Showing papers in "Scandinavian Journal of Public Health in 2002"
TL;DR: There are gender and age differences in both prevalence and degree of complaints; the intensity of subjective health complaints forms a continuum, and there is no obvious cut-off point to indicate what are ``normal' ' complaints and what is illness.
Abstract: Aims : As subjective health complaints are one of the major reasons for short- and long-term sickness absence it is important to know the prevalence of these conditions in the general population. Methods : In this cross-sectional study, 1,240 individuals (aged 15-84 years) from the normal population in Norway answered the Subjective Health Complaint (SHC) inventory in spring 1996. Results : The prevalence of reporting subjective health complaints was high: 80% reported musculoskeletal complaints, 65% reported ``pseudoneurological' ' complaints (tiredness, depression, dizziness), 60% gastrointestinal complaints, 34% allergic complaints, and 54% flu-like complaints. The prevalence of substantial complaints was low: 13% reported musculoskeletal complaints, 5% reported "pseudoneurological' 'complaints, 4% gastrointestinal complaints, 2% allergic complaints, and 18% flu-like complaints. Women had higher prevalence of musculoskeletal, ``pseudoneurological' ' , and allergic complaints compared with men, and repo...
289 citations
TL;DR: Poor self-rated health among young men is a predictor of future mortality, and psychological factors seem to be important explanatory variables.
Abstract: Aims: This study examined the relation between self-rated health (SRH) and mortality among young men, and factors in youth and adolescence that could explain the relation. Methods: Using logistic regression relative risks of mortality between various levels of self-rated health were compared in a longitudinal study of 49,321 men born in 1949-51, participating in a nationwide military conscription survey in 1969-70. Results: Poor self-rated health at conscription was associated with increased mortality during 27 years of follow up for those stating Rather poor or Very poor compared with those stating Very good SRH. SRH was most strongly related to alcohol- and drug-related mortality. Three psychological factors ( low emotional control, psychiatric diagnosis at conscription, and self-reported medication for nervous problems) were found to account for 84% of the increased mortality in the group stating Rather poor or Very poor SRH (remaining RR=1.1). However, the explanatory power of the psychologicalfactors...
148 citations
TL;DR: Subjects recruited to a population-based prospective cohort study by community versus personal invitation, and subjects responding late versus early to personal invitation may have different sociodemographic and lifestyle characteristics, and may vary with regard to prevalent disease, cancer incidence and subsequent mortality.
Abstract: AIM: The present study compares subjects recruited to a population-based prospective cohort study by community versus personal invitation, and subjects responding late versus early to personal invitation. Subjects were compared with respect to sociodemographic characteristics, selected lifestyle factors, cancer incidence and mortality. METHODS: The Malmo Diet and Cancer Study recruited a total of 28,098 subjects between 1991 and 1996. Entire birth-year cohorts, born 1923-50, were recruited using community directed (passive) invitation, and a personal letter of invitation (active recruitment). Information on sociodemography and lifestyle was obtained using a self-administered questionnaire. Anthropometric measurements were assessed at a physical examination. Cancer incidence and cause of death were retrieved using record linkage with national registries. RESULTS: Subjects responding to community directed invitation were older, and more often females, than participants recruited using personal invitation. Furthermore, participants recruited through passive invitation had a comparably more favourable situation with regard to sociodemographic and lifestyle factors. They also had a lower frequency of prevalent disease, lower incidence of cancer and lower mortality. Contrary to this, men were more likely to respond late to a personal letter of invitation and late responders were also older, as compared with subjects responding early to personal invitation. Furthermore, those who responded late had a comparatively unfavourable socioeconomic situation and were characterized by a high prevalence of current smoking, obesity, weight change, and prevalent disease. CONCLUSIONS: Subjects who are recruited using different strategies in population-based cohort studies may have different sociodemographic and lifestyle characteristics, and may vary with regard to prevalent disease, cancer incidence and subsequent mortality.
139 citations
TL;DR: Investigation of falls among frail older people living in three different types of Swedish residential care settings found areas of particular interest should include falls after mealtimes and falls at night, conditions of acute diseases, rising up from sitting, walking, and activities in progress, especially visits to the lavatory.
Abstract: AIMS: A prospective study was carried out to investigate the incidence, circumstances, and injuries from falls among frail older people living in three different types of Swedish residential care settings. METHODS: The settings were senior citizens' apartments, an old people's home, and a group dwelling for people with dementia. The falls were registered during the three-year study period on a semi-structured fall report, and injurious falls were categorized according to severity. RESULTS: In total 428 falls occurred among 121 residents. The incidence rate of falls at the group dwelling was twice the rates of the old people's home and senior citizens' apartments (4282 compared with 1709 and 2114 falls per 1000 person-years respectively). Some 27% of the falls occurred during the night (2100h to 0600h) and 28% were related to a visit to the lavatory. The presence of acute disease at the time of a fall was diagnosed in 23% of the falls. Some type of injury occurred in 118 falls (28%) and 36 of these (8%) led to moderate or serious injuries. In total 48 fractures were diagnosed. CONCLUSIONS: In a preventive programme for falls and injuries in residential care settings, areas of particular interest should include falls after mealtimes and falls at night, conditions of acute diseases, rising up from sitting, walking, and activities in progress, especially visits to the lavatory. Language: en
129 citations
TL;DR: The purpose is to remind researchers been registered in Sweden since 1751 (computerized of the potential of register-based research), while the oldest cancer register is the many researchers do use the registers, they are still an Danish one dating back to 1943.
Abstract: population. Here I refer to the National Cancer bene ts of register-based research and how con denRegister, the Medical Birth Register (including maltiality is secured. The public have usually paid indirformation), the Hospital Discharge Register and the ectly for the research and have the right to be well Causes of Death Register. Thus causes of death have informed. The other purpose is to remind researchers been registered in Sweden since 1751 (computerized of the potential of register-based research. Though from 1952) while the oldest cancer register is the many researchers do use the registers, they are still an Danish one dating back to 1943. The register of under-used `̀ goldmine’ ’ . Congenital Malformations was established in Sweden To ful l these two purposes some concrete examples in 1964 as an early warning system and as a direct of the usefulness of the national registers will be given response to the thalidomide catastrophe. The Medical and the ethical issues will be considered. Birth Register founded in the 1970s includes informaThe National Board diary shows more than 500 tion on mothers and children, e.g. diagnoses, birth requests annually for data from the Swedish health weight and height, operations, maternal tobacco, and data registers alone. Over the years this has resulted in drug use during pregnancy etc. The Hospital Discharge many more than 1000 peer-reviewed articles (Table I). Register covers all publicly run inpatient care in The Cancer Register has been an important source for Sweden from 1987, including information on diaganalysing the association between residential radon noses, surgical procedures etc. From 2001, the exposure and lung cancer (1), the potential eVects of Government has empowered the National Board also magnetic elds (2), trends in cancer survival (3, 4) and to collect information on hospital outpatient care. The the eVects of cervical cancer screening (5, 6). The value of these registers grows continuously as time Medical Birth Register has also been used extensively, passes. e.g. to analyse the risk of smoking during pregnancy Using a unique personal identi cation number (7± 9), pregnancy outcome after the Chernobyl acci(PIN), it is possible to link data on exposure or treatdent (10), associations between administration of ment from other sources to outcomes in these health vitamin K to newborns and childhood cancer (11), data registers. This Nordic system has created large teenage pregnancy outcomes (12) and eVects on childatabanks that are invaluable to the research commundren born after in vitro fertilization (13). Since 1994, ity, giving our register researchers a huge competitive data on maternal drug use has been collected in the advantage since they do not have to start collecting Medical Birth Register. This information has already data from scratch. Thousands of scienti c articles have resulted in some publications, but will evidently result been published based on data from these registers. The in many more and increase our knowledge of the knowledge derived has saved many lives and improved eVects, both positive and negative, of drug use during the quality of many more. However, there is legitimate pregnancy (14, 15 ). concern about the con dentiality of these registers.
129 citations
TL;DR: The identification of a somatic and a psychological factor indicates the existence of two different dimensions that may have different aetiologies and the gender difference in latent means across age groups may suggest a different developmental pattern amongst girls and boys.
Abstract: Aims: The aim of this study is to investigate dimensional structures in subjective health complaints in adolescents and to examine the variation in levels and dimensionality across gender and age g...
126 citations
TL;DR: The main barriers identified indicate that smoking cessation expertise needs to be more accessible and one alternative is to establish telephone help-lines that are easily available for all and could serve as a back-up for the GPs.
Abstract: Aims: Studies indicate that doctors may be reluctant to discuss smoking with their patients. Knowledge about how this problem might be solved is limited. The aim of this study was to identify barri...
103 citations
TL;DR: The magnitude of socioeconomic gradients in health in this study seemed somewhat smaller than results from national studies, and on the average compared to studies from other European countries; there was no detectable time trend in health differentials.
Abstract: Health inequalities by socioeconomic status among men in the Nord-Trondelag Health Study, Norway.
101 citations
TL;DR: LBP in persons with widespread musculoskeletal pain predicted long-term work disability, while localized LBP did not, and LBP accompanied by widespread pain did not.
Abstract: Aim: To investigate low back pain (LBP), with and without other musculoskeletal pains, as a predictor of long-term work disability. Method: A four-year prospective study was conducted. All inhabita...
98 citations
TL;DR: Most physicians practise self-treatment when they are ill, and although they prefer to be treated by a physician they do not have personal ties to, many contact friends and colleagues when they need help from another physician.
Abstract: Background: Information on physicians' illness behaviour is to a large extent based on studies of selected groups of physicians. The objective of this paper is to study self-treatment and help-seek...
91 citations
TL;DR: A review of articles on sexual behaviour of school students in sub-Saharan Africa published between 1987 and 1999 indicates a relatively low number of articles when one considers the scope of the problems related to adolescent sexual behaviour in the region.
Abstract: Aims: This is a review of articles on sexual behaviour of school students in sub-Saharan Africa published between 1987 and 1999. The objective was to describe what is known in this regard and identify gaps in knowledge. Methods: Literature search using electronic databases and a thumb search of relevant journals identified 47 articles reporting sexual behaviours of school-based young persons aged between 14 and 24 years. Results: The findings indicate a relatively low number of articles when one considers the scope of the problems related to adolescent sexual behaviour in the region; high prevalence rates of sexual intercourse; infrequent use of condoms and other contraceptives; and significant proportions of adolescents who have two or more lifetime sexual partners. More data are needed on the extent to which adolescents engage in non-penetrative sexual behaviour and penetrative sex other than heterosexual vaginal intercourse; characteristics of the sexual partners of adolescents; and proximal psychosocial antecedents of sexual behaviour and consistent risk-reduction behaviours. Conclusions: Cultural influences on sexual behaviour, the sensitivity of such research in adolescent populations, and the opportunity afforded by school systems for intervention suggest a need for additional exploratory and methodological studies. Placing such information firmly within sociocultural contexts in which young people are raised will better inform effective interventions that both delay the onset of sexual intercourse and encourage use of risk reduction strategies.
TL;DR: Findings suggest that broadening the view from the traditional psychosocial work characteristics to justice in management may assist in efforts to promote physicians' health and well-being.
Abstract: Aims: Prior research has reported high levels of stress for physicians, but determinants of this stress are poorly understood. We explored whether problems in decision-making procedures and treatment of employees, as expressed in the theory of organizational fairness, may contribute to psychological distress in hospital physicians. Methods: Structural equation modelling (LISREL) was based on survey responses from 251 male and 196 female physicians working in 11 public hospitals in Finland. Results: Low organizational fairness increased the risk of psychological distress in male physicians but not in female physicians. In the former group, the association between organizational fairness and psychological distress was partially mediated by decreased job control and increased workload. Conclusions: These findings suggest that broadening the view from the traditional psychosocial work characteristics to justice in management may assist in efforts to promote physicians' health and well-being.
TL;DR: It is argued that workplace strategies deserve high priority on any agenda that aims at reducing social inequalities in health, and two leading theoretical models of work-related stress, the demand-control model and the model of effort-reward imbalance are discussed.
Abstract: Despite reduced health risks in terms of physical and chemical hazards current trends in occupational life continue to contribute to ill health and disease among economically active people. Stress at work plays a crucial role in this respect, as evidenced by recent scientific progress. This paper discusses two leading theoretical models of work-related stress, the demand-control model and the model of effort-reward imbalance, and it summarizes available evidence on adverse health effects. As work stress in terms of these models is more prevalent among lower socioeconomic status groups, these conditions contribute to the explanation of socially graded risks of morbidity and mortality in midlife. Implications of this new knowledge for the design and implementation of worksite health-promotion measures are elaborated. In conclusion, it is argued that workplace strategies deserve high priority on any agenda that aims at reducing social inequalities in health.
TL;DR: The results show that young persons, living in poor households, unemployed or early retired, reporting a high degree of impairment, present a greater probability of experiencing fi nancial strain.
Abstract: Aims This study aims to investigate whether those individuals exposed to certain socioeconomic events (e.g. unemployment or early retirement) are more at risk of experiencing financial strain if they are also exposed to some limiting long-term illness. Methods This is a cross-sectional study using a Swedish sample of 41,497 individuals between the ages of 25 and 65 selected from the Survey of Living Conditions of Statistics Sweden. The measure of association used in the study is the prevalence odds ratio, and interaction analyses are performed in order to assess differential susceptibility to experience financial strain. Results The results show that young persons, living in poor households, unemployed or early retired, reporting a high degree of impairment, present a greater probability of experiencing financial strain. Severe impairment has proved to be a component in the possible causal chain leading to the experience of financial strain, which interacts with the factors studied, increasing significantly the probability of certain groups experiencing financial hardship. Conclusion The results sustain the hypothesis that social consequences of illness, such as financial strain, might contribute to aggravate inequalities between socioeconomic groups under certain conditions such as unemployment and poverty.
TL;DR: The increasing mortality of the early retirement recipients is consistent with an adverse effect on health of retirement itself, but may also be due to the cessation of health selection in the group of disability benefit recipients after retirement.
Abstract: Aims: The aim of this study was to examine whether early retirement is gained by persons with poor health or whether retirement leads to negative changes in health. Mortality for persons in Denmark using one of two publicly financed retirement schemes was investigated. Disability benefit (fortidspension) was granted for health reasons mainly, while early retirement benefit (efterlon) was earned through long-term membership of an unemployment benefit scheme. Methods: Data from Danish population-based registers were used for each year in the period 1986-96. The study setting was the population of Denmark, born between 1926 and 1936. Results: the standardized mortality ratio in employed persons was low (0.59 and 0.51 for men and women, respectively) and high in disability benefit recipients (2.31 and 1.66). The mortality in the early retirement benefit recipients (0.88 and 0.72) was in between the mortality for the disability benefit recipients and the employed persons. Disability benefit recipients had a hi...
TL;DR: Study of the types of action and interaction that the women considered to have benefited from by participating in group treatment for women with chronic muscular pain confirmed that recognition had an important effect on how much they benefited from the treatment programme.
Abstract: Aims: Since 1992, the authors have completed 11 treatment groups for women with chronic muscular pain. The programme includes movement training and group discussions. Qualitative data indicate that the participants valued the experience of being recognized in the groups as a crucial and beneficial effect of the treatment. In the present article, this finding is examined in more detail by studying the types of action and interaction that the women considered to have benefited from by participating in group treatment. Methods: Data are drawn from an action research project and the material originates from three treatment groups where 24 participants completed the programme. Qualitative data originating from five focus group interviews are analysed using Giorgi's principles of phenomenological analysis. Results: The women described different concrete aspects of interaction and awareness illustrating psychologist Lovlie Schibbye's theoretical perspectives of a recognizing attitude: listening, understanding, a...
TL;DR: A review of articles on sexual behaviour of school students in sub-Saharan Africa published between 1987 and 1999 indicates a relatively low number of articles when one considers the scope of the problems related to adolescent sexual behaviour in the region.
Abstract: Aims: This is a review of articles on sexual behaviour of school students in sub-Saharan Africa published between 1987 and 1999. The objective was to describe what is known in this regard and identify gaps in knowledge. Methods: Literature search using electronic databases and a thumb search of relevant journals identified 47 articles reporting sexual behaviours of school-based young persons aged between 14 and 24 years. Results: The fi ndings indicate a relatively low number of articles when one considers the scope of the problems related to adolescent sexual behaviour in the region; high prevalence rates of sexual intercourse; infrequent use of condoms and other contraceptives; and signifi cant proportions of adolescents who have two or more lifetime sexual partners. More data are needed on the extent to which adolescents engage in non-penetrative sexual behaviour and penetrative sex other than heterosexual vaginal intercourse; characteristics of the sexual partners of adolescents; and proximal psychoso...
Journal Article•
TL;DR: The finding that women with common symptoms are at risk of future sickness absence is of particular importance in a primary health care setting and the finding that Women in active job positions had a higher risk of sickness absence might be an effect of modern working conditions for women.
Abstract: Do common symptoms in women predict long spells of sickness absence? A prospective community-based study on Swedish women 40 to 50 years of age : Scandinavian Journal of Public Health
TL;DR: It was found that there was a geographical inequity in use of public health services while there was relatively equal use of these services between social, gender, and ethnic groups.
Abstract: Aims : The aim of this study is to describe the use of public health services in different social and ethnic groups and to explore the implementation of user fee exemption in a mountainous area in Vietnam. Methods: A cross-sectional household survey with a structured questionnaire and a four-week diary were used to collect information on illnesses, health seeking behaviour and socioeconomic factors. Three communes in a mountainous district in Northern Vietnam were selected and a random sample of 1,452 individuals in 300 households was drawn. Results: Self-medication was most common (57%) while 30% used public health services when suffering from a health problem. Persons living far from health services attended public health services less frequently than the others (adjusted OR=0.28; 95% CI 0.15-0.51). This was especially the case for ethnic minorities who were less likely to use public health services than the others were (adjusted OR=0.47; 95% CI 0.25-0.87). Persons with mild conditions tended to use pub...
TL;DR: Examination of self-perceived health in Bulgaria in relation to financial status (measured by income and self-assessed financial status) after adjustment for other potential explanatory variables found marked inequalities in self-reported health.
Abstract: AIMS: Self-reported health has been widely used in studies of health inequalities in many industrialized countries, but there is still little information on their distribution within populations in countries in Central and Eastern Europe (CEE). There is growing evidence that, since the political transition at the end of the 1980s, income and health inequalities have widened considerably throughout CEE. This paper examined self-perceived health in Bulgaria in relation to financial status (measured by income and self-assessed financial status) after adjustment for other potential explanatory variables. METHODS: Data were derived from a national representative survey of the population of Bulgaria aged over 18, in 1997. Respondents were asked "How would you describe your own health status over the past 12 months on the whole?" with answers "good", "rather good", "rather poor", and "poor". Responses were assessed in relation to a variety of measures including income, education, marital status, and self-perceived financial hardship. RESULTS: As expected, the prevalence of poor/rather poor health increases steeply with age. Those with only primary education are more likely to be in poor/rather poor health than those with secondary or higher education. Self-assessed financial status is a much better predictor of health than is income, with the relationship especially strong among women. There was no association with marital status or urban vs. rural dwelling. CONCLUSIONS: The survey found marked inequalities in self-reported health in Bulgaria. Some of its determinants, such as age and education, are comparable to those seen in the West. Self-reported health is particularly associated with self-perceived financial hardship, a proxy for material deprivation that is sensitive to informal economic exchanges. An accelerated pace of economic and social reforms at the end of the 1990s means that the health divisions in Bulgaria are likely to increase in the short term.
TL;DR: In this article, a questionnaire containing items on socioeconomic and psychosocial variables was sent to a random population of women, 40 to 50 years of age, living in a rural Swedish community.
Abstract: Aims: To investigate whether a high level of commonly experienced physical and mental symptoms could predict long spells of sickness absence in Swedish women and, further, to investigate the causal pattern of socioeconomic and psychosocial factors in relation to long spells of sickness absence. Methods: A questionnaire containing items on socioeconomic and psychosocial variables was sent to a random population of women, 40 to 50 years of age, living in a rural Swedish community. The response rate was 81.7% ( 397 women). Data on long spells of sickness absence (> 14 days) for the year following the baseline survey were obtained from the social insurance office. Odds ratios (OR) were used to estimate bivariate associations. Multiple logistic regression analysis was used to test for confounding and effect modification. Results: Women suffering from a high level of common symptoms were at risk of subsequent long spells of sickness absence, OR= 3.39 (1.86-6.17). High demands at work and an active job position (i.e. the combination of high demands and a high degree of job control) were both associated with long spells of sickness absence, OR= 2.16 (1.12-4.17) and OR= 1.92 ( 1.01-3.67). The combined exposure ( high level of common symptoms and an active job position) increased the odds for long spells of sickness absence (OR= 9.13; 3.39-24.58) with synergy noted. Conclusions: The finding that women with common symptoms are at risk of future sickness absence is of particular importance in a primary health care setting. The finding that women in active job positions had a higher risk of sickness absence might be an effect of modern working conditions for women. (Less)
TL;DR: A combination of interview and questionnaire increases the possibility of interpreting the association between working conditions and health and may provide a more effective basis for interventions.
Abstract: Background: The aim of this study was to present, evaluate and propose a tool for the assessment of psychosocial working conditions in epidemiological studies. A referent group of the large epidemiological study, the MUSIC-Norrtalje study of musculoskeletal disorders, was used. The respondents were 950 working persons (585 female and 365 male). Method: Self-administered questionnaire and personal interview were used. The responses were subjected to factor analysis. The resulting model had components generated from the demand-control-support model and action theory. Result: The result supported the use of different aspects of psychological job demands. The interview data seemed to be more related to factual exposure and the questionnaire data more to individual perception. The usefulness of the model was supported by associations between the model and psychosomatic symptoms and sleep disturbances. Conclusion : A combination of interview and questionnaire increases the possibility of interpreting the associ...
TL;DR: The need for better information is reviewed to document the scale of inequalities, to evaluate interventions designed to reduce them, and to disseminate evidence of good practice is reviewed.
Abstract: Policies to reduce inequalities in health are needed in many different settings, one of which is the healthcare setting. This paper, drawing on the conclusions of the Copenhagen conference, explores the contribution that such policies can make within the healthcare system. In doing so it examines four themes. It begins by exploring the contribution that healthcare makes to health. It challenges the widely held view that this contribution is small, arguing that there have been major advances in the effectiveness of medical care and the use of evidence-based healthcare, so that interventions of proven effectiveness are increasingly delivered to those who will benefit. Unfortunately, there is growing evidence that the benefits of modern healthcare do not benefit all groups equally. Thus, there is an unfinished agenda in many countries to enhance the equitable distribution of access to effective healthcare. Second, it explores the dynamic relationship between illness and poverty and, specifically, the impoverishing nature of illness in the absence of effective mechanisms to ensure solidarity and to provide social safety nets. It identifies how all elements within a healthcare system have a part to play. Those responsible for healthcare financing should ensure that funds are obtained in an equitable manner. Those who provide healthcare can do much to promote access for the disadvantaged and to use their facilities to promote health as well as cure disease. Third, it considers the specific needs of disadvantaged populations, and especially those whose needs are least visible, such as illegal migrants. It concludes by reviewing the need for better information to document the scale of inequalities, to evaluate interventions designed to reduce them, and to disseminate evidence of good practice.
TL;DR: The findings of this study imply the importance of social support and social network factors as modifiers of the rate of decline of the CD4 lymphocyte level, which is an important prognostic marker of survival in HIV-positive homosexual men.
Abstract: AIMS: To test a stress-disease hypothesis by investigating the influence of social network and social support factors on the course over time of the CD4 lymphocytes in an HIV-positive population of gay men. METHODS: The study is a prospective cohort study of a representative population of HIV-positive gay men, undertaken at the Department of Infectious Diseases, Malmo University Hospital. This is the only clinic providing care for HIV-positive individuals in the city of Malmo in southern Sweden (population 248,000). A total of 115 HIV-positive homosexual men, who had not received an AIDS diagnosis, were invited to take part in the study. Seventy-five men (65%) accepted to be interviewed and 64 men (56%) fulfilled the inclusion criteria for the statistical analysis. RESULTS: In a multivariate analysis adjustments were made for age, level of the first CD4 count and time since first contact with the clinic. Men with high family contact frequency had a longer half-life (20.3 years) of the CD4 lymphocyte count than men with a low family contact frequency (7.4 years) (p = 0.03). Men with high social participation also had a longer half-life of CD4 lymphocyte count (14.7 years), compared with men with low social participation (6.3 years, p = 0.10). CONCLUSIONS: The findings of this study imply the importance of social support and social network factors as modifiers of the rate of decline of the CD4 lymphocyte level, which is an important prognostic marker of survival in HIV-positive homosexual men. (Less)
TL;DR: Analysis of variations of sickness leave rates among the Barcelona city council civil servants by administrative category and gender found women had generally higher rates than men did, and manual categories hadHigher rates than non-manual ones, which was more evident for men and long episodes.
Abstract: The ``Casa Gran work organization, social inequalities ive category, and gender, which were key points in in health and gender’’ project was set up to analyse the Dr Moncada’s presentation ``Improving working factors of the structure and the psychosocial work envir- conditions to reduce health inequalities: the Casa Gran onment associated with health inequalities among project’’ at the International Conference on Reducing Barcelona City Council’s civil servants, with a special Social Inequalities in Health. interest in studying health inequalities related to gender. The Casa Gran project aimed to give the social partners scientie c evidence of occupational factors related to the SOCIAL AND GENDER INEQUALITIES IN health of workers and the organization, including health HEALTH AND SICKNESS LEAVE inequalities and gender. Managers of the organization and worker representatives are the key groups who should act Social inequalities in health have widely been documented as worse mortality and morbidity indicators for
TL;DR: To present life expectancy and mortality trend analysis in comparison with other European countries, and to demonstrate risk of Lithuanian population to major noncommunicable diseases related to social inequalities and inequities in health, is demonstrated.
Abstract: Aims: The major aim of this study was to assess existing inequalities in health of Lithuanian population and to present the process of health policy development as a major tool for reducing inequalities. The objectives were: to present life expectancy and mortality trend analysis in comparison with other European countries; to demonstrate risk profi le of Lithuanian population to major noncommunicable diseases related to social inequalities and inequities in health; and to present the process of National health policy development as potential for effective reduction of inequalities in health of Lithuanian population.Methods: Information about demographic, general health situation and inequalities in health was obtained from Lithuanian Department of Statistics, National Health Information Centre and research studies performed at Kaunas University of Medicine.Results: Considerable demographic, social and territorial inequalities in health were disclosed in Lithuania. Large proportion of them might be relate...
TL;DR: The observed trends are a change towards less effective use of contraceptive methods among teenagers, and there is also evidence of the earlier start of teenage sexual activity at the end of the 1990s.
Abstract: Aims: This study analyses trends and regional variation in teenage pregnancy, abortion, and fertility rates in Finland in the 1990s, by single-year age group. Methods: Individual-level data from Finnish abortion and birth registers maintained by the National Research and Development Centre for Welfare and Health (STAKES) were used to calculate the rates and the abortion ratio. The abortion ratio was also calculated using conception as the time reference. Results: Teenage pregnancy rates and abortion rates reverted from decrease to increase in the mid-1990s. This was accompanied by an increase in the share of teenage pregnancies that ended in an abortion. The increase in abortions started first among older teenagers, and spread gradually to younger girls. Regional variation in the rates remained the same throughout the study period. Conclusions: The observed trends refl ect a change towards less effective use of contraceptive methods among teenagers. There is also evidence of the earlier start of teenage s...
TL;DR: In this paper, the authors investigated the association in women between conditions during childhood and adolescence and alcohol dependence or abuse in adulthood on the one hand, and disability pensions and long-term sickness absence on the other.
Abstract: AIMS: This study investigates the association in women between conditions during childhood and adolescence and alcohol dependence or abuse in adulthood on the one hand, and disability pensions and long-term sickness absence on the other. METHODS: A stratified population-based sample of women in Goteborg was interviewed. For analyses in this study the following variables were selected from the interview protocol: childhood and adolescence, education, employment, social class, self-rated physical health and alcohol dependence or abuse (ADA), with diagnoses assessed according to DSM-III-R. Information on disability pension and sickness absence was obtained from the local Social Insurance Office. RESULTS: Unfavourable conditions during childhood and adolescence and school difficulties as well as early deviant behaviours predicted disability pension and long-term sickness absence in adulthood. For most risk factors ADA could explain only a minor part of the odds ratios found in crude and age-adjusted analyses. CONCLUSION: It is concluded that conditions early in life are predictors in women of disability pension and long-term incapacity to work. There are similarities in the pattern of early risk factors for later alcohol dependence or abuse and for disability pension/long-term sickness absence. Language: en
TL;DR: The aim of this paper is to refl ect on the type of evidence that is required to design policy measures and interventions to reduce inequalities in health, and the political feasibility of policy measures was explored during a number of conferences.
Abstract: The aim of this paper is to reflect on the type of evidence that is required to design policy measures and interventions to reduce inequalities in health. This issue will be discussed in the context of the Dutch national research programmes on inequalities in health. The first type of evidence relates to the background of socioeconomic inequalities in health. From a very simple conceptual scheme, four policy options can be derived: (1) reducing inequalities in socioeconomic goods; (2) changing the distribution of specific risk factors across socioeconomic groups; (3) diminishing the effect of health on socioeconomic status; (4) offering extra healthcare for people in lower socioeconomic groups. Whereas the evidence on the background of socioeconomic inequalities in health has increased enormously, there is clearly a lack of evidence on the effectiveness of interventions to tackle inequalities in health, which is the second type of evidence that is required. The Dutch five-year programme, including 12 (quasi) experimental studies on specific interventions in different policy fields, showed that this second type of evidence is more difficult to collect, partly because of the methodological complexity of these studies. The third type of evidence relates to the political feasibility of policy measures. It is not enough to know that a specific determinant of socioeconomic inequalities in health might be effectively addressed by a specific intervention. The political will to implement that intervention is obviously a necessary prerequisite for actually reducing inequalities in health. Within the Dutch research programme, the political feasibility of policy measures was explored during a number of conferences, for several policy fields. The lack of evidence on, in particular, the effectiveness of interventions to reduce inequalities in health is clearly an obstacle to tackling inequalities in health. On the other hand, it should be ensured that the lack of evidence is not used as an excuse for not taking policy measures at all.
TL;DR: The pattern of cancer incidence and mortality seen in physicians in Estonia is similar to the pattern seen among professional classes in other countries.
Abstract: Aims: To evaluate whether the presumed knowledge of physicians about healthier lifestyle decreases their risk of cancer and mortality, a retrospective cohort study of male and female physicians was conducted in Estonia. Methods: The cancer incidence and cause-specifi c mortality of 3,673 physicians (870 M, 2,803 F ) in Estonia was compared with the rates of the general population. Information on cancer cases and deaths in the cohort between 1983 and 1998 was obtained from the Estonian Cancer Registry and the mortality database of Estonia. Results: The standardized incidence ratio (SIR) for all cancers was 1.32 (95% confi dence interval (CI) 1.15-1.48) in women and 0.92 (95% CI 0.73-1.13) in men. Female physicians had an elevated risk for breast cancer (SIR 2.03, 95% CI 1.62-2.51) and myeloid leukaemia (SIR 3.69, 95% CI 1.35-8.02). Male physicians had an excess of skin melanoma (SIR 4.88, 95% CI 1.58-11.38). A large defi cit of lung cancer was observed (SIR 0.24, 95% CI 0.11-0.48). The very low all-cause m...