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  • 1.
    Afroz, B.
    et al.
    Karlstad University, Division of Public Health Sciences.
    Moniruzzaman, S.
    Karlstad University, Division of Public Health Sciences.
    Ekman, Diana Stark
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för hälsa och kultur.
    Andersson, R.
    Karlstad University, Division of Public Health Sciences.
    The impact of economic crisis on injury mortality: The case of the 'Asian crisis'2012Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 126, nr 10, s. 836-838Artikkel i tidsskrift (Fagfellevurdert)
  • 2. Asp, M.
    et al.
    Simonsson, B.
    Larm, P.
    Molarius, Anu
    Physical mobility, physical activity, and obesity among elderly: findings from a large population-based Swedish survey2017Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 147, s. 84-91Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To examine how physical activity and physical mobility are related to obesity in the elderly. Study design: A cross-sectional study of 2558 men and women aged 65 years and older who participated in a population survey in 2012 was conducted in mid-Sweden with an overall response rate of 67%. Methods: Obesity (body mass index >= 30 kg/m(2)) was based on self-reported weight and height, and physical activity and physical mobility on questionnaire data. Chi-squared test and multiple logistic regressions were used as statistical analyses. Results: The overall prevalence of obesity was 19% in women and 15% in men and decreased after the age of 75 years. A strong association between both physical activity and obesity, and physical mobility and obesity was found. The odds for obesity were higher for impaired physical mobility (odds ratio [OR] 2.83, 95% confidence interval [CI] 2.14-3.75) than for physical inactivity (OR 1.63, 95% CI 1.28-2.08) when adjusted for gender, age, socio-economic status and fruit and vegetable intake. However, physical activity was associated with obesity only among elderly with physical mobility but not among those with impaired physical mobility. Conclusion: It is important to focus on making it easier for elderly with physical mobility to become or stay physically active, whereas elderly with impaired physical mobility have a higher prevalence of obesity irrespective of physical activity. (C) 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  • 3.
    Asp, M.
    et al.
    Malardalens Univ, Sch Hlth Care & Social Welf, Hogskoleplan 1,POB 883, S-72123 Vasteras, Sweden..
    Simonsson, B.
    Competence Ctr Hlth Reg Vastmanland, S-72189 Adelsogatan, Vasteras, Sweden..
    Larm, Peter
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås. Malardalens Univ, Sch Hlth Care & Social Welf, Hogskoleplan 1,POB 883, S-72123 Vasteras, Sweden.
    Molarius, A.
    Competence Ctr Hlth Reg Vastmanland, S-72189 Adelsogatan, Vasteras, Sweden.;Karlstad Univ, Dept Hlth Sci, Univ Svagen 2, S-65188 Karlstad, Sweden..
    Physical mobility, physical activity, and obesity among elderly: findings from a large population-based Swedish survey2017Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 147, s. 84-91Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To examine how physical activity and physical mobility are related to obesity in the elderly.

    Study design: A cross-sectional study of 2558 men and women aged 65 years and older who participated in a population survey in 2012 was conducted in mid-Sweden with an overall response rate of 67%.

    Methods: Obesity (body mass index >= 30 kg/m(2)) was based on self-reported weight and height, and physical activity and physical mobility on questionnaire data. Chi-squared test and multiple logistic regressions were used as statistical analyses.

    Results: The overall prevalence of obesity was 19% in women and 15% in men and decreased after the age of 75 years. A strong association between both physical activity and obesity, and physical mobility and obesity was found. The odds for obesity were higher for impaired physical mobility (odds ratio [OR] 2.83, 95% confidence interval [CI] 2.14-3.75) than for physical inactivity (OR 1.63, 95% CI 1.28-2.08) when adjusted for gender, age, socio-economic status and fruit and vegetable intake. However, physical activity was associated with obesity only among elderly with physical mobility but not among those with impaired physical mobility.

    Conclusion: It is important to focus on making it easier for elderly with physical mobility to become or stay physically active, whereas elderly with impaired physical mobility have a higher prevalence of obesity irrespective of physical activity.

  • 4.
    Asp, Margareta
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Simonsson, B.
    Competence Ctr Hlth Reg Västmanland, Västerås, Sweden.
    Peter, Larm
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Uppsala Univ, Sweden.
    Molarius, A.
    Karlstad Univ, Sweden.
    Physical mobility, physical activity, and obesity among elderly: findings from a large population-based Swedish survey2017Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 147, s. 84-91Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To examine how physical activity and physical mobility are related to obesity in the elderly. Study design: A cross-sectional study of 2558 men and women aged 65 years and older who participated in a population survey in 2012 was conducted in mid-Sweden with an overall response rate of 67%. Methods: Obesity (body mass index >= 30 kg/m(2)) was based on self-reported weight and height, and physical activity and physical mobility on questionnaire data. Chi-squared test and multiple logistic regressions were used as statistical analyses. Results: The overall prevalence of obesity was 19% in women and 15% in men and decreased after the age of 75 years. A strong association between both physical activity and obesity, and physical mobility and obesity was found. The odds for obesity were higher for impaired physical mobility (odds ratio [OR] 2.83, 95% confidence interval [CI] 2.14-3.75) than for physical inactivity (OR 1.63, 95% CI 1.28-2.08) when adjusted for gender, age, socio-economic status and fruit and vegetable intake. However, physical activity was associated with obesity only among elderly with physical mobility but not among those with impaired physical mobility. Conclusion: It is important to focus on making it easier for elderly with physical mobility to become or stay physically active, whereas elderly with impaired physical mobility have a higher prevalence of obesity irrespective of physical activity.

  • 5. Baburin, A.
    et al.
    Lai, T.
    Leinsalu, Mall
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Avoidable mortality in Estonia: exploring the differences in life expectancy between Estonians and non-Estonians in 2005-20072011Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 125, nr 11, s. 754-762Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: A considerable increase in social inequalities in mortality was observed in Eastern Europe during the post-communist transition. This study evaluated the contribution of avoidable causes of death to the difference in life expectancy between Estonians and non-Estonians in Estonia. Study design: Descriptive study. Methods: Temporary life expectancy (TLE) was calculated for Estonian and non-Estonian men and women aged 0-74 years in 2005-2007. The ethnic TLE gap was decomposed by age and cause of death (classified as preventable or treatable). Results: The TLE of non-Estonian men was 3.53 years less than that of Estonian men, and the TLE of non-Estonian women was 1.36 years less than that of Estonian women. Preventable causes of death contributed 2.19 years to the gap for men and 0.78 years to the gap for women, while treatable causes contributed 0.67 and 0.33 years, respectively. Cardiorespiratory conditions were the major treatable causes of death, with ischaemic heart disease alone contributing 0.29 and 0.08 years to the gap for men and women, respectively. Conditions related to alcohol and substance use represented the largest proportion of preventable causes of death. Conclusions: Inequalities in health behaviours underlie the ethnic TLE gap in Estonia, rather than inequalities in access to health care or the quality of health care. Public health interventions should prioritize primary prevention aimed at alcohol and substance use, and should be implemented in conjunction with wider social policy measures

  • 6.
    Baburin, Aleksei
    et al.
    National Institute for Health Development, Tallinn, Estonia / University of Tampere, Tampere, Finland.
    Lai, Taavi
    University of Tartu, Tartu, Estonia.
    Leinsalu, Mall
    Södertörns högskola, Institutionen för samhällsvetenskaper, Sociologi. Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre on Health of Societies in Transition). Centre for Health Equity Studies, Stockholm University/Karolinska Institutet.
    Avoidable mortality in Estonia: Exploring the differences in life expectancy between Estonians and non-Estonians in 2005-2007.2011Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 125, nr 11, s. 754-762Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: A considerable increase in social inequalities in mortality was observed in Eastern Europe during the post-communist transition. This study evaluated the contribution of avoidable causes of death to the difference in life expectancy between Estonians and non-Estonians in Estonia.

    STUDY DESIGN: Descriptive study.

    METHODS: Temporary life expectancy (TLE) was calculated for Estonian and non-Estonian men and women aged 0-74 years in 2005-2007. The ethnic TLE gap was decomposed by age and cause of death (classified as preventable or treatable).

    RESULTS: The TLE of non-Estonian men was 3.53 years less than that of Estonian men, and the TLE of non-Estonian women was 1.36 years less than that of Estonian women. Preventable causes of death contributed 2.19 years to the gap for men and 0.78 years to the gap for women, while treatable causes contributed 0.67 and 0.33 years, respectively. Cardiorespiratory conditions were the major treatable causes of death, with ischaemic heart disease alone contributing 0.29 and 0.08 years to the gap for men and women, respectively. Conditions related to alcohol and substance use represented the largest proportion of preventable causes of death.

    CONCLUSIONS: Inequalities in health behaviours underlie the ethnic TLE gap in Estonia, rather than inequalities in access to health care or the quality of health care. Public health interventions should prioritize primary prevention aimed at alcohol and substance use, and should be implemented in conjunction with wider social policy measures.

  • 7. Baigi, A
    et al.
    Fridlund, Bengt
    Lunds universitet.
    Marklund, B
    Oden, A
    Cardiovascular mortality focusing on socio-economic influence: the low-risk population of Halland compared to the population of Sweden as a whole2002Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 116, nr 5, s. 285-288Artikkel i tidsskrift (Fagfellevurdert)
  • 8.
    Baigi, Amir
    et al.
    Primary Health Care Halland, Falkenberg.
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Marklund, B.
    Göteborg University.
    Oden, A.
    Statistics, Göteborg.
    Cardiovascular mortality focusing on socio-economic influence: the low-risk population of Halland compared to the population of Sweden as a whole2002Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 116, nr 5, s. 285-288Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the study was to investigate the relationship between mortality from cardiovascular diseases (CVD) and socioeconomic status (SES) in Sweden and to estimate to what extent the difference between a province with low mortality and the rest of Sweden was dependent on socio-economic factors. A population-based retrospective study with a historical prospective approach was performed covering a 10-y period in the province of Halland, Sweden, as well as Sweden as a whole. Altogether 1654 744 men and 1592 467 women were included, of whom 45 394 men and 43 403 women were from Halland, distributed according to SES. Multivariate analysis with Poisson regression was used. Relative risks with 95% confidence intervals were calculated. Both men and women with a low SES showed a significantly higher risk of death from CVD in Sweden as a whole. The risk was 23% higher for male blue-collar workers and 44% higher for female blue-collar workers when compared to their white-collar counterparts. The level of mortality in Halland was 14% lower compared to the country as a whole when only age was taken into account. When the socio-economic variable was also included, this figure was 8%. The results show the substantial significance of social differences with respect to CVD mortality. The effect of SES seems to be more important than that of geographical conditions when the latter are isolated from socio-economic influence.

  • 9.
    Barrett, Damon
    Stockholms universitet, Juridiska fakulteten, Juridiska institutionen. University of Essex, UK.
    Re: ‘Access to treatment with controlled medicines: rationale and recommendations for neutral, precise, and respectful language’2018Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 160, s. 156-156Artikkel i tidsskrift (Annet vitenskapelig)
  • 10. Berth, H
    et al.
    Baigi, A
    Fridlund, Bengt
    Växjö universitet.
    Marklund, B
    Life events, social support and sense of coherence among frequent attenders in primary health care2006Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 120, nr 3, s. 229-236Artikkel i tidsskrift (Fagfellevurdert)
  • 11.
    Brynhildsen, Jan
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Sydsjö, Adam
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Norinder, E.
    Ekholm, Katarina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi.
    Sydsjö, Gunilla
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Trends in body mass index during early pregnancy in Swedish women 1978-20012006Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 120, nr 5, s. 393-399Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: to study the body mass index (BMI) in women seeking maternity health care during early pregnancy in Sweden, and to show trends for a period of more than 20 years. Study design: register study. Methods: data from the maternity health programme on consecutively delivered women in two Swedish hospitals were collected for the years 1978, 1986, 1992, 1997 and 2001. All women were weighed at their first midwife visit between 8 and 10 weeks of gestation and height was also measured. Results: data on 4883 women were collected. Data on weight were available for 4490 (92%) women and data on BMI were available for 4378 (90%) women. The age-adjusted average weight increased from 59.5 kg in 1978 to 68.2 kg in 2001, and the BMI increased from 21.7 in 1978 to 24.7 in 2001. In 2001, 38.6% of the women had a BMI >25 compared with 11.2 in 1978. In 2001, 11.6% of the women were obese compared with 2.2% in 1978. Conclusions: during the last two decades, an alarming increase in weight has occurred in Swedish women of childbearing age. © 2005.

  • 12.
    Byass, Peter
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Alberts, M
    Burger, S
    Motherhood, migration and mortality in Dikgale: modelling life events among women in a rural South African community2011Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 125, nr 5, s. 318-323Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Although particular types of life events in populations are often studied separately, this study investigated the joint effects of three major event types in South African women’s lives: motherhood, migration and mortality.

    Study design: Data were taken from a health and demographic surveillance site (HDSS) over an 11-year period, reflecting the entire population of a defined geographic area as an open cohort, in which individuals participated in regular longitudinal surveillance for health and demographic events. This HDSS is a member of the Indepth Network.

    Methods: Multivariate Poisson regression models were built for each of the three life event types, in which individual person-time observed out of the total possible 11-year period was used as a rate multiplier. These models were used to calculate adjusted incidence rate ratios for each factor.

    Results: In the 21,587 person–years observed for women aged 15–49 years, from 1996 to 2006, adjusted rate ratios for mortality and migration increased substantially over time, while motherhood remained fairly constant. Women who migrated were less likely to bear children; temporary migrants were at greater risk of dying, while permanent in-migrants had higher survival rates. Women who subsequently died were much less likely to bear children or migrate.

    Conclusions: The associations between motherhood, migration and mortality among these rural South African women were complex and dynamic. Extremely rapid increases in mortality over the period studied are presumed to reflect the effects of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic. Understanding these complex interactions between various life events at population level is crucial for effective public health planning and service delivery.

  • 13.
    Byass, Peter
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Berhane, Y
    Emmelin, Anders
    Kebede, D
    Andersson, T
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Högberg, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Wall, Stig
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    The role of demographic surveillance systems (DSS) in assessing the health of communities: an example from rural Ethiopia2002Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 116, nr 3, s. 145-150Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Longitudinal demographic surveillance systems (DSSs) in selected populations can provide important information in situations where routine health information is incomplete or absent, particularly in developing countries. The Butajira Rural Health Project is one such example, initiated in rural Ethiopia in 1987. DSSs rely on regular community-based surveillance as a means of vital event registration, among a sufficient population base to draw meaningful conclusions about rates and trends in relatively rare events such as maternal death. Enquiries into specific health problems can also then use this framework to quantify particular issues or evaluate interventions. Demographic characteristics and trends for a rural Ethiopian population over a 10-y period are presented as an illustration of the DSS approach, based on 336 000 person-years observed. Overall life expectancy at birth was 50 y. Demographic parameters generally showed modest trends towards improvement over the 10-y period. The DSS approach is useful in characterising populations at the community level over a period of time, providing important information for health planning and intervention. Methodological issues underlying this approach need further exploration and development.

  • 14.
    DeKeyser, Nicholas
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi.
    Josefsson, Ann
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Monfils-Gustavsson, Wiktor
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Claesson, Ing-Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Carlsson, Per
    Linköpings universitet, Institutionen för medicin och hälsa, Utvärdering och hälsoekonomi. Linköpings universitet, Hälsouniversitetet.
    Sydsjö, Adam
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Sydsjö, Gunilla
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Total cost comparison of standard antenatal care with a weight gain restriction programme for obese pregnant women2011Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 125, nr 5, s. 311-317Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To perform a cost comparison of a weight gain restriction programme for obese pregnant women with standard antenatal care, and to identify if there were differences in healthcare costs within the intervention group related to degree of gestational weight gain or degree of obesity at programme entry. Study design: A comparison of mean healthcare costs for participants of an intervention study at antenatal care clinics with controls in south-east Sweden. Methods: In total, 155 women in an intervention group attempted to restrict their gestational weight gain to less than7 kg. The control group comprised 193 women. Mean costs during pregnancy, delivery and the neonatal period were compared with the costs of standard care. Costs were converted from Swedish Kronor to Euros ((sic)). Results: Healthcare costs during pregnancy were lower in the intervention group. There was no significant difference in total healthcare costs (i.e. sum of costs during pregnancy, delivery and the neonatal period) between the intervention group and the control group. Within the intervention group, the subgroup that gained 4.5-9.5 kg had the lowest costs. The total cost, including intervention costs, was (sic)1283 more per woman/ infant in the intervention group compared with the control group (P = 0.025). The degree of obesity at programme entry had no bearing on the outcome. Conclusions: The weight gain restriction programme for obese pregnant women was effective in restricting gestational weight gain to less than7 kg, but had a higher total cost compared with standard antenatal care.

  • 15.
    Fantahun, M
    et al.
    School of Public Health, Addis Ababa University, Ethiopia.
    Berhane, Y
    School of Public Health, Addis Ababa University, Ethiopia.
    Högberg, Ulf
    Umeå International School of Public Health, Epidemiology and Public Health Sciences, Umeå University, Sweden.
    Wall, S
    Umeå International School of Public Health, Epidemiology and Public Health Sciences, Umeå University, Sweden.
    Byass, P
    Umeå International School of Public Health, Epidemiology and Public Health Sciences, Umeå University, Sweden.
    Ageing of a rural Ethiopian population: who are the survivors?2009Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 123, nr 4, s. 326-30Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: This study assessed trends in survival to old age and identified the factors associated with longevity among the elderly (age > or = 65 years).

    STUDY DESIGN: Cohort analysis of demographic surveillance data.

    METHODS: The study was conducted in the Butajira Rural Health Programme Demographic Surveillance Site in Ethiopia. Using data collected between 1987 and 2004, the probability of survival to 65 years and remaining life expectancy for women and men aged 65 years were computed. Cox regression analysis was used to assess survival by different factors.

    RESULTS: Although the elderly represented 3% of the population, their person-time contribution increased by 48% over the 18-year period. Less than half reached 65 years of age, with remaining life expectancy at 65 years ranging from 15 years in rural men to 19 years in urban women. Rural residence, illiteracy and widowhood were associated with lower survival adjusted for other factors, whereas gender did not show a significant difference. However, the effect of these factors differed between men and women, as demonstrated by survival curves and Cox regression. Widowhood [hazard ratio (HR) 2.02, 95% confidence interval (CI) 1.59-2.57] and illiteracy (HR 2.26, 95% CI 1.86-2.73) affected males to a greater extent than females, and rural residence was associated with poorer female survival (HR 1.68, 95% CI 1.55-1.83).

    CONCLUSIONS: The number of elderly people is increasing in Ethiopia, with the chance of survival into older age being similar between men and women and approaching that in developed countries. However, rural women and illiterate women and men, particularly widowers, are disadvantaged in terms of survival.

  • 16.
    Fottrell, Edward
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Byass, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Identifying humanitarian crises in population surveillance field sites: simple procedures and ethical imperatives.2009Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 123, nr 2, s. 151-155Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: Effective early warning systems of humanitarian crises may help to avert substantial increases in mortality and morbidity, and prevent major population movements. The Butajira Rural Health Programme (BRHP) in Ethiopia has maintained a programme of epidemiological surveillance since 1987. Inspection of the BRHP data revealed large peaks of mortality in 1998 and 1999, well in excess of the normally observed year-to-year variation. Further investigation and enquiry revealed that these peaks related to a measles epidemic, and a serious episode of drought and consequent food insecurity that went undetected by the BRHP. This paper applies international humanitarian crisis threshold definitions to the BRHP data in an attempt to identify suitable mortality thresholds that may be used for the prospective detection of humanitarian crises in population surveillance sites in developing countries.

    STUDY DESIGN: Empirical investigation using secondary analysis of longitudinal population-based cohort data.

    METHODS: The daily, weekly and monthly thresholds for crises in Butajira were applied to mortality data for the 5-year period incorporating the crisis periods of 1998-1999. Days, weeks and months in which mortality exceeded each threshold level were identified. Each threshold level was assessed in terms of prospectively identifying the true crisis periods in a timely manner whilst avoiding false alarms.

    RESULTS: The daily threshold definition is too sensitive to accurately detect impending or real crises in the population surveillance setting of the BRHP. However, the weekly threshold level is useful in identifying important increases in mortality in a timely manner without the excessive sensitivity of the daily threshold. The weekly threshold level detects the crisis periods approximately 2 weeks before the monthly threshold level.

    CONCLUSION: Mortality measures are highly specific indicators of the health status of populations, and simple procedures can be used to apply international crisis threshold definitions in population surveillance settings for the prospective detection of important changes in mortality rate. Standards for the timely use of surveillance data and ethical responsibilities of those responsible for the data should be made explicit to improve the public health functioning of current sentinel surveillance methodologies.

  • 17.
    Ganedahl, H.
    et al.
    University of Skovde, Sweden.
    Zsaludek Viklund, P.
    University of Skovde, Sweden.
    Carlen, K.
    University of Skovde, Sweden.
    Kylberg, E.
    University of Skovde, Sweden.
    Ekberg, Joakim
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för hälso- och vårdutveckling, Folkhälsocentrum.
    Work-site wellness programmes in Sweden: a cross-sectional study of physical activity, self-efficacy, and health2015Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 129, nr 5, s. 525-530Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In Sweden, a work-site wellness programme implies reimbursing some of the expenses for health-promoting activities. Although work-site wellness programmes are readily available in Sweden, a large number of employees elect not to participate. Objectives: The aim of this study was to investigate the association of physical activity, self-reported general health assessment and self-efficacy with participation in a work-site wellness programme. Study design: A cross-sectional study design was used. Methods: An online questionnaire was distributed to employees of a manufacturing company with 2500 employees in southwest Sweden. Results: Those who took advantage of the work-site wellness programme assessed their general health as better and had higher assessment of physical activity. The study showed that being enlisted also implies a higher level of physical activity and general health; however, the effect sizes of these correlations were small. Self-efficacy, i.e. perceived behavioural control, was not associated with participation in the work-site wellness programme. However, self-efficacy was correlated with both general health assessment and physical activity. A regression analysis to determine explanatory contributions to the general health assessment score showed no significant contribution from participation in a work-site wellness programme, but was instead explained by perceived behavioural control and physical activity. Conclusions: Given the small effect size of the difference in physical activity between participators and non-participators in the work-site wellness programme, it is probable that only a small proportion of participators changed their health-promoting activities as a result of the work-site wellness programme. (C) 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  • 18.
    Gillander Gådin, Katja
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Hammarström, A.
    Can school-related factors predict future health behaviour among young adolescents?2002Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 116, nr 1, s. 22-29Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Although the prevention of unfavourable health behaviour among young people has high priority in public health, the possibility of finding risk factors at school has not been sufficiently studied. The objective of this study was to find predictors among young pupils for later unfavourable health behaviour, with special focus on school-related factors.A three-year prospective study was started in 1994 including 279 pupils (141 girls and 138 boys) from different socioeconomic areas. The pupils answered a comprehensive questionnaire in grade six and grade nine. The non-response rate was negligible. The best predictors for health behaviour among boys and girls in grade nine were factors related to earlier health/health behaviour. The results also indicated that school-related factors could predict future health behaviour, especially in relation to low physical activity among girls.The school has an important role to play in identification of future unfavourable health behaviour among pupils at the school, both directly through recognising school-related risk factors and also indirectly through paying special attention to pupils with unfavourable health/health behaviour. Our findings indicate the need for more research in younger ages, as negative health behaviour already seems to be established at 12 y of age.

  • 19.
    Grjibovski, A M
    et al.
    Unit for Preventive Nutrition, Department of Biosciences at Novum, Karolinska Institutet, Huddinge, Sweden; Institute of Hygiene/Medical Ecology, Northern State Medical University, Arkhnagelsk, Russian Federation .
    Bygren, L O
    Unit for Preventive Nutrition, Department of Biosciences at Novum, Karolinska Institutet, Huddinge, Sweden; Dept. of Comm. Med./Rehabilitation, Umeå University, Umeå, Sweden.
    Yngve, Agneta
    Unit for Preventive Nutrition, Department of Biosciences at Novum, Karolinska Institutet, Huddinge, Sweden .
    Sjöström, Michael
    Unit for Preventive Nutrition, Department of Biosciences at Novum, Karolinska Institutet, Huddinge, Sweden .
    Large social disparities in spontaneous preterm birth rates in transitional Russia2005Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 119, nr 2, s. 77-86Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: This study estimated the effect of maternal sociodemographic, obstetric and lifestyle factors on the risk of spontaneous preterm birth in a Russian town.

    METHODS: All women with singleton pregnancies registered at prenatal care centres in Severodvinsk in 1999 comprised the cohort for this study (n=1559). Analysis was based on spontaneous live singleton births at the maternity home (n=1103). Multivariable logistic regression was applied to quantify the effect of the studied factors on the risk of preterm birth. Differences in gestation duration were studied using multiple linear regression.

    RESULTS: In total, 5.6% of all spontaneous births were preterm. Increased risks of preterm delivery were found in women with lower levels of education and in students. Placental complications, stress and a history of fetal death in previous pregnancies were also associated with elevated risks for preterm delivery. Smoking, hypertension and multigravidity were associated with reduced length of pregnancy in metric form.

    CONCLUSION: In addition to medical risk factors, social factors are important determinants of preterm birth in transitional Russia. Large disparities in preterm birth rates may reflect the level of inequalities in transitional Russia. Social variations in pregnancy outcomes should be monitored.

  • 20.
    Grjibovski, A M
    et al.
    Unit for Preventive Nutrition, Department of Biosciences at Novum, Karolinska Institutet, Huddinge, Sweden; Institute of Hygiene/Medical Ecology, Northern State Medical University, Arkhnagelsk, Russian Federation .
    Bygren, L O
    Unit for Preventive Nutrition, Department of Biosciences at Novum, Karolinska Institutet, Huddinge, Sweden; Dept. of Comm. Med./Rehabilitation, Umeå University, Umeå, Sweden.
    Yngve, Agneta
    Unit for Preventive Nutrition, Department of Biosciences at Novum, Karolinska Institutet, Huddinge, Sweden .
    Sjöström, Michael
    Unit for Preventive Nutrition, Department of Biosciences at Novum, Karolinska Institutet, Huddinge, Sweden .
    Large social disparities in spontaneous preterm birth rates in transitional Russia2005Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 119, nr 2, s. 77-86Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: This study estimated the effect of maternal sociodemographic, obstetric and lifestyle factors on the risk of spontaneous preterm birth in a Russian town.

    METHODS: All women with singleton pregnancies registered at prenatal care centres in Severodvinsk in 1999 comprised the cohort for this study (n=1559). Analysis was based on spontaneous live singleton births at the maternity home (n=1103). Multivariable logistic regression was applied to quantify the effect of the studied factors on the risk of preterm birth. Differences in gestation duration were studied using multiple linear regression.

    RESULTS: In total, 5.6% of all spontaneous births were preterm. Increased risks of preterm delivery were found in women with lower levels of education and in students. Placental complications, stress and a history of fetal death in previous pregnancies were also associated with elevated risks for preterm delivery. Smoking, hypertension and multigravidity were associated with reduced length of pregnancy in metric form.

    CONCLUSION: In addition to medical risk factors, social factors are important determinants of preterm birth in transitional Russia. Large disparities in preterm birth rates may reflect the level of inequalities in transitional Russia. Social variations in pregnancy outcomes should be monitored.

  • 21. Grjibovski, A M
    et al.
    Bygren, Lars Olov
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering. Unit for Preventive Nutrition, Department of Biosciences at Novum, Karolinska Institutet, 141 157 Huddinge, Sweden.
    Yngve, Agneta
    Sjöström, M
    Large social disparities in spontaneous preterm birth rates in transitional Russia2005Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 119, nr 2, s. 77-86Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective. This study estimated the effect of maternal sociodemographic, obstetric and lifestyle factors on the risk of spontaneous preterm birth in a Russian town.

    Methods. All women with singleton pregnancies registered at prenatal care centres in Severodvinsk in 1999 comprised the cohort for this study (n = 1559). Analysis was based on spontaneous live singleton births at the maternity home (n=1103). Muttivariable logistic regression was applied to quantify the effect of the studied factors on the risk of preterm birth. Differences in gestation duration were studied using multiple Linear regression.

    Results. In total, 5.6% of all spontaneous births were preterm. Increased risks of preterm delivery were found in women with lower Levels of education and in students. Placental complications, stress and a history of fetal death in previous pregnancies were also associated with elevated risks for preterm delivery. Smoking, hypertension and multigravidity were associated with reduced length of pregnancy in metric form.

    Conclusion. In addition to medical risk factors, social factors are important determinants of preterm birth in transitional Russia. Large disparities in preterm birth rates may reflect the level of inequalities in transitional Russia. Social variations in pregnancy outcomes should be monitored.

  • 22.
    Gånedahl, Hanna
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Zsaludek Viklund, Pernilla
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Carlén, Kristina
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande.
    Kylberg, Elisabeth
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande.
    Ekberg, Joakim
    Unit for Health Analysis, Centre for Healthcare Development, County Council of Östergötland, Linköping, Sweden / Unit of Community Medicine, Department of Medicine and Health, Linköping University, Sweden.
    Work-site wellness programmes in Sweden: a cross-sectional study of physical activity, self-efficacy, and health2015Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 129, nr 5, s. 525-530Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In Sweden, a work-site wellness programme implies reimbursing some of the expenses for health-promoting activities. Although work-site wellness programmes are readily available in Sweden, a large number of employees elect not to participate.

    OBJECTIVES: The aim of this study was to investigate the association of physical activity, self-reported general health assessment and self-efficacy with participation in a work-site wellness programme.

    STUDY DESIGN: A cross-sectional study design was used.

    METHODS: An online questionnaire was distributed to employees of a manufacturing company with 2500 employees in southwest Sweden.

    RESULTS: Those who took advantage of the work-site wellness programme assessed their general health as better and had higher assessment of physical activity. The study showed that being enlisted also implies a higher level of physical activity and general health; however, the effect sizes of these correlations were small. Self-efficacy, i.e. perceived behavioural control, was not associated with participation in the work-site wellness programme. However, self-efficacy was correlated with both general health assessment and physical activity. A regression analysis to determine explanatory contributions to the general health assessment score showed no significant contribution from participation in a work-site wellness programme, but was instead explained by perceived behavioural control and physical activity.

    CONCLUSIONS: Given the small effect size of the difference in physical activity between participators and non-participators in the work-site wellness programme, it is probable that only a small proportion of participators changed their health-promoting activities as a result of the work-site wellness programme.

  • 23.
    Hammarström, Anne
    et al.
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Lehti, Arja
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Danielsson, Ulla
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Bengs, Carita
    Umeå universitet, Sociologiska institutionen.
    Johansson, E.E.
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Gender-related explanatory models of depression: a critical evaluation of medical articles2009Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 123, nr 10, s. 689-693Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Although research has consistently shown a higher prevalence of depression among women compared with men, there is a lack of consensus regarding explanatory factors for these gender-related differences. The aim of this paper was to analyse the scientific quality of different gender-related explanatory models of depression in the medical database PubMed.

    Study design: Qualitative and quantitative analyses of PubMed articles.

    Methods: In a database search in PubMed for 2002, 82 articles on gender and depression were selected and analysed with qualitative and quantitative content analyses. In total, 10 explanatory factors and four explanatory models were found. The ISI Web of Science database was searched in order to obtain the citation number and journal impact factor for each article.

    Results: The most commonly used gender-related explanatory model for depression was the biomedical model (especially gonadal hormones), followed by the sociocultural and psychological models. Compared with the other models, the biomedical model scored highest on bibliometric measures but lowest on measures of multifactorial dimensions and differences within the group of men/women.

    Conclusion: The biomedical model for explaining gender-related aspects of depression had the highest quality when bibliometric methods were used. However, the sociocultural and psychological models had higher quality than the biomedical model when multifactoriality and intersectionality were analysed. There is a need for the development of new methods in order to evaluate the scientific quality of research.

  • 24.
    Hammarström, Anne
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Lehti, Arja
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Danielsson, Ulla
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Bengs, Carita
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Johansson, E.E.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Gender-related explanatory models of depression: a critical evaluation of medical articles2009Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 123, nr 10, s. 689-693Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Although research has consistently shown a higher prevalence of depression among women compared with men, there is a lack of consensus regarding explanatory factors for these gender-related differences. The aim of this paper was to analyse the scientific quality of different gender-related explanatory models of depression in the medical database PubMed.

    Study design: Qualitative and quantitative analyses of PubMed articles.

    Methods: In a database search in PubMed for 2002, 82 articles on gender and depression were selected and analysed with qualitative and quantitative content analyses. In total, 10 explanatory factors and four explanatory models were found. The ISI Web of Science database was searched in order to obtain the citation number and journal impact factor for each article.

    Results: The most commonly used gender-related explanatory model for depression was the biomedical model (especially gonadal hormones), followed by the sociocultural and psychological models. Compared with the other models, the biomedical model scored highest on bibliometric measures but lowest on measures of multifactorial dimensions and differences within the group of men/women.

    Conclusion: The biomedical model for explaining gender-related aspects of depression had the highest quality when bibliometric methods were used. However, the sociocultural and psychological models had higher quality than the biomedical model when multifactoriality and intersectionality were analysed. There is a need for the development of new methods in order to evaluate the scientific quality of research.

  • 25.
    Hammarström, Anne
    et al.
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Stenlund, Hans
    Umeå universitet, Epidemiologi och global hälsa.
    Janlert, Urban
    Umeå universitet, Epidemiologi och global hälsa.
    Mechanisms for the social gradient in health: results from a 14-year follow-up of the northern swedish cohort2011Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 125, nr 9, s. 567-576Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Although numerous studies have demonstrated a socio-economic gradient in health, there is still a lack of research about the mechanisms behind this gradient. The aim of this study was to analyse possible mechanisms from adolescence to adulthood to explain the socio-economic gradient in somatic symptoms among men and women in the Northern Swedish Cohort. Study design: A prospective cohort study was performed, in which all pupils (n = 1083) in the last year of compulsory school were followed for 14 years. The response rate was high, with 96.6% still participating after 14 years. The data were mainly collected through repeated comprehensive self-administered questionnaires.

    Methods: The main dependent variable was a combination of socio-economic position and somatic health at 30 years of age. Multivariate multinomial and bivariate logistic regression analyses were undertaken.

    Results: After controlling for parental working-class position and health-related selection, the authors identified mechanisms from adolescence to adulthood for the socio-economic gradient in health that were related to social relations (poor relationship with father and unemployed friends among men, violence among women), labour market experiences (unemployment among men and women, physically heavy work among women), economic hardship (among women) and poor health behaviour.

    Conclusion: These analyses contribute to the development of epidemiological methods for analysing mechanisms for the socio-economic gradient in health. (C) 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  • 26.
    Hammarström, Anne
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Stenlund, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Janlert, Urban
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Mechanisms for the social gradient in health: results from a 14-year follow-up of the northern swedish cohort2011Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 125, nr 9, s. 567-576Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Although numerous studies have demonstrated a socio-economic gradient in health, there is still a lack of research about the mechanisms behind this gradient. The aim of this study was to analyse possible mechanisms from adolescence to adulthood to explain the socio-economic gradient in somatic symptoms among men and women in the Northern Swedish Cohort. Study design: A prospective cohort study was performed, in which all pupils (n = 1083) in the last year of compulsory school were followed for 14 years. The response rate was high, with 96.6% still participating after 14 years. The data were mainly collected through repeated comprehensive self-administered questionnaires.

    Methods: The main dependent variable was a combination of socio-economic position and somatic health at 30 years of age. Multivariate multinomial and bivariate logistic regression analyses were undertaken.

    Results: After controlling for parental working-class position and health-related selection, the authors identified mechanisms from adolescence to adulthood for the socio-economic gradient in health that were related to social relations (poor relationship with father and unemployed friends among men, violence among women), labour market experiences (unemployment among men and women, physically heavy work among women), economic hardship (among women) and poor health behaviour.

    Conclusion: These analyses contribute to the development of epidemiological methods for analysing mechanisms for the socio-economic gradient in health. (C) 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  • 27. Hang, Hoang Minh
    et al.
    Bach, T T
    Byass, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Unintentional injuries over a 1-year period in a rural Vietnamese community: describing an iceberg.2005Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 119, nr 6, s. 466-473Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: To document unintentional injuries in a rural community over a 1-year period as a basis for prioritizing preventive activities. STUDY DESIGN: Quarterly home visits over 1 year to elicit experience of injury among household members in the preceding 3 months. METHODS: In total, 24,776 people living in rural communities in the Bavi District, Northern Vietnam, were surveyed in home visits during 2000. In the home visits, injuries that needed care or disrupted normal activities were recorded, together with their circumstances. RESULTS: Overall, 2079 new non-fatal injuries were recorded over 23,338 person-years, a rate of 89/1000 person-years-at-risk. Males had a significantly higher injury rate than females for all age groups except for those aged 35-59 years and the elderly (P<0.05). The elderly were at highest risk of injury (P<0.05), particularly females. Home injuries occurred at the highest overall rate, particularly among the elderly. Road traffic injuries were most common among children. Most injuries involved contact with another object. Less than one-quarter of injury victims sought care at a health facility. CONCLUSIONS: Community-based household surveys revealed the hidden part of the injury iceberg, as well as showing high incidence rates, indicating that injury is an important public health problem which should be a priority for intervention in rural Vietnam, and probably elsewhere. This comprehensive study is intended to contribute evidence and methods to the Ministry of Health's national programme for injury prevention, and to a wider audience.

  • 28. Hang, Hoang Minh
    et al.
    Byass, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Difficulties in getting treatment for injuries in rural Vietnam2009Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 123, nr 1, s. 58-65Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: Knowledge about the health-seeking behaviour of injury patients is important for the improvement of community health services. The aims of this study were: (1) to describe the healthcare-seeking behaviour of injury patients; (2) to examine factors associated with injury patients seeking care at health facilities; and (3) to describe the costs of health care for injury patients. STUDY DESIGN: This study took place in Bavi District, northern Vietnam within a longitudinal community surveillance site (FilaBavi). All non-fatal unintentional injuries occurring in a sample of 24,776 people during 2000 were recorded. METHOD: The injury questionnaire included information on care-seeking behaviour, severity and consequences of injury. Both univariate and multivariate logistic regression models were used to find associations between sociodemographic factors and utilization of any health services, as well as for each type of health service used, compared with the group who did not use any health services. RESULT: Of 24,776 persons living in the study area, 1917 reported 2079 new non-fatal debilitating injuries during the four 3-month periods of observation. Health-seeking behaviour relating to the first 1917 injuries was analysed. Self-treatment was most common (51.7%), even in cases of severe injury. There was low usage of public health services (23.2%) among injury patients. Long distances, poor economic status and residence in difficult geographic areas such as highlands and mountains were barriers for seeking health services. A large proportion of household income was spent on treating injury patients. Poor people spent a greater proportion of their income on health care than the rich, and often used less qualified or untrained private providers. CONCLUSIONS: These results demonstrate the logistical and financial difficulties associated with the treatment of injuries in rural Vietnam. This suggests the need to make public health subsidies available more efficiently and equitably. Whilst this study looked at the situation specifically in the context of injury treatment, it is likely that similar patterns apply in other areas of health care.

  • 29. Hansson, A
    et al.
    Forsell, Y
    Hochwälder , Jacek
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för samhällsvetenskap.
    Hillerås, P
    Impact of changes in life circumstances on subjective well-being in an adult population over a 3-year period2008Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 122, nr 12, s. 1392-1398Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Mental health problems are a major issue worldwide, and there is a need to further explore factorsthat may increase or decrease people's subjective well-being (SWB). The main aim of the present study was to extendknowledge concerning changes in cohabitation, social support or financial situation and their influence on SWB, aftercontrolling for personality (i.e. neuroticism), in a 3-year follow-up of an adult population-based sample. The change inoverall well-being was also studied during the 3-year interval.Study design: Longitudinal design.Methods: A random sample of Swedish citizens, aged 20-64 years, residing in Stockholm County received aquestionnaire by post, comprising items pertaining to demographics, personality, social support and SWB. All therespondents received a second questionnaire 3 years later. In total, 8324 subjects were included in the present study.Results: The overall well-being of the study sample was relatively stable. Separate analyses of the three lifecircumstances indicated that, after controlling for personality, positive and negative changes in each sphere of life stillaffected SWB.Conclusions: Despite personality and the stability of SWB, these results indicate that changes in financial situation,social support and cohabitation influence SWB. It is important for society and the healthcare services to be aware that anegative change in any of these life circumstances may lead to decreased well-being for a period of at least 3 years.

  • 30.
    Hansson, Anna
    et al.
    Sophiahemmet Högskola.
    Forsell, Yvonne
    Hochwälder, J
    Hillerås, Pernilla
    Sophiahemmet Högskola.
    Impact of changes in life circumstances on subjective well-being in an adult population over a 3-year period2008Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 122, nr 12, s. 1392-8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: Mental health problems are a major issue worldwide, and there is a need to further explore factors that may increase or decrease people's subjective well-being (SWB). The main aim of the present study was to extend knowledge concerning changes in cohabitation, social support or financial situation and their influence on SWB, after controlling for personality (i.e. neuroticism), in a 3-year follow-up of an adult population-based sample. The change in overall well-being was also studied during the 3- year interval. STUDY DESIGN: Longitudinal design. METHODS: A random sample of Swedish citizens, aged 20-64 years, residing in Stockholm County received a questionnaire by post, comprising items pertaining to demographics, personality, social support and SWB. All the respondents received a second questionnaire 3 years later. In total, 8324 subjects were included in the present study. RESULTS: The overall well-being of the study sample was relatively stable. Separate analyses of the three life circumstances indicated that, after controlling for personality, positive and negative changes in each sphere of life still affected SWB. CONCLUSIONS: Despite personality and the stability of SWB, these results indicate that changes in financial situation, social support and cohabitation influence SWB. It is important for society and the healthcare services to be aware that a negative change in any of these life circumstances may lead to decreased well-being for a period of at least 3 years.

  • 31.
    Hansson, Anna
    et al.
    Karolinska Institutet / Sophiahemmet.
    Forsell, Yvonne
    Karolinska Institutet.
    Hochwälder, Jacek
    Mittuniversitetet.
    Hillerås, Pernilla
    Sophiahemmet / Karolinska institutet.
    Impact of changes in life circumstances on subjective well-being in an adult population over a 3-year period2008Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 122, nr 12, s. 1392-1398Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES:

    Mental health problems are a major issue worldwide, and there is a need to further explore factors that may increase or decrease people's subjective well-being (SWB). The main aim of the present study was to extend knowledge concerning changes in cohabitation, social support or financial situation and their influence on SWB, after controlling for personality (i.e. neuroticism), in a 3-year follow-up of an adult population-based sample. The change in overall well-being was also studied during the 3- year interval.

    STUDY DESIGN:

    Longitudinal design.

    METHODS:

    A random sample of Swedish citizens, aged 20-64 years, residing in Stockholm County received a questionnaire by post, comprising items pertaining to demographics, personality, social support and SWB. All the respondents received a second questionnaire 3 years later. In total, 8324 subjects were included in the present study.

    RESULTS:

    The overall well-being of the study sample was relatively stable. Separate analyses of the three life circumstances indicated that, after controlling for personality, positive and negative changes in each sphere of life still affected SWB.

    CONCLUSIONS:

    Despite personality and the stability of SWB, these results indicate that changes in financial situation, social support and cohabitation influence SWB. It is important for society and the healthcare services to be aware that a negative change in any of these life circumstances may lead to decreased well-being for a period of at least 3 years.

  • 32.
    Haraldsson, Katarina
    et al.
    Department of Public Health and Community Medicine, Göteborg University, Göteborg, Sweden.
    Lindgren, Eva-Carin
    Department of Public Health and Community Medicine, Göteborg University, Göteborg, Sweden.
    Fridlund, Bengt
    Department of Public Health and Community Medicine, Göteborg University, Göteborg, Sweden.
    Baigi, Amir
    Department of Public Health and Community Medicine, Göteborg University, Göteborg, Sweden.
    Lydell, Marie C.
    Department of Public Health and Community Medicine, Göteborg University, Göteborg, Sweden.
    Marklund, Bertil
    Department of Public Health and Community Medicine, Göteborg University, Göteborg, Sweden.
    Evaluation of a school-based health promotion programme for adolescents aged 12-15 years with focus on well-being related to stress2008Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 122, nr 1, s. 25-33Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aim of this study was to evaluate a school-based adolescent health promotion programme with focus on well-being related to stress.

    Study design: Interventional and evaluative with tests before and after the intervention. The study was performed in two secondary schools in a town on the west coast of Sweden.

    Methods: A health promotion programme comprising massage and mental training was implemented for a single academic year in one school (intervention school, 153 participants) in order to strengthen and maintain well-being. No intervention was implemented in the other school (non-intervention school, 287 participants). A questionnaire was developed and tested, resulting in 23 items distributed across the following six areas: self-reliance; leisure time; being an outsider; general and home satisfaction; school satisfaction; and school environment.

    Results: A pre- and postintervention comparison of the six areas was made within each school. In the intervention school, the boys maintained a very good or good sense of well-being related to stress in all six areas, while the girls’ sense of well-being was maintained in five areas and deteriorated in one area. In the non-intervention school, the boys maintained a very good or good sense of well-being related to stress in four areas and deteriorated in two areas, while the girls’ sense of well-being was maintained in two areas and deteriorated in four areas.

    Conclusion: Massage and mental training helped to maintain adolescents’ very good or good sense of well-being related to stress. A questionnaire with acceptable validity and reliability was developed and tested in order to evaluate the health promotional approach. However, there is a need for further study to develop both the intervention and the questionnaire for young people.

  • 33. Haraldsson, Katarina S
    et al.
    Lindgren, Eva-Carin M
    Fridlund, Bengt G A
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Baigi, Amir M A E
    Lydell, Marie C
    Marklund, Bertil R G
    Evaluation of a school-based health promotion programme for adolescents aged 12-15 years with focus on well-being related to stress2008Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 122, nr 1, s. 25-33Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The aim of this study was to evaluate a school-based adolescent health promotion programme with focus on well-being related to stress. STUDY DESIGN: Interventional and evaluative with tests before and after the intervention. The study was performed in two secondary schools in a town on the west coast of Sweden. METHODS: A health promotion programme comprising massage and mental training was implemented for a single academic year in one school (intervention school, 153 participants) in order to strengthen and maintain well-being. No intervention was implemented in the other school (non-intervention school, 287 participants). A questionnaire was developed and tested, resulting in 23 items distributed across the following six areas: self-reliance; leisure time; being an outsider; general and home satisfaction; school satisfaction; and school environment. RESULTS: A pre- and postintervention comparison of the six areas was made within each school. In the intervention school, the boys maintained a very good or good sense of well-being related to stress in all six areas, while the girls' sense of well-being was maintained in five areas and deteriorated in one area. In the non-intervention school, the boys maintained a very good or good sense of well-being related to stress in four areas and deteriorated in two areas, while the girls' sense of well-being was maintained in two areas and deteriorated in four areas. CONCLUSION: Massage and mental training helped to maintain adolescents' very good or good sense of well-being related to stress. A questionnaire with acceptable validity and reliability was developed and tested in order to evaluate the health promotional approach. However, there is a need for further study to develop both the intervention and the questionnaire for young people.

  • 34. Huong, Dao Lan
    et al.
    Van Minh, Hoang
    Janlert, Urban
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Van, Do Duc
    Byass, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Socio-economic status inequality and major causes of death in adults: a 5-year follow-up study in rural Vietnam.2006Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 120, nr 6, s. 497-504Artikkel i tidsskrift (Fagfellevurdert)
  • 35.
    Johansson, Kjell
    et al.
    Linköpings universitet, Institutionen för hälsa och samhälle, Socialmedicin och folkhälsovetenskap. Linköpings universitet, Hälsouniversitetet.
    Bendtsen, Preben
    Linköpings universitet, Institutionen för hälsa och samhälle, Socialmedicin och folkhälsovetenskap. Linköpings universitet, Hälsouniversitetet.
    Åkerlind, Ingemar
    Linköpings universitet, Institutionen för hälsa och samhälle, Socialmedicin och folkhälsovetenskap. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland. Linköpings universitet, Hälsouniversitetet.
    Factors influencing GPs' decisions regarding screening for high alcohol consumption: a focus group study in Swedish primary care2005Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 119, nr 9, s. 781-788Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective The aim of this study was to explore factors that influence general practitioners' (GPs') decisions regarding screening for high alcohol consumption.

    Methods GPs working at three primary healthcare centres in Sweden participated in focus group interviews. The interviews were recorded and transcribed verbatim, and a deductive framework approach was used for the analysis.

    Results The majority of the participating GPs did not believe in asking all patients about their alcohol consumption. Reported factors that influenced how many and which patients were questioned about alcohol consumption were time, age of the patient, consultation setting, patient–physician relationship, what symptoms the patient presented with, and knowledge of measures if patients appear to have a high alcohol consumption. Thus, alcohol screening and intervention were not performed in all patient groups as was originally intended, but were performed in limited groups of patients such as those with alcohol-related symptoms.

    Conclusions Although the number of participants in this study was small and the conclusions cannot be generalized, the results provide some valuable insights into why GPs are hesitant to engage in screening for high alcohol consumption. Since prevention of alcohol-related health problems is an important public health issue, many different screening and intervention strategies have to be formulated and evaluated in order to reach patients with both hazardous and harmful alcohol consumption within the healthcare system. Screening all consecutive patients for a limited period or screening patient groups known to include a fairly high frequency of high alcohol consumers are two ways of limiting the time requirements and increasing role legitimacy. Still, there is a need for a broader public health strategy involving many players in the community in alcohol preventive measures, especially in more primary preventive approaches.

  • 36.
    Kaarme, Johan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Hickman, Rachel A.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Infektionssjukdomar.
    Nevéus, Tryggve
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Blomberg, Jonas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk mikrobiologi och infektionsmedicin.
    Öhrmalm, Christina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk mikrobiologi och infektionsmedicin.
    Reassuringly low carriage of enteropathogens among healthy Swedish children in day care centres2016Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 140, s. 221-227Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Infectious gastroenteritis is one of the most common diseases among children and has a considerable impact on health and socio-economy. Day care centres are highrisk environments for infections. The aim of this study was to investigate if asymptomatic preschool children constitute a reservoir for potential enteropathogens. Study design: In total, 438 individual diapers were collected from day care centres in Uppsala, Sweden, during spring and autumn, and molecular techniques were used to estimate the prevalence of asymptomatic carriage of multiple enteropathogens. Methods: Faecal samples were analysed with multiplex polymerase chain reaction (PCR) (xTAG® Gastrointestinal Pathogen Panel; Luminex Corporation, Toronto, Canada) targeting 21 different pathogens. Samples with a median fluorescence intensity above threshold were re-analysed with a second PCR assay. Results: Sixteen of the 438 samples were positive for enteropathogens, 1.6% for enteric adenovirus, 0.7% for Campylobacter spp., and 0.7% for norovirus. Conclusions: Preschool children in Uppsala constitute a limited reservoir for potential enteropathogens

  • 37.
    Kallin, Kristina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Lundin-Olsson, Lillemor
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Jensen, Jane
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Nyberg, L
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Gustafson, Yngve
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Predisposing and precipitating factors for falls among older people in residential care2002Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 116, nr 5, s. 263-271Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Falls and their consequences are serious health problems among older populations. To study predisposing and precipitating factors for falls among older people in residential care we used a cross-sectional study design with a prospective follow up for falls. Fifty-eight women and 25 men, with a mean age of 79.6 y, were included and prospectively followed up regarding falls for a period of 1 y after baseline assessments. All those who fell were assessed regarding factors that might have precipitated the fall. The incidence rate was 2.29 falls/person years. Antidepressants (selective serotonin reuptake inhibitors, SSRIs), impaired vision and being unable to use stairs without assistance were independently associated with being a 'faller'. Twenty-eight (53.8%) of the fallers suffered injuries as a result of their falls, including 21 fractures. Twenty-seven percent of the falls were judged to be precipitated by an acute illness or disease and 8.6% by a side effect of a drug. Acute symptoms of diseases or drug side effects were associated with 58% of the falls which resulted in fractures. We conclude that SSRIs seem to constitute one important factor that predisposes older people to fall, once or repeatedly. Since acute illnesses and drug side-effects were important precipitating factors, falls should be regarded as a possible symptom of disease or a side-effect of a drug until it is proven otherwise.

  • 38.
    Kallin, Kristina
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Lundin-Olsson, Lillemor
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Jensen, Jane
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Predisposing and precipitating factors for falls among older people in residential care2002Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 116, nr 5, s. 263-71Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Falls and their consequences are serious health problems among older populations. To study predisposing and precipitating factors for falls among older people in residential care we used a cross-sectional study design with a prospective follow up for falls. Fifty-eight women and 25 men, with a mean age of 79.6 y, were included and prospectively followed up regarding falls for a period of 1 y after baseline assessments. All those who fell were assessed regarding factors that might have precipitated the fall. The incidence rate was 2.29 falls/person years. Antidepressants (selective serotonin reuptake inhibitors, SSRIs), impaired vision and being unable to use stairs without assistance were independently associated with being a 'faller'. Twenty-eight (53.8%) of the fallers suffered injuries as a result of their falls, including 21 fractures. Twenty-seven percent of the falls were judged to be precipitated by an acute illness or disease and 8.6% by a side effect of a drug. Acute symptoms of diseases or drug side effects were associated with 58% of the falls which resulted in fractures. We conclude that SSRIs seem to constitute one important factor that predisposes older people to fall, once or repeatedly. Since acute illnesses and drug side-effects were important precipitating factors, falls should be regarded as a possible symptom of disease or a side-effect of a drug until it is proven otherwise.

  • 39.
    Konlaan, Boinkum Benson
    et al.
    Röda Korsets Högskola. University of Umeå.
    Theobald, H
    Karolinska Institute.
    Bygren, L O
    University of Umeå.
    Leisure time activity as a determinant of survival: a 26-year follow-up of a Swedish cohort2002Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 116, nr 4, s. 227-230Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    An individual's leisure time (pastime) engagements are in a way important for society. Irrespective of whether leisure time activities are causal determinants of health or health is a prerequisite for taking full part in society, the interaction is a challenge for Public Health. The first question is whether the sum of their influence results in coherence between enjoying good health and having leisure time activity. The aim of this study was to estimate their covariance. A random sample was drawn from the adult population of Stockholm County, Sweden. The residents were mailed a questionnaire regarding their social circumstances, their health complaints, the social repercussions of the complaints, and if they had any leisure time activity. Altogether, 7252 (about 93%) individuals responding to the questionnaire constituted our cohort, The individuals aged 18-65 y in November 1969 were followed up to the age of 65 y, or to 1996 as to mortality. The main outcome measure was mortality irrespective of cause of death. More than two-thirds of the respondents (71%) reported that they had some leisure time activity. Leisure time activity was a determinant of survival in the statistical sense. The risk ratio was 0.77 and its 95% confidence interval was 0.68-0.87 for those reporting leisure time activity when age, sex, baseline health and baseline alcohol consumption was discounted. The conclusion was that having leisure time activity, unspecified, covaried with health. Further studies should specify the pastime activities.

  • 40.
    Lindqvist, Kent
    et al.
    Linköpings universitet, Institutionen för hälsa och samhälle. Linköpings universitet, Hälsouniversitetet.
    Lindholm, L.
    Department of Public Health and Clinical Medicine, Umeå University, Sweden.
    A cost-benefit analysis of the community-based injury prevention programme in Motala, Sweden—a WHO Safe Community2001Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 115, nr 5, s. 317-322Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The objective in this study was to calculate costs and benefits caused by a safe community injury prevention programme in Motala, Sweden. The study design was a quasi-experimental evaluation involving an intervention population and a non-random control population. All injuries were recorded before and after an intervention programme. The presented calculations show that costs of injuries in a societal perspective decreased from 116 million Swedish Crowns (SEK) to 96 million SEK, while the cost for the intervention was estimated at approximately 10 million SEK. Thus, the safe community injury prevention programme in Motala should be judged as cost-effective. 

  • 41.
    Lindqvist, Kent
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Socialmedicin och folkhälsovetenskap.
    Timpka, Toomas
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Socialmedicin och folkhälsovetenskap. Östergötlands Läns Landsting, Folkhälsovetenskapligt centrum, Folkhälsovetenskapligt centrum.
    Schelp, L
    Evaluation of an inter-organizational prevention program against injuries among the elderly in a WHO Safe Community2001Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 115, nr 5, s. 308-316Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the study was to evaluate the outcome of a participatory community-based prevention program against injuries among the elderly. A population-based quasi-experimental design was used with pre- and post-implementation measurements in an intervention and a control area. The program was based on cross-sectoral participation in detecting and taking action against injuries among the elderly. Change in the relative risk of injury was estimated by the odds ratio. Morbidity in moderately (AIS 2) severe injury in the study area was reduced from 46 per 1000 population years to 25 per 1000 population years (odds ratio 0.55, 95% confidence interval 0.46-0.65), while the minor (AIS 1) injuries increased (odds ratio 1.55, 95% confidence interval 1.21-1.91). The risk of severe or fatal (AIS 3-6) injuries remained constant. In the study area, only a slight decrease in the total morbidity rate was observed (odds ratio 0.87, 95% confidence interval 0.77-0.99). In the control area, there was no evident change in the total morbidity rates. Falls decreased or showed a tendency to decrease in the age groups 65 to 79-y-old in the study area, while they increased in the older age group. The results indicate that no sharp boundaries should be drawn between safety education, physical conditioning, environmental adjustments and secondary prevention measures when planning safety promotion among the elderly. Future studies should address these issues along with the methodological complexity associated with assessment of participatory community-based safety promotion programs.

  • 42.
    Lundin, A.
    et al.
    Stockholm Cty Council, Ctr Epidemiol & Community Med, Stockholm, Sweden.;Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden..
    Hallgren, M.
    Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden..
    Theobald, H.
    Stockholm Cty Council, Acad Primary Hlth Care Ctr, Stockholm, Sweden.;Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Hellgren, C.
    Swedish Council Higher Educ, Stockholm, Sweden..
    Torgén, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Validity of the 12-item version of the General Health Questionnaire in detecting depression in the general population2016Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 136, s. 66-74Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: The 12-item version of the General Health Questionnaire (GHQ-12) is frequently used to measure common mental disorder in public health surveys, but few population-based validations have been made. We validated the GHQ-12 against structured psychiatric interviews of depression using a population-based cohort in Stockholm, Sweden. Methods: We used a population-based cohort of 484 individuals in Stockholm, Sweden (participation rate 62%). All completed the GHQ-12 and a semi-structured psychiatric interview. Last month DSM-III-R symptoms were used to classify major and minor depression. Three scoring methods for GHQ-12 were assessed, the Standard, Likert and Corrected method. Discriminatory ability was assessed with area under the receiver operating characteristic (ROC) curve. Results: A total of 9.5% had a major or minor depression. The area under the ROC curve was for the Standard method 0.73 (0.65-0.82), the Likert method 0.80 (0.72-0.87) and the Corrected method 0.80 (0.73-0.87) when using major or minor depression as standard criterion. Adequate sensitivity and specificity for separating those with or without a depressive disorder was reached at >12 Likert scored points (80.4 and 69.6%) or >6 Corrected GHQ points (78.3 and 73.7%). Sensitivity and specificity was at >= 2 Standard scored points 67.4% and 74.2%. Conclusion: When scored using the Likert and Corrected methods, the GHQ-12 performed excellently. When scored using the Standard method, performance was acceptable in detecting depressive disorder in the general population. The GHQ-12 appears to be a good proxy for depressive disorder when used in public health surveys.

  • 43. Lundin, A.
    et al.
    Lundberg, Ingvar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Allebeck, P.
    Hemmingsson, T.
    Unemployment and suicide in the Stockholm population: A register-based study on 771,068 men and women2012Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 126, nr 5, s. 371-377Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Several studies have reported a higher risk of suicide among the unemployed. Some individuals may be more prone to both unemployment and suicide due to an underlying health-related factor. In that case, suicide among the unemployed might be a consequence of health-related selection. This study aimed to investigate the relationship between unemployment and suicide, and the importance of previous sickness absence to this relationship.

    Study design: The study was based on 771,068 adults aged 25-58 years in Stockholm County in 1990-1991. Data on sickness absence in 1990-1991 and unemployment in 1991-1993 were collected from registers for each individual. Time and cause of death in 1994-1995 were obtained from Sweden's Cause of Death Register.

    Methods: The association between sickness absence in 1990-1991 and unemployment in 1992-1993, and the association between unemployment in 1992-1993 and suicide in 1994-1995 was investigated using logistic regression.

    Results: Unemployment lasting for >90 days in 1992-1993 was associated with suicide in men in 1994-1995 [odds ratio (OR) 2.16, 95% confidence interval (CI) 1.38-3.38], while unemployment lasting for <= 90 days in 1992-1993 was associated with suicide in women in 1994-1995 (OR 2.68, 95% CI 1.23-5.85). Higher levels of sickness absence were related to an increased risk of subsequent unemployment in both sexes. The higher prevalence of sickness absence among the unemployed attenuated the association between unemployment and suicide in both men and women.

    Conclusions: Unemployment is related to suicide. Individuals in poor health are at increased risk of unemployment and also suicide. The higher relative risk of suicide among the unemployed seems to be, in part, a consequence of exclusion of less healthy individuals from the labour market.

  • 44.
    Macassa, Gloria
    et al.
    Karolinska Institutet.
    Ghilagaber, G
    Bernhardt, E
    Burström, B
    Trends in infant and child mortality in Mozambique during and after a period ofconflict2003Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 117, nr 4, s. 221-227Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study describes urban and rural trends of infant, child and under-five mortality in Mozambique (1973–1997) by mother's place of residence. A direct method of estimation was applied to the 1997 Mozambican Demographic and Health Survey data. The levels of infant, child and under-five mortality were considerably higher in rural than in urban areas. The difference in mortality between urban and rural areas increased over time until 1988–1992 and thereafter diminished. Possible causes of the different trends (e.g. the impact of civil war, drought, migration, adjustment programme and HIV/AIDS) are discussed. The increase in mortality in urban areas during the last few years before the survey may have been related to the immigration to urban areas of mothers whose children had high levels of mortality. Higher levels of infant, child and under-five mortality still prevail, particularly in rural areas. Further studies are needed to investigate the differentials of infant and child mortality by mother's place of residence.

  • 45.
    Macassa, Gloria
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Ghilagaber, Gebrenegus
    Stockholms universitet, Stockholm, Sweden.
    Bernhardt, Eva
    Stockholms universitet, Stockholm, Sweden.
    Burström, Bo
    Karolinska Institutet, Stockholm, Sweden.
    Trends in infant and child mortality in Mozambique during and after a period of conflict2003Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 117, nr 4, s. 221-227Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study describes urban and rural trends of infant, child and under-five mortality in Mozambique (1973-1997) by mother's place of residence. A direct method of estimation was applied to the 1997 Mozambican Demographic and Health Survey data. The levels of infant, child and under-five mortality were considerably higher in rural than in urban areas. The difference in mortality between urban and rural areas increased over time until 1988-1992 and thereafter diminished. Possible causes of the different trends (e.g. the impact of civil war, drought, migration, adjustment programme and HIV/AIDS) are discussed. The increase in mortality in urban areas during the last few years before the survey may have been related to the immigration to urban areas of mothers whose children had high levels of mortality. Higher levels of infant, child and under-five mortality still prevail, particularly in rural areas. Further studies are needed to investigate the differentials of infant and child mortality by mother's place of residence. (C) 2003 The Royal Institute of Public Health. Published by Elsevier Science Ltd. All rights reserved.

  • 46. Maron, Julian
    et al.
    Gomes de Matos, Elena
    Piontek, Daniela
    Kraus, Ludwig
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). IFT Institut für Therapieforschung, Germany; ELTE Eötvös Loránd University, Hungary.
    Pogarell, Oliver
    Exploring socio-economic inequalities in the use of medicines: is the relation mediated by health status?2019Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 169, s. 1-9Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: This study evaluated mediating effects of the health status on the association between socio-economic status (SES) and medicine use. It was hypothesized that more privileged people show a reduced use of medicines, as compared with the underprivileged, because of their superior health status. It was further hypothesized that people may apply medication based on their type of health complaint (ill physical versus mental status).

    Study design: Data were taken from the 2012 German Epidemiological Survey of Substance Abuse, a nationally representative cross-sectional study of n = 9084 individuals of the German general population aged 18-64 years.

    Methods: Direct and indirect effects of SES on weekly use of analgesics and sedatives/hypnotics were examined by applying generalized structural equation modeling. Self-rated physical and mental health statuses were considered as potential mediators. SES was measured by using educational level as a proxy. All analyses were gender-stratified.

    Results: Among men, both physical and mental health mediated the path from SES to the use of analgesics and sedatives/hypnotics, respectively, with a stronger effect of physical health on analgesic use and mental health on sedative/hypnotic use. These effects were only partially found among women.

    Conclusions: Social inequalities in health seem to have substantial impact on the prevalence of medicine use. Identification and elimination of the reasons for poor health among people of low SES may, therefore, not only help to reduce health inequalities directly. A decline in the use of medicines would also result in less side-effects and a reduced number of people with medicine-related misuse and addiction.

  • 47. McKee, M
    et al.
    Balabanova, D
    Akingbade, K
    Pomerleau, J
    Stickley, Andrew
    Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Rose, R
    Haerpfer, C
    Access to water in the countries of the former Soviet Union2006Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 120, nr 4, s. 364-372Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: During the Soviet period, authorities in the USSR invested heavily in collective farming and modernization of living conditions in rural areas. However, many problems remained, including poor access to many basic amenities such as water. Since then, the situation is likely to have changed; economic decline has coincided with migration and widening social inequalities, potentially increasing disparities within and between countries. Aim: To examine access to water and sanitation and its determinants in urban and rural areas of eight former Soviet countries. Methods: A series of nationally representative surveys in Armenia, Belarus, Georgia, Moldova, Kazakhstan, Kyrgyzstan, Russia and Ukraine was undertaken in 2001, covering 18,428 individuals (aged 18+ years). Results: The percentage of respondents Living in rural areas varied between 27 and 59% among countries. There are wide urban-rural differences in access to amenities. Even in urban areas, only about 90% of respondents had access to cold running water in their home (60% in Kyrgyzstan). In rural areas, less than one-third had cold running water in their homes (44% in Russia, under 10% in Kyrgyzstan and Moldova). Between one-third and one-half of rural respondents in some countries (such as Belarus, Kazakhstan and Moldova) obtained their water from welts and similar sources. Access to hot running water inside the homes was an exception in rural households, reflecting the tack of modern heating methods in villages. Similarly, indoor access to toilets is common in urban areas but rare in rural areas. Access to all amenities was better in Russia compared with elsewhere in the region. Indoor access to cold water was significantly more common among rural residents Living in apartments, and in settlements served by asphalt roads rather than dirt roads. People with more assets or income and living with other people were significantly more likely to have water on tap. In addition, people who had moved in more recently were more likely to have an indoor water supply. Conclusions: This was the largest single study of its kind undertaken in this region, and demonstrates that a significant number of people living in rural parts of the former Soviet Union do not have indoor access to running water and sanitation. There are significant variations among countries, with the worse situation in central Asia and the Caucasus, and the best situation in Russia. Access to water strongly correlates with socio-economic characteristics. These findings suggest a need for sustained investment in rebuilding basic infrastructure in the region, and monitoring the impact of living conditions on health.

  • 48.
    Moniruzzaman, Syed
    et al.
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper.
    Andersson, Ragnar
    Relationship between economic development and suicide mortality: a global cross-sectional analysis in an epidemiological transition perspective2004Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 118, s. 346-348Artikkel i tidsskrift (Fagfellevurdert)
  • 49.
    Novak, Masuma
    et al.
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Ahlgren, Christina
    Umeå universitet, Institutionen för samhällsmedicin och rehabilitering.
    Hammarström, Anne
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Social and health-related correlates of intergenerational and intragenerational social mobility among Swedish men and women2012Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 126, nr 4, s. 349-357Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The present study explored the pattern and the determinants of social mobility among men and women both at inter and intragenerational transitional periods. Specifically the study addressed what impact do the various health related measures, health-behaviours, psychosocial environments at home and school, material resources, and ethnicity have on the chances and the direction of social mobility.

    Methods: A Swedish 14-year prospective longitudinal study with 96.5% response rate. Detail information on 546 men and 495 women regarding their occupation, health status, health-related behaviour, psychosocial environment at home and school, material recourses and ethnicity prior to mobility were available from ages 16, 21 and 30. Odds Ratios and 99% confidence interval were calculated using logistic regression to determine social mobility.

    Results: At the inter-generational analyses, being liked in school (liked by the teachers and students) predicted upward mobility in men and women. Additionally, being taller predicted upward mobility in women. Downward mobility was predicted by being less liked in school and smoking for both men and women. Additionally, having an unemployed family member for men and not having an own room for women predicted downward mobility. At the intra-generational analyses, less alcohol consumption for men and better financial resources for women predicted upward mobility. Downward mobility among men was predicted by smoking and having restricted financial resources. The chances and the directions of mobility were not influenced by ethnic background.

    Conclusions: Except height among women, health status was not associated with mobility in this cohort for men or for women neither internor intra-generationally, however material deprivation, economical deprivation, poor health behaviours, and unfavourable school environment were.

  • 50.
    Novak, Masuma
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Ahlgren, Christina
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Hammarström, Anne
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Social and health-related correlates of intergenerational and intragenerational social mobility among Swedish men and women2012Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 126, nr 4, s. 349-357Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The present study explored the pattern and the determinants of social mobility among men and women both at inter and intragenerational transitional periods. Specifically the study addressed what impact do the various health related measures, health-behaviours, psychosocial environments at home and school, material resources, and ethnicity have on the chances and the direction of social mobility.

    Methods: A Swedish 14-year prospective longitudinal study with 96.5% response rate. Detail information on 546 men and 495 women regarding their occupation, health status, health-related behaviour, psychosocial environment at home and school, material recourses and ethnicity prior to mobility were available from ages 16, 21 and 30. Odds Ratios and 99% confidence interval were calculated using logistic regression to determine social mobility.

    Results: At the inter-generational analyses, being liked in school (liked by the teachers and students) predicted upward mobility in men and women. Additionally, being taller predicted upward mobility in women. Downward mobility was predicted by being less liked in school and smoking for both men and women. Additionally, having an unemployed family member for men and not having an own room for women predicted downward mobility. At the intra-generational analyses, less alcohol consumption for men and better financial resources for women predicted upward mobility. Downward mobility among men was predicted by smoking and having restricted financial resources. The chances and the directions of mobility were not influenced by ethnic background.

    Conclusions: Except height among women, health status was not associated with mobility in this cohort for men or for women neither internor intra-generationally, however material deprivation, economical deprivation, poor health behaviours, and unfavourable school environment were.

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