| 11. |
- Moussa, Kontie, et al.
(author)
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Socioeconomic differences in smoking trends among pregnant women at first antenatal visit in Sweden 1982-2001 : increasing importance of educational level for the total burden of smoking
- 2009
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In: Tobacco Control. - : BMJ. - 0964-4563 .- 1468-3318. ; 18:2, s. 92-97
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Journal article (peer-reviewed)abstract
- BACKGROUND: There was a decrease in smoking during early pregnancy in Swedish women between 1982 and 2001. We sought to determine whether there was a parallel decrease in socioeconomic inequality in smoking. METHODS: Registry data indicating educational level and smoking status at first antenatal visit in all 2,022,469 pregnancies in Sweden 1982-2001 were analysed. Prevalence differences, odds ratios based on prevalences and total attributable fractions were compared for five-year intervals. RESULTS: The prevalence differences of smoking showed a greater decrease at the lowest and middle educational level compared with the highest educational level (14.5%, 15.7% and 10.2%, respectively) indicating reduced inequality in absolute terms. However, odds ratios regarding low educational attainment versus high, increased from 5.6 to 14.2, signifying increased inequality in relative terms. Moreover, the total attributable fraction of low and intermediate educational level regarding smoking at first antenatal visit increased from 61% to 76% during the period studied. CONCLUSIONS: Smoking at first antenatal visit in Sweden between 1982 to 2001 decreased in a way that conclusions regarding trends in inequalities in smoking at first antenatal visit depend on the type of measure applied. However, using the measure of total attributable fraction, which takes into consideration the impact of the exposure on the individual as well as the effect of the varying size of the group of exposed, the growing importance of educational level for the behaviour in the population was demonstrated.
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| 12. |
- Sjögren Forss, Katarina, et al.
(author)
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Physical Activity in Relation to Wellbeing Among Newly Arrived Refugees in Sweden : A Quantitative Study
- 2021
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In: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 8
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Journal article (peer-reviewed)abstract
- Background: Little is known about physical activity among newly arrived refugees and what impact physical activity might have on their health, as measured by mental wellbeing, vitality, stress and sleep quality. Thus, this study sought to investigate the relationship between physical activity and wellbeing among refugees who were newly arrived in Sweden. Methods: The present study was based on the results from a survey, conducted in 2015-2016 among newly arrived adult refugees who spoke Arabic, Pashto, Somali or Dari, participated in a mandatory public integration support programme in the Scania region of Sweden and agreed to participate in the survey. Ultimately 681 participants completed the survey (a response rate of 39.5%). Results: We found a significant association between physical activity and mental wellbeing, vitality, stress and sleep quality among newly arrived refugees. Conclusions: Newly arrived refugees need to be informed about the importance of prioritizing physical activity for their health and wellbeing, regardless of their external circumstances, and supported in their attempts to do so.
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| 13. |
- Sundbeck, Mats, et al.
(author)
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Snuff use associated with abdominal obesity in former smokers.
- 2009
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In: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 37:5, s. 487-93
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Journal article (peer-reviewed)abstract
- AIM: To describe the consumption of snuff in a rural male population and to explore associations between snuff use and obesity. Participants and METHODS: Tobacco use was explored in 834 men aged 30-75 years old who participated in a cross-sectional population survey in the municipality of Vara (participation rate was 81%). Self-reported questionnaires assessed the habits of smoking and snuff use. Anthropometric measures were obtained during a health examination. RESULTS: Of these men 21% (n = 179) were snuff users, 13% (n = 109) current smokers, and 65% (n = 546) were non-users. Of all snuff users 65% (n = 116) were former smokers, and 35% (n = 63) were exclusive snuff users (current users who never smoked). Among non-users 65% (n = 357) were never users and 35% (n = 189) had quit smoking without nicotine substitution. These men were characterized by abdominal obesity; OR 1.84 (1.08-3.12) (p = 0.002) (WHR 41.0) and OR 1.71 (1.08-2.72) (p = 0.022) (waist circumference 4102 cm). One can/week use of snuff among ex-smokers was associated with a 1.21 cm wider (0.05-2.36) (p = 0.041) waist circumference and 0.01 (0.00-0.02) units higher (p = 0.021) WHR. There were statistically significant associations between former smoking without current nicotine substitute and both general and abdominal obesity. No similar association with abdominal obesity was seen among exclusive snuff users. CONCLUSIONS: Abdominal obesity in current snuff users is limited to former smokers. The remaining effect of previous smoking has to be considered in future studies on obesity and related disorders in snuff users. Counselling among people who substitute snuff for smoking should include measures to prevent weight gain.
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| 14. |
- Zdravkovic, Slobodan, et al.
(author)
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Kartläggning av hälsa, levnadsvanor, sociala relationer, arbetsmarknad och boendemiljö bland arabisktalande nyanlända inom etableringen : Delrapport från MILSA 2.0
- 2020
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Reports (pop. science, debate, etc.)abstract
- BakgrundAtt tvingas fly är en påfrestande och svår process att genomleva. Att efter flykten etablera sig i mottagarlandet medför ytterligare utmaningar. Vägen till att etablera sig i det nya samhället är ofta lång och kantad av svårigheter. Att lära sig språket, att förstå det svenska samhället samt utmaningar med svårigheter att validera diplom och kompetens är några av de svårigheter nyanlända upplever under den första tiden i landet. En ytterligare vanligt förekommande utmaning är att finna ett stabilt och tryggt boende. En förutsättning för att överhuvudtaget kunna bemöta dessa svårigheter är det egna hälsokapitalet. Hur ser hälsokapitalet ut bland dem som varit på flykt från krig och oroligheter och är det tillräckligt starkt för att hantera allt som möter individen under etableringen? I hälsokapitalet bör alla hälsorelaterade faktorer innefattas, vilka på ett eller annat sätt berör det mänskliga livet. För att främja etablering och inkludering av nyanlända individer är det viktigt att ha en grundläggande förståelse för den situation som denna grupp av nytillkomna invånare befinner sig i vad gäller hälsa och dess olika riskfaktorer.SyfteSyftet med undersökningen har varit att studera hälsa och hälsorelaterade faktorer bland vuxna nyanlända i Skåne som befinner sig inom etableringen i Skåne.Material och metodAlla vuxna nyanlända arabisktalande individer som deltagit i samhällsorientering genom Partnerskap Skåne har bjudits in till att delta i undersökningen. Insamlingsperioden har varit mellan maj månad 2018 till och med mars månad 2019. Mätinstrumentet har utvecklats på svenska för att sedan översättas till arabiska. Enkäten baserades på frågor som fokuserar på bland annat olika sjukdomar, vårdbehov, migrationsspecifika frågor, boende, sociala relationer, våld, levnadsvanor samt sexuell hälsa. Frågeformuläret delades ut i form av pappersenkät inom ramen för samhällsorienteringen av samhälls- och hälsokommunikatörer. Totalt antal svarande blev 315 vilket innebär en svarsfrekvens på 25,3 %.9SlutsatsResultatet visade att en stor andel migranter led av antingen övervikt eller fetma och en ganska stor andel av dessa ansåg att deras vikt ökat sedan flykten till Sverige. Drygt var tionde nyanländ upplevde sitt hälsotillstånd vara dåligt eller mycket dåligt och var tredje person ansåg det vara någorlunda. Det var nära hälften som upplevde en förbättring i självupplevd hälsa efter att de fått uppehållstillstånd medan nästan var femte person upplevde en försämring. Nästan varannan nyanländ hade varit i behov av läkarvård under de senaste tre månaderna innan undersökningen genomfördes men inte sökt vård. Drygt var tredje nyanländ hade en risk för psykisk ohälsa och det var en högre andel män än kvinnor som hade denna risk. Mer än hälften av de nyanlända utförde antingen ingen fysisk aktivitet alls eller under mindre än 30 minuter per vecka. Majoriteten av de tillfrågade ansåg inte att det går att lita på människor runtomkring. En betydande del saknade ett socialt nätverk när det gällde att kunna skaffa ett arbete och hälften saknade kontakt med arbetsgivare och nästan var tredje hade svårt att få sin utbildning validerad.
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| 15. |
- Zdravkovic, Slobodan, et al.
(author)
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Kartläggning av nyanländas hälsa
- 2016
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Reports (other academic/artistic)abstract
- Bakgrund God hälsa är en förutsättning för en inkluderande och effektiv etablering av nyanlända flyktingar i Sverige. En migrationsprocess föranledd av flykt utgör en belastande livserfarenhet. Kännedom om hur tiden innan och efter flykten påverkar hälsan, och det allmänna hälsotillståndet i nära anslutning till flykten, utgör viktig kunskap för beslutsfattare. Denna kunskap utgör en central grund för att kunna behovsanpassa etableringsinsatser för nyanlända flyktingar. Syfte Syftet med kartläggningen är att ge en väl underbyggd bild av hälsoläget bland nyanlända flyktingar som omfattas av etableringslagstiftningen. Material och metod Studien vänder sig till alla vuxna nyanlända flyktingar med modersmålen arabiska, dari, pashto eller somaliska. Ett mätinstrument, i det här fallet en enkät, utvecklades på respektive språk och omfattar bland annat självrapporterad hälsa, förändring i hälsa, sjukdomar, läkemedel, bakgrundsfaktorer, livsstilsfaktorer, sociala bestämningsfaktorer, sömn- och välbefinnande, tandhälsa, smittsamma sexuella sjukdomar och preventivmedel samt hälsolitteracitet. Enkätutdelningen påbörjades den 13 februari 2015 och avslutades den 12 februari 2016. Studien bygger på frivilligt deltagande och anonymitet. Totalt besvarades 681 enkäter (svarsfrekvens 39,5 %) varav 93,7 % på arabiska och 6,3 % på dari. 69,3 % av respondenterna var män. Enkäter på pashto och somaliska har inte delats ut eftersom det 10 vid tiden för datainsamlingsperioden inte funnits grupper på dessa språk inom samhälls- och hälsokommunikationen. Majoriteten av respondenterna var födda i Syrien (75,6 %) följt av Irak (4,1 %) och Afghanistan (3,1 %). Konklusion De flesta nyanlända som besvarat enkäten har långsiktiga planer på att stanna i Sverige och ser ljust eller mycket ljust på framtiden. Det rådande hälsotillståndet bland respondenterna verkar utgöra en god utgångspunkt för en effektiv etablering. Självrapporterad hälsa, hälsobesvär och använda läkemedel är någorlunda i linje med den övriga befolkningen. Oroväckande livsstilsfaktorer för framtida sjukdom är övervikt och fetma samt fysisk inaktivitet och rökning. Bekymmersamma sociala faktorer är trångboddhet, osäker boendesituation, låg tillit och lågt förtroende för samhällsinstitutioner såsom sjukvården och tolkar. Flertalet har varit utsatta för allvarliga hot om våld innan flykten och nästan hälften lider av dålig psykisk hälsa. Var tionde ser mörkt eller mycket mörkt på framtiden. Var femte sover ganska eller mycket dåligt och varannan har dålig eller mycket dålig tandhälsa. Ekonomisk stress verkar inte utgöra en riskfaktor men väldigt få har en kontantmarginal att klara en oförutsedd situation. Var femte har hälsoproblem som hindrar ett aktivt jobbsökande. Otillfredsställda vårdbehov eller bristfällig kunskap om vården är vanligt förekommande. Att läsa och förstå skriftlig hälsoinformation är problematisk och bristande för många nyanlända. Det är viktigt att uppmärksamma att föreliggande resultat främst gäller arabisktalande nyanlända med högre utbildningsnivå. Alla resultat och konklusioner bör också sättas i förhållande till den situation de nyanlända befinner sig i. Upplevelse av en underordnad situation i mötet med myndigheter tillsammans med viljan och behovet till etablering och självförsörjning kan eventuellt i vissa fall ha lett till en överskattning av den egna hälsorelaterade förmågan.
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| 16. |
- Zdravkovic, Slobodan, et al.
(author)
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Recently arrived migrants’ health status in the region of Scania, Sweden
- 2016
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In: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 26:Suppl 1, s. 492-492
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Journal article (other academic/artistic)abstract
- Background Knowledge of health and health related issues in recently arrived migrants (i.e. refugees) to Sweden is limited, although studies indicate that health status of migrants in general is worse than people born in Sweden and that it deteriorates over time. Regular public health surveys have difficulty reaching new migrants, partly due to language barriers. In order to address health and health related issues a study was initiated in Scania targeting recently arrived migrants. A grant for the study was received by the European refugee fund. Methods Data was collected within the framework of the public system for supporting migrants’ establishment to society and labour market, which ensures coverage. The inclusion criteria were all adult recently arrived migrants to Scania, 18 to 64 years taking part in the public support system between February 13, 2015 and February 12, 2016. Questionnaires in Arabic, Dari, Pashto and Somali were used for data collection. Health issues covered diabetes, asthma, war injuries, dental, mental, and selfreported health among others. Health related issues address health-literacy, smoking, drug use, physical activity, and health system use as well as education and social relations mentioning few. The further aims of the study are to identify evidence for introducing need-specific strategies and to enhance the possibility for evaluating the adequacy of present practices. Results The study reveals necessary knowledge about health and health related needs in this group of new residents of Scania. Results will be available after the summer 2016 also including methodological concerns. Conclusions The study adds knowledge on health and health related needs in recently arrived residents and serves as a complement to the regular public health survey in Scania. It also addresses a number of methodological questions. Key messages: - Unique health and health related knowledge will be revealed in recently arrived immigrants of Scania - The study will reveal evidence for need-specific health strategies and for evaluating the adequacy of present practices
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| 17. |
- Zdravkovic, Slobodan, et al.
(author)
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Self-reported health and country of origin : Does level of education and length of stay in Sweden make a difference?
- 2014
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Conference paper (other academic/artistic)abstract
- Background Self-reported health (SRH) is an important indicator for general health status of an individual. The latest measure of SRH in Scania resulted in the majority reporting good or very good health. This encouraging overall finding does not target vulnerable subgroups such as migrants. The aim of this study is to address the effect of country of birth on SRH and explore if level of education and length of stay (LOS) makes a difference. Methods The 2012 public health survey in Scania served as the basis for the study. Data was collected on 28029 adults aged 18-80. The variables of interest were SRH, LOS in Sweden of foreign born and level of education. Results The mean age of people born in Sweden was 51.4 and 48.6 for those born abroad. The odds ratio (OR) of poor SRH was 1.38 (95% CI=1.30-1.47) where people born abroad reported worse SRH overall and across different levels of education. People born in Sweden reported poor SRH more than those born abroad with LOS below 10 years 1.24 (1.10-1.41) independent of education, except for highly educated people born in Sweden 0.72 (0.59-0.89). People born in Sweden reported poor SRH less than those born abroad with LOS above 10 years 0.55 (0.51-0.60) independent of education. Conclusions Inequalities in health persist across educational levels and SRH deteriorates with LOS. Recommended actions: a. Enhance the understanding of health inequalities. b. Improve procedures for including foreign born to the society. c. Initiate future studies in the field. Message 1 Inequalities in health due to country of birth are not due to level of education. Message 2 LOS in the country worsens health in those born abroad as compared to people born in Sweden independently of education.
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| 18. |
- Zdravkovic, Slobodan, et al.
(author)
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Self-reported health issues in recently arrived migrants to Sweden
- 2016
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In: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 26:suppl 1, s. 220-220
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Journal article (other academic/artistic)abstract
- Background The awareness of health and health related needs in migrants (i.e. refugees) is crucial for effective public support systems. For this and other reasons a regional survey was established to address various health issues in recently arrived migrants to Scania. The questions that the present study is seeking answers for relates health, changes in health as well as self-reported possibility to affect health in general but also in relation to level of education. Methods Data collection occurred between February 13, 2015 and February 12, 2016. The inclusion criteria were recently arrived adult migrants speaking Arabic, Dari, Pashto or Somali participating in the public support system. Questions on selfreported health, self-reported changes in health since the move to Sweden, self-reported possibility to affect own health as well as education was examined among others in an extensive health survey. The survey was funded by the European refugee fund. Results 681 respondents took part in the survey where 94% were Arabic speaking. 69% were men and 51% were 18 to 34 years. 23% graded self-reported health as very well and 46% as well. Highly educated reported very well to a higher degree (30%) than the primary (17%) and the secondary level (12%) (pvalue< 0.01). Change in health was reported by 32% as negative and by 21% as positive. No significant difference was observed in relation to education. 70% reported the possibility of affecting own health as very important and the comparison with education was significant (p-value<0.01). Over 64%, independently of education, reported own contribution as very important. Conclusions The majority of recently arrived migrants’ reports good health and own contribution for health as very important. Negative change in health was reported by almost a third of the migrants. (a) Increase efforts to stop negative changes in health. (b) Enhance health information practice to increase the benefits of own contribution for health. Key messages: - Recently arrived migrants reports a similar level of good health as the inhabitants of Scania observed in the latest regional public health survey - A third of the respondents reports worsening health since the move to Sweden
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