the day before up to the anniversary was observed among women bereaved between the ages of 18 and 34 years (OR, 3.46; 95% CI, 1.14-10.56) and between the ages of 50 and 65 years (OR, 2.53; 95% CI, 1.04-6.15). Men had an attenuated suicide risk for the period from the day before up to the anniversary (OR, 0.57; 95% CI, 0.36-0.92).CONCLUSIONS AND RELEVANCE: These findings suggest that the anniversary of a parent's death is associated with an increased suicide risk among women. Women bereaved at younger or older ages, those who were maternally bereaved, and those who never married appeared to be particularly vulnerable. Families and social and health care professionals need to consider anniversary reactions in suicide prevention.
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4.
  • Heikkila, Katriina, et al. (author)
  • Long working hours and cancer risk : a multi-cohort study
  • 2016
  • In: British Journal of Cancer. - : Springer Science and Business Media LLC. - 0007-0920 .- 1532-1827. ; 114, s. 813-818
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Working longer than the maximum recommended hours is associated with an increased risk of cardiovascular disease, but the relationship of excess working hours with incident cancer is unclear.METHODS: This multi-cohort study examined the association between working hours and cancer risk in 116 462 men and women who were free of cancer at baseline. Incident cancers were ascertained from national cancer, hospitalisation and death registers; weekly working hours were self-reported.RESULTS: During median follow-up of 10.8 years, 4371 participants developed cancer (n colorectal cancer: 393; n lung cancer: 247; n breast cancer: 833; and n prostate cancer: 534). We found no clear evidence for an association between working hours and the overall cancer risk. Working hours were also unrelated the risk of incident colorectal, lung or prostate cancers. Working ⩾55 h per week was associated with 1.60-fold (95% confidence interval 1.12-2.29) increase in female breast cancer risk independently of age, socioeconomic position, shift- and night-time work and lifestyle factors, but this observation may have been influenced by residual confounding from parity.CONCLUSIONS: Our findings suggest that working long hours is unrelated to the overall cancer risk or the risk of lung, colorectal or prostate cancers. The observed association with breast cancer would warrant further research.
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5.
  • Hiyoshi, Ayako, 1972-, et al. (author)
  • Substance use disorder and suicide-related behaviour around dates of parental death and its anniversaries : a register-based cohort study
  • 2022
  • In: The Lancet Public Health. - : Elsevier. - 2468-2667. ; 7:8, s. e683-e693
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Parental death and its anniversaries, including anticipation of these dates, might cause distress and increase the risk of substance use disorder and suicide-related behaviour in bereaved adolescents and young adults. We examined whether the risk of substance use disorder and suicide-related behaviour increases around the date of parental death and subsequent anniversaries.METHODS: Using Swedish national registers, we conducted a cohort study of individuals aged 12-24 years. We included individuals aged 12-24 years between Jan 1, 2001, and Dec 31, 2014, whose parents were alive at entry (n=1 858 327) and followed up with them until the end of age 24 years. We excluded individuals with a half-sibling, a history of emigration, a previous record of the outcome events, a parental death before study entry, two parental deaths on the same day during the follow-up, or missing data for relevant variables. Follow-up ended on the day of an outcome event or on Dec 31, 2014; at age 25 years, emigration, or death; or a year before the second parental death. We studied substance use disorder and suicide-related behaviour outcomes separately and included non-fatal and fatal events in both outcomes. We used Cox regression to estimate hazard ratios (HRs), controlling for baseline psychiatric, demographic, and socioeconomic characteristics. Parental death was modelled as a time-varying exposure over 72 monthly periods, starting from 1 year before the parental death to the fifth year and later after the death. Unmeasured confounding was also addressed in within-individual comparisons using a case-crossover design.FINDINGS: During follow-up (median 7·5 [IQR 4·3-10·6] years), there were 42 854 substance use disorder events, with a crude rate of 3·1 per 1000 person-years. For suicide-related behaviour, there were 19 827 events, with a crude rate of 1·4 per 1000 person-years. Most of the events studied were non-fatal. In the month of parental death, the HR for substance use disorder risk was 1·89 (95% CI 1·07-3·33) among male participants, and, for suicide-related behaviour, was 3·76 (1·79-7·89) among male participants and 2·90 (1·61-5·24) among female participants. In male participants, there was an increased risk around the first anniversary (substance use disorder: HR 2·64 [95% CI 1·56-4·46] during the anniversary month; 2·21 [1·25-3·89] for the subsequent month; and for suicide-related behaviour: 3·18 [1·32-7·66] for the subsequent month). Among female participants, an increased risk of substance use disorder recurred around every year consistently in the month before the anniversary of the death and there was an increased risk for suicide-related behaviour in the months of the first and second anniversaries.INTERPRETATION: Although effect sizes were large in this cohort study, the number of individuals who had the outcomes was small. Nevertheless, adolescents and young adults, especially women and girls, who had the death of a parent showed increased risk of substance use disorder and suicide-related behaviour around the first few death anniversaries. Adolescents and young adults, especially women and girls, who had the death of a parent could benefit from preventive measures to reduce distress around the first few years of death anniversaries.
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6.
  • Hiyoshi, Ayako, et al. (author)
  • Substance use disorder and suicide-related behaviour around dates of parental death and its anniversaries : a register-based cohort study
  • 2022
  • In: The Lancet Public Health. - : Elsevier BV. - 2468-2667. ; 7:8, s. e683-e693
  • Journal article (peer-reviewed)abstract
    • Background Parental death and its anniversaries, including anticipation of these dates, might cause distress andincrease the risk of substance use disorder and suicide-related behaviour in bereaved adolescents and young adults.We examined whether the risk of substance use disorder and suicide-related behaviour increases around the date ofparental death and subsequent anniversaries.Methods Using Swedish national registers, we conducted a cohort study of individuals aged 12–24 years. We includedindividuals aged 12–24 years between Jan 1, 2001, and Dec 31, 2014, whose parents were alive at entry (n=1 858 327)and followed up with them until the end of age 24 years. We excluded individuals with a half-sibling, a history ofemigration, a previous record of the outcome events, a parental death before study entry, two parental deaths on thesame day during the follow-up, or missing data for relevant variables. Follow-up ended on the day of an outcomeevent or on Dec 31, 2014; at age 25 years, emigration, or death; or a year before the second parental death. We studiedsubstance use disorder and suicide-related behaviour outcomes separately and included non-fatal and fatal events inboth outcomes. We used Cox regression to estimate hazard ratios (HRs), controlling for baseline psychiatric,demographic, and socioeconomic characteristics. Parental death was modelled as a time-varying exposure over72 monthly periods, starting from 1 year before the parental death to the fifth year and later after the death.Unmeasured confounding was also addressed in within-individual comparisons using a case-crossover design.Findings During follow-up (median 7·5 [IQR 4·3–10·6] years), there were 42 854 substance use disorder events, witha crude rate of 3·1 per 1000 person-years. For suicide-related behaviour, there were 19 827 events, with a crude rate of1·4 per 1000 person-years. Most of the events studied were non-fatal. In the month of parental death, the HR forsubstance use disorder risk was 1·89 (95% CI 1·07–3·33) among male participants, and, for suicide-related behaviour,was 3·76 (1·79–7·89) among male participants and 2·90 (1·61–5·24) among female participants. In male participants,there was an increased risk around the first anniversary (substance use disorder: HR 2·64 [95% CI 1·56–4·46] duringthe anniversary month; 2·21 [1·25–3 ·89] for the subsequent month; and for suicide-related behaviour: 3·18[1·32–7·66] for the subsequent month). Among female participants, an increased risk of substance use disorderrecurred around every year consistently in the month before the anniversary of the death and there was an increasedrisk for suicide-related behaviour in the months of the first and second anniversaries.Interpretation Although effect sizes were large in this cohort study, the number of individuals who had the outcomeswas small. Nevertheless, adolescents and young adults, especially women and girls, who had the death of a parentshowed increased risk of substance use disorder and suicide-related behaviour around the first few death anniversaries.Adolescents and young adults, especially women and girls, who had the death of a parent could benefit from preventivemeasures to reduce distress around the first few years of death anniversaries
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7.
  • Islam, M Kamrul, et al. (author)
  • Social capital and health: does egalitarianism matter? A literature review
  • 2006
  • In: International Journal for Equity in Health. - : Springer Science and Business Media LLC. - 1475-9276. ; 5:3
  • Research review (peer-reviewed)abstract
    • The aim of the paper is to critically review the notion of social capital and review empirical literature on the association between social capital and health across countries. The methodology used for the review includes a systematic search on electronic databases for peer-reviewed published literature. We categorize studies according to level of analysis (single and multilevel) and examine whether studies reveal a significant health impact of individual and area level social capital. We compare the study conclusions according to the country's degrees of economic egalitarianism. Regardless of study design, our findings indicate that a positive association (fixed effect) exists between social capital and better health irrespective of countries degree of egalitarianism. However, we find that the between-area variance (random effect) in health tends to be lower in more egalitarian countries than in less egalitarian countries. Our tentative conclusion is that an association between social capital and health at the individual level is robust with respect to the degree of egalitarianism within a country. Area level or contextual social capital may be less salient in egalitarian countries in explaining health differences across places.
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9.
  • Kilpi, Fanny, et al. (author)
  • The Spillover Influence of Partner’s Education on Myocardial Infarction Incidence and Survival
  • 2018
  • In: Epidemiology. - 1044-3983 .- 1531-5487. ; 29:2, s. 237-245
  • Journal article (peer-reviewed)abstract
    • Background: Education is believed to have positive spillover effects across network connections. Partner’s education may be an important resource preventing the incidence of disease and helping patients cope with illness. We examined how partner’s education predicted myocardial infarction (MI) incidence and survival net of own education and other socioeconomic resources in Finland.Methods: A sample of adults aged 40–69 years at baseline in Finland in 1990 was followed up for MI incidence and mortality during the period 1991–2007 (n = 354,100).Results: Lower own and spousal education both contributed independently to a higher risk of MI incidence and fatality when mutually adjusted. Having a partner with basic education was particularly strongly associated with long-term fatality in women with a hazard ratio of 1.53 (95% confidence interval, 1.22–1.92) compared with women with tertiary level educated partners. There was some evidence that the incidence risk associated with basic spousal education was weaker in those with own basic education. The highest risks of MI incidence and fatality were consistently found in those without a partner, whereas the most favorable outcomes were in households where both partners had a tertiary level of education.Conclusions: Accounting for spousal education demonstrates how health-enhancing resources accumulate to some households. Marriage between people of similar educational levels may therefore contribute to the widening of educational differences in MI incidence and survival.
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10.
  • Kivimäki, Mika, et al. (author)
  • Influence of retirement on nonadherence to medication for hypertension and diabetes
  • 2013
  • In: CMJA. Canadian Medical Association Journal. Onlineutg. Med tittel. - : CMA Joule Inc.. - 0820-3946 .- 1488-2329. ; 85:17, s. E784-E790
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: The extent to which common life transitions influence medication adherence among patients remains unknown. We examined whether retirement is associated with a change in adherence to medication in patients with hypertension or type 2 diabetes. METHODS: Participants in the Finnish Public Sector study were linked to national registers. We included data for the years 1994-2011. We identified and followed 3468 adult patients with hypertension and 412 adult patients with type 2 diabetes for medication adherence for the 3 years before their retirement and the 4 years after their retirement (mean follow-up 6.8 yr). Our primary outcome was proportion of patients with poor adherence to medication, which we defined as less than 40% of days covered by treatment. We determined these proportions before and after retirement using data from filled prescriptions. RESULTS: The preretirement prevalence of poor adherence to medication was 6% in men and women with hypertension, 2% in men with diabetes and 4% in women with diabetes. Among men, retirement was associated with an increased risk of poor adherence to both antihypertensive agents (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.03-1.68) and antidiabetic drugs (OR 2.40, 95% CI 1.37-4.20). Among women, an increased risk of poor adherence was seen only for antihypertensive agents (OR 1.25, 95% CI 1.07-1.46). Similar results were apparent for alternative definitions of poor adherence. Our results did not differ across strata of age, socioeconomic status or comorbidity. INTERPRETATION: We found a decline in adherence to medication after retirement among men and women with hypertension and men with type 2 diabetes. If these findings can be confirmed, we need randomized controlled trials to determine whether interventions to reduce poor adherence after retirement could improve clinical outcomes of treatments for hypertension and diabetes.
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11.
  • Kivimäki, Mika, et al. (author)
  • Long working hours as a risk factor for atrial fibrillation : a multi-cohort study
  • 2017
  • In: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 38:34, s. 2621-2628
  • Journal article (peer-reviewed)abstract
    • Aims Studies suggest that people who work long hours are at increased risk of stroke, but the association of long working hours with atrial fibrillation, the most common cardiac arrhythmia and a risk factor for stroke, is unknown. We examined the risk of atrial fibrillation in individuals working long hours (>= 55 per week) and those working standard 35-40 h/week. Methods and results In this prospective multi-cohort study from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium, the study population was 85 494 working men and women (mean age 43.4 years) with no recorded atrial fibrillation. Working hours were assessed at study baseline (1991-2004). Mean follow-up for incident atrial fibrillation was 10 years and cases were defined using data on electrocardiograms, hospital records, drug reimbursement registers, and death certificates. We identified 1061 new cases of atrial fibrillation (10-year cumulative incidence 12.4 per 1000). After adjustment for age, sex and socioeconomic status, individuals working long hours had a 1.4-fold increased risk of atrial fibrillation compared with those working standard hours (hazard ratio = 1.42, 95% CI= 1.13-1.80, P= 0.003). There was no significant heterogeneity between the cohort-specific effect estimates (I-2= 0%, P = 0.66) and the finding remained after excluding participants with coronary heart disease or stroke at baseline or during the follow-up (N= 2006, hazard ratio= 1.36, 95% CI= 1.05-1.76, P = 0.0180). Adjustment for potential confounding factors, such as obesity, risky alcohol use and high blood pressure, had little impact on this association. Conclusion Individuals who worked long hours were more likely to develop atrial fibrillation than those working standard hours.
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12.
  • Kivimäki, Mika, et al. (author)
  • Long working hours, socioeconomic status, and the risk of incident type 2 diabetes : a meta-analysis of published and unpublished data from 222 120 individuals.
  • 2015
  • In: The Lancet Diabetes and Endocrinology. - 2213-8587 .- 2213-8595. ; 3:1, s. 27-34
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Working long hours might have adverse health effects, but whether this is true for all socioeconomic status groups is unclear. In this meta-analysis stratified by socioeconomic status, we investigated the role of long working hours as a risk factor for type 2 diabetes.METHODS: We identified four published studies through a systematic literature search of PubMed and Embase up to April 30, 2014. Study inclusion criteria were English-language publication; prospective design (cohort study); investigation of the effect of working hours or overtime work; incident diabetes as an outcome; and relative risks, odds ratios, or hazard ratios (HRs) with 95% CIs, or sufficient information to calculate these estimates. Additionally, we used unpublished individual-level data from 19 cohort studies from the Individual-Participant-Data Meta-analysis in Working-Populations Consortium and international open-access data archives. Effect estimates from published and unpublished data from 222 120 men and women from the USA, Europe, Japan, and Australia were pooled with random-effects meta-analysis.FINDINGS: During 1·7 million person-years at risk, 4963 individuals developed diabetes (incidence 29 per 10 000 person-years). The minimally adjusted summary risk ratio for long (≥55 h per week) compared with standard working hours (35-40 h) was 1·07 (95% CI 0·89-1·27, difference in incidence three cases per 10 000 person-years) with significant heterogeneity in study-specific estimates (I(2)=53%, p=0·0016). In an analysis stratified by socioeconomic status, the association between long working hours and diabetes was evident in the low socioeconomic status group (risk ratio 1·29, 95% CI 1·06-1·57, difference in incidence 13 per 10 000 person-years, I(2)=0%, p=0·4662), but was null in the high socioeconomic status group (1·00, 95% CI 0·80-1·25, incidence difference zero per 10 000 person-years, I(2)=15%, p=0·2464). The association in the low socioeconomic status group was robust to adjustment for age, sex, obesity, and physical activity, and remained after exclusion of shift workers.INTERPRETATION: In this meta-analysis, the link between longer working hours and type 2 diabetes was apparent only in individuals in the low socioeconomic status groups.FUNDING: Medical Research Council, European Union New and Emerging Risks in Occupational Safety and Health research programme, Finnish Work Environment Fund, Swedish Research Council for Working Life and Social Research, German Social Accident Insurance, Danish National Research Centre for the Working Environment, Academy of Finland, Ministry of Social Affairs and Employment (Netherlands), Economic and Social Research Council, US National Institutes of Health, and British Heart Foundation.
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13.
  • Lagström, Hanna, et al. (author)
  • Neighborhood socioeconomic status and adherence to dietary recommendations among Finnish adults : A retrospective follow-up study
  • 2019
  • In: Health and Place. - : Elsevier. - 1353-8292 .- 1873-2054. ; 55, s. 43-50
  • Journal article (peer-reviewed)abstract
    • Neighborhood socioeconomic status (SES) is associated with dietary habits among the residents, but few studies have examined this association separately among long-term residents and movers. We calculated cumulative neighborhood SES score weighted by residential time in each address over 6 years for non-movers (n = 7704) and movers (n = 8818) using national grid database. Increase in average neighborhood SES was associated with higher adherence to dietary recommendations in both groups. Among the movers, an upward trajectory from low to high neighborhood SES was also associated with better adherence. Our findings suggest high SES areas might offer healthier food environments than low SES areas.
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14.
  • Lindström, Martin, et al. (author)
  • Social capital and health-related behaviors
  • 2008
  • In: Social Capital and Health. - New York, NY : Springer New York. - 9780387713106 - 9780387713113 ; , s. 215-238
  • Book chapter (peer-reviewed)abstract
    • Behaviors such as tobacco smoking, alcohol consumption, physical activity (or a sedentary lifestyle) and diet are major determinants of health because of their causal effects on cardiovascular diseases, cancers, and many other chronic diseases (The World Health Report, 2002). Some other health-related behaviors such as the abuse of narcotic drugs (which lead to premature death for a variety of reasons) and sexual behaviors (which lead to sexually transmitted diseases/infections) are mainly causally linked to health for other reasons.
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15.
  • Liu, Can, 1984-, et al. (author)
  • Parental death and initiation of antidepressant treatment in surviving children and youth : a national register-based matched cohort study
  • 2023
  • In: eClinicalMedicine. - : Elsevier. - 2589-5370. ; 60
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Population-based longitudinal studies on bereaved children and youth's mental health care use are scarce and few have assessed the role of surviving parents' mental health status.METHODS: Using register data of individuals born in Sweden in 1992-1999, we performed a matched cohort study (n = 117,518) on the association between parental death and subsequent initiation of antidepressant treatment among individuals bereaved at ages 7-24 years. We used flexible parametric survival models to estimate the hazard ratios (HRs) over time after bereavement, adjusting for individual and parental factors. We further examined if the association varied by age at loss, sex, parental sociodemographic factors, cause of death, and the surviving parents' psychiatric care.FINDINGS: The bereaved were more likely to initiate antidepressants treatment than the nonbereaved matched individuals during follow-up (incidence rate per 1000 person years 27.5 [26.5-28.5] vs. 18.2 [17.9-18.6]). The HRs peaked in the first year after bereavement and remained higher than the nonbereaved individuals until the end of the follow-up. The average HR over the 12 years of follow-up was 1.48 (95% confidence interval [1.39-1.58]) for father's death and 1.33 [1.22-1.46] for mother's death. The HRs were particularly high when the surviving parents received psychiatric care before bereavement (2.11 [1.89-2.56] for father's death; 2.14 [1.79-2.56] for mother's death) or treated for anxiety or depression after bereavement (1.80 [1.67-1.94]; 1.82 [1.59-2.07]).INTERPRETATION: The risk of initiating antidepressant treatment was the highest in the first year after parental death and remained elevated over the next decade. The risk was particularly high among individuals with surviving parents affected by psychiatric morbidity.
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16.
  • Merlo, Juan, et al. (author)
  • Revisiting causal neighborhood effects on individual ischemic heart disease risk: A quasi-experimental multilevel analysis among Swedish siblings.
  • 2013
  • In: Social Science and Medicine. - : Elsevier BV. - 1873-5347 .- 0277-9536. ; 76, s. 39-46
  • Journal article (peer-reviewed)abstract
    • Neighborhood socioeconomic disadvantage is associated to increased individual risk of ischemic heart disease (IHD). However, the value of this association for causal inference is uncertain. Moreover, neighborhoods are often defined by available administrative boundaries without evaluating in which degree these boundaries embrace a relevant socio-geographical context that condition individual differences in IHD risk. Therefore, we performed an analysis of variance, and also compared the associations obtained by conventional multilevel analyses and by quasi-experimental family-based design that provides stronger evidence for causal inference. Linking the Swedish Multi-Generation Register to several other national registers, we analyzed 184,931 families embracing 415,540 full brothers 45-64 years old in 2004, and residing in 8408 small-area market statistics (SAMS) considered as "neighborhoods" in our study. We investigated the association between low neighborhood income (categorized in groups by deciles) and IHD risk in the next four years. We distinguished between family mean and intrafamilial-centered low neighborhood income, which allowed us to investigate both unrelated individuals from different families and full brothers within families. We applied multilevel logistic regression techniques to obtain odds ratios (OR), variance partition coefficients (VPC) and 95% credible intervals (CI). In unrelated individuals a decile unit increase of low neighborhood income increased individual IHD risk (OR = 1.04, 95% CI: 1.03-1.07). In the intrafamilial analysis this association was reduced (OR = 1.02, 95% CI: 1.02-1.04). Low neighborhood income seems associated with IHD risk in middle-aged men. However, despite the family-based design, we cannot exclude residual confounding by genetic and non-shared environmental factors. Besides, the low neighborhood level VPC = 1.5% suggest that the SAMS are a rather inappropriate construct of the socio-geographic context that conditions individual variance in IHD risk. In contrast the high family level VPC = 20.1% confirms the relevance of the family context for understanding IHD risk.
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17.
  • Oksanen, Tuula, et al. (author)
  • Is retirement beneficial for mental health? : Antidepressant use before and after retirement
  • 2011
  • In: Epidemiology. - 1044-3983 .- 1531-5487. ; 22:4, s. 553-559
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Recent studies based on self-reported data suggest that retirement may have beneficial effects on mental health, but studies using objective endpoints remain scarce. This study examines longitudinally the changes in antidepressant medication use across the 9 years spanning the transition to retirement. METHODS: Participants were Finnish public-sector employees: 7138 retired at statutory retirement age (76% women; mean age, 61.2 years), 1238 retired early due to mental health issues (78% women; mean age, 52.0 years), and 2643 retired due to physical health issues (72% women; mean age, 55.4 years). Information on purchase of antidepressant medication 4 years before and 4 years after retirement year was based on comprehensive national pharmacy records in 1994-2005. RESULTS: One year before retirement, the use of antidepressants was 4% among those who would retire at statutory age, 61% among those who would retire due to mental health issues, and 14% among those who would retire due to physical health issues. Retirement-related changes in antidepressant use depended on the reason for retirement. Among old-age retirees, antidepressant medication use decreased during the transition period (age- and calendar-year-adjusted prevalence ratio for antidepressant use 1 year after versus 1 year before retirement = 0.77 [95% confidence interval = 0.68 to 0.88]). Among those whose main reason for disability pension was mental health issues or physical health issues, there was an increasing trend in antidepressant use prior to retirement and, for mental health retirements, a decrease after retirement. CONCLUSIONS: Trajectories of recorded purchases of antidepressant medication are consistent with the hypothesis that retirement is beneficial for mental health.
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19.
  • Pega, Frank, et al. (author)
  • The impact of in-work tax credit for families on self-rated health in adults : a cohort study of 6900 New Zealanders
  • 2013
  • In: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 67:8, s. 682-688
  • Journal article (peer-reviewed)abstract
    • Background In-work tax credit (IWTC) for families, a welfare-to-work policy intervention, may impact health status by improving income and employment. Most studies estimate that IWTCs in the USA and the UK have no effect on self-rated health (SRH) and several other health outcomes, but these estimates may be biased by confounding. The current study estimates the impact of one such IWTC intervention (called In-Work Tax Credit) on SRH in adults in New Zealand, controlling more fully for confounding. Methods We used data from seven waves (2002-2009) of the Survey of Family, Income and Employment, restricted to a balanced panel of adults in families. The exposures, eligibility for IWTC and the amount of IWTC a family was eligible for, were derived for each wave by applying government eligibility and entitlement criteria. The outcome, SRH, was collected annually. We used fixed effects regression analyses to eliminate time-invariant confounding and adjusted for measured time-varying confounders. Results Becoming eligible for IWTC was associated with no detectable change in SRH over the past year (=0.001, 95% CI -0.022 to 0.023). A $1000 increase in the IWTC amount a family was eligible for increased SRH by 0.003 units (95% CI -0.005 to 0.011). Conclusions This study found that becoming eligible for IWTC or a substantial increase in the IWTC amount was not associated with any detectable difference in SRH over the short term. Future research should investigate the impact of IWTC on health over the longer term.
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20.
  • Rostila, Mikael, et al. (author)
  • Birth Order and Suicide in Adulthood : Evidence From Swedish Population Data
  • 2014
  • In: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 179:12, s. 1450-1457
  • Journal article (peer-reviewed)abstract
    • Each year, almost 1 million people die from suicide, which is among the leading causes of death in young people. We studied how birth order was associated with suicide and other main causes of death. A follow-up study based on the Swedish population register was conducted for sibling groups born from 1932 to 1980 who were observed during the period 1981-2002. Focus was on the within-family variation in suicide risk, meaning that we studied sibling groups that consisted of 2 or more children in which at least 1 died from suicide. These family-fixed effects analyses revealed that each increase in birth order was related to an 18% higher suicide risk (95% confidence interval (CI): 1.14, 1.23, P = 0.000). The association was slightly lower among sibling groups born in 1932-1955 (hazard ratio = 1.13, 95% CI: 1.06, 1.21, P = 0.000) than among those born in 1967-1980 (hazard ratio = 1.24, 95% CI: 0.97, 1.57, P = 0.080). Further analyses suggested that the association between birth order and suicide was only modestly influenced by sex, birth spacing, size of the sibling group, own socioeconomic position, own marital status, and socioeconomic rank within the sibling group. Causes of death other than suicide and other external causes were not associated with birth order.
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21.
  • Rostila, Mikael, et al. (author)
  • Experience of Sibling Death in Childhood and Risk of Death in Adulthood : A National Cohort Study From Sweden
  • 2017
  • In: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 185:12, s. 1247-1254
  • Journal article (peer-reviewed)abstract
    • Although there is some evidence of an association between loss of a sibling in adulthood and subsequentmortality, there have been no previous studies in which investigators have examined whether the death of a sibling in childhood is associated with adult mortality using total population data. Data on a national cohort born in Sweden in 1973-1982 (n = 717,723) were prospectively collected from the Cause of Death Register until 2013 (i.e., from the ages of 18 years to 31-40 years). Cox proportional hazards models were used to analyze the association between sibling loss during childhood and death in young adulthood. After adjustment for sociodemographic confounders and parental psychosocial covariates, the hazard ratio for all-cause mortality in bereaved siblings versus nonbereaved siblings was 1.39 (95% confidence interval: 1.14, 1.69). Risks were more pronounced for those who lost a noninfant sibling (i.e., > 1 year of age) (hazard ratio = 1.53, 95% confidence interval: 1.18, 1.95) and those who lost a sibling in adolescence (i.e., between the ages of 12 and 18 years) (hazard ratio = 1.71, 95% confidence interval: 1.24, 2.35). Excess mortality risk was found for concordant causes of death (i. e., siblings dying from the same causes) but not for discordant causes.
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22.
  • Rostila, Mikael, et al. (author)
  • Experience of sibling death in childhood and risk of psychiatric care in adulthood : a national cohort study from Sweden
  • 2019
  • In: European Child and Adolescent Psychiatry. - : Springer Science and Business Media LLC. - 1018-8827 .- 1435-165X. ; 28:12, s. 1581-1588
  • Journal article (peer-reviewed)abstract
    • Studies have found that sibling loss is associated with an increased risk of death from external causes (i.e. suicides, accidents and homicides). Increased psychiatric health problems following bereavement could underlie such an association. We studied the influence of sibling loss during childhood on psychiatric care in young adulthood, adjusting for psychosocial covariates shared by siblings in childhood. A national cohort born in Sweden in 1973–1982 (N = 701,270) was followed prospectively until 2013. Cox proportional hazards models were used to analyse the association between sibling loss during childhood and psychiatric inpatient and outpatient care identified by the Hospital Discharge Register. After adjustment for confounders, the HRs of psychiatric care in men who experienced sibling loss were 1.17 (95% CI 1.07–1.27) while the associations turned non-significant in women after adjustment for family-related psychosocial covariates, HR 1.07 (95% CI 0.99–1.16). An increased risk was found in men bereaved in early childhood (1.22 95% CI 1.07–1.38) and adolescence (1.27 95% CI 1.08–1.48). Among women, loss of a sibling during adolescence was significantly associated with psychiatric care (1.19 95% CI 1.03–1.36). Increased psychiatric health problems following bereavement could underlie the previously found association between sibling loss and mortality from external causes. Family-related psychosocial conditions shared by siblings in childhood may account for the association between sibling death and psychiatric care in adulthood.
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23.
  • Rostila, Mikael, et al. (author)
  • Fatal Stroke after the Death of a Sibling : A Nationwide Follow-Up Study from Sweden
  • 2013
  • In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:2, s. e56994-
  • Journal article (peer-reviewed)abstract
    • Background: Although less studied than other types of familial losses, the loss of a sibling could be a potential trigger of stroke as it represents a stressful life event. We studied the association between loss of a sibling and fatal stroke up to 18 years since bereavement. Methodology/Principal Findings: We conducted a follow-up study between 1981 and 2002, based on register data covering the total population of Swedes aged 40-69 years (n = 1,617,010). An increased risk of fatal stroke (1.31 CI: 1.05, 1.62) was found among women who had experienced the loss of a sibling. No increase in the overall mortality risk was found in men (1.11 CI: 0.92, 1.33). An elevated risk in the short term (during the second and third half-year after the death) was found among both men and women, whereas longer-term elevation in risk was found primarily for women. Both external (1.47 CI: 1.00, 2.17) and not external (1.26 CI: 1.00, 1.60) causes of sibling death showed associations among women. In men, an association was found only if the sibling also died from stroke (1.78 CI: 1.00, 3.17). However, among women, we found an increased risk of stroke mortality if the sibling died from causes other than stroke (1.30 CI: 1.04, 1.62). Conclusions/Significance: The findings suggest an increased risk of dying from stroke mortality after the death of a sibling, and that bereavement affects particularly women. It is important for health care workers to follow bereaved siblings and recognize potential changes of stress-levels and health related behaviours that could lead to risk of stroke.
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24.
  • Rostila, Mikael, 1977- (author)
  • Healthy bridges : Studies of social capital, welfare, and health
  • 2008
  • Doctoral thesis (other academic/artistic)abstract
    • The aim of this thesis is to study whether social capital is related to health and health inequality, and to investigate the significance of welfare state features for levels of social capital. Another aim is to examine whether social capital may be important for the relation between the welfare state and health. A final aim is to examine the downsides of social capital in relation to health.The theoretical definition of social capital guiding this thesis suggests that it comprises social resources that evolve in social networks and social structures characterized by mutual trust. These social resources, in turn, facilitate access to various instrumental and expressive returns, which might benefit the individual as well as the collective.The findings suggest that universal welfare states generally seem to have a positive influence on levels of social capital, as social capital increased rather than decreased during the time period when the Swedish welfare state was maturing. Accordingly, cross-national comparisons show that the highest levels of social capital are to be found in the universal welfare states, amongst them Sweden.The findings further show that both individual and collective social capital are related to various health outcomes, although the most robust findings are found at the individual level. Some of the findings also support that associations may be causal. Hence, social capital may be considered an important social determinant of health. Moreover, social capital at the individual level is important in explaining health inequalities especially between groups based on country of birth in Sweden, whereas collective social capital is important in explaining health inequalities between clusters of European countries, grouped into welfare regimes. Thus, social capital seems important in explaining and understanding health inequalities both between and within countries.Finally, the principle of migrant homophily – when migrants chiefly interact with other migrants – has negative consequences for migrants’ health in Sweden. However, only those migrants included in homogenous and closed networks have poorer health. This supports the hypothesis that social capital chiefly has negative health externalities when social networks are characterized by a high degree of network closure, lacking bridges to other networks.
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25.
  • Rostila, Mikael, et al. (author)
  • Mortality From Myocardial Infarction After the Death of a Sibling : A Nationwide Follow‐up Study From Sweden
  • 2013
  • In: Journal of the American Heart Association. - 2047-9980. ; 2:2
  • Journal article (peer-reviewed)abstract
    • Background Death of a sibling represents a stressful life event and could be a potential trigger of myocardial infarction (MI). We studied the association between loss of an adult sibling and mortality from MI up to 18 years after bereavement.                       Methods and Results We conducted a follow‐up study for Swedes aged 40 to 69 years between 1981 and 2002, based on register data covering the total population (N=1 617 010). Sibling deaths could be observed from 1981 and on. An increased mortality rate from MI was found among women (1.25 CI 1.02 to 1.54) and men (1.15 CI 1.03 to 1.28) who had experienced death of an adult sibling. An elevated rate some years after bereavement was found among both women (during the fourth to sixth half‐years after the death) and men (during the second to sixth half‐years after the death), whereas limited support for a short‐term elevation in the rate was found (during the first few months since bereavement). External causes of sibling death were associated with increased MI mortality among women (1.54 CI 1.07 to 2.22), whereas nonexternal causes showed associations in men (1.23 CI 1.09 to 1.38). However, further analyses showed that if the sibling also died from MI, associations were primarily found among both women (1.62 CI 1.00 to 2.61) and men (1.98 CI 1.59 to 2.48).                       Conclusions Our study provided the first large‐scale evidence for mortality from MI associated with the death of a sibling at an adult age. The fact that findings suggested associations primarily between concordant causes of death (both died of MI) could indicate genetic resemblance or shared risk factors during childhood. Future studies on bereavement should carefully deal with the possibility of residual confounding.                       
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