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  • 1. Andersen, Ronald
    et al.
    Smedby, Björn
    Vågerö, Denny
    Cost containment, solidarity and cautious experimentation: Swedish dilemmas2001Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 52, s. 1195-1204Artikkel i tidsskrift (Fagfellevurdert)
    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.
    Billingsley, Sunnee
    Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Intragenerational mobility and mortality in Russia: Short and longer-term effects2012Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 75, nr 12, s. 2326-2236Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study uses the Russian Longitudinal Monitoring Survey to explore the relationship between mortality of men age 65 or younger and intragenerational mobility, measured objectively through household income and subjectively through social ranking. This relationship is considered in light of the social selection and social causation mechanisms developed in the literature as well as a proposed mechanism in which mobility itself is a consequential life event. The analysis spans the years 1994-2010, which covers the transitional period in Russia characterized by labor market restructuring and economic crisis as well as a later period of economic growth and recovery. Using Cox proportional hazard models, immediate and longer-term associations between mobility and mortality are estimated. Both subjective and objective downward mobility had an immediate positive association with mortality risk (increased by 44% and 24%, respectively). In contrast, upward mobility had a more pronounced effect over a longer-term horizon and lowered mortality risk by 17%. Controlling for destination status attenuated some associations, but findings were robust to the adjustment of selection-related factors such as alcohol consumption and health status in the year preceding mobility. Findings suggest that the negative relationship between upward mobility and mortality may be driven by social causation, whereas downward mobility may have an independent effect beyond selection or causation.

  • 3.
    Carlson, Per
    Stockholms universitet.
    Educational differences in Self-Rated Health during the Russian Transition2000Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 51, nr 9, s. 1363-74Artikkel i tidsskrift (Fagfellevurdert)
  • 4.
    Carlson, Per
    Stockholms universitet.
    Self-perceived health in east and west Europe: Another European health divide1998Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 46, s. 1355-1366Artikkel i tidsskrift (Fagfellevurdert)
  • 5.
    Carlson, Per
    Södertörns högskola, Institutionen för sociologi, idéhistoria, samtidshistoria och arkeologi, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    The European health divide: a matter of financial or social capital?2004Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 59, nr 9, s. 1985-1992Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The 'European east-west health divide' has been documented both for mortality and for self-rated health. The reason for this divide, however, remains to be explained. The aim of this study is, firstly, to investigate whether in 1995-97 differences in self-rated health persisted between countries in central and eastern Europe, the former Soviet Union, and western Europe. A further aim is to try to explain these differences with reference to people's financial status and social capital. This study found substantial differences in self-rated health between countries in western Europe, in central and eastern Europe, and in the former Soviet Union (where self-rated health seems to be poorest in general). There were also substantial differences between areas in terms of economic and social capital, with western Europe doing better in all the analysed circumstances. In economic terms people in the former Soviet Union seemed to be more dissatisfied than those living in central and eastern Europe. When one looks at differences in social capital between the two post-communist areas the picture is more mixed. Economic satisfaction was demonstrated to have a strong and significant effect on people's self-rated health, with a higher satisfaction reducing the odds of 'poor' health. When this factor was controlled for the area, differences in self-rated health were reduced dramatically, for both men and women. Organisational activity (men only), trust in people, and confidence in the legal system also reduced the odds of 'less than good health', but were not as important in explaining the health differences between areas. One can conclude that economic factors as well as some aspects of social capital play a role for area differences in self-rated health. Of these it would appear that economic factors are the more important.

  • 6.
    Ferlander, Sara
    et al.
    Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre on Health of Societies in Transition). Södertörns högskola, Institutionen för samhällsvetenskaper, Sociologi.
    Mäkinen, Ilkka Henrik
    Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre on Health of Societies in Transition). Södertörns högskola, Institutionen för samhällsvetenskaper, Sociologi.
    Social capital, gender and self-rated health. Evidence from the Moscow Health Survey 20042009Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 69, nr 9, s. 1323-1332Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The state of public health in Russia is undoubtedly poor compared with other European countries. The health crisis that has characterised the transition period has been attributed to a number of factors, with an increasing interest being focused on the impact of social capital - or the lack of it. However, there have been relatively few studies of the relation between social capital and health in Russia, and especially in Moscow. The aim of this study is to examine the relationship between social capital and self-rated health in Greater Moscow. The study draws on data from the Moscow Health Survey 2004, where 1190 Muscovites were interviewed. Our results indicate that among women, there is no relationship between any form of social capital and self-rated health. However, an association was detected between social capital outside the family and men’s self-rated health. Men who rarely or never visit friends and acquaintances are significantly more likely to report less than good health than those who visit more often. Likewise, men who are not members of any voluntary associations have significantly higher odds of reporting poorer health than those who are, while social capital in the family does not seem to be of importance at all. We suggest that these findings might be due to the different gender roles in Russia, and the different socializing patterns and values embedded in them. In addition, different forms of social capital provide access to different forms of resources, influence, and support. They also imply different obligations. These differences are highly relevant for health outcomes, both in Moscow and elsewhere.

  • 7.
    Jukkala, Tanya
    et al.
    Södertörns högskola, Institutionen för samhällsvetenskaper, Sociologi. Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Mäkinen, Ilkka Henrik
    Södertörns högskola, Institutionen för samhällsvetenskaper, Sociologi. Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Kislitsyna, Olga
    Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Ferlander, Sara
    Södertörns högskola, Institutionen för samhällsvetenskaper, Sociologi. Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Vågerö, Denny
    Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Economic strain, social relations, gender, and binge drinking in Moscow2008Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 66, s. 663-674Artikkel i tidsskrift (Fagfellevurdert)
    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. Kulhánová, Ivana
    et al.
    Hoffmann, Rasmus
    Judge, Ken
    Looman, Caspar W N
    Eikemo, Terje A
    Bopp, Matthias
    Deboosere, Patrick
    Leinsalu, Mall
    Södertörns högskola, Institutionen för samhällsvetenskaper, Sociologi. Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre on Health of Societies in Transition). National Institute for Health Development, Tallinn, Estonia.
    Martikainen, Pekka
    Rychtaříková, Jitka
    Wojtyniak, Bogdan
    Menvielle, Gwenn
    Mackenbach, Johan P
    Assessing the potential impact of increased participation in higher education on mortality: Evidence from 21 European populations2014Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 117, s. 142-149Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Although higher education has been associated with lower mortality rates in many studies, the effect of potential improvements in educational distribution on future mortality levels is unknown. We therefore estimated the impact of projected increases in higher education on mortality in European populations. We used mortality and population data according to educational level from 21 European populations and developed counterfactual scenarios. The first scenario represented the improvement in the future distribution of educational attainment as expected on the basis of an assumption of cohort replacement. We estimated the effect of this counterfactual scenario on mortality with a 10-15-year time horizon among men and women aged 30-79 years using a specially developed tool based on population attributable fractions (PAF). We compared this with a second, upward levelling scenario in which everyone has obtained tertiary education. The reduction of mortality in the cohort replacement scenario ranged from 1.9 to 10.1% for men and from 1.7 to 9.0% for women. The reduction of mortality in the upward levelling scenario ranged from 22.0 to 57.0% for men and from 9.6 to 50.0% for women. The cohort replacement scenario was estimated to achieve only part (4-25% (men) and 10-31% (women)) of the potential mortality decrease seen in the upward levelling scenario. We concluded that the effect of on-going improvements in educational attainment on average mortality in the population differs across Europe, and can be substantial. Further investments in education may have important positive side-effects on population health.

  • 9.
    Leinsalu, Mall
    Södertörns högskola, Avdelning 4, Sociologi. Södertörns högskola, Avdelning 4, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Social variation in self-rated health in Estonia: a cross-sectional study2002Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 55, nr 5, s. 847-861Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Over the past 40 years Estonia has experienced similar developments in mortality to other former Soviet countries. The stagnation in overall mortality has been caused mainly by increasing adult mortality. However, less is known about the social variation in health. This study examines differences in self-rated health by eight main dimensions of the social structure on the basis of the Estonian Health Interview Survey, carried out in 1996/1997. A multistage random sample (n = 4711) of the Estonian population aged 15-79 was interviewed; the response rate was 78.3%. This study includes those respondents aged 25-79 (n = 4011) with analyses being performed separately for men and women. The study revealed that a low educational level, Russian nationality, low personal income and for men only, rural residence were the most influential factors underlying poor health. Education had the biggest independent effect on health ratings: for women with less than an upper secondary education the odds of having poor health were almost fourfold (OR = 3.88) when compared to those with a university education, and for men these odds were almost two and a half times (OR = 2.32). Material resources, in this study measured by personal income, were important factors in explaining some of the educational and ethnic differences (especially for Russian women) in poor self-rated health. Overall, we found no differences between men and women in their health ratings. On the contrary, when we controlled for physical health status, emotional distress and locus of control women reported better health than men. Health selection contributed to, but did not explain the differences by structural dimension. This study also showed a strong association of poor self-rated health with three correlates-physical health status, emotional distress and locus of control, although the influence of these correlates on poor health ratings was not seen equally in the different structural dimensions.

  • 10. Mackenbach, J. P.
    et al.
    Kulhánová, I.
    Bopp, M.
    Deboosere, P.
    Eikemo, T. A.
    Hoffmann, R.
    Kulik, M. C.
    Leinsalu, Mall
    Södertörns högskola, Institutionen för samhällsvetenskaper, Sociologi. Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia .
    Martikainen, P.
    Menvielle, G.
    Regidor, E.
    Wojtyniak, B.
    Östergren, O.
    Lundberg, O.
    Variations in the relation between education and cause-specific mortality in 19 European populations: A test of the "fundamental causes" theory of social inequalities in health2015Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, nr 127, s. 51-62Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Link and Phelan have proposed to explain the persistence of health inequalities from the fact that socioeconomic status is a "fundamental cause" which embodies an array of resources that can be used to avoid disease risks no matter what mechanisms are relevant at any given time. To test this theory we compared the magnitude of inequalities in mortality between more and less preventable causes of death in 19 European populations, and assessed whether inequalities in mortality from preventable causes are larger in countries with larger resource inequalities. We collected and harmonized mortality data by educational level on 19 national and regional populations from 16 European countries in the first decade of the 21st century. We calculated age-adjusted Relative Risks of mortality among men and women aged 30-79 for 24 causes of death, which were classified into four groups: amenable to behavior change, amenable to medical intervention, amenable to injury prevention, and non-preventable. Although an overwhelming majority of Relative Risks indicate higher mortality risks among the lower educated, the strength of the education-mortality relation is highly variable between causes of death and populations. Inequalities in mortality are generally larger for causes amenable to behavior change, medical intervention and injury prevention than for non-preventable causes. The contrast between preventable and non-preventable causes is large for causes amenable to behavior change, but absent for causes amenable to injury prevention among women. The contrast between preventable and non-preventable causes is larger in Central & Eastern Europe, where resource inequalities are substantial, than in the Nordic countries and continental Europe, where resource inequalities are relatively small, but they are absent or small in Southern Europe, where resource inequalities are also large. In conclusion, our results provide some further support for the theory of "fundamental causes". However, the absence of larger inequalities for preventable causes in Southern Europe and for injury mortality among women indicate that further empirical and theoretical analysis is necessary to understand when and why the additional resources that a higher socioeconomic status provides, do and do not protect against prevailing health risks.

  • 11. 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 men2008Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 66, s. 822-834Artikkel i tidsskrift (Fagfellevurdert)
  • 12. 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 men2008Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 66, s. 822-834Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 13. Modin, Bitte
    et al.
    Vågerö, Denny
    Koupil, Ilona
    The impact of early twentieth century illegitimacy across three generations: Longevity and intergenerational health correlates.2009Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 68, nr 9, s. 1633-1640Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 14. Mäkinen, Ilkka Henrik
    Are There Social Correlates to Suicide?1997Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 44, nr 12, s. 1919-1929Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A structural-sociological approach to suicide research holds that an aggregate-level cause of suicide should correlate with the suicide rates in a population. In 1980, Sainsbury, Jenkins, and Levey published the article “The Social Correlates of Suicide in Europe” which related the suicide rates in 1961–1963 and the changes in them in the following 11 years to 15 social variables in 18 European countries. Its main findings were that the changes in suicide rates could be attributed to specific changes in the social environment. Complementary discriminant analyses showed that it was possible accurately to divide the countries into low- and high-change suicide rate groups on the basis of a combination of the social variables.

    Although criticized for its method, the study has been widely quoted and sometimes presented as the most definitive current study on the subject. In order to see whether its results held for similar data 16 years later it was replicated for 1977–1979 and the ensuing 11 years, with data and method as similar as possible to the original.

    The results agreed with those of the original study on only one point: the correlations between the levels of the social variables and those of the suicide rates were similar in both periods. However, changes in the suicide rates were unrelated to either the levels of the social variables or the changes in them: correlations found in the original study tended to change profoundly or disappear. Moreover, the results of the original discriminant analyses were a property of the method employed and thus independent of the data.

    Statistical artefacts or social processes such as changing expectations are unlikely to explain the suddenly changing or vanishing correlations. The original correlations seem to have been largely spurious and dependent on the fact that the more modern countries in Europe experienced a “suicide boom” in the 1960s. As the boom waned in these, it was beginning in the less modern countries: the correlations between the processes indicated by the social variables and the suicide rates were reversed or disappeared.

    The results call the existence of clear relations between these “suicidogenic” social circumstances and the suicide rates into question. Since many of the variables used are traditional “Durkheimian” indicators of the integration of society, a critique of this still-dominant view of the relationship between society and suicide mortality, or its common operationalization, is implied.

  • 15.
    Mäkinen, Ilkka Henrik
    Södertörns högskola, Avdelning 4, Sociologi. Södertörns högskola, Avdelning 3, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Eastern European Transition and Suicide Mortality2000Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 51, nr 9, s. 1405-1420Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The current paper seeks to systematize the discussion on the causes of the changes in Eastern European countries’ suicide mortality during the last 15 years by analyzing the changes in relation to some common causes: alcohol consumption, economic changes, “general pathogenic social stress”, political changes, and social disorganization. It is found that the developments in suicide have been very different in different countries, and that the same causes cannot apply to all of them. However, the relation between suicide mortality and social processes is obvious. A model consisting of the hypothetical general stress (as indicated by mortality/life expectancy), democratization, alcohol consumption, and social disorganization (with a period-dependent effect) predicted the percentual changes in the suicide rates in 16 out of the 28 Eastern Bloc countries in 1984–89 and 1989–94 fairly accurately, while it failed to do this for Albania, Poland, Romania, Slovakia, and the Caucasian and Central Asian newly independent states. Most interesting were the strong roles played by changes in life expectancy, the causes of which are discussed, and the fact that economic change seemed to lack explanatory power in multiple analyses. The data are subject to many potential sources of error, the small number of units and the large multicollinearity between the independent variables may distort the results. Nevertheless, the results indicate that the changes in Eastern European suicide mortality, both decreases and increases, may be explained with the same set of variables. However, more than one factor is needed, and the multicollinearity will continue to pose problems.

  • 16.
    Mäkinen, Ilkka Henrik
    Södertörns högskola, Institutionen för samhällsvetenskaper, Sociologi. Södertörns högskola, Institutionen för sociologi, idéhistoria, samtidshistoria och arkeologi, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Suicide Mortality of Eastern European Regions before and after the Communist Period2006Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 63, nr 2, s. 307-319Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to investigate the spatial distribution of Eastern European suicide mortality both before and at the end of the Communist period, as well as the changes that occurred during this period.

    Regional data on suicide mortality were collected from Czarist “European Russia” in 1910 and from the corresponding area in 1989. The distribution of suicide mortality was mapped at both points in time. Regional continuity over time was further studied with the help of geographical units specially constructed for this purpose.

    In 1910, suicide mortality was found to be high in the northern Baltic provinces, in the urban parts of north and central Russia, the more urbanized parts of northern and western Poland, in east Ukraine, and in the northern Caucasus, while suicide rates were generally low in south Russia, Dagestan, and in southern Poland. In 1989, suicide mortality was highest in the Urals, the east Russian “ethnic” areas, and in southeast Russia. The rates were low in Poland, Moldavia, and in most of the northern Caucasus. The across-time analysis using specially constructed comparison units showed that the spatial distributions of suicide mortality in 1910 and 1989 were not correlated with each other. Additional analyses pointed to a short-term consistency of regional patterns both in the 1900s–1920s and the 1980s–1990s.

    The lack of regional continuity in suicide mortality in the area may imply an absence of strong and continuous regional cultures, or a strong influence of other factors, such as societal modernization, on suicide mortality. Suicide as an act changed its social nature during the Communist period, becoming more normal, and more equally distributed among social classes and geographical locations.

  • 17.
    Rojas, Yerko
    et al.
    Södertörns högskola, Institutionen för sociologi, idéhistoria, samtidshistoria och arkeologi, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Carlson, Per
    Södertörns högskola, Institutionen för sociologi, idéhistoria, samtidshistoria och arkeologi, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    The stratification of social capital and its consequences for self-rated health in Taganrog, Russia2006Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 62, nr 11, s. 2732-2741Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Russian public health and its social determinants have been the theme of several recent studies. In one of these, Rose [(2000). How much does social capital add to individual health? A survey study of Russians. Social Science & Medicine, 51(9), 1421-1435] puts forward a composite model as a way of getting away from two traditions: one that postulates that social capital influences health independently of human capital attributes (education, social class, income, etc.) and one that postulates that human capital is the main determinant of health, while social capital is more or less irrelevant. In this study, we investigate the composite model, conceptualising social capital as a type of capital, on the basis of Bourdieu. By doing this, not only do the relations between social capital and other types of capital become relevant, but also whether the effect of social capital on health differs depending on the possession of other types of capital. We used the Taganrog survey of 1998 which used structured interviews with the family members of 1009 households and the response rate was 81%. We found that social capital is stratified by education, and also that its effect on health varies depending on the volume of educational capital possessed. It also seems to be extremely important to specify different types of social capital, in order to get a better overview of possible mechanisms by means of which different types of capital might affect health.

  • 18. Schaap, Maartje M
    et al.
    Kunst, Anton E
    Leinsalu, Mall
    Södertörns högskola, Institutionen för samhällsvetenskaper, Sociologi. Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Regidor, Enrique
    Espelt, Albert
    Ekholm, Ola
    Helmert, Uwe
    Klumbiene, Jurate
    Mackenbach, Johan P
    Female ever-smoking, education, emancipation and economic development in 19 European countries2009Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 68, nr 7, s. 1271-1278Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Large differences in ever-smoking rates among women are found between countries and socio-economic groups. This study examined the socio-economic inequalities in female ever-smoking rates in 19 European countries, and explored the association between cross-national differences in these inequalities and economic development and women's emancipation. Data on smoking were derived from national health interview surveys from 19 European countries. For each country, age group (25-39, 40-59 and 60+ years), educational level (4 standard levels), and cumulative ever-smoking rates were calculated as the proportion of current and former smokers of the total survey population. A Relative Index of Inequality was estimated for women in the three age groups to measure the magnitude of educational differences. In regression analyses the association of ever-smoking rates of women age 25-39 years with the gross domestic product (GDP) and the Gender Empowerment Measure (GEM) was explored. Less educated women aged 25-39 years were more likely to have ever smoked than more educated women in all countries, except Portugal. In the age groups 40-59 years the educational pattern differed between countries. Women aged 60+ years who were less educated were less likely to have ever smoked in all countries, except Norway and England. The size of inequalities varied considerably between countries and reversed within three age groups. For women 25-39 years, the association of ever-smoking rates with GDP was positive, especially for more educated women. The association of ever-smoking rates with GEM was positive for less educated women, but negative for more educated women. The results are consistent with the idea that economic development and social-cultural processes related to gender empowerment have affected the diffusion of smoking in different ways for more and less educated women.

  • 19.
    Stickley, Andrew
    et al.
    Södertörns högskola, Institutionen för samhällsvetenskaper, Sociologi. Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre for Health and Social Change). University of London.
    Koyanagi, Ai
    Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre for Health and Social Change).
    Roberts, Bayard
    Rotman, David
    McKee, Martin
    Criminal victimisation and health: Examining the relation in nine countries of the former Soviet Union2013Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 91, s. 76-83Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Previous research suggests that criminal victimisation can impact negatively on both physical and psychological health. However, as yet, little is known about crime and its effects on population health in the former Soviet Union (fSU) - despite a sharp growth in crime rates in the countries in this region after the collapse of the communist system. Given this gap in current knowledge, this study examined two forms of crime, theft and violent victimisation, in nine fSU countries - Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Using nationally representative data from the Health in Times of Transition (HITT) study collected from 18,000 respondents in 2010/11, the study had two main objectives: (1) to identify which demographic and socioeconomic factors are associated with being a victim of crime; (2) to examine the relation between criminal victimisation and two health outcomes - self-rated health and psychological distress. We found that similar factors were associated with experiencing both forms of crime among respondents. Those who were younger, not married and who consumed alcohol more frequently were at increased risk of victimisation, while greater social capital was associated with lower odds for victimisation. Low education increased the risk of experiencing violence by 1.5 times. Victimisation was strongly associated with poorer health: victims of violence were 2.5 and 2.9 times more likely to report poor self-rated health and psychological distress, respectively, while the corresponding figures for theft victimisation were 1.9 and 1.8. The strong association we observed between criminal victimisation and poorer individual health suggests that, in addition to policies that reduce rates of crime, more research is now urgently needed on victimisation. Specifically, researchers should ascertain whether the association with poor health is causal, determine its potential mechanisms, and evaluate interventions that might mitigate its impact on health that are contextually appropriate in the fSU.

  • 20.
    Stjerna, Marie-Louise
    et al.
    Stockholm University.
    Olin Lauritzen, Sonja
    Tillgren, Per
    ”Social thinking” and cultural images: Teenagers' notions of tobacco use.2004Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 59, nr 3, s. 573-583Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The health hazards of tobacco use are well-known, and it is considered particularly important to prevent tobacco use among teenagers. New generations of teenagers still start using tobacco. To develop a more profound understanding of tobacco use among teenagers, the purpose of this study is to explore representations of tobacco use, smoking as well as snuffing, at the age when young people often start using tobacco. Focus-group interviews were carried out with 14-15 year olds in two schools in the Stockholm area. The analysis reveals that teenagers are well informed about the health-hazards of tobacco use. At the same time they hold complex and conflicting ideas concerning the relationship between tobacco use, risk, the body and "human nature". At the most general level of "social thinking" there is a dynamic relation between the three main representations of tobacco use related to: (1) notions of risk, (2) "human nature" and; (3) society's efforts to discipline its citizens, which together can be seen as the social representation of tobacco use. These representations of tobacco use are discussed as related to the teenagers' identity-work and gender identities.

  • 21. Tiikkaja, Sanna
    et al.
    Hemström, Örjan
    Vågerö, Denny
    Intergenerational class mobility and cardiovascular mortality among Swedish women: a population-based register study2009Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 68, s. 733-739Artikkel i tidsskrift (Fagfellevurdert)
    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.

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