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  • 1.
    Blom, Helena
    et al.
    Umeå University, Sweden Sundsvall Hospital, Sweden .
    Hogberg, Ulf
    Uppsala University, Sweden .
    Olofsson, Niclas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Vasternorrland County Council, Sweden.
    Danielsson, Ingela
    Umeå University, Sweden Vasternorrland County Council, Sweden .
    Strong association between earlier abuse and revictimization in youth2014In: BMC Public Health, E-ISSN 1471-2458, Vol. 14, no 715Article in journal (Refereed)
    Abstract [en]

    Background: Violence victimization among youth is recognized as a public health problem. The objective was to analyze the risk pattern of emotional, physical, and sexual abuse during the past 12 months by gender, sociodemographic factors, health risk behaviors, and exposure to abuse before the age of 15, among young men and women attending youth health centers in Sweden. Methods: A cross-sectional survey was conducted using a nationally representative sample of youth health centers. A total of 2,250 young women and 920 young men aged 15-23 completed a self-administered questionnaire. Odds ratios (OR) and adjusted odds ratios (AOR) with 95% CI were calculated. Results: A consistent and strong association was noted between exposure to all types of violence during the past year and victimization before the age of 15 for all types of violence for both women and men. The only exceptions were childhood sexual victimization and sexual violence during the past year for men. Younger age was associated with all violence exposure for the women and with emotional violence for the men. For the women, drug use was associated with all types of violence, while the association with hazardous alcohol use and not living with parents was restricted to physical and sexual violence exposure, present smoking was restricted to emotional and physical violence exposure, and partnership and living in urban areas were restricted to sexual violence. For men, not being partnered, hazardous alcohol consumption, and drug use meant increased risk for physical violence, while smoking and living in urban areas were associated with sexual violence. After adjustment, immigration had no association with violence exposure. Conclusions: Violence victimization in young men and women is often not a single experience. Findings underline the importance of early interventions among previously abused youth.

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  • 2.
    Färnkvist, Lisbeth
    et al.
    Department of Public Health and Research, Härnösand-Medelpad Medical Service, Sundsvall, Sweden..
    Olofsson, Niclas
    County Council of Västernorrland.
    Weinehall, Lars
    Umeå University.
    Did a health dialogue matter? Self-reported cardiovascular disease and diabetes 11 years after health screening.2008In: Scandinavian journal of primary health care, ISSN 1502-7724, Vol. 26, no 3, p. 135-139Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study the potential impact of health screening, with or without a motivational health dialogue, on the risk and morbidity of cardiovascular diseases (CVD) and diabetes (DM). DESIGN: Two cross-sectional studies with an interval of 11 years. SETTING: The community of Härnösand, Sweden. SUBJECTS: In the first study, 402 men born in 1934, 1944, or 1954 underwent health screening for CVD prevention in 1989. In the second study, 415 men (of the same ages) completed a questionnaire in 2000 (11 years later). MAIN OUTCOME MEASURES: Odds ratio (OR) for self-reported CVD and DM. RESULTS: The odds ratio of self-reported CVD and DM was more than doubled among participants in the health screening without a health dialogue (OR 2.5; 95% CI 0.8-7.4) and threefold for those not participating (OR 3.0; 95% CI 1.0-8.8) compared with those who reported participation in health screening that included a structured health dialogue. CONCLUSIONS: Health screening for the prevention of CVD and DM benefits from inclusion of a structured, motivational health dialogue.

  • 3.
    Olofsson, Niclas
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Violence through the life cycle: A public health problem2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Violence has probably always been part of the human experience. Its impact can be seen, in various forms, in all parts of the world. In 1996, WHO:s Forty-Ninth World Health Assembly adopted a resolution , declaring violence a major and growing public health problem around the world. Public health work centers around health promotion and disease prevention activities in the population and public health is an expression of the health status of the population taking into account both the level and the distribution of health. Exposure to violence can have many aspects, differing throughout the life course — deprivation of autonomy, financial exploitation, psychological and physical neglect or abuse — but all types share common characteristics: the use of destructive force to control others by depriving them of safety, freedom, health and, in too many instances, life; the epidemic proportions of the problem, particularly among vulnerable groups; a devastating impact on individuals, families, neighborhoods, communities, and society.

    Methods: Three different data sources were used in the four articles, three cross-sectional studies (“Life and Health in Norrland” and “Health on Equal Terms 2004 and 2006”) and one longitudinal (“Level-of-Living Survey”).

    Results: We present an important picture of the strong association between exposure to violence and ill health through the life cycle. A population-based study showed an increased risk of poorer physical and psychological health among boys and girls aged 0-18, as reported by their mothers exposed to violence. Further, a strong association between those exposed to violence and physical and mental ill health was demonstrated in young adults aged 18-25, also after adjusting for possible confounders, specifically for women. Even in an elder group aged 65-84, representative results showed an extensive negative health outcome panorama caused by fear of crime and exposure to abuse both in elderly men and women. Lastly, in trying to provide additional empirical support for the association between exposure to violence and ill health the prospective study demonstrated that violence exposure in adolescence and young adulthood presented a negative association to severe illness burden in adulthood for women but not men.

    Conclusion: Exposure to violence among both men and women is an important risk factor for ill health and should receive greater attention in public health work. A strong association between violence and various health outcomes was demonstrated in different time periods through the life cycle.

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    Violence through the life cycle: A public health problem
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  • 4.
    Olofsson, Niclas
    et al.
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Lindqvist, Kent
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Danielsson, I
    Vasternorrland County Council.
    Fear of crime and psychological and physical abuse associated with ill health in a Swedish population aged 65-84 years2012In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 126, no 4, p. 358-364Article in journal (Refereed)
    Abstract [en]

    Objectives: To assess the association between fear of crime and/or psychological and/or physical abuse in relation to self-reported physical and psychological health, using a large representative sample of elderly women and men in Sweden. less thanbrgreater than less thanbrgreater thanStudy design: Cross-sectional national survey. less thanbrgreater than less thanbrgreater thanMethods: Data were taken from a nationwide representative public health survey (2006). Men and women between the ages of 65 and 84 years were selected for the present analyses (4386 men and 4974 women). The response rate for this age group was 59% for men and 70% for women. less thanbrgreater than less thanbrgreater thanResults: Psychological and physical abuse against elderly women and men led to higher odds ratios for negative health outcomes, independently of socio-economic status. Strong correlation was found between psychological abuse and negative health outcomes in both men and women, while the correlation was less strong for physical abuse, especially among women. The men had high odds ratios for suicidal thoughts and even for attempted suicide in connection with physical and psychological abuse and fear of crime. less thanbrgreater than less thanbrgreater thanConclusions: The study provides representative results addressing an extensive negative health outcome panorama caused by fear of crime and exposure to abuse.

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  • 5.
    Olofsson, Niclas
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences. Vasternorrland County Council, Sweden.
    Lindqvist, Kent
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Danielsson, Ingela
    Vasternorrland County Council, Sweden; Umeå University, Sweden.
    Higher Risk of Violence Exposure in Men and Women With Physical or Sensory Disabilities: Results From a Public Health Survey2015In: Journal of Interpersonal Violence, ISSN 0886-2605, E-ISSN 1552-6518, Vol. 30, no 10, p. 1671-1686Article in journal (Refereed)
    Abstract [en]

    The World Health Organization has declared that violence is a global public health problem. The prevalence of violence exposure among adults with intellectual and unspecific disabilities has been demonstrated in several studies, whereas only a few articles on people with sensory disabilities have been published. The aim of this study was to investigate the prevalence and risk for exposure to physical violence, psychological offence, or threats of violence in people with physical and/or sensory disabilities, compared with people with no such disabilities, controlling for socioeconomic data. Data from a public health survey were analyzed. A nationally representative sample of women and men aged 16 to 84 years had answered a questionnaire. In the present study, the whole sample, comprised of 25,461 women and 21,545 men, was used. Women with auditory disabilities were generally more often violence exposed than non-disabled women, whereas men with physical disabilities were more often violence exposed than non-impaired men. Some age groups among both women and men with visual disabilities had higher prevalence rates than women and men without disabilities. The adjusted odds ratios (ORs) were significantly higher among the auditory impairment group for exposure to physical (OR = 1.4, confidence interval [CI] = [1.1, 1.9]) and psychological (OR = 1.4, CI = [1.1, 1.8]) violence among women. Men with physical disabilities had raised odds ratios for physical violence (OR = 1.7, CI = [1.2, 2.4]) and psychological violence (OR = 1.4, CI = [1.0, 2.0]) compared with the non-disabled group. Both men and women with a physical or sensory disability showed higher odds of being exposed to violence than men and women without a disability. The results indicated that socioeconomic situation, smoking, and hazardous drinking strengthened the association between impairment and violence.

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  • 6.
    Olofsson, Niclas
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Lindqvist, Kent
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Gillander Gadin, Katja
    University Sundsvall.
    Danielsson, Ingela
    Sundsvall Hospital.
    Violence Against Young Men and Women: A Vital Health Issue2009In: The Open Public Health Journal, ISSN 1874-9445, Vol. 2, p. 1-6Article in journal (Refereed)
    Abstract [en]

    Objectives: Violence is regarded as a major health issue in an increasing amount of literature and is known as an important factor in women's ill health. Little however is known about violence against young men and women and its impact on their health. The principal aim of this study was to analyze health outcomes and health care utilization as reported among men and women aged 18-25 exposed and not exposed to physical and/or emotional violence.

    Study design: A cross-sectional national health survey in Sweden.

    Methods: Postal questionnaires were sent to nearly 3,000 men and women. Three questions were used to ask about violence. Sociodemographic characteristics for those exposed to violence during the past 12 months were analyzed and compared to those not exposed. Crude and adjusted odds ratios were calculated for health outcomes and medical care utilization.

    Results: Increased odds ratios were found for most health outcomes, and health care utilization for those exposed to violence compared to non-exposed. After adjusting for socioeconomic factors, smoking, and use of alcohol and cannabis, most variables were principally unchanged for women but considerably lower for men. Socioeconomic factors, smoking, and the use of drugs were all correlated to victimization.

    Conclusions: A strong association between those exposed to violence and physical and mental ill health was demonstrated also after adjusting for possible confounders, specifically for women. It is time to include questions about violence in public health questionnaires aimed at young people, but also to start asking about it more frequently in health care settings.

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  • 7.
    Olofsson, Niclas
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Lindqvist, Kent
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Gådin, Katja Gillander
    Department of Health Sciences, Mid-Sweden University Sundsvall Sweden.
    Bråbäck, Lennart
    Pediatrik Umeå universitet.
    Danielsson, Ingela
    Obstetrics and Gynaecology, Umeå universitet.
    Physical and psychological symptoms and learning difficulties in children of women exposed and non-exposed to violence: a population-based study.2011In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 56, no 1, p. 89-96Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To analyse the association between violence against mothers and the health of their children as reported by the mothers. METHODS: The data originate from a multistage sampling health-questionnaire survey, distributed to a representative sample of women in Sweden. The health of 283 children (aged 0-18 years), as reported by women who had been exposed to violence at home or outside home during the past 12 months, was compared with that of 4,664 children of non-exposed mothers. RESULTS: Odds ratios regarding most registered physical symptoms showed that children of violence-exposed mothers had a significant higher risk of ill health than children of non-exposed mothers. Regarding psychological symptoms and learning difficulties, the odds were raised for girls for most symptoms, but not for boys. A twofold increase in health-care utilisation and an overall general increase in the risk of pharmaceutical consumption were shown for both girls and boys of exposed mothers. CONCLUSIONS: This population-based study shows an increased risk of poorer health amongst boys and girls aged 0-18 years, as reported by mothers exposed to violence.

  • 8.
    Olofsson, Niclas
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Lindqvist, Kent
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Shaw, Benjamin A.
    Department of Health Policy, Management and Behavior, University at Albany, SUNY, Albany, NY, USA.
    Danielsson, Ingela
    Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå.
    Long-term health consequences of violence exposure in adolescence: A 26–year prospective study2012In: BMC Public Health, E-ISSN 1471-2458, Vol. 12, no 411Article in journal (Refereed)
    Abstract [en]

    Background: Violence victimization represents a serious risk factor for health related symptoms, for both men and women. The aim of this study was to evaluate the long-term effects of violence exposure in late adolescence and early adulthood on adult health, physical as well as mental, using a long-term prospective population-based study, with a follow up of 9, 19, and 26 years.

    Methods: The primary data source is a longitudinal panel from one of the longest running social science surveys in the world, the Swedish Level-of-Living surveys (LNU). We analyzed three cohorts, individuals aged 15-19 in 1974 and 1981, and individuals aged 18-19 in 1991 which were followed up 2000. Structured interviews on childhood, family relationships, life-events, living conditions, health history and status, working conditions, behavioral, psychosocial, and demographic variables were repeatedly used in all cohorts.

    Results: Multivariate models of violence exposures in adolescence in the 1974-91 cohorts as predictors of adult health in 2000 are reported for both men and women. Women exposed to violence had raised odds ratios for ill health, measured as heavy illness burden, and poor self rated health, after controlling for possible confounders. No such associations were found for men.

    Conclusions: This study’s findings provide additional empirical support for the importance of policies and practices to identify and prevent violence exposure in adolescence and young adulthood and to supply treatments for adolescence exposed to violence and above all the young women.

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  • 9.
    Palm, Anna
    et al.
    Uppsala University, Sweden; Sundsvall Hospital, Sweden.
    Danielsson, Ingela
    Umeå University, Sweden.
    Skalkidou, Alkistis
    Uppsala University, Sweden.
    Olofsson, Niclas
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine.
    Högberg, Ulf
    Uppsala University, Sweden.
    Violence victimisation-a watershed for young womens mental and physical health2016In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 26, no 5, p. 861-867Article in journal (Refereed)
    Abstract [en]

    Purpose: The association between victimisation and adverse health in children is well established but few studies have addressed the effect of victimisation, especially multiple victimisations, in older adolescents and young adults. The aim of this study was to assess self-reported health in young women (15-22 years) victimised to one or more types of violence, compared with non-victimised.aEuro integral Methods: Young women visiting youth health centres in Sweden answered a questionnaire constructed from standardised instruments addressing violence victimisation (emotional, physical, sexual and family violence), socio-demographics, substance use and physical and mental health. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and attributable risk (AR) were assessed.aEuro integral Results: Of 1051 women (73% of eligible women), 25% were lifetime victims of one type of violence and 31% of two or more types of violence. Sexual-minority young women were more victimised than heterosexual women. Violence victimisation increased the risk for adverse health outcomes, especially evident for those multiply victimised. Victims of two or more types of violence had AOR 11.8 (CI 6.9-20.1) for post-traumatic stress symptoms, 6.3 (CI 3.9-10.2) for anxiety symptoms and 10.8 (CI 5.2-22.5) for suicide ideation. The AR of victimisation accounted for 41% of post-traumatic stress symptoms, 30% of anxiety symptoms and 27% of suicide ideation. Stratified analyses showed that lower economic resources did not influence health negatively for non-victimised, whereas it multiplicatively reinforced ill-health when combined with violence victimisation.aEuro integral Conclusion: Violence victimisation, and particularly multiple victimisations, was strongly associated with mental ill-health in young women, especially evident in those with low economic resources.

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