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  • 1.
    Eneroth, Mari
    et al.
    Stockholm University.
    Gustafsson Sendén, Marie
    Södertörn University, School of Social Sciences, Psychology. Stockholm University.
    Lovseth, Lise T.
    St. Olavs University Hospital, Trondheim, Norway.
    Schenck-Gustafsson, Karin
    Karolinska Institutet.
    Fridner, Ann
    Stockholm Univeristy / Karolinska Institutet.
    A comparison of risk and protective factors related to suicide ideation among residents and specialists in academic medicine2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, article id 271Article in journal (Refereed)
    Abstract [en]

    Background: Physicians have an elevated risk of experiencing suicidal thoughts, which might be due to work-related factors. However, the hierarchical work positions as well as work-related health differ among resident and specialist physicians. As such, the correlates of suicide ideation may also vary between these two groups. Methods: In the present study, work- and health-related factors and their association with suicidal thoughts among residents (n=234) and specialists (n=813) working at a university hospital were examined using cross-sectional data. Results: Logistic regression analysis showed that having supportive meetings was associated with a lower level of suicide ideation among specialists (OR=0.68, 95% CI: 0.50-0.94), while an empowering leadership was related to a lower level of suicide ideation among residents (OR=0.55, 95% CI: 0.32-0.94). Having been harassed at work was associated with suicidal ideation among specialists (OR=2.26, 95% CI: 1.31-3.91). In addition, sickness presenteeism and work disengagement were associated with suicide ideation in both groups of physicians. Conclusions: These findings suggest that different workplace interventions are needed to prevent suicide ideation in residents and specialists.

  • 2.
    Jukkala, Tanya
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Mäkinen, Ilkka Henrik
    Uppsala University.
    Baburin, Aleksei
    National Institute for Health Development, Tallinn, Estonia.
    Sparén, Pär
    Karolinska Institutet.
    Age, period and cohort effects on suicide mortality in Russia, 1956-20052017In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, no 1, article id 235Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Russian suicide mortality rates changed rapidly over the second half of the twentieth century. This study attempts to differentiate between underlying period and cohort effects in relation to the changes in suicide mortality in Russia between 1956 and 2005.

    METHODS: Sex- and age-specific suicide mortality data were analyzed using an age-period-cohort (APC) approach. Descriptive analyses and APC modeling with log-linear Poisson regression were performed.

    RESULTS: Strong period effects were observed for the years during and after Gorbachev's political reforms (including the anti-alcohol campaign) and for those following the break-up of the Soviet Union. After mutual adjustment, the cohort- and period-specific relative risk estimates for suicide revealed differing underlying processes. While the estimated period effects had an overall positive trend, cohort-specific developments indicated a positive trend for the male cohorts born between 1891 and 1931 and for the female cohorts born between 1891 and 1911, but a negative trend for subsequent cohorts.

    CONCLUSIONS: Our results indicate that the specific life experiences of cohorts may be important for variations in suicide mortality across time, in addition to more immediate effects of changes in the social environment.

  • 3. Kaleta, Dorota
    et al.
    Usidame, Bukola
    Dziankowska-Zaborszczyk, Elżbieta
    Makowiec-Dąbrowska, Teresa
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia.
    Prevalence and factors associated with hardcore smoking in Poland: Findings from the Global Adult Tobacco Survey (2009–2010)2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, p. 583-Article in journal (Refereed)
  • 4.
    Koyanagi, A.
    et al.
    Parc Sanitari Sant Joan de Déu, Barcelona, Spain / Centro de Investigación Biomédica en Red de Salud Mental, Cibersam, Spain .
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). The University of Tokyo, Tokyo, Japan .
    Garin, N.
    Parc Sanitari Sant Joan de Déu, Barcelona, Spain / Centro de Investigación Biomédica en Red de Salud Mental, Cibersam, Spain.
    Miret, M.
    Universidad Autónoma de Madrid, Madrid, Spain / Centro de Investigación Biomédica en Red de Salud Mental, Cibersam, Spain / Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain .
    Ayuso-Mateos, J. L.
    Universidad Autónoma de Madrid, Madrid, Spain / Centro de Investigación Biomédica en Red de Salud Mental, Cibersam, Spain / Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain .
    Leonardi, M.
    Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy.
    Koskinen, S.
    National Institute for Health and Welfare, Helsinki, Finland .
    Galas, A.
    Jagiellonian University Medical College, Krakow, Poland .
    Haro, J. M.
    Parc Sanitari Sant Joan de Déu, Barcelona, Spain / Centro de Investigación Biomédica en Red de Salud Mental, Cibersam, Spain .
    The association between obesity and back pain in nine countries: A cross-sectional study2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, no 1, article id 123Article in journal (Refereed)
    Abstract [en]

    Background: The association between obesity and back pain has mainly been studied in high-income settings with inconclusive results, and data from older populations and developing countries are scarce. The aim of this study was to assess this association in nine countries in Asia, Africa, Europe, and Latin America among older adults using nationally-representative data. Methods: Data on 42116 individuals ≥50 years who participated in the Collaborative Research on Ageing in Europe (COURAGE) study conducted in Finland, Poland, and Spain in 2011-2012, and the World Health Organization's Study on Global Ageing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia, and South Africa in 2007-2010 were analysed. Information on measured height and weight available in the two datasets was used to calculate Body Mass Index (BMI). Self-reported back pain occurring in the past 30 days was the outcome. Multivariable logistic regression analysis was used to assess the association between BMI and back pain. Results: The prevalence of back pain ranged from 21.5% (China) to 57.5% (Poland). In the multivariable analysis, compared to BMI 18.5-24.9 kg/m2, significantly higher odds for back pain were observed for BMI ≥35 kg/m2 in Finland (OR 3.33), Russia (OR 2.20), Poland (OR 2.03), Spain (OR 1.56), and South Africa (OR 1.48); BMI 30.0-34.0 kg/m2 in Russia (OR 2.76), South Africa (OR 1.51), and Poland (OR 1.47); and BMI 25.0-29.9 kg/m2 in Russia (OR 1.51) and Poland (OR 1.40). No significant associations were found in the other countries. Conclusions: The strength of the association between obesity and back pain may vary by country. Future studies are needed to determine the factors contributing to differences in the associations observed. © 2015 Koyanagi et al.

  • 5.
    Kulhánová, Ivana
    et al.
    Erasmus Medical Center, Rotterdam, Netherlands .
    Menvielle, Gwenn
    Pierre Louis Institute of Epidemiology and Public Health, Paris, France .
    Bopp, Matthias
    University of Zürich, Zürich, Switzerland .
    Borrell, Carme
    Agència de Salut Pública de Barcelona, Barcelona, Spain .
    Deboosere, Patrick
    Universiteit Brussel, Brussels, Belgium .
    Eikemo, Terje A
    Erasmus Medical Center, Rotterdam, Netherlands / Norwegian University of Science and Technology, Trondheim, Norway.
    Hoffmann, Rasmus
    Erasmus Medical Center, Rotterdam, Netherlands .
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia .
    Martikainen, Pekka
    University of Helsinki, Helsinki, Finland .
    Regidor, Enrique
    Universidad Complutense de Madrid, Madrid, Spain .
    Rodríguez-Sanz, Maica
    Agència de Salut Pública de Barcelona, Barcelona, Spain .
    Rychtaříková, Jitka
    Charles University in Prague, Prague, Czech Republic .
    Wojtyniak, Bogdan
    National Institute of Public Health, National Institute of Hygiene, Warsaw, Poland .
    Mackenbach, Johan P
    Erasmus Medical Center, Rotterdam, Netherlands .
    Socioeconomic differences in the use of ill-defined causes of death in 16 European countries2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, article id 1295Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Cause-of-death data linked to information on socioeconomic position form one of the most important sources of information about health inequalities in many countries. The proportion of deaths from ill-defined conditions is one of the indicators of the quality of cause-of-death data. We investigated educational differences in the use of ill-defined causes of death in official mortality statistics.

    METHODS: Using age-standardized mortality rates from 16 European countries, we calculated the proportion of all deaths in each educational group that were classified as due to "Symptoms, signs and ill-defined conditions". We tested if this proportion differed across educational groups using Chi-square tests.

    RESULTS: The proportion of ill-defined causes of death was lower than 6.5% among men and 4.5% among women in all European countries, without any clear geographical pattern. This proportion statistically significantly differed by educational groups in several countries with in most cases a higher proportion among less than secondary educated people compared with tertiary educated people.

    CONCLUSIONS: We found evidence for educational differences in the distribution of ill-defined causes of death. However, the differences between educational groups were small suggesting that socioeconomic inequalities in cause-specific mortality in Europe are not likely to be biased.

  • 6.
    Leinsalu, Mall
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Kaposvári, Csilla
    Kunst, Anton E
    Is income or employment a stronger predictor of smoking than education in economically less developed countries?: A cross-sectional study in Hungary2011In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, p. 97-Article in journal (Refereed)
    Abstract [en]

    Patterns of inequalities in smoking in Hungary can be best understood in relation to two processes: the smoking epidemic, and the additional effects of poverty. Equity orientated tobacco control measures should target the low educated to prevent their smoking initiation, and the poor to improve their cessation rates.

  • 7. Plug, Iris
    et al.
    Hoffmann, Rasmus
    Artnik, Barbara
    Bopp, Matthias
    Borrell, Carme
    Costa, Giuseppe
    Deboosere, Patrick
    Esnaola, Santi
    Kalediene, Ramune
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Lundberg, Olle
    Martikainen, Pekka
    Regidor, Enrique
    Rychtarikova, Jitka
    Strand, Bjorn Heine
    Wojtyniak, Bogdan
    Mackenbach, Johan P
    Socioeconomic inequalities in mortality from conditions amenable to medical interventions: do they reflect inequalities in access or quality of health care?2012In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, article id 346Article in journal (Refereed)
    Abstract [en]

    ABSTRACT: BACKGROUND: Previous studies have reported large socioeconomic inequalities in mortality from conditions amenable to medical intervention, but it is unclear whether these can be attributed to inequalities in access or quality of health care, or to confounding influences such as inequalities in background risk of diseases. We therefore studied whether inequalities in mortality from conditions amenable to medical intervention vary between countries in patterns which differ from those observed for other (non-amenable) causes of death. More specifically, we hypothesized that, as compared to non-amenable causes, inequalities in mortality from amenable causes are more strongly associated with inequalities in health care use and less strongly with inequalities in common risk factors for disease such as smoking. Data and methods Cause-specific mortality data for people aged 30-74 years were obtained for 14 countries, and were analysed by calculating age-standardized mortality rates and relative risks comparing a lower with a higher educational group. Survey data on health care use and behavioural risk factors for people aged 30-74 years were obtained for 12 countries, and were analysed by calculating age-and sex-adjusted odds ratios comparing a low with a higher educational group. Patterns of association were explored by calculating correlation coefficients. RESULTS: In most countries and for most amenable causes of death substantial inequalities in mortality were observed, but inequalities in mortality from amenable causes did not vary between countries in patterns that are different from those seen for inequalities in non-amenable mortality. As compared to non-amenable causes, inequalities in mortality from amenable causes are not more strongly associated with inequalities in health care use. Inequalities in mortality from amenable causes are also not less strongly associated with common risk factors such as smoking. CONCLUSIONS: We did not find evidence that inequalities in mortality from amenable conditions are related to inequalities in access or quality of health care. Further research is needed to find the causes of socio-economic inequalities in mortality from amenable conditions, and caution should be exercised in interpreting these inequalities as indicating health care deficiencies.

  • 8.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). University of Tokyo.
    Koyanagi, Ai
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Koposov, Roman
    The Arctic University of Norway, Tromsø, Norway .
    Schwab-Stone, Mary
    Yale University Medical School, New Haven, CT, USA .
    Ruchkin, Vladislav
    Karolinska Institutet.
    Loneliness and health risk behaviours among Russian and US adolescents: a cross-sectional study2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, article id 366Article in journal (Refereed)
    Abstract [en]

    Background: For some adolescents feeling lonely can be a protracted and painful experience. It has been suggested that engaging in health risk behaviours such as substance use and sexual behaviour may be a way of coping with the distress arising from loneliness during adolescence. However, the association between loneliness and health risk behaviour has been little studied to date. To address this research gap, the current study examined this relation among Russian and U.S. adolescents. Methods: Data were used from the Social and Health Assessment (SAHA), a school-based survey conducted in 2003. A total of 1995 Russian and 2050 U.S. students aged 13-15 years old were included in the analysis. Logistic regression was used to examine the association between loneliness and substance use, sexual risk behaviour, and violence. Results: After adjusting for demographic characteristics and depressive symptoms, loneliness was associated with a significantly increased risk of adolescent substance use in both Russia and the United States. Lonely Russian girls were significantly more likely to have used marijuana (odds ratio [OR]: 2.28; confidence interval [CI]: 1.17-4.45), while lonely Russian boys had higher odds for past 30-day smoking (OR, 1.87; CI, 1.08-3.24). In the U.S. loneliness was associated with the lifetime use of illicit drugs (excepting marijuana) among boys (OR, 3.09; CI, 1.41-6.77) and with lifetime marijuana use (OR, 1.79; CI, 1.26-2.55), past 30-day alcohol consumption (OR, 1.80; CI, 1.18-2.75) and past 30-day binge drinking (OR, 2.40; CI, 1.56-3.70) among girls. The only relation between loneliness and sexual risk behaviour was among Russian girls, where loneliness was associated with significantly higher odds for ever having been pregnant (OR, 1.69; CI: 1.12-2.54). Loneliness was not associated with violent behaviour among boys or girls in either country. Conclusion: Loneliness is associated with adolescent health risk behaviour among boys and girls in both Russia and the United States. Further research is now needed in both settings using quantitative and qualitative methods to better understand the association between loneliness and health risk behaviours so that effective interventions can be designed and implemented to mitigate loneliness and its effects on adolescent well-being.

  • 9.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). London School of Hygiene & Tropical Medicine , London, UK / University of Tokyo, Tokyo, Japan.
    Koyanagi, Ai
    Fundacio St Joan Deu, Barcelona, Spain / Inst Salud Carlos III, CIBERSAM, Madrid, Spain.
    Roberts, Bayard
    London School of Hygiene and Tropical Medicine, London, UK.
    Goryakin, Yevgeniy
    University of East Anglia, Norwich, UK .
    Mckee, Martin
    London School of Hygiene and Tropical Medicine, London, UK .
    Crime and subjective well-being in the countries of the former Soviet Union2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 1010Article in journal (Refereed)
    Abstract [en]

    Background: Criminal victimisation and subjective well-being have both been linked to health outcomes, although as yet, comparatively little is known about the relationship between these two phenomena. In this study we used data from nine countries of the former Soviet Union (fSU) to examine the association between different types of crime and subjective well-being. Methods: Data were obtained from 18,000 individuals aged 18 and above collected during the Health in Times of Transition (HITT) survey in 2010/11 in Armenia, Azerbaijan, Belarus, Georgia, Moldova, Kazakhstan, Kyrgyzstan, Russia and Ukraine. Information was obtained on respondents' experience of crime (violence and theft) and self-reported affective (happiness) and cognitive (life satisfaction) well-being. Ordered probit and ordinary least squares (OLS) regression analyses were undertaken to examine the associations between these variables. Results: In pooled country analyses, experiencing violence was associated with significantly lower happiness and life satisfaction. Theft victimisation was associated with significantly reduced life satisfaction but not happiness. Among the individual countries, there was a more pronounced association between violent victimisation and reduced happiness in Kazakhstan and Moldova. Conclusions: The finding that criminal victimisation is linked to lower levels of subjective well-being highlights the importance of reducing crime in the fSU, and also of having effective support services in place for victims of crime to reduce its detrimental effects on health and well-being.

  • 10.
    Vals, Kaire
    et al.
    University of Tartu, Tartu, Estonia / National Institute for Health Development, Tallinn, Estonia.
    Kiivet, Raul-Allan
    University of Tartu, Tartu, Estonia.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). National Institute for Health Development, Tallinn, Estonia.
    Alcohol consumption, smoking and overweight as a burden for health care services utilization: a cross-sectional study in Estonia2013In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, article id 772Article in journal (Refereed)
    Abstract [en]

    Background: Alcohol consumption, smoking and weight problems are common risk factors for different health problems. We examine how these risk factors are associated with the use of health care services.

    Methods: Data for 6500 individuals in the 25-64 age group came from three cross-sectional postal surveys conducted in 2004, 2006, and 2008 in Estonia. The effect of alcohol consumption, smoking and weight problems on the use of primary and specialist care services, hospitalizations and ambulance calls was analysed separately for men and women by using binary logistic regression.

    Results: Overweight and/or obesity were strongly related to the use of primary care and out-patient specialist services for both genders, and to hospitalizations and ambulance calls for women. Current smoking was related to ambulance calls for both genders, whereas smoking in the past was related to the use of primary care and specialist services among men and to hospitalizations among women. Beer drinking was negatively associated with all types of health care services and similar   association was found between wine drinking and hospitalizations. Wine drinking was positively related to specialist visits. The frequent drinking of strong alcohol led to an increased risk for ambulance calls. Drinking light alcoholic drinks was positively associated with all types of health care services (except ambulance calls) among men and with the use of specialist services among women.

    Conclusions: Overweight and smoking had the largest impact on health care utilization in Estonia. Considering the high prevalence of these behavioural risk factors, health policies should prioritize preventive programs that promote healthy lifestyles in order to decrease the disease burden and to reduce health care costs.

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