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12. |
- Dunlavy, Andrea, 1979-
(author)
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Between Two Worlds : Studies of migration, work, and health
- 2017
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Doctoral thesis (other academic/artistic)abstract
- This thesis aims to investigate the extent to which work-related factors contribute to the health inequalities often observed between foreign-origin and native-origin persons in Sweden. Four empirical studies using survey data and population-based registers assessed the health impact of different labor market adversities among groups of foreign-origin persons who were both in and outside the labor market relative to native-origin Swedes.Studies I and II examined associations between different measures of working life quality, including adverse psychosocial and physical working conditions and educational mismatch, and self-reported health among the employed. Adverse psychosocial and physical working conditions minimally contributed to the excess risk of poor health found among workers from low- and middle-income countries. Over-education had a stronger association with increased risk of poor health, most notably among foreign-born workers from countries outside of Western Europe. Under-educated women from these countries also demonstrated an elevated risk of poor health. There was no association between educational mismatch and poor health among native-born workers. Studies III and IV focused on the health implications of labor market exclusion, and examined relationships between employment status and risk of all-cause mortality and suicide. The majority of foreign-origin groups that experienced unemployment showed an elevated risk of both mortality and suicide. The magnitude of excess risk varied by generational status and region of origin. Variations in patterns of suicide risk were also evident among migrants by age at arrival and duration of residence. Yet within many foreign-origin groups, health advantages were observed among the employed.The health of migrants is affected by the confluence of several different pre- and post-migration factors. The extent to which health inequalities are found among persons of foreign-origin in Sweden is influenced by the degree to which they experience labor market adversities, as well as differential vulnerability to the negative effects of these adversities across foreign-origin groups.
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13. |
- Dunlavy, Andrea C., et al.
(author)
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Suicide risk among native- and foreign-origin persons in Sweden : a longitudinal examination of the role of unemployment status
- 2019
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In: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 54:5, s. 579-590
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Journal article (peer-reviewed)abstract
- PURPOSE: Prior research has documented an association between unemployment and elevated suicide risk. Yet, few Swedish studies have explicitly considered how such risk may vary by different migration background characteristics among persons of foreign-origin, who often experience diverse forms of labor market marginalization. This study examines the extent to which unemployment status may differentially influence suicide risk among the foreign-origin by generational status, region of origin, age at arrival, and duration of residence.METHODS: Population-based registers were used to conduct a longitudinal, open cohort study of native-origin and foreign-origin Swedish residents of working age (25-64 years) from 1993 to 2008. Hazard ratios and 95% confidence intervals for suicide mortality were estimated using gender-stratified Cox proportional hazards models.RESULTS: Elevated suicide risk observed among foreign-origin unemployed groups was generally of a similar or lower magnitude than that found in unemployed native-origin, although unemployed second-generation Swedish men demonstrated significantly greater (p < 0.05) excess risk of suicide than that observed among their native-origin counterparts. Unemployed foreign-born men with a younger age at arrival and longer duration of residence demonstrated an increased risk of suicide, while those who arrived as adults, and a shorter duration of residence did not show any increased risk. Among foreign-born women, excess suicide risk persisted regardless of age at arrival and duration of residence in the long-term unemployed.CONCLUSIONS: Multiple migration background characteristics should be considered when examining relationships between employment status and suicide among the foreign-origin.
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14. |
- Dunlavy, Andrea, et al.
(author)
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Migration background characteristics and the association between unemployment and suicide
- 2017
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In: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 27:Suppl. 3
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Journal article (peer-reviewed)abstract
- BackgroundPersons of foreign-origin have higher rates of unemployment compared to those of native-origin, yet few studies have assessed relationships between unemployment and mental health in persons of foreign-origin relative to the native-origin. This study aims to examine the extent to which generational status, region of origin, age at arrival, and duration of residence modify the relationship between employment status and suicide risk.MethodsPopulation-based registers were used to conduct a longitudinal, open cohort study of native-origin and foreign-origin Swedish residents of working age (25-64 years) from 1993-2008. Hazard ratios and 95% confidence intervals for suicide mortality were estimated using gender-stratified Cox proportional hazards models.ResultsElevated hazard ratios for suicide were observed among the majority of foreign-origin persons exposed to unemployment. Second generation Swedish men exposed to unemployment demonstrated significantly greater (p < 0.05) excess risk of suicide (HR = 3.63, 95% CI: 2.90-4.54) than that observed among native-origin Swedish men exposed to unemployment (HR = 1.67, 95% CI: 1.29-2.16). In unemployed foreign-born men, younger age at arrival and longer duration of residence were associated with increased risk of suicide, whereas unemployed foreign-born men who arrived as adults and had a shorter duration of residence did not demonstrate excess suicide risk.ConclusionsAnalyses indicated that the majority of the foreign-origin exposed to unemployment demonstrated excess risk of suicide that was of a similar magnitude to that observed among their native-origin counterparts. Yet there were notable differences in patterns of association by generational status, region of origin, age at arrival, and duration of residence. The high excess risk observed in unemployed second generation men suggests that ensuring employment among this group may be of particular public health importance.
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16. |
- Fahlén Bergh, Cecilia, et al.
(author)
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Factors of importance for discontinuation of thiazides associated with hyponatremia in Sweden: A population-based register study.
- 2019
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In: Pharmacoepidemiology and Drug Safety. - : Wiley. - 1053-8569 .- 1099-1557.
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Journal article (peer-reviewed)abstract
- PURPOSE: In a patient with clinically significant hyponatremia without other clear causes, thiazide treatment should be replaced with another drug. Data describing to which extent this is being done are scarce. The aim of this study was to investigate sociodemographic and socioeconomic factors that may be of importance for the withdrawal of thiazide diuretics in patients hospitalized due to hyponatremia.METHODS: The study population was sampled from a case-control study investigating individuals hospitalized with a main diagnosis of hyponatremia. For every case, four matched controls were included. In the present study, cases (n = 5204) and controls (n = 7425) that had been dispensed a thiazide diuretic prior to index date were identified and followed onward regarding further dispensations. To investigate the influence of socioeconomic and sociodemographic factors, multiple logistic regression was used.RESULTS: The crude prevalence of thiazide withdrawal for cases and controls was 71.9% and 10.8%, respectively. Thiazide diuretics were more often withdrawn in medium-sized towns (adjusted OR, 1.52; 95% CI, 1.21-1.90) and rural areas (aOR, 1.81; 95% CI, 1.40-2.34) compared with metropolitan areas and less so among divorced (aOR, 0.72; 95% CI, 0.53-0.97). However, education, employment status, income, age, country of birth, and gender did not influence withdrawal of thiazides among patients with hyponatremia.CONCLUSIONS: Thiazide diuretics were discontinued in almost three out of four patients hospitalized due to hyponatremia. Educational, income, gender, and most other sociodemographic and socioeconomic factors were not associated with withdrawal of thiazides.
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17. |
- Gisselmann, Marit, et al.
(author)
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Kön, genus och skillnader i hälsa
- 2018. - 267
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In: Den orättvisa hälsan - om socioekonomiska skillnader i hälsa och livslängd. - Stockholm : Liber. - 9789147113545 ; , s. 67-85
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Book chapter (peer-reviewed)
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18. |
- Griep, Rosane Haerter, et al.
(author)
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Job strain and unhealthy lifestyle : results from the baseline cohort study, Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
- 2015
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 15
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Journal article (peer-reviewed)abstract
- Background: Unhealthy lifestyle choices, such as smoking and sedentary behavior, are among the main modifiable risk factors for chronic non-communicable diseases. The workplace is regarded as an important site of potential health risks where preventive strategies can be effective. We investigated independent associations among psychosocial job strain, leisure-time physical inactivity, and smoking in public servants in the largest Brazilian adult cohort. Methods: We conducted a cross-sectional analysis of baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)-a multicenter prospective cohort study of civil servants. Our analytical samples comprised 11,779 and 11,963 current workers for, respectively, analyses of job strain and leisure-time physical activity and analyses of job strain and smoking. Job strain was assessed using the Brazilian version of the Swedish Demand-Control-Support Questionnaire; physical activity was evaluated using a short form of the International Physical Activity Questionnaire. We also examined smoking status and number of cigarettes smoked per day. The association reported in this paper was assessed by means of multinomial and logistic regression, stratified by sex. Results: Among men, compared with low-strain activities (low demand and high control), job strain showed an association with physical inactivity (odds ratio [OR] = 1.34; 95% confidence interval [CI] = 1.09-1.64) or with the practice of physical activities of less than recommended duration (OR = 1.44; 95% CI = 1.15-1.82). Among women, greater likelihood of physical inactivity was identified among job-strain and passive-job groups (OR = 1.47; 95% CI = 1.22-1.77 and OR = 1.42; 95% CI = 1.20-1.67, respectively). Greater control at work was a protective factor for physical inactivity among both men and women. Social support at work was a protective factor for physical inactivity among women, as was smoking for both genders. We observed no association between demand or control dimensions and smoking. Conclusions: Job strain, job control, and social support were associated with physical activity. Social support at work was protective of smoking. Our results are comparable to those found in more developed countries; they provide additional evidence of an association between an adverse psychosocial work environment and health-related behaviors.
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19. |
- Griep, Rosane Härter, et al.
(author)
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Work-family conflict, lack of time for personal care and leisure, and job strain in migraine : Results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
- 2016
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In: American Journal of Industrial Medicine. - : Wiley. - 0271-3586 .- 1097-0274. ; 59:11, s. 987-1000
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Journal article (peer-reviewed)abstract
- BACKGROUND: Work-family conflict and time scarcity may affect health. We investigated the association between these issues and migraine, taking into account job strain.METHODS: Baseline data from ELSA-Brasil (6,183 women; 5,664 men) included four indicators of work-family conflict: time- and strain-based interference of work with family (TB-WFC, SB-WFC), interference of family with work (FWC) and lack of time for personal care and leisure (LOT). Migraine was classified according to International Headache Society criteria.RESULTS: Among women, definite migraine was associated with SB-WFC (odds ratio [OR] = 1.28; 95% confidence interval [CI] 1.06-1.55), FWC (OR = 1.32; 1.00-1.75), and LOT (OR = 1.30; 1.08-1.58). Probable migraine was associated with SB-WFC (OR = 1.17; 1.00-1.36). High psychological job demands and low social support interacted with LOT in association with definite migraine. Among men, probable migraine was associated with LOT (OR = 1.34; 1.09-1.64), and there were interactions between job strain and WFC for probable migraine.CONCLUSIONS: Balancing the demands of professional and domestic spheres could be highly relevant in the management of migraines. Am. J. Ind. Med. 59:987-1000, 2016. © 2016 Wiley Periodicals, Inc.
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