Showing papers in "Scandinavian Journal of Public Health in 2004"
TL;DR: The health of the Inuit has undergone substantial changes over the past five centuries, as a result of social, cultural, and economic changes brought about by interactions with Europeans.
Abstract: The health of the Inuit has undergone substantial changes over the past five centuries, as a result of social, cultural, and economic changes brought about by interactions with Europeans. This process was accelerated considerably in the second half of the twentieth century. The incidence of infectious diseases has declined considerably but is still high compared with Western societies. Chronic diseases such as diabetes and cardiovascular disease are on the increase, while accidents, suicides, violence, and substance abuse are of major importance for the pattern of ill health in most Inuit communities. Lifestyle changes, social change, and changes in society and the environment are major determinants of health among the Inuit.
235 citations
TL;DR: To help the mothers who would like to breastfeed their baby, it is necessary to improve the ability to identify mothers at risk of early cessation, and mother's schooling, her intention, self-efficacy and earlier breastfeeding experience can be used as early predictors.
Abstract: Aim: A study was undertaken to examine to what extent psychosocial factors are related to the length of breastfeeding. Methods: A cohort of Danish mothers giving birth to a single child was followed up for four months. Information on mother and baby including psychosocial variables was obtained from a self-report questionnaire. Breastfeeding status was subsequently monitored by a health visitor. Results: A total of 471 (88%) mothers participated, 98.7 % initiated breastfeeding and after four months 277 (59%) were still exclusive breastfeeding; 99 mothers, 51% of those who stopped, stopped within the first five weeks. In Cox regression analyses the duration of breastfeeding showed a positive association with mother's schooling ( p=0.002), her intention to breastfeed ( p=0.001), previous experience with breastfeeding ( p<0.001), self-efficacy with respect to breastfeeding ( p<0.001), her confidence in breastfeeding ( p=0.012) and knowledge about breastfeeding ( p=0.001). The effect of the mother's knowledge...
220 citations
TL;DR: Though genetic research in bioethical debate is often viewed as a potential threat to the integrity of the donor, the confidentiality of medical records still seems to concern donors more.
Abstract: AIMS: The procurement and usage of tissue samples has begun receiving increasing legal and ethical attention. The authors' aim was to develop an empirically based understanding of public attitude ...
195 citations
TL;DR: There was little support for combining the models as the combined model was dominated by the predictive power of dimensions from the ERI and the results also showed that the models or dimensions of the models made distinct contributions to explaining perceived work stress in different types of occupation.
Abstract: Background: The Demand Control Model (DCM) and the Effort - Reward Imbalance Model (ERI) offer putative explanations of the relationship between stressful working conditions, job strain, and psychological and physical ill health. Aims: The aims of this study are to: (a) compare the predictive powers of the two models for explaining perceived job stress and mental distress amongst workers as a whole, (b) identify whether a model which combines dimensions of the DCM and ERI might have more predictive power than either of them separately, and (c) ascertain whether the models make distinct contributions to explaining stress at work in specific occupational settings. Methods: Statistical analysis was carried out on data collected from a cross-sectional postal survey of a random sample (n=7,069), of the adult population in an urban area in Southern England. The analysis focused on the 4,135 respondents who were in paid employment. Results: There was little support for combining the models as the combined model was dominated by the predictive power of dimensions from the ERI. However, the results also showed that the models or dimensions of the models made distinct contributions to explaining perceived work stress in different types of occupation. Conclusions: There is little evidence to support a combined model of work characteristics. The ERI appears to be the stronger of the two models although the DCM has explanatory value for specific occupations.
140 citations
TL;DR: The results show that both earnings and disposable household income are strongly related to health, a finding that holds for both women and men, and indicates that income-equalizing policies may have an impact on health.
Abstract: Aims: This paper explores the relationship between income and health among adults in Sweden. An analysis was made as to what extent the association differs when one studies individual earnings and equivalent disposable income, as well as gender differentials. Further, a study was undertaken to investigate how, and by what magnitude, the income - health relationship changes when one controls for other structural factors, such as education and class. Finally the functional form of the relationship was scrutinized, because of its obvious policy impact. Methods: Data came from the 1996-97 Swedish Living Condition Surveys, which include individuals aged 25 - 64 (n=7,201). Logistic regression was used, including various polynomial terms of the income variable. Results: The results show that both earnings and disposable household income are strongly related to health, a finding that holds for both women and men. The strength of the association becomes somewhat weaker when one controls for other structural factor...
135 citations
TL;DR: Higher utilization rates among some immigrant groups may be explained by disparities in health or lack of knowledge about the Danish healthcare system as well as barriers to seeking primary care including language, fear of discrimination, and low satisfaction with primary care.
Abstract: Background: The aim of the study was to investigate whether utilization of the emergency room differed between immigrant groups and Danish-born residents in Copenhagen, Denmark. Methods: The author...
135 citations
TL;DR: The change in mean BMI and prevalence of overweight and obesity in children in this study is mainly due to the pronounced change in BMI at the upper end of the spectrum, indicating that the factors leading to overweight or obesity have changed in only a subgroup of the child population.
Abstract: AIMS: This study was undertaken to assess current prevalence and regional differences of overweight in 2001 and changes in body mass index (BMI) distribution between 1987 and 2001 in Swedish adoles ...
95 citations
TL;DR: Findings indicate that the actions to reduce psychosocial risk factors of sickness absence should match the specific needs of each socioeconomic group.
Abstract: Aims: The majority of the research on the effects of the psychosocial work environment on sickness absenteeism has focused on components of job strain and social support among public sector employees without stratification by socioeconomic status. The authors examined less-studied work-related psychosocial predictors of sickness absence in the private sector by socioeconomic status. Methods: Questionnaire data on psychosocial factors at work were used to predict the rates of recorded short (1 - 3 days), long (4 - 21 days), and very long (over 21 days) sickness absences among 3,850 white- and blue-collar male and female employees in a large-scale enterprise. Multivariate Poisson regression models were adjusted for age, prior absence, and psychosocial factors at work. Results: In white-collar men, low role clarity was associated with a 3.0 (95% CI 1.3 - 7.1) times greater rate of very long absences than high role clarity. Low fairness in the division of labor predicted a 1.3-fold (95% CI 1.1 - 1.5) rate of ...
86 citations
TL;DR: Nordic collaborative analyses of social gradients in infant death are needed, taking advantage of the population-covering registers in longitudinal designs, to explore the mechanisms behind the social patterns in infant mortality.
Abstract: Aim: Social equity in health is an important goal of public health policies in the Nordic countries. Infant mortality is often used as an indicator of the health of societies, and has decreased substantially in the Nordic welfare states over the past 20 years. To identify social patterns in infant mortality in this context the authors set out to review the existing epidemiological literature on associations between social indicators and infant mortality in Denmark, Finland, Norway, and Sweden during the period 1980 - 2000. Methods: Nordic epidemiological studies in the databases ISI Web of Science, PubMed, and OVID, published between 1980 and 2000 focusing on social indicators of infant, neonatal, and postneonatal mortality, were identified. The selected keywords on social indicators were: education, income, occupation, social factors, socioeconomic status, social position, and social class. Results: Social inequality in infant mortality was reported from Denmark, Finland, Norway, and Sweden, and it was f...
85 citations
77 citations
TL;DR: It is concluded that self-report of hip, wrist, or upper arm fractures among Danish nurses is relatively accurate but varies by the site of fracture.
Abstract: Background: The authors compared self-reported non-spine fractures obtained from a cohort of Danish female nurses with fracture diagnoses registered in the Danish National Hospital Register (DNHR)....
TL;DR: The results indicate a strong association between occupational gender segregation and musculoskeletal-related sickness absence, and grouping occupations according to degree of numerical gender segregation revealed the highest incidence and duration of sickness absence for women in male-dominated occupations.
Abstract: Background: Musculoskeletal disorders represent a considerable public health problem and the most common diagnoses behind sickness absence and disability pensions. However, little is known about ho...
TL;DR: Most welfare states have public or private sickness absence funds or insurances covering workers’ loss of income due to ill health.
Abstract: Societies have always had to deal with the fact that individuals can have short- and long-term work incapacity due to ill health. With industrialization new methods of addressing this were developed and a common way was to establish sickness absence funds. Over the last century such funds grew larger and today most welfare states have public or private sickness absence funds or insurances covering workers’ loss of income due to ill health.
TL;DR: Doctors and nurses showed the most positive attitudes towards different statements about immigrants, and assistant nurses the most negative, which provides a foundation for new interventions and priorities within the healthcare system regarding immigrant patients.
Abstract: Aims: A study was undertaken to identify variations in knowledge, attitudes, experiences, and communication among different categories of hospital staff with regard to immigrant patients in order to identify potential barriers for effective diagnosis, treatment, and care of immigrant patients. Methods: The study is based on a questionnaire mailed to doctors, nurses, and assistant nurses at Bispebjerg Hospital, a major general hospital in Copenhagen. Among the 1,012 persons included the total response rate was 58%. Results: A majority of all three professional groups obtain their knowledge on immigrants through the media and patient contact, and less through travels, courses, and colleagues. Doctors and nurses showed the most positive attitudes towards different statements about immigrants, and assistant nurses the most negative. Doctors and nurses also had most frequent contacts with immigrant patients and found their communication more satisfactory compared with assistant nurses. Many health workers expr...
TL;DR: It was showed that psychosocial factors could be the theoretically most important focus for preventing SGA in immigrant women, and a possible synergistic relation was demonstrated between foreign origin of the mother and low social anchorage.
Abstract: Aims: This study investigates the risk of small for gestational age (SGA) in relation to country of origin of the mother. The role of psychosocial resources, socioeconomic and lifestyle factors was examined in different causal models. Methods: Among all pregnant nulliparous women in the city of Malmo¨ , Sweden, who gave birth in 1991 – 92, 872 (87.7%) women completed a questionnaire during their first antenatal visit. The study was carried out among women whose pregnancies resulted in a singleton live birth (n~826); 22% (n~182) of these women were foreign-born. Results: Fifty-five (6.7%) of the infants were classified as SGA, 37 (5.7%) of mothers of Swedish origin and 18 (9.7%) of foreign origin. SGA deliveries were much more prevalent among Middle East- and North Africa-born women (22%) and sub-Saharan-born women (15%). In all, women of foreign origin had increased odds for delivering SGA babies (OR~1.8, 95% CI~1.0,3.2). In a multivariate analysis psychosocial and socioeconomic factors explained 30% and 40%, respectively, of the increased SGA risk. Psychosocial factors seemed to be more prominent risk factors for SGA among mothers of foreign origin. A possible synergistic relation was demonstrated between foreign origin of the mother and low social anchorage. Conclusions: This study showed that psychosocial factors, most probably linked to a disadvantaged social situation, could be the theoretically most important focus for preventing SGA in immigrant women. This could also further support a hypothesis of a link between psychosocial stress and SGA in general. However, this should not exclude the need for intervention in the antenatal care system in terms of specially tailored support and education. (Less)
TL;DR: It is suggested that gender bias is involved in medical management of IBS but men and women physicians may show disparate patterns of gender bias.
Abstract: AIMS: Research has raised concerns about gender bias in medicine, i.e. that men and women might be treated differently due to gender-stereotyped attitudes among physicians. The authors investigated ...
TL;DR: For instance, the authors found that 50% of women in 1998 and 60% of the women in 2000 had heard about folate, 33% and 46% knew about its role in pregnancy, and 9.5% and 21% knew that it may prevent a congenital malformation.
Abstract: Aims: From March 1998, Norwegian nutrition authorities have recommended that women consume a folic acid supplement before and early in pregnancy to prevent neural tube defects. The authors wished to establish Norwegian data on knowledge of, use of, and attitudes to folic acid supplement and dietary supplements before and after implementing national information campaigns on folate and pregnancy. Methods: Telephone surveys were carried out in late 1998 and in late 2000 among, respectively, 1,146 and 1,218 Norwegian women of reproductive age. Results: Overall, 50% of the women in 1998 and 60% of the women in 2000 had heard about folate, 33% and 46% knew about its role in pregnancy, and 9.5% and 21% knew that it may prevent a congenital malformation. Only 4.0% and 8.5% of the women, respectively, knew that the critical period for folic acid supplement to reduce the risk of neural tube defect is before and early in pregnancy. Knowledge and increase in knowledge between the two surveys were highest among women ...
TL;DR: It was found that depressive complaints and psychosomatic problems increased with increasing frequency of intoxication, and adolescents with moderate and heavy alcohol consumption are more sociable with friends, abstainers and light drinkers appear emotionally healthier.
Abstract: Aim: Alcohol use and intoxication are highly prevalent among adolescents and may be an important element of the socialization process in the teenage years. Significant short- and long-term health consequences seem evident. The aim of this study was to investigate the relationship between alcohol consumption and several aspects of psychological health and social integration in adolescents. Methods: The study is based on data from a 1997 cross-sectional survey of 828 Norwegian tertiary school students in Forde (91% of all students). Three hundred and eighty (46%) were female. The majority of students were aged 20 or younger, with 64% aged 15 - 17. Four groups were defined according to frequency of alcohol intoxication. Emotional health and social integration in the four groups are reported as means and the differences from the reference groups (with 95% confidence limits) were estimated. Control of confounding and interaction was performed. Results: The study reveals that alcohol intoxication is an establis...
TL;DR: The results support the role stress theory, especially among women, but it is only among women that an increase in the percentage desiring a reduction in their working hours can be found.
Abstract: Aims: The aim of this study is to analyse how increasing demands from work and family life affect the level of strain and whether there are any significant gender differences in this respect. This is be done by testing the following hypotheses: An increase in work and family demands causes (a) an increased risk of suffering from fatigue; (b) an increased need for working fewer hours. Methods: The hypotheses are analysed by using a longitudinal data set consisting of nearly 9,000 Swedish individuals. Results: Multiple demands increase the risk of suffering from fatigue among both women and men, but it is only among women that an increase in the percentage desiring a reduction in their working hours can be found. Conclusions: The results support the role stress theory, especially among women.
TL;DR: It was found that a gender difference in the risk of being on disability pension was still apparent when sick leave during the follow-up period is taken into account, and the reason for the gender differences ought to be found among other factors than prior levels of sickness absence.
Abstract: Aim: A study was undertaken to ascertain whether the differences in risk in relation to gender and citizenship observed in a previous study of the same cohort would remain if more recent data on sickness absence were used. Methods: This was an 11-year prospective population-based cohort study. The dataset includes all individuals in a Swedish city who, in 1985, were aged 25 - 34 and had a sick-leave spell≥28 days with neck, shoulder, or back diagnoses (n=213). The data covered the following: for 1985 - 96, disability pension, emigration, and death; for 1982 - 96, sickness absence; for 1985, sex and citizenship. The data were subjected to Cox regression analyses with a time-dependent covariate. Results: Disability pension was granted to 22% (n=46) of the cohort. The relative risk for disability pension increased by 9.3 with each sick-leave spell≥90 days during the two previous years. The risk was higher for women than men, and also higher for foreign citizens than Swedes. Conclusion: Many studies have reve...
TL;DR: Long-term sick leave during pregnancy was frequent and to some extent predictable, and efforts should be made to organize work for pregnant women in a manner that optimizes their health and well-being.
Abstract: Aim: The authors sought to describe risk indicators of long-term sick leave during pregnancy among hospital employees. Methods: A register-based study was undertaken of 4,852 female hospital employees aged 20 - 45 years from the second largest hospital in Denmark during 1995 - 99 based on job titles, working time, sick leave, and births combined with a survey among a total of 773 women who had been pregnant during their employment (response rate 85%). Results: Altogether 236 (31%) were on sick leave for at least 10% of their scheduled work time during their latest pregnancy and 169 (22%) had been absent at least 20% of the time. The pregnant women had an average sickness absence of 6.1 days per month, non-pregnant women 0.95 days per month. Sick leave was more frequent in late than in early gestation. Women employed as nursing aides or hospital orderlies, launderers, and nurses had more sick leave days than other hospital employees. Part-time work, previous sickness absence not related to pregnancy, and p...
TL;DR: The finding that suicide among the young and elderly in South Africa is increasing suggests that preventive efforts are indicated, especially for white males, and attention to trends in these countries may predict future trends in youth suicide.
Abstract: Aims: A study was undertaken to investigate suicide rates and proportional mortality trends in South Africa from 1968 to 1990. Methods: Suicide rates per 100,000 population per year and suicide pro...
TL;DR: The probability of smoking cessation differs between people with different exposures to certain work environmental factors, and for medium versus low levels of responsibility at work.
Abstract: Aims: The authors set out to estimate effects of occupational factors on smoking cessation among Danish employees. Methods: Data from 3,606 observations of smokers gathered from the Danish National...
TL;DR: The results suggest that socioeconomic factors associated with community characteristics rather than individual lifestyle are related to the risk of childhood leukaemia and that these factors act early in life.
Abstract: Aims: The aim of this study was to assess the influence of socioeconomic status on the risk of childhood leukaemia. Methods: A matched case-control design was used. The study population comprised all children (0 - 14 years old) born and reported to the Danish Cancer Registry between 1976 and 1991 for a diagnosis of leukaemia (n=377). Controls were selected from the Central Population Registry and matched by sex, age, and time of birth. Each child was assigned three categories of socioeconomic status, one corresponding to the annual average income in the municipality of residence at the time of birth, another corresponding to that at the time of diagnosis, and, finally, each family was assigned one of five social classes by use of the job titles of the parents. Conditional logistic regression was used to estimate the effect of socioeconomic status on the risk of childhood leukaemia. Results: Children born in low-income municipalities had a significantly increased risk of leukaemia (RR=2.71; 95% CI=1.41 - 5...
TL;DR: The World Health Report conveys a ‘‘new’’ inequality where the traditional gap between North and South is shifting to that within “developing” countries and between their lowand high-mortality countries, sub-Saharan Africa being the extreme of the latter.
Abstract: This quotation from the recent World Health Report represents one characteristic feature of the partly new public health map drawn by the World Health Organization in its report released on 18 December (1). As many times before, the Report raises the question about justice when addressing striking variations between the poor and non-poor within countries and between geopolitical areas. The report unsurprisingly calls for a global health emergency while at the same time alerting us to a couple of success stories. The report conveys a ‘‘new’’ inequality where the traditional gap between North and South is shifting to that within ‘‘developing’’ countries and between their lowand high-mortality countries, sub-Saharan Africa being the extreme of the latter, drastically left behind as a result of the HIV/AIDS epidemic. There, 23% of global births occur, 46% of global child deaths and 90% of all HIV/AIDS deaths among children.
TL;DR: Second-generation immigrants are at particular risk for illicit drug abuse in Sweden, and adverse socioeconomic living conditions are very important in explaining this high risk.
Abstract: Aims: This study investigates ethnic and socioeconomic risk factors for hospital admissions related to illicit drug abuse in second-generation immigrants in Sweden. Method: Cox analyses of proportional hazards were used to estimate the relative risk of sociodemographic covariates in analyses of register data on hospital admissions because of illicit drug abuse during 1990 - 99. The study population was a national cohort of 1.25 million residents (aged 10 - 30 years). Results: Second-generation immigrants had two- to three fold higher age and sex-adjusted relative risks (RRs) for hospital admissions because of illicit drug use compared with the Swedish majority population with a limited variation between different ethnic groups. The RRs decreased greatly after the model was adjusted for socioeconomic indicators of the childhood household. Intercountry adoptees had the highest risk for hospital admission related to illicit drug abuse of all study groups after adjustment for sociodemographic variables (RR 2....
TL;DR: A model is suggested for identification and analysis of the ethical conflicts in measles vaccination programmes, which contains two different dimensions: the affected persons and the relevant ethical principles.
Abstract: Background: Immunization programmes are ethically defensible and society has a significant role to play in providing vaccination against measles and safeguarding herd immunity to optimize its individuals' capabilities. Since preventive actions interfere with individuals who consider themselves as healthy, public health strategies - as distinct from advice in a clinical consultation - require something approaching certainty as to benefits and possible side effects of an intervention. The principle of individual autonomy, a fundamental value in bioethics, often makes discussions covering ethical issues in public health interventions difficult and non-productive as to practical solutions. In encounters intended to provide information on vaccination, discussions regarding risks tend to simplify the issue into an individual one: either the child gets measles or not, or is affected by side effects or not. Method and conclusions: A model is suggested for identification and analysis of the ethical conflicts in measles vaccination programmes, which contains two different dimensions: the affected persons and the relevant ethical principles. Justice as solidarity, not utility, should be paired with autonomy in ethical deliberations on preventive health interventions such as a vaccination programme for measles. If the goal is solidarity rather than conformity, the parents must be free to decide what they think is right, because that is what moral responsibility is all about. Solidarity, however, could never be accepted as an argument without parents trusting the messages from the health institutions and availability of reasonable societal support for those who claim an association between vaccinations and possible side effects.
TL;DR: Patients' experiences of the examination of the body given in Norwegian Psychomotor Physiotherapy are elucidated to emphasize the importance of cooperation between the physiotherapist and the patient in exploring the social and emotional context in order to understand the meaning of the bodies symptoms.
Abstract: Aims: The intention of this study was to elucidate patients' experiences of the examination of the body given in Norwegian Psychomotor Physiotherapy. Methods: A qualitative approach was used, based on interviews with nine women and one man aged between 41 and 65 years. The data were analysed with the aid of grounded theory, using the first two steps: open and axial coding. Results: Three categories were identified from the patients' experiences. The first category "The Situation before Treatment'', emerged from the subcategories "Prejudice concerning the prefix `psycho''', "Difficulties in recognizing the body's information'', and "The body is ambiguous''. The second category, "Establishing the Relationship'', emerged from the subcategories "Getting to know the therapist as an empathic person'' and "Discovering professional skills''. The third category, "Examination is Interaction'', emerged from the subcategories "Dialogues - room for reflection'', "Undress, the feeling of disclosure'', and "Personal bou...
TL;DR: The generalized high prevalence of low physical activity level during leisure time in Albania gives cause for concern regarding future health trends.
Abstract: Aims: This paper describes the work and leisure-time physical activity levels of adults living in Tirana City (Albania). Methods: A cross-sectional survey was undertaken in Tirana City in mid-2001....
TL;DR: Low levels of trust and the miniaturization of community may enhance non-specific patient dissatisfaction such as experience of lack of openness by the patient, and have implications for the evaluation of patient dissatisfaction.
Abstract: Aims: A study was undertaken to assess the impact of social participation, trust and the miniaturization of community, i.e. high social participation/low trust, on two measures of patient dissatisfaction in primary healthcare. Methods: The Scania 2000 public-health survey is a cross-sectional, postal questionnaire study. A total of 3,456 persons aged 18-80 years who had a regular doctor within the primary healthcare system were included. A logistic regression model was used to investigate the association between the social capital variables and dissatisfaction. Multivariate analysis analysed the importance of confounders on the differences in lack of general openness and lack of information concerning treatment in accordance with social capital variables. Results: Lack of openness is positively associated with low trust, the miniaturization of community and low social capital, while lack of information is not significantly associated with the miniaturization of community, but to a lesser extent with low trust and low social capital. Conclusions: Low levels of trust and the miniaturization of community may enhance non-specific patient dissatisfaction such as experience of lack of openness by the patient. In contrast, the miniaturization of community was not significantly associated with the more specific "lack of information". The results have implications for the evaluation of patient dissatisfaction.