| 1. |
- Ericsson, Lovisa, et al.
(author)
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Revisiting socio-economic inequalities in sedentary leisure time in Sweden : An intersectional analysis of individual heterogeneity and discriminatory accuracy (AIHDA)
- 2023
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In: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 51:4, s. 570-578
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Journal article (peer-reviewed)abstract
- Aims: Swedish public health reports have repeatedly provided information about socio-economic inequalities in sedentary leisure time, despite that, in the interest of health equity, physical activity should be equally distributed in the population. Such public health reports, however, neither consider the intersection of multiple socio-demographic factors nor the individual heterogeneity around group averages. Drawing on intersectionality theory, this study aimed to revisit previous findings on sedentary leisure time from Swedish public health surveys and demonstrate how the analysis of individual heterogeneity and discriminatory accuracy (AIHDA) can be used for analysing complex health inequalities.Methods: Using data from Swedish national public health surveys (2004–2015), we applied the AIHDA to define 72 intersectional groups by categories of age, gender, educational achievement, migration status and household composition. We then calculated (a) the absolute and relative risk of sedentary leisure time and (b) the discriminatory accuracy (DA) of the intersectional grouping.Results: The average risk of sedentary leisure time ranged from 5.8% among native-born, highly educated, young women living alone to 41.0% among immigrated young men, living alone, with low education. The risk was higher in strata comprising immigrated people with low education and lower in strata including native-born, highly educated people. However, the DA of the grouping was poor, indicating a substantial overlap of individual risk between groups.Conclusions: Using the AIHDA and drawing on intersectionality, this study provides an improved mapping of the socio-economic distribution of sedentary leisure time in Sweden, with the poor DA suggesting universal rather than targeted physical activity interventions.
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| 2. |
- Gunnarsson, Lena, 1978-, et al.
(author)
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On the verge between the scientific and the alternative : Swedish women’s claims about systemic side effects of the copper intrauterine device
- 2023
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In: Public Understanding of Science. - : Sage Publications. - 0963-6625 .- 1361-6609. ; 32:2, s. 175-189
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Journal article (peer-reviewed)abstract
- The article intervenes in discussions on lay knowledge production about health in the Internet era, through the case of a group of women claiming that their use of copper intrauterine devices has led to systemic side effects. Based on online group interviews and written essays, we examine how women embracing these knowledge claims navigate various sources of information, focusing on the role of scientificity in these epistemic negotiations. The women were found to be involved in an active, scientifically oriented process of knowledge formation, which we refer to as a collective labour of scientific patchworking. Meanwhile, due to a perceived lack of scientifically based expertise on their condition, the women reported having little choice but turn to resources with weaker scientific foothold. We argue that the tendency to portray these women’s claims as unscientific simplifies the nature of lay knowledge production, potentially deepening divides between medical authorities and the public.
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| 3. |
- Gunnarsson, Lena, 1978-, et al.
(author)
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The different facets of 'experiential knowledge' in Swedish women's claims about systemic side effects of the copper intrauterine device
- 2023
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In: Sociology of Health and Illness. - : John Wiley & Sons. - 0141-9889 .- 1467-9566. ; 45:7, s. 1483-1501
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Journal article (peer-reviewed)abstract
- 'Experiential knowledge' has been identified as a key epistemic resource used by lay people to contest medical authorities and build new knowledge related to health. The Internet has created unprecedented opportunities for such experience-based epistemic projects. This article contributes to understandings of the as yet under-theorised concept of experiential knowledge by analysing accounts of a group of Swedish women who claim that their use of contraceptive copper IUDs has led to systemic side effects not recognised by health care providers. Based on digital group interviews and written essays, we distinguish between three components or stages of experiential knowledge at work in the women's use of experience as an epistemic resource: somatic knowing, collective validation and self-experimentation. Drawing on a critical realist framework, we defend a notion of experiential knowledge as crucially, while only partially, based on a bodily and practical access to aspects of reality organised by extra-discursive principles. By providing theoretical complexity to the notion of experiential knowledge, we contribute resources for discriminating between and evaluating various experience-based claims, something that is particularly needed in the current 'post-truth' era where experience-based knowledge claims pointing in divergent directions flourish.
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| 4. |
- Hernández-Yumar, Aránzazu, et al.
(author)
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Impact of the Economic Crisis on Body Mass Index in Spain : An Intersectional Multilevel Analysis Using a Socioeconomic and Regional Perspective
- 2023
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In: Population Research and Policy Review. - : Springer. - 0167-5923 .- 1573-7829. ; 42:4
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Journal article (peer-reviewed)abstract
- The Great Recession hit Spain deteriorating the living conditions of many Spanish people, increasing the prevalence of several chronic health issues, including obesity, and affecting health inequalities. We analyse the impact of this economic crisis on body mass index (BMI) disparities in Spain, from two perspectives: the socioeconomic and the territorial, through the application of an intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy. We use data from the Spanish National Health Surveys of 2006/2007, 2011/2012 and 2016/2017 to build multilevel linear regression models and estimate BMI averages and components of variance. We find a greater increase in the overall average BMI and a widening of the socioeconomic disparities during the hardest years of the crisis. However, these differences decreased when the economic situation in the country began to improve. Both socioeconomic and geographical information contribute to mapping the distribution of BMI in the population. However, according to the ICC values, considering the regional perspective provides a better understanding of the distribution of the BMI, during the period of economic crisis, in the Spanish population. Therefore, regional policies can play an important role in counteracting obesity in times of crisis.
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| 5. |
- Svalin, Klara, et al.
(author)
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Attitudes regarding intimate partner violence against women (IPVAW) among university students in Sweden
- 2023
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In: European Conference on Domestic Violence, September 11-13, 2023, Reykjavik Iceland. - Reykjavik : University of Iceland Press. - 9789935468277 ; , s. 148-
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Conference paper (peer-reviewed)abstract
- Intimate partner violence towards women (IPVAW) is a global problem, also prevalent in the Nordic countries including Sweden. Attitudes regarding IPVAW are important for the addressing and prevention of the issue. At the individual level, a tolerate attitude towards violence against women has shown to be related to IPV perpetration, while a permissive public view of the issue can have a negative impact on the help-seeking behavior of exposed women. More knowledge regarding IPV attitudes can therefore contribute to the development of preventive measures. The current study investigates University students’ attitudes regarding intimate partner violence towards women (IPVAW). Students responded to a survey covering four different aspects of attitudes to IPVAW: perceived severity and acceptability of IPVAW, victim-blaming and willingness to intervene in cases of IPVAW, usinga validated questionnaire. The respondents (n=656, ≥18 years old) represented different scientific fields (e.g. behavioral, technical, and social sciences) at three different universitiesin Sweden. 81% of them were women and most were undergraduate students. While the results point to low victim-blaming and acceptability of IPVAW overall, differences between female and male students and other student groups were identified, with implications forfuture research, policy and practice.
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| 6. |
- Wemrell, Maria, et al.
(author)
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Assessing the use of clinical guidelines against domestic violence in southern Sweden : A mixed-methods study
- 2023
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In: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 37:3, s. 828-841
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Journal article (peer-reviewed)abstract
- Background and Aim: Domestic violence is a prevalent public health issue. While clinical guidelines and care programs for its identification and handling have been formulated in all administrative regions of Sweden, their degree of implementation is largely unknown. This study aims to assess the implementation of one administrative region's care program, including how it is seen to align with and function in clinical practice, and any perceived barriers to or facilitators of its use.Methods: A survey was distributed to first-line managers for healthcare units with patient contact in the region (n = 807). The responses were analysed using descriptive statistics. Open responses were analysed thematically. Group interviews (n = 5) were held with caregivers (n = 15) working primarily with young patients and analysed thematically.Results: 73% of the survey respondents reported previous awareness of the care program, and 27% reported knowledge of its content. The extent to which their staff knew about and followed the care program was assessed to be relatively low. The survey response rate was 19%. Among interview participants, knowledge of the care program was generally quite low. Survey responses and interview discussions pointed to the importance of developing routines, of collegial and managerial support and of training on domestic violence and the care program.Conclusion: This study indicates that the knowledge and use of the regional care program is limited among healthcare staff, including among those working with young patients. This underscores the importance of information and training for furthering the implementation of clinical guidelines on domestic violence.
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| 7. |
- Wemrell, Maria, et al.
(author)
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Claims in the clinic : A qualitative group interview study on healthcare communication about unestablished side effects of the copper IUD
- 2023
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:9
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Journal article (peer-reviewed)abstract
- Background: Lay online communication about health-related issues has in recent years largely been associated with the spread of misinformation and decreased trust in healthcare. Such communication has included claims about systemic side effects of the copper IUD. In Sweden, a social media group centered on this issue now gathers around 8,700 members. This study aimed to use the case of reported yet unestablished side effects of the copper IUD to investigate experiences of and reasoning about healthcare encounters between caregivers and patients contesting established medical knowledge.Methods: We conducted qualitative, semi-structured, digital group interviews with members of the social media group (seven groups, n = 23) and with midwives and gynecologists (six groups, n = 15). We also gathered essays written by social media group members (n = 23). The material was analyzed thematically.Results: The participant accounts pointed towards tensions related to principles of evidence-based medicine, i.e., perceived insufficiency of research on the safety of the copper IUD and lack of clarity in routines for reporting and following up suspected side effects, and of patient-centered care, i.e., listening respectfully to patients. Tension between caregivers’ obligation to adhere to evidence-based medicine while also providing patient-centered care was noted.Conclusion. Healthcare providers’ efforts to assess and address patient claims contesting established medical knowledge should include ensuring and communicating sufficient research, clarifying procedures for reporting suspected side effects, and improving person-centered care. This can increase the quality of care while contributing to the mitigation of distrust in healthcare and the spreading of health-related misinformation.
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| 8. |
- Wemrell, Maria, et al.
(author)
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Mapping sociodemographic and geographical differences in human papillomavirus non-vaccination among young girls in Sweden
- 2023
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 51:2
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Journal article (peer-reviewed)abstract
- Aims:Human papillomavirus (HPV) vaccination plays a key role in the prevention of cervical cancer. Yet, disparities in HPV vaccination in Sweden have persisted. Previous research on such disparities has typically focused on singular sociodemographic variables and measures of average risk. Using a multi-categorical approach and drawing on intersectionality theory, this study aimed to provide a more precise mapping of HPV non-vaccination among girls in different sociodemographic groups and geographical areas in Sweden during 2013–2020.Methods:Using nationwide register data, we conducted a multi-categorical analysis of individual heterogeneity and discriminatory accuracy complemented by a multilevel geographical analysis. We mapped HPV non-vaccination prevalence across 54 strata defined by parental income, education and country of birth, and urban versus rural place of residence. We also disentangled municipal and regional influences on HPV non-vaccination.Results:HPV non-vaccination was more common in groups with a low income, a low education and an immigration background, whereas among those with an immigration background, the association between income, education and HPV non-vaccination was more complex. Geographical differences were found between municipalities. However, the discriminatory accuracy of the sociodemographic and geographical groups was weak, and 50% of the non-vaccination cases were observed in eight strata, of which some are among those with low risk.Conclusions:Our findings underscore the importance of universal yet tailored approaches, including providing adequate information about HPV vaccination in Swedish and other languages, and of health-care professionals displaying sensitivity to patients’ and parents’ questions or needs.
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| 9. |
- Wemrell, Maria
(author)
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Paradox and complexity : intimate partner violence against women and gender (in)equality in Sweden
- 2023
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In: European Conference on Domestic Violence, September 11-13, 2023, Reykjavik Iceland. - Reykjavik : University of Iceland Press. - 9789935468277 ; , s. 51-52
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Conference paper (peer-reviewed)abstract
- The perhaps puzzling co-existence of highly rated country-level gender equality and survey reported experiences of intimate partner violence against women (IPVAW) in Sweden and neighboring Nordic countries has been referred to as a Nordic paradox. Hypothetical partial explanations for this apparent paradox have pointed to backlash effects, i.e., resistance from individuals in positions of relative privilege to changes resulting in their loss of power, and to the complex or multidimensional nature of gender in/equality. Based on qualitative in-depth interviews with 23 women exposed to IPVAW in Sweden, analyzed thematically, this presentation will discuss the participant’s narrated experiences of gender in/equality and of backlash dynamics in their violent intimate relationships.
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| 10. |
- Wemrell, Maria
(author)
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Stories of Backlash in Interviews With Survivors of Intimate Partner Violence Against Women in Sweden
- 2023
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In: Violence Against Women. - : SAGE Publications. - 1077-8012 .- 1552-8448. ; 29:2, s. 154-184
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Journal article (peer-reviewed)abstract
- Despite high gender equality ratings, Sweden shows a high prevalence of intimate partner violence against women (IPVAW). Suggested factors underlying this apparent paradox include backlash effects against women's empowerment. This study explores stories of backlash in interviews with 23 IPVAW survivors in Sweden. Thematic analysis identified categories of narrative segments referring to phenomena provoking violence; the victims’ resources, agency, breaking with gender norms and resistance, and the partner's feelings of subordination, while case-centered narrative analysis pointed to divergences between how these categories appear in the stories. The study underscores the complexity of links between gender (in)equality and IPVAW in Sweden.
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