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  • 1. Andersen, Ronald
    et al.
    Smedby, Björn
    Vågerö, Denny
    Cost containment, solidarity and cautious experimentation: Swedish dilemmas2001In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 52, p. 1195-1204Article in journal (Refereed)
    Abstract [en]

    This paper uses secondary data analysis and a literature review to explore a “Swedish Dilemma”: Can Sweden continue to provide a high level of comprehensive health services for all regardless of ability to pay — a policy emphasizing “solidarity” — or must it decide to impose increasing constraints on health services spending and service delivery — a policy emphasizing “cost containment?” It examines recent policies and longer term trends including: changes in health personnel and facilities; integration of health and social services for older persons; introduction of competition among providers; cost sharing for patients; dismantling of dental insurance; decentralization of government responsibility; priority settings for treatment; and encouragement of the private sector. It is apparent that the Swedes have had considerable success in attaining cost containment — not primarily through “market mechanisms” but through government budget controls and service reduction. Further, it appears that equal access to care, or solidarity, may be adversely affected by some of the system changes.

  • 2.
    Carlson, Per
    et al.
    Stockholms universitet.
    Mäkinen, llkka
    Stockholms universitet.
    Vågerö, Denny
    Stockholms universitet.
    Självmord, mord och kultur1994In: Sociologisk forskning, ISSN 0038-0342, Vol. 31, p. 78-89Article in journal (Refereed)
  • 3.
    Carlson, Per
    et al.
    Södertörn University, Avdelning 4, SCOHOST (Stockholm Centre on Health of Societies in Transition). Stockholms universitet.
    Vågerö, Denny
    Södertörn University, Avdelning 4, SCOHOST (Stockholm Centre on Health of Societies in Transition). Stockholms universitet.
    The social pattern of heavy drinking in Russia during transition: Evidence from Taganrog 19931998In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 8, no 4, p. 280-285Article in journal (Refereed)
  • 4. Farahmand, Bahman
    et al.
    Broman, G.
    de Faire, Ulf
    Vågerö, Denny
    Ahlbom, Anders
    Golf- a game of life and death: Reduced mortality in Swedish golf players2009In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 19, no 3, p. 419-424Article in journal (Refereed)
    Abstract [en]

    The specific health benefits achieved from different formsand patterns of leisure-time physical activity are not established.We analyzed the mortality in a cohort of Swedishgolf players. We used the Swedish Golf Federation’s membershipregistry and the nationwide Mortality Registry. Wecalculated standardized mortality ratios (SMR) with stratificationfor age, sex, and socioeconomic status. The cohortincluded 300 818 golfers, and the total number of deaths was1053. The overall SMR was 0.60 [95% confidence intervals(CIs): 0.57–0.64]. The mortality reduction was observed inmen and women, in all age groups, and in all socioeconomiccategories. Golfers with the lowest handicap (the mostskilled players) had the lowest mortality; SMR50.53(95% CI: 0.41–0.67) compared with 0.68 (95% CI: 0.61–0.75) for those with the highest handicap. While we cannotconclude with certainty that all the 40% decreased mortalityrates are explained by the physical activity associatedwith playing golf, we conclude that most likely this is part ofthe explanation. To put the observed mortality reduction incontext, it may be noted that a 40% reduction of mortalityrates corresponds to an increase in life expectancy of about5 years.

  • 5. Friel, Sharon
    et al.
    Marmot, Michael
    McMichael, Anthony J.
    Kjellstrom, Tord
    Vågerö, Denny
    Global health equity and climate stabilisation: a common agenda2008In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 372, no 9650, p. 1677-1683Article in journal (Refereed)
    Abstract [en]

    Although health has improved for many people, the extent of health inequities between and within countries is growing. Meanwhile, humankind is disrupting the global climate and other life-supporting environmental systems, thereby creating serious risks for health and wellbeing, especially in vulnerable populations but ultimately for everybody. Underlying determinants of health inequity and environmental change overlap substantially; they are signs of an economic system predicated on asymmetric growth and competition, shaped by market forces that mostly disregard health and environmental consequences rather than by values of fairness and support. A shift is needed in priorities in economic development towards healthy forms of urbanisation, more efficient and renewable energy sources, and a sustainable and fairer food system. Global interconnectedness and interdependence enable the social and environmental determinants of health to be addressed in ways that will increase health equity, reduce poverty, and build societies that live within environmental limits.

  • 6. Geyer, Siegfried
    et al.
    Hemström, Örjan
    Peter, Richard
    Vågerö, Denny
    Stockholms universitet.
    Education, income, and occupational class cannot be used interchangeably in social epidemiology: Empirical evidence against a common practice2006In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 60, p. 804-810Article in journal (Refereed)
    Abstract [en]

    Study objective: Education, income, and occupational class are often used interchangeably in studies showing social inequalities in health. This procedure implies that all three characteristics measure the same underlying phenomena. This paper questions this practice. The study looked for any independent effects of education, income, and occupational class on four health outcomes: diabetes prevalence, myocardial infarction incidence and mortality, and finally all cause mortality in populations from Sweden and Germany.Design: Sweden: follow up of myocardial infarction mortality and all cause mortality in the entire population, based on census linkage to the Cause of Death Registry. Germany: follow up of myocardial infarction morbidity and all cause mortality in statutory health insurance data, plus analysis of prevalence data on diabetes. Multiple regression analyses were performed to calculate the effects of education, income, and occupational class before and after mutual adjustments.Setting and participants: Sweden (all residents aged 25-64) and Germany (Mettman district, Nordrhein-Westfalen, all insured persons aged 25-64).Main results: Correlations between education, income, and occupational class were low to moderate. Which of these yielded the strongest effects on health depended on type of health outcome in question. For diabetes, education was the strongest predictor and for all cause mortality it was income. Myocardial infarction morbidity and mortality showed a more mixed picture. In mutually adjusted analyses each social dimension had an independent effect on each health outcome in both countries.Conclusions: Education, income, and occupational class cannot be used interchangeably as indicators of a hypothetical latent social dimension. Although correlated, they measure different phenomena and tap into different causal mechanisms.

  • 7.
    Jukkala, Tanya
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Mäkinen, Ilkka Henrik
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Kislitsyna, Olga
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Ferlander, Sara
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Vågerö, Denny
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Economic strain, social relations, gender, and binge drinking in Moscow2008In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 66, p. 663-674Article in journal (Refereed)
    Abstract [en]

    The harmful effects of alcohol consumption are not necessarily limited to the amounts consumed. Drinking in binges is a specific feature of Russian alcohol consumption that may be of importance even for explaining the current mortality crisis. Based on interviews conducted with a stratified random sample of 1190 Muscovites in 2004, this paper examines binge drinking in relation to the respondents’ economic situation and social relations. Consistent with prior research, this study provides further evidence for a negative relationship between educational level and binge drinking. Our results also indicate a strong but complex link between economic strain and binge drinking. The odds ratios for binge drinking of men experiencing manifold economic problems were almost twice as high compared to those for men with few economic problems. However, the opposite seemed to be true for women. Being married or cohabiting seemed to have a strong protective effect on binge drinking among women compared to being single, while it seemed to have no effect at all among men. Women having regular contact with friends also had more than twice the odds for binge drinking compared to those with little contact with friends, while again no effect was found among men. Gender roles and the behavioural differences embedded in these, may explain the difference. The different effects of economic hardship on binge drinking may also constitute an important factor when explaining the large mortality difference between men and women in Russia.

  • 8. Koupil, Ilona
    et al.
    Mann, Vera
    Leon, David A.
    Lundberg, Ulf
    Byberg, Liisa
    Vågerö, Denny
    Morning cortisol does not mediate the association of size at birth with blood pressure in children born from full-term pregnancies2005In: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 62, p. 661-666Article in journal (Refereed)
    Abstract [en]

    Objective It had been suggested that programming of the hypothalamo-pituitary-adrenal axis may underlie the associations of reduced size at birth with raised blood pressure in later life. We investigated whether morning salivary cortisol mediates the inverse association of birthweight with systolic blood pressure in children.Design Subjects and measurements – a historical cohort study involving 1152 Swedish children aged 5–14 years, who took part in a family study comprised of mother, father, and two full-sibs delivered in 1987–1995 after 38–41 weeks gestation within 36 months of each other. Birthweight and gestational age were available from obstetric records. Blood pressure, weight, height and puberty stage were measured at a clinic. Cortisol was measured by radioimmunoassay in morning salivary samples taken at home, within 30 min of waking.Results Morning cortisol showed a weak negative association with length of gestation in siblings, was not related to birthweight or to systolic or diastolic blood pressure. There was no change in the strength of the negative association between birthweight and systolic blood pressure on adjustment for cortisol (−1·4 mmHg/kg, 95% CI −2·7, −0·2; adjusted for age, sex, puberty stage, weight and height, and cortisol).Conclusions Morning cortisol was not associated with size at birth, and did not mediate the birthweight–blood pressure association in children born from full-term pregnancies. It is possible that basal cortisol levels are of more importance in explaining associations of size at birth with later blood pressure in older subjects, or in populations with more varied length of gestation. Alternatively, our results may be caused by misclassification of the hypothalamo–pituitary-adrenal activity.

  • 9. Koupil, Ilona
    et al.
    Modin, Bitte
    Byberg, Liisa
    Fritzell, Jonas
    Vågerö, Denny
    Early and adult life social influences on circulatory disease mortality [abstract]2004In: Central European Journal of Public Health, ISSN 1210-7778, E-ISSN 1803-1048, Vol. 14, no Suppl. 1, p. 45-Article in journal (Refereed)
  • 10. Koupil, Ilona
    et al.
    Plavinskaja, Svetlana
    Parfenova, Nina
    Shestov, Dmitri B.
    Danziger, Phoebe Day
    Vågerö, Denny
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Cancer mortality in women and men who survived the siege of Leningrad (1941-1944)2009In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 124, no 6, p. 1416-1421Article in journal (Refereed)
    Abstract [en]

    The population of Leningrad suffered from severe starvation, coldand psychological stress during the siege in World War II in1941–1944. We investigated the long-term effects of the siege oncancer mortality in 3,901 men and 1,429 women, born between1910 and 1940. All study subjects were residents of St. Petersburg,formerly Leningrad, between 1975 and 1982. One third of themhad experienced the siege as children, adolescents or young adults(age range, 1–31 years at the peak of starvation in 1941–1942).Associations of siege exposure with risk of death from cancer werestudied using a multivariable Cox regression, stratified by genderand period of birth, adjusted for age, smoking, alcohol and socialcharacteristics, from 1975 to 1977 (men) and 1980 to 1982, respectively(women), until the end of 2005. Women who were 10–18 years old at the peak of starvation were taller as adults (ageadjusteddifference, 1.7 cm; 95% CI, 0.5–3.0) and had a higherrisk of dying from breast cancer compared with unexposedwomen born during the same period (age-adjusted HR, 9.9; 95%CI, 1.1–86.5). Mortality from prostate cancer was nonsignificantlyhigher in exposed men. The experience of severe starvation andstress during childhood and adolescence may have long-termeffects on cancer in surviving men and women.

  • 11. Koupil, Ilona
    et al.
    Rahu, Kaja
    Rahu, Mati
    Karro, Helle
    Vågerö, Denny
    Major improvements, but persisting inequalities in infant survival in Estonia 1992-20022006In: Central European Journal of Public Health, ISSN 1210-7778, E-ISSN 1803-1048, Vol. 17, no 1, p. 8-16Article in journal (Refereed)
    Abstract [en]

    Background: Inequality in adult health increased in Estonia during the transition period after 1991. We examined inequality in infant survival from 1992 to 2002. Methods: All 132 854 singleton live births reported to the Estonian Medical Birth Registry in 1992–2001 were linked to the Estonian Mortality Database. The effect of mother's education, nationality, marital status, and place of residence on neonatal (0–27 days) and post-neonatal (28–364 days) death was evaluated in logistic regression with adjustments for maternal age, parity, smoking, sex of the infant, birth weight, and gestational age. Results: Infant mortality decreased substantially. Risk of death in neonatal period was lowest in Tartu, with a decline from 4.9/1000 in infants born in 1992–1996 to 2.1/1000 in those born in 1997–2001. Decline in neonatal mortality in other regions was from 9.2/1000 to 5.1/1000. Persisting regional differences were unexplained by mothers' nationality, education, or marital status, or the infants' length of gestation. Decline in post-neonatal mortality was less marked and although risk differences between different socio-economic groups decreased, mothers' marital status and education in particular remained strongly associated with risk of post-neonatal death [odds ratio for infants born to mothers with basic or lower education compared to university education 3.70 (95% confidence interval 2.34–5.85) in 1992–1996 and 3.56 (2.06–6.14) in 1997–2001]. Conclusions: Infant survival improved appreciably in Estonia after 1991 and risk differences between social groups decreased. The improvements were not accompanied by reduction in the strength of the effects of social characteristics on infant death measured as risk ratios.

  • 12. Koupil, Ilona
    et al.
    Shestov, Dmitri B.
    Sparén, Pär
    Plavinskaja, Svetlana
    Parfenova, Nina
    Vågerö, Denny
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Blood pressure, hypertension and mortality from circulatory disease in men and women who survived the siege of Leningrad2007In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 22, no 4, p. 223-234Article in journal (Refereed)
    Abstract [en]

    The population of Leningrad suffered from severe starvation, cold and psychological stress during the siege in 1941–1944. We investigated long-term effects of the siege on cardiovascular risk factors and mortality in surviving men and women. 3905 men born 1916–1935 and 1729 women born 1910–1940, resident in St Petersburg (formerly Leningrad) between 1975 and 1982, of whom a third experienced the siege as children, adolescents or young adults,were examined for cardiovascular risk factors in 1975–1977 and 1980–1982 respectively and followed till end 2005. Effects of siege exposure on bloodpressure, lipids, body size, and mortality were studied in multivariate analysis stratified by gender and period of birth, adjusted for age, smoking, alcohol and social characteristics. Women who were 6–8 years old and men who were 9–15 years-old at the peak of starvation had higher systolic blood pressure compared to unexposed subjects born during the same period of birth (fully adjusted difference 8.8, 95% CI:0.1–17.5 mm Hg in women and 2.9, 95% CI: 0.7–5.0 mm Hg in men). Mean height of women who were exposed to siege as children appeared to be greater than that of unexposed women. Higher mortality from ischaemic heart disease and cerebrovascular disease was noted in men exposed at age 6–8 and 9–15, respectively. The experience of severe stress and starvation in childhood and puberty may have long-term effects on systolic blood pressure and circulatory disease in surviving men and women with potential gender differences in the effect of siege experienced at pre-pubertal age.

  • 13. Koupil, Ilona
    et al.
    Shestov, Dmitri B.
    Sparén, Pär
    Plavinskaja, Svetlana
    Parfenova, Nina
    Vågerö, Denny
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Blood pressure in men and women who survived the siege of Leningrad [abstract]2005In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 58, no 5, p. 1103-Article in journal (Refereed)
  • 14. Koupil, Ilona
    et al.
    Shestov, Dmitri B.
    Vågerö, Denny
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Increased breast cancer mortality in women who survived the siege of Leningrad (1941-1944) [abstract]2007In: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 83, no Supplement 1, p. S71-S71Article in journal (Other academic)
  • 15. Kunst, Anton E
    et al.
    Groenhof, Feikje
    Andersen, Otto
    Borgan, Jens-Kristian
    Costa, Giuseppe
    Desplanques, Guy
    Filakti, Haroulla
    Giraldes, Maria do R
    Faggiano, Fabrizio
    Harding, Seeromanie
    Junker, Christoph
    Martikainen, Pekka
    Minder, Christoph
    Nolan, Brian
    Pagnanelli, Floriano
    Regidor, Enrique
    Vågerö, Denny
    Valkonen, Tapani
    Mackenbach, Johan P
    Occupational class and ischemic heart disease mortality in the United States and 11 European countries.1999In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 89, p. 47-53Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Twelve countries were compared with respect to occupational class differences in ischemic heart disease mortality in order to identify factors that are associated with smaller or larger mortality differences. METHODS: Data on mortality by occupational class among men aged 30 to 64 years were obtained from national longitudinal or cross-sectional studies for the 1980s. A common occupational class scheme was applied to most countries. Potential effects of the main data problems were evaluated quantitatively. RESULTS: A north-south contrast existed within Europe. In England and Wales, Ireland, and Nordic countries, manual classes had higher mortality rates than nonmanual classes. In France, Switzerland, and Mediterranean countries, manual classes had mortality rates as low as, or lower than, those among nonmanual classes. Compared with Northern Europe, mortality differences in the United States were smaller (among men aged 30-44 years) or about as large (among men aged 45-64 years). CONCLUSIONS: The results underline the highly variable nature of socioeconomic inequalities in ischemic heart disease mortality. These inequalities appear to be highly sensitive to social gradients in behavioral risk factors. These risk factor gradients are determined by cultural as well as socioeconomic developments.

  • 16.
    Lager, Anton
    et al.
    Stockholms universitet, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Bremberg, S.
    Vågerö, Denny
    The association of early IQ and education with mortality: 65 year longitudinal study in Malmö, Sweden2009In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 339, p. b5282-Article in journal (Refereed)
    Abstract [en]

    Objectives To establish whether differences in early IQ explain why people with longer education live longer, or whether differences in father’s or own educational attainment explain why people with higher early IQ live longer.Design Population based longitudinal study. Mortality risks were estimated with Cox proportional hazards regressions.Setting Malmö, Sweden.Participants 1530 children who took IQ tests at age 10 and were followed up until age 75.Results Own educational attainment was negatively associated with all cause mortality in both sexes, even when early IQ and father’s education were adjusted for (hazard ratio (HR) for each additional year in school 0.91 (95% CI 0.85 to 0.97) for men and HR 0.88 (95 % CI 0.78 to 0.98) for women). Higher early IQ was linked with a reduced mortality risk in men, even when own educational attainment and father’s education were adjusted for (HR for one standard deviation increase in IQ 0.85 (95 % CI 0.75 to 0.96)). In contrast, there was no crude effect of early IQ for women, and women with above average IQ had an increased mortality risk when own educational attainment was adjusted for, but only after the age of 60 (HR 1.60 (95 % CI 1.06 to 2.42)). Adding measures of social career over and above educational attainment to the model (for example, occupational status at age 36 and number of children) only marginally affected the hazard ratio for women with above average IQ (<5%).Conclusions Mortality differences by own educational attainment were not explained by early IQ. Childhood IQ was independently linked, albeit differently, to male adult mortality and to female adult mortality even when father’s education and own educational attainment was adjusted for, thus social background and own social career seem unlikely to be responsible for mortality differences by childhood IQ. The clear difference in the effect of IQ between men and women suggests that the link between IQ and mortality involves the social and physical environment rather than simply being a marker of a healthy body to begin with. Cognitive skills should, therefore, be addressed in our efforts to create childhood environments that promote health.

  • 17.
    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). Erasmus University Medical Centre, Rotterdam, The Netherlands / National Institute for Health Development, Tallinn, Estonia.
    Stirbu, Irina
    Erasmus University Medical Centre, Rotterdam, The Netherlands.
    Vågerö, Denny
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institute.
    Kalediene, Ramune
    Kaunas University of Medicine, Kaunas, Lithuania.
    Kovacs, Katalin
    Demographic Research Institute, HCSO, Budapest, Hungary.
    Wojtyniak, Bogdan
    National Institute of Hygiene, Warsaw, Poland.
    Wróblewska, Wiktoria
    Warsaw School of Economics, Warsaw, Poland.
    Mackenbach, Johan P.
    Erasmus University Medical Centre, Rotterdam, The Netherlands.
    Kunst, Anton E.
    Erasmus University Medical Centre, Rotterdam, The Netherlands.
    Educational inequalities in mortality in four Eastern European countries: divergence in trends during the post-communist transition from 1990 to 20002009In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 38, p. 512-525Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Post-communist transition has had a huge impact on mortality in Eastern Europe. We examined how educational inequalities in mortality changed between 1990 and 2000 in Estonia, Lithuania, Poland and Hungary.

    METHODS:

    Cross-sectional data for the years around 1990 and 2000 were used. Age-standardized mortality rates and mortality rate ratios (for total mortality only) were calculated for men and women aged 35-64 in three educational categories, for five broad cause-of-death groups and for five (seven among women) specific causes of death.

    RESULTS:

    Educational inequalities in mortality increased in all four countries but in two completely different ways. In Poland and Hungary, mortality rates decreased or remained the same in all educational groups. In Estonia and Lithuania, mortality rates decreased among the highly educated, but increased among those of low education. In Estonia and Lithuania, for men and women combined, external causes and circulatory diseases contributed most to the increasing educational gap in total mortality.

    CONCLUSIONS:

    Different trends were observed between the two former Soviet republics and the two Central Eastern European countries. This divergence can be related to differences in socioeconomic development during the 1990s and in particular, to the spread of poverty, deprivation and marginalization. Alcohol and psychosocial stress may also have been important mediating factors.

  • 18.
    Leinsalu, Mall
    et al.
    Södertörn University, Avdelning 4, Sociology.
    Vågerö, Denny
    Södertörn University, Avdelning 4, Sociology. Södertörn University, Department of Society and History, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Kunst, Anton E
    Estonia 1989-2000: enormous increase in mortality differences by education2003In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 32, no 6, p. 1081-1087Article in journal (Refereed)
    Abstract [en]

    Social disruption and increasing inequalities in wealth can be considered main recent determinants; however, causal processes, shaped decades before recent reforms, also contribute to this widening gap.

  • 19.
    Leinsalu, Mall
    et al.
    Södertörn University, School of Sociology and Contemporary History, Sociology.
    Vågerö, Denny
    Södertörn University, Department of Society and History, SCOHOST (Stockholm Centre on Health of Societies in Transition). Södertörn University, Department of Society and History, Sociology.
    Kunst, Anton E
    Increasing ethnic differences in mortality in Estonia after the collapse of the Soviet Union2004In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 58, no 7, p. 583-589Article in journal (Refereed)
    Abstract [en]

    Political and economic upheaval, increasing poverty, and alcohol consumption can be considered the main underlying causes of the widening ethnic mortality gap.

  • 20. Modin, Bitte
    et al.
    Vågerö, Denny
    Hallqvist, Johan
    Koupil, Ilona
    The contribution of parental and grandparental childhood social disadvantage to circulatory disease diagnosis in young Swedish men2008In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 66, p. 822-834Article in journal (Refereed)
  • 21. Modin, Bitte
    et al.
    Vågerö, Denny
    Hallqvist, Johan
    Koupil, Ilona
    The contribution of parental and grandparental childhood social disadvantage to circulatory disease diagnosis in young Swedish men2008In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 66, p. 822-834Article in journal (Refereed)
    Abstract [en]

    Men born out of wedlock in early twentieth century Sweden who never married have previously been shown to have a doubled mortality risk from ischaemic heart disease compared to the corresponding group of men born to married parents. This study further explores the question of childhood social disadvantage and its long-term consequences for cardiovascular health by examining the two subsequent generations. The question posed is whether the sons and grandsons of men and women born out of wedlock in early twentieth century Sweden have an increased risk of circulatory disease compared with the corresponding descendants of those born inside marriage. We examined this by use of military conscription data. The material used is the Uppsala Birth Cohort Multigenerational database consisting of individuals born at Uppsala University Hospital between 1915 and 1929 (UG1), their children (UG2) and grandchildren (UG3). Conscription data were available for UG2s born between 1950 and 1982 (n = 5,231) and UG3s born between 1953 and 1985 (n = 10,074) corresponding to 72.1% and 73.6%, respectively, of all males born in each time-period. Logistic regression showed that significant excess risk of circulatory disease diagnoses was present only among descendants of men born outside marriage, with sons and grandsons demonstrating odds ratios of 1.64 and 1.83, respectively, when BMI and height at the time of conscription, father's social class in mid-life and father's or grandfather's history of circulatory disease had been adjusted for. Separate analyses showed that the effect of the maternal and paternal grandfather was of approximately the same magnitude. Further analyses revealed an interaction between the father's social class and the grandfather's legitimacy status at birth on UG3-men's likelihood of having a circulatory disease, with elevated odds only among those whose fathers were either manual workers or self-employed. The results of this study suggest that social disadvantage in one generation can be linked to health disadvantage in the subsequent two generations.

  • 22. Modin, Bitte
    et al.
    Vågerö, Denny
    Koupil, Ilona
    The impact of early twentieth century illegitimacy across three generations: Longevity and intergenerational health correlates.2009In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 68, no 9, p. 1633-1640Article in journal (Refereed)
    Abstract [en]

    This study contributes to the understanding of how social mortality patterns are reproduced across generations by documenting associations of women's marital status at childbirth in the beginning of last century with selected health indicators across three subsequent generations of their offspring, and by highlighting a special set of plausible mechanisms linked to this particular event in history. We use the Multigenerational Uppsala Birth Cohort Study (UBCoS) database consisting of 12,168 individuals born at Uppsala University Hospital in 1915-1929 (UG1), their children (UG2) and grandchildren (UG3). Results showed that men and women born outside wedlock (BOW) in early twentieth century Sweden were at an increased risk of adult mortality compared to those who were born in wedlock (BIW), and the men were also significantly less likely to reach their 80th birthday. The question of childhood social disadvantage and its long-term consequences for health is then taken one step further by examining their offspring in two subsequent generations in terms of four specific anthropometric and psychological outcomes at the time of military conscription, all known to predict disease and mortality later in life. Results showed that sons of men BOW as well as sons and grandsons of women BOW had significantly lower psychological functioning and cognitive ability. Regarding body mass index and height, however, significant associations were found only among descendants of men BOW. The anthropometric and psychological disadvantages found among descendents of individuals BOW were partly mediated by their social class background. The four outcomes observed early in the lives of UG2s and UG3s do in fact constitute early health determinants, each potentially influencing longevity and mortality risk in these generations. We conclude that the social disadvantage imposed on those BOW in early twentieth century Sweden appears to be reproduced as a health disadvantage in their children and grandchildren, with likely consequences for mortality among these.

  • 23.
    Moran, Paul
    et al.
    Institute of Psychiatry, King's College London, UK.
    af Klinteberg, Britt
    Stockholms universitet, Psykologiska institutionen.
    Batty, G. David
    University of Glasgow, and University of Edinburgh, UK.
    Vågerö, Denny
    Childhood Intelligence Predicts Hospitalization with Personality Disorder in Adulthood: Evidence from a Population-Based Study in Sweden2009In: Journal of Personality Disorders, ISSN 0885-579x, Vol. 23, no 5, p. 535-540Article in journal (Refereed)
    Abstract [en]

    Although low pre-morbid IQ is an established risk factor for severe mental illness, its association with personality disorder (PD) is unclear. We set out to examine whether there is a prospective association between childhood intelligence and PD in adulthood. Using a population-based prospective cohort study, we linked childhood IQ scores to routinely collected hospital discharge records in adulthood. Lower IQ scores were related to higher risk of being hospitalized with a PD across the full range of IQ scores, (odds ratio per one SD increase in IQ was 0.60; 95% CI: 0.49–0.75; p(trend) = 0.001). Adjusting for potential confounding variables had virtually no impact. We conclude that low childhood IQ predicts hospitalization with PD and may be an important factor in the development of PD.

  • 24.
    Sparén, Pär
    et al.
    Södertörn University, Avdelning 4, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Vågerö, Denny
    Stockholm University.
    Stagnation, sammanbrott och social nyordning - rötterna till den ryska folkhälsokrisen2000In: Sociologisk forskning, ISSN 0038-0342, Vol. 37, no 1, p. 127-149Article in journal (Refereed)
    Abstract [en]

    Long term trends of deteriorating health status in Soviet Union and Eastern Europe during the last two decades of communism were followed by a new crisis in health, after the collapse of its social system. In contrast, the perestroika period coincided with strongly improved public health. Explanations for the latest Russian health crisis are discussed. It is concluded that explanations based on poor medical care, excessive alcohol consumption or nutrional deprivation are, at best, insufficient. The collapse of the social system itself has lead to a narrowing of individual and collective decision latitudes; we speculate that historical factors, such as vulnerability of specific birth cohorts or segments of the population, may be part of the unexpected and very steep rise of mortality during the first half of the 1990s.

  • 25. Sparén, Pär
    et al.
    Vågerö, Denny
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Shestov, Dmitri B
    Plavinskaja, Svetlana
    Parfenova, Nina
    Hoptiar, Valeri
    Paturot, Dominique
    Galanti, Maria Rosaria
    Long term mortality after severe starvation during the siege of Leningrad: prospective cohort study2004In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 328, no 7430, p. 11-14AArticle in journal (Refereed)
    Abstract [en]

    Objectives To determine whether starvation during periods of increased growth after birth have long term health consequences.Design Analysis of cardiovascular risk factors and mortality in a longitudinal follow up after the 1941-4 siege of Leningrad. Mortality measured from 1975 up to the end of 1999.Setting St Petersburg, Russia (formerly Leningrad).Participants 5000 men born 1916-35 who lived in Leningrad, randomly selected to take part in health examinations in 1975-7. Of the 3905 men who participated, a third had experienced the siege.Main outcome measures Relative risk of ischaemic heart disease and mortality from stroke by siege exposure. Odds ratios and means for several cardiovascular risk factors.Results Three to six decades after the siege, in men who experienced the siege around the age of puberty blood pressure was raised (mean difference in systolic 3.3 mm Hg, in diastolic 1.3 mm Hg) as was mortality from ischaemic heart disease (relative risk 1.39, 95% confidence interval 1.07 to 1.79) and stroke (1.67, 1.15 to 2.43), including haemorrhagic stroke (1.71, 0.90 to 3.22). The effect on mortality was partly mediated via blood pressure but not by any other measured biological, behavioural, or social factor.Conclusions Starvation, or accompanying chronic stress, particularly at the onset of or during puberty, may increase vulnerability to later cardiovascular disease.

  • 26. Stenberg, Sten-Ņke
    et al.
    Vågerö, Denny
    Cohort Profile: The Stockholm birth cohort of 19532006In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 35, p. 546-548Article in journal (Refereed)
  • 27. Stenberg, Sten-Åke
    et al.
    Vågerö, Denny
    Österman, Reidar
    Arvidsson, Emma
    von Otter, Cecilia
    Janson, Carl-Gunnar
    Stockholm Birth Cohort Study 1953-2003: A new tool for life-courses studies2007In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 35, no 1, p. 104-110Article in journal (Refereed)
    Abstract [en]

    To create a new tool for life-course studies of health outcomes as well as social outcomes. Methods: Two anonymous data sets, one a local birth cohort and the other a nationwide registry, covering information from early and middle life, respectively, were matched using a "key for probability matching" based on a large number of variables, common to both data sets. The first data set provides social and health information from birth, childhood, and adolescence on boys and girls, born in Stockholm in 1953. The second data set provides information on income, work, and education as well as any inpatient visits and any mortality from mid-life for the entire Swedish population. Results: For 96% of the original cohort it was possible to add data from mid-life. Thus, a new database has been created, referred to as the Stockholm Birth Cohort Study, which provides rich and unique life-course data from birth to age 50 for 14,294 individuals: 7,305 men and 6,989 women. Comparison of matched and unmatched cases in the original cohort suggests that those individuals that could not be matched had slightly more favourable social and intellectual circumstances and had often moved away from Sweden in the 1980s. Conclusion: The new database provides excellent opportunities for life-course studies on health and social outcomes. It allows for studies that have not previously been possible in Sweden or elsewhere. Further, it provides an opportunity for collaborative work with similar databases in Copenhagen and Aberdeen.

  • 28.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Kislitsyna, Olga
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Timofeeva, Irina
    Södertörn University, Centre for Baltic and East European Studies (CBEES), Baltic & East European Graduate School (BEEGS).
    Vågerö, Denny
    Attitudes Toward Intimate Partner Violence Against Women in Moscow2008In: Journal of family Violence, ISSN 0885-7482, E-ISSN 1573-2851, Vol. 23, p. 447-456Article in journal (Refereed)
    Abstract [en]

    This study examines attitudes towards violenceagainst women among the populace in Moscow, Russiausing data drawn from the Moscow Health Survey.Information was obtained from 1,190 subjects (510 menand 680 women) about their perceptions of whetherviolence against women was a serious problem in contemporaryRussia, and under what circumstances they thoughtit was justifiable for a husband to hit his wife. Less thanhalf the respondents thought violence was a seriousproblem, while for a small number of interviewees therewere several scenarios where violence was regarded asbeing permissible against a wife. Being young, divorced orwidowed, having financial difficulties, and regularly consumingalcohol were associated with attitudes moresupportive of violence amongst men; having a loweducational level underpinned supportive attitudes amongboth men and women. Results are discussed in terms of the public reemergence of patriarchal attitudes in Russia in thepost-Soviet period.

  • 29.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology.
    Andreev, Evgueni
    Razvodovsky, Yury
    Vågerö, Denny
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    McKee, Martin
    Alcohol poisoning in Russia and the countries in the European part of the former Soviet Union, 1970-20022007In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 17, no 5, p. 444-449Article in journal (Refereed)
    Abstract [en]

    Acute alcohol poisoning has now reached unprecedented rates in parts of the ex-USSR with worrying trends among men as well as among women. Effective action by the governments concerned is now essential.

  • 30. Tiikkaja, Sanna
    et al.
    Hemström, Örjan
    Vågerö, Denny
    Intergenerational class mobility and cardiovascular mortality among Swedish women: a population-based register study2009In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 68, p. 733-739Article in journal (Refereed)
    Abstract [en]

    Class inequalities in cardiovascular disease (CVD) mortality are well documented, but the impact of intergenerational class mobility on CVD mortality among women has not been studied thoroughly. We examined whether women's mobility trajectories might contribute to CVD mortality beyond what could be expected from their childhood and adult social class position. The Swedish Work and Mortality Data Base provided childhood (1960) and adulthood (1990) social indicators. Women born 1945–59 (N = 791 846) were followed up for CVD mortality 1990–2002 (2019 deaths) by means of logistic regression analysis. CVD mortality risks were estimated for 16 mobility trajectories. Gross and net impact of four childhood and four adult classes, based on occupation, were analysed for mortality in ischemic heart disease (IHD), stroke, other CVD, – and all CVD. Differences between the two most extreme trajectories were 10-fold, but the common trajectory of moving from manual to non-manual position was linked to only a slight excess mortality (OR = 1.26) compared to the equally common trajectory of maintaining a stable non-manual position (reference category). Moving into adult manual class resulted in an elevated CVD mortality whatever the childhood position (ORs varied between 1.42 and 2.24). After adjustment for adult class, childhood class had some effect, in particular there was a low risk of coming from a self-employed childhood class on all outcomes (all ORs around = 0.80). A woman's own education had a stronger influence on the mortality estimates than did household income. Social mobility trajectories among Swedish women are linked to their CVD mortality risk. Educational achievement seems to be a key factor for intergenerational continuity and discontinuity in class-related risk of CVD mortality among Swedish women. However, on mutual adjustment, adult class was much more closely related to CVD mortality than was class in childhood.

  • 31. Vågerö, Denny
    Commentary: The role of alcohol in mortality differences between European countries2007In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 36, no 2, p. 468-469Article in journal (Refereed)
  • 32.
    Vågerö, Denny
    Södertörn University College, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Do health inequalities persist in the new global order?: A European perspective2006In: Inequalities of the world: [new theoretical frameworks, multiple empirical approaches] / [ed] Göran Therborn, London: Verso Publications , 2006, p. 61-92Chapter in book (Other academic)
  • 33. Vågerö, Denny
    Health inequalities in women and men: Studies of specific causes of death should use household criteria2000In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 320, p. 1286-1287Article in journal (Refereed)
  • 34. Vågerö, Denny
    Material and cultural factors2004In: Key concepts in medical sociology / [ed] Jonathan Gabe, Michael Bury and Mary Ann Elston, London: Sage Publications , 2004, p. 32-35Chapter in book (Other academic)
  • 35. Vågerö, Denny
    Social class2004In: Key concepts in medical sociology / [ed] Jonathan Gabe, Michael Bury and Mary Ann Elston, London: SAGE , 2004, p. 3-7Chapter in book (Other academic)
  • 36. Vågerö, Denny
    The East- West health divide in Europe: Growing and shifting eastwards2010In: European Review, ISSN 1062-7987, E-ISSN 1474-0575, Vol. 18, no 1, p. 23-34Article in journal (Refereed)
    Abstract [en]

    Over a four-decade long period, a health gap has opened up between European countries, in particular along the East/West dimension. One could speak of a European health divide. The divide is growing larger and, at the same time, shifting eastwards, leaving countries such as Russia, Ukraine, Belarus and Moldova at an increasing health disadvantage. Health inequalities, or differences between social classes, within European countries also seem to have been growing for the last couple of decades. Those countries that were previously led by communist regimes today show larger health inequalities than do countries in Western Europe. The countries that were once part of the Soviet Union demonstrate the most alarming health trends, with large segments of the population actually experiencing falling life expectancies. Reducing global and European health inequalities so that the health chances of a newborn child are not dependent on which country and social class he or she is born in, is a truly formidable task, which implies an entirely new way of seeing human development.

  • 37.
    Vågerö, Denny
    Södertörn University College, Department of Society and History, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    The unknown Sorokin: his life in Russia and the essay on suicide2002Book (Other academic)
    Abstract [de]

    Pitirim Sorokin (1889-1968) was one of the greatest sociologists of the twentieth century. Born in north-eastern Russia, he was forced into exile in 1922. The truth about his deep involvement in the social upheavals in Russia at the time was long suppressed in his own country, as were his sociological works in Russian.

    As Russia now once again takes up its place in the international academic community, the interest in Sorokin’s work and life is growing. In the present volume his previously unknown essay on suicide is reprinted in Russian as well as in English translation and analysed by Ilkka Henrik Mäkinen, while Sorokin's intellectual and political development before his exile is presented by Andrew Stickley.

  • 38.
    Vågerö, Denny
    Stockholm University.
    Where does new theory come from?2006In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 60, p. 573-574Article in journal (Refereed)
  • 39.
    Vågerö, Denny
    et al.
    Södertörn University College, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Ferlander, Sara
    Södertörn University College, School of Social Sciences, Sociology. Södertörn University College, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Leinsalu, Mall
    Södertörn University College, School of Social Sciences, Sociology. Södertörn University College, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Mäkinen, Ilkka Henrik
    Södertörn University College, School of Social Sciences, Sociology. Södertörn University College, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Stickley, Andrew
    Södertörn University College, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Unhealthy Societies?: Health Stagnation and Growing Health Inequalities Are Not Consistent with Sustainable Development2006In: Realizing a Common Vision for a Baltic Sea Eco-Region: Report from a Research Symposium on Sustainable Development Patterns 28-29 October 2005 / [ed] Lars Rydén, 2006, p. 39-46Conference paper (Other academic)
  • 40.
    Vågerö, Denny
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Kislitsyna, Olga
    Self-reported heart symptoms are strongly linked to past and present poverty in Russia: evidence from the 1998 Taganrog interview survey2005In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 15, p. 418-423Article in journal (Refereed)
    Abstract [en]

    Background: In this Russian-Swedish collaborative study the question of how symptoms of heart disease are linked to poverty in Russia was addressed. Method: A random sample household survey was conducted in Taganrog, southern Russia. It covered questions about living circumstances, poverty and health. Health questions included both symptoms of heart problems, such as chest pain and high blood pressure, psychological problems such as depression and anxiety, as well as health-related behaviours such as alcohol drinking. Answers from 1972 women and men aged 18-70 are analysed here. Results: The poorest fifth of the population were more than twice as likely as others to report heart symptoms. Problems in affording vegetables, meat or fish, clothes and footwear were linked to heart symptoms more closely than other economic indicators, such as car ownership or ownership of consumer durables. Psychological symptoms, sleeping problems and alcohol drinking were all related to self-reported heart symptoms, but explained little of the excess risks attributable to present poverty. Childhood poverty was also linked to present heart symptoms. Conclusion: Life-time accumulated experience of economic hardship contributes to present levels of heart disease symptomology in Russia.

  • 41.
    Vågerö, Denny
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). CHESS, Stockholm University/Karolinska Institutet.
    Kislitsyna, Olga
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). Russian Academy of Sciences, Moscow, Russian Federation .
    Ferlander, Sara
    Södertörn University, School of Social Sciences, Sociology.
    Migranova, Ludmila
    Carlson, Per
    Mid Sweden University.
    Rimachevskaya, Natalia
    Moscow Health Survey 2004: social surveying under difficult circumstances2008In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 53, no 4, p. 171-179Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this paper is to present the Moscow Health Survey 2004, which was designed to examine health inequalities in Moscow. In particular we want to discuss social survey problems, such as non-response, in Moscow and Russia. Methods: Interviews, covering social and economic circumstances, health and social trust, of a stratified random sample of the greater Moscow population, aged 18+. Reasons for nonresponse were noted down with great care. Odds ratios (ORs) for self-rated health by gender and by six social dimensions were estimated separately for districts with low and high response rates. Bias due to non-response is discussed. Results and conclusions: About one in two (53.1 %) of approached individuals could not be interviewed, resulting in 1190 completed interviews. Non-response in most Russian surveys, but perhaps particularly in Moscow, is large, partly due to fear of strangers and distrust of authorities. ORs for poor health vary significantly by gender, occupational class, education and economic hardship. We find no significant differences in these ORs when comparing districts with low and high response rates. Non-response may be a problem when estimating prevalence rates or population means, but much less so when estimating odds ratios in multivariate analyses.

  • 42.
    Vågerö, Denny
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). CHESS, Stockholm Universtiy / Karolinska Institutet.
    Koupil, Ilona
    CHESS, Stockholm Universtiy / Karolinska Institutet.
    Parfenova, Nina
    Russian Academy of Medicine Science, St. Petersburg, Russia.
    Sparen, Pär
    Karolinska Institutet.
    Long-term health consequences following the siege of Leningrad2013In: Early life nutrition and adult health and development: lessons from changing dietary patterns, famines and experimental studies / [ed] L.H. Lumey and Alexander Vaiserman, New York: Nova Science Publishers, Inc., 2013, p. 207-225Chapter in book (Other academic)
    Abstract [en]

    We are interested in the long-term health consequences associated with severe starvation and war trauma, and whether certain "age windows" exist when exposure to such events are particularly harmful.The siege of Leningrad (now St. Petersburg) during World War II provided an opportunity to study this. For 872 days, German troops prevented supplies from reaching Leningrad. Simultaneously, there was a food blockade and a steady and merciless bombardment by shells from guns and from the air. The first winter, 1941/42, represents the most severe food shortage, amounting to mass starvation or semi-starvation. Our late colleague, Professor Dimitri Shestov, had suffered the consequences of the Leningrad siege as a boy and believed that it had taken a toll on people beyond its immediate short- and medium-range consequences. He was particularly concerned about its long-term consequences for circulatory disease. A 1973 US-Soviet agreement, the socalled Lipid Research Clinics Collaboration, gave him an opportunity to study this. From 1975 to 1982 men and women living in Leningrad (now St. Petersburg) were randomly sampled and invited to examine their health and cardiovascular functioning. Dimitri Shestov added a simple question to this examination: "Were you in Leningrad during the blockade?" A third of the participants were. They had experienced peak starvation (in January 1942) at ages 1-31 (women) or 6-26 (men).The mortality follow-up began immediately after the first clinical examinations in 1975 and continued for three decades, until the end of 2005. Our analyses show that the siege of Leningrad, particularly when experienced in puberty, has had long-term effects on blood pressure both in men and women.We also found a raised IHD and stroke risk among those men. This was partly mediated via blood pressure but not by any other measured biological, behavioral, or social factors.Girls experiencing the siege around puberty suffered an elevated risk of dying from breast cancer later in life.The fact that the effect of siege exposure is modified by the age at exposure is highly interesting from a scientific point of view. It may suggest that a reprogramming of physiological systems can occur at specific age windows in response to starvation and/or war trauma. The team that worked from 1975-2005 to collect clinical information and death certificates for participants in the study included Svetlana Plavinskaya, born in Leningrad during the siege. Dimitri Shestov and Svetlana Plavinskaya died in 2010 and 2011, respectively. We dedicate this chapter to their memory.

  • 43. Vågerö, Denny
    et al.
    Koupilová, Ilona
    Leon, David A
    Lithell, Ulla-Britt
    Social determinants of birthweight, ponderal index and gestational age in Sweden in the 1920s and the 1980s1999In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 88, p. 445-453Article in journal (Refereed)
    Abstract [en]
    This study compared the effect of social class and marital status on birth outcomes in Sweden, using (i) data on all births at the Akademiska Hospital in Uppsala from 1920 to 1924 with socioeconomic information from records at birth; and (ii) a linkage of the Medical Births Registry for all births in Sweden in November/December 1985 to the 1985 Census. Preterm births (<37 weeks) have become less common during the 20th century. Between 1920–24 and 1985, mean and median birthweight increased, as did mean ponderal index, indicating a shift to the right of the birthweight and ponderal index distributions. In 1920–24, birthweight and ponderal index were associated with the social class of the household and with the marital status of the mother. Babies of single mothers were lighter and thinner, and had a much greater probability of being born preterm. In contrast, in 1985, maternal marital status (and cohabitation status) had a weaker effect on birthweight and ponderal index. The importance of household social class for ponderal index and preterm birth changed similarly, but its importance for birthweight remained. The mediating mechanism may have changed. Mothers from farming households now gave birth to the heaviest babies (nearly 200 g heavier than those of unskilled workers). Adjustment for a number of factors, including smoking, had a limited effect on these social class differences. In conclusion, biological processes during the foetal period are systematically linked to the social circumstances of the mother, but in a different way in the 1920s and in 1985.
  • 44.
    Vågerö, Denny
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Leinsalu, Mall
    Södertörn University, School of Sociology and Contemporary History, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Commentary: Health inequalities and social dynamics in Europe2005In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 331, no 7510, p. 186-187Article in journal (Refereed)
  • 45. Vågerö, Denny
    et al.
    Modin, Bitte
    Prenatal growth, subsequent marital status, and mortality: longitudinal study2002In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 324, p. 398-Article in journal (Refereed)
  • 46. Vågerö, Denny
    et al.
    Modin, Bitte
    The associations between height, cognition and education and their relevance for health studies: [a comment to Magnusson et al. : International Journal of Epidemiology]2006In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 35, p. 663-664Article in journal (Refereed)
  • 47. Vågerö, Denny
    et al.
    Modin, Bitte
    Koupil, Ilona
    Reproductive history and cardiovascular mortality among women: Evidence from the Uppsala Birth Cohort Multigeneration Study [abstract]2005In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 58, no 5, p. 1077-Article in journal (Refereed)
  • 48.
    Vågerö, Denny
    et al.
    Stockholm University.
    Shestov, Dmitri B.
    Galanti, Maria Rosaria
    Sparén, Pär
    Long term mortality after severe starvation during the siege of Leningrad: authors' reply2004In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 328, no 7435, p. 346-347Article in journal (Refereed)
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