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  • 1. Alvarez, J. L.
    et al.
    Kunst, A. E.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Bopp, M.
    Strand, B. H.
    Menvielle, G.
    Lundberg, O.
    Martikainen, P.
    Deboosere, P.
    Kalediene, R.
    Artnik, B.
    Mackenbach, J. P.
    Richardus, J. H.
    Educational inequalities in tuberculosis mortality in sixteen European populations2011In: The International Journal of Tuberculosis and Lung Disease, ISSN 1027-3719, E-ISSN 1815-7920, Vol. 15, no 11, 1461-1467 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe the magnitude of socioeconomic inequalities in tuberculosis (TB) mortality by level of education in male, female, urban and rural populations in several European countries. DESIGN: Data were obtained from the Eurothine Project, covering 16 populations between 1990 and 2003. Age- and sex-standardised mortality rates, the relative index of inequality and the slope index of inequality were used to assess educational inequalities. RESULTS: The number of TB deaths reported was 8530, with a death rate of 3 per 100000 per year, of which 73% were males. Educational inequalities in TB mortality were present in all European populations. Inequalities in TB mortality were greater than in total mortality. Relative and absolute inequalities were large in Eastern European and Baltic countries but relatively small in Southern European countries and in Norway, Finland and Sweden. Inequalities in mortality were observed among both men and women, and in both rural and urban populations. CONCLUSIONS: Socio-economic inequalities in TB mortality exist in all European countries. Firm political commitment is required to reduce inequalities in the social determinants of TB incidence. Targeted public health measures are called for to improve access to treatment of vulnerable groups and thereby reduce TB mortality.

  • 2.
    Baburin, Aleksei
    et al.
    National Institute for Health Development, Tallinn, Estonia / University of Tampere, Tampere, Finland.
    Lai, Taavi
    University of Tartu, Tartu, Estonia.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). Centre for Health Equity Studies, Stockholm University/Karolinska Institutet.
    Avoidable mortality in Estonia: Exploring the differences in life expectancy between Estonians and non-Estonians in 2005-2007.2011In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 125, no 11, 754-762 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: A considerable increase in social inequalities in mortality was observed in Eastern Europe during the post-communist transition. This study evaluated the contribution of avoidable causes of death to the difference in life expectancy between Estonians and non-Estonians in Estonia.

    STUDY DESIGN: Descriptive study.

    METHODS: Temporary life expectancy (TLE) was calculated for Estonian and non-Estonian men and women aged 0-74 years in 2005-2007. The ethnic TLE gap was decomposed by age and cause of death (classified as preventable or treatable).

    RESULTS: The TLE of non-Estonian men was 3.53 years less than that of Estonian men, and the TLE of non-Estonian women was 1.36 years less than that of Estonian women. Preventable causes of death contributed 2.19 years to the gap for men and 0.78 years to the gap for women, while treatable causes contributed 0.67 and 0.33 years, respectively. Cardiorespiratory conditions were the major treatable causes of death, with ischaemic heart disease alone contributing 0.29 and 0.08 years to the gap for men and women, respectively. Conditions related to alcohol and substance use represented the largest proportion of preventable causes of death.

    CONCLUSIONS: Inequalities in health behaviours underlie the ethnic TLE gap in Estonia, rather than inequalities in access to health care or the quality of health care. Public health interventions should prioritize primary prevention aimed at alcohol and substance use, and should be implemented in conjunction with wider social policy measures.

  • 3.
    Billingsley, Sunnee
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Intragenerational mobility and mortality in Russia: Short and longer-term effects2012In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 75, no 12, 2326-2236 p.Article in journal (Refereed)
    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.

  • 4. Bouzarovski, Stefan
    et al.
    Salukvadze, Joseph
    Gentile, Michael
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    A Socially Resilient Urban Transition?: The Contested Landscapes of Apartment Building Extensions in Two Post-communist Cities2011In: Urban Studies, ISSN 0042-0980, E-ISSN 1360-063X, Vol. 48, no 13, 2689-2714 p.Article in journal (Refereed)
    Abstract [en]

    Even though social processes across the globe are increasingly being theorised through a resilience lens, this has rarely been the case within the domain of everyday life in the city. The resilience debate also remains highly geographically selective, as regions that have undergone far-reaching systemic change over the past 20 years-including the post-communist states of the former Soviet Union and eastern and central Europe (ECE)-generally remain omitted from it. In order to address such knowledge gaps, an investigation is made of the relationships between social resilience and micro-level socio-spatial change in the built environment of the post-communist city, by focusing on the institutional, spatial and economic underpinnings of apartment building extensions (ABEs) on multistorey residential buildings in the Macedonian capital of Skopje and the Georgian capital of Tbilisi. Both cities contain a wide variety of ABEs, whose reinforced concrete frame constructions often rival the host buildings in terms of size and function. By exploring the architectural and social landscapes created by the extensions, it is hoped to highlight their embeddedness in a set of policy decisions and coping strategies, as well as their controversial implications on the present and future use of urban space.

  • 5. Bursztein Lipsicas, Cendrine
    et al.
    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).
    Immigration and suicidality in the young.2010In: Canadian journal of psychiatry, ISSN 0706-7437, Vol. 55, no 5, 274-281 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Little research has focused on the relation of immigration and suicidal behaviour in youth. Nevertheless, the impact of migration on the mental health of youth is an issue of increasing societal importance. This review aimed to present studies on the prevalence of suicidal behaviour in immigrant youth in various countries and to provide possible explanations for suicidal behaviour in immigrant youth, especially regarding acculturation.

    METHODS: The review included a literature search to locate articles on the subject of suicidal behaviour in immigrant youth in the context of acculturation.

    RESULTS: Studies on suicidal behaviour in culturally diverse youth are few and most of the existing research does not differentiate ethnic minorities from immigrants. Studies on epidemiology and on specific risk factors were found regarding various immigrant youth including Hispanics in the United States, Asians in North America and Europe, as well as comparative studies between different immigrant groups in specific countries.

    CONCLUSIONS: The relation between immigration status and suicidal behaviours in youth appears to vary by ethnicity and country of settlement. Time spent in the new country as well as intergenerational communication and conflicts with parents have, in many of the studies, been related to suicidality in immigrant youth. Summing up, there is a clear and urgent need to further pursue the work in this field, to develop targeted public health interventions as well as psychosocial treatment for preventing suicide in these youth.

  • 6. Espelt, A.
    et al.
    Borrell, Carme
    Roskam, Albert-Jan
    Rodríguez-Sanz, M
    Stirbu, Irina
    Dalmau-Bueno, A
    Regidor, Enrique
    Bopp, Matthias
    Martikainen, Pekka
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Artnik, Barbara
    Rychtarikova, Jitka
    Kalediene, Ramune
    Dzurova, D
    Mackenbach, Johan P.
    Kunst, Anton E.
    Socioeconomic inequalities in diabetes mellitus across Europe at the beginning of the 21st century2008In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 51, no 11, 1971-1979 p.Article in journal (Refereed)
    Abstract [en]

    In Europe, educational attainment and diabetes are inversely related, in terms of both morbidity and mortality rates. This underlines the importance of targeting interventions towards low SEP groups. Access and use of healthcare services by people with diabetes also need to be improved.

  • 7. Ezendam, Nicole P M
    et al.
    Stirbu, Irina
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Lundberg, Olle
    Kalediene, Ramune
    Wojtyniak, Bogdan
    Martikainen, Pekka
    Mackenbach, Johan P.
    Kunst, Anton E.
    Educational inequalities in cancer mortality differ greatly between countries around the Baltic Sea2008In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 44, no 3, 454-464 p.Article in journal (Refereed)
    Abstract [en]

    Countries of the Baltic Sea region differ strongly with regard to the magnitude and pattern of the educational inequalities in cancer mortality.

  • 8.
    Ferlander, Sara
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    The importance of different forms of social capital for health2007In: Acta Sociologica, ISSN 0001-6993, E-ISSN 1502-3869, Vol. 50, no 2, 115-128 p.Article, review/survey (Refereed)
    Abstract [en]

    The aim of this article is to provide an overview of the concept of social capital and to distinguish its different forms, focusing on their potential effects on health. According to many scholars, social capital comprises social networks, norms of reciprocity or social support and social trust. In this article the core element, the social network, has been further distinguished by the direction of ties and levels of formality, strength and diversity. In the past few years there has been increased interest in social capital in the health field and a great deal of research has suggested that social capital is generally positively related to health. However, little research has been conducted into how different forms of social capital or social networks influence health. What is the difference, for instance, between bonding and bridging social capital in terms of health outcomes? It is important to distinguish the different forms because they imply different resources, support and obligations. More research needs to be conducted into the different forms of social capital and their effects on health. A special focus should be placed on the health impacts of cross-cutting - or bridging and linking - forms of social capital.

  • 9.
    Ferlander, Sara
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). Södertörn University, School of Social Sciences, Sociology.
    Mäkinen, Ilkka Henrik
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). Södertörn University, School of Social Sciences, Sociology.
    Social capital, gender and self-rated health. Evidence from the Moscow Health Survey 20042009In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 69, no 9, 1323-1332 p.Article in journal (Refereed)
    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.

  • 10.
    Gentile, Michael
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Mass Privatisation, Unemployment and Mortality2012In: Europe-Asia Studies, ISSN 0966-8136, E-ISSN 1465-3427, Vol. 64, no 4, 785-787 p.Article in journal (Refereed)
  • 11.
    Gentile, Michael
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Marcinczak, Szymon
    No more work for Stakhanov: migrants and stayers in teh depopulating Donbas, Ukraine2012In: Urban geography, ISSN 0272-3638, E-ISSN 1938-2847, Vol. 33, no 3, 401-419 p.Article in journal (Refereed)
    Abstract [en]

    Labor migration from the less to the more affluent cities and regions is a defining trait of the patterns of population redistribution in Central and Eastern Europe, especially in the former Soviet Union, where international disparities in income and living standards are particularly manifest. While these macro-trends are well portrayed in the literature, their outcome at the household level seldom figures in the literature. In Ukraine, labor out-migration to Russia is a frequently chosen strategy, not least because of the Russophone background of eastern Ukraine and of many of the major cities, including Kiev and Odessa. This out-migration contributes to urban decline. Using multivariate methods, we analyze the characteristics of population subgroups with and without the experience of working abroad. We also use descriptive statistics to assess the impact of migration events within households on the standard of living of the latter. Our data source is the city of Stakhanov Health Interview Survey 2009 (n = 3,000).

  • 12.
    Gentile, Michael
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Sjöberg, Örjan
    Soviet housing: who built what and when? The case of Daugavpils, Latvia2010In: Journal of Historical Geography, ISSN 0305-7488, E-ISSN 1095-8614, Vol. 36, no 4, 453-465 p.Article in journal (Refereed)
    Abstract [en]

    Throughout much of the Soviet period, access to housing was a major consideration, both for individual citizens and employers intent on increasing their number of employees. Because of the heavy emphasis on industry, and despite the progress made within the area since the late 1950s, Soviet urban residential provision never managed to fully recover from the acute housing shortage that characterized the Stalin years. In this paper, we address the quantitative side of housing construction during the socialist era. Using the mid-sized diversified industrial town of Daugavpils (Latvia) as a case study, we set out to investigate the extent to which employers were involved in decisions concerning housing provision. To do this, we consult a large volume of archival records, our focus being on documents tracing entries indicating that new living quarters were ready and could be allocated to employees of sponsoring organizations and enterprises.

  • 13.
    Gentile, Michael
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Sjöberg, Örjan
    Spaces of Priority: The Geography of Soviet Housing Construction in Daugavpils, Latvia2010In: Annals of the Association of American Geographers, ISSN 0004-5608, E-ISSN 1467-8306, Vol. 100, no 1, 112-136 p.Article in journal (Refereed)
    Abstract [en]

    As a result of the absence of a land market, socialist-era cities tended to look different from their market-economy equivalents. The difference was made more pronounced by the fact that the command economy also favored industrial investment over infrastructure and housing. Yet, with an increasing appetite for additional labor, needed by production units to ensure plan fulfillment, housing became a means to recruit and retain employees. Not all employers could afford to put resources into such ononproductiveo investment, however, and the literature suggests that the notion of priorities allows for discriminating between those enterprises that enjoyed soft budget constraints, and therefore could afford to spend money on worker welfare, and those that could not. As a heuristic framework based on the economics of shortage, the priority model is compelling, but as yet it lacks empirical substantiation. Setting out to test the landscapes of priority model of urban development, this article details the developments of housing construction in Daugavpils, Latvia, during the Soviet period. Based on extensive archive and field research covering all newly constructed or converted housing projects over the period from 1951 to 1991, it yields considerable, if not unqualified, support for the model that until now has not been made subject to systematic empirical tests.

  • 14.
    Gentile, Michael
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Tammaru, Tiit
    van Kempen, Ronald
    Heteropolitanization: Social and spatial change in Central and East European Cities2012In: Cities, ISSN 0264-2751, E-ISSN 1873-6084, Vol. 29, no 5, 291-299 p.Article in journal (Refereed)
  • 15.
    Jukkala, Tanya
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). Södertörn University, School of Social Sciences, Sociology.
    Mäkinen, Ilkka Henrik
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). Södertörn University, School of Social Sciences, Sociology.
    Acceptance of suicide in Moscow2011In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 46, no 8, 753-765 p.Article in journal (Refereed)
    Abstract [en]

    Attitudes concerning the acceptability of suicide have been emphasized as being important for understanding why levels of suicide mortality vary in different societies across the world. While Russian suicide mortality levels are among the highest in the world, not much is known about attitudes to suicide in Russia. This study aims to obtain a greater understanding about the levels and correlates of suicide acceptance in Russia. Data from a survey of 1,190 Muscovites were analysed using logistic regression techniques. Suicide acceptance was examined among respondents in relation to social, economic and demographic factors as well as in relation to attitudes towards other moral questions. The majority of interviewees (80%) expressed condemnatory attitudes towards suicide, although men were slightly less condemning. The young, the higher educated, and the non-religious were more accepting of suicide (OR > 2). However, the two first-mentioned effects disappeared when controlling for tolerance, while a positive effect of lower education on suicide acceptance appeared. When controlling for other independent variables, no significant effects were found on suicide attitudes by gender, one's current family situation, or by health-related or economic problems. The most important determinants of the respondents' attitudes towards suicide were their tolerance regarding other moral questions and their religiosity. More tolerant views, in general, also seemed to explain the more accepting views towards suicide among the young and the higher educated. Differences in suicide attitudes between the sexes seemed to be dependent on differences in other factors rather than on gender per se. Suicide attitudes also seemed to be more affected by one's earlier experiences in terms of upbringing and socialization than by events and processes later in life.

  • 16.
    Jukkala, Tanya
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). Södertörn University, School of Social Sciences, Sociology.
    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).
    Suicide in Changing Societies2010In: Baltic Worlds, ISSN 2000-2955, Vol. 3, 10-16 p.Article in journal (Refereed)
  • 17.
    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, 663-674 p.Article 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.

  • 18. Kislitsyna, Olga
    et al.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Gilmore, Anna
    McKee, Martin
    The social determinants of adolescent smoking in Russia in 20042010In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 55, no 6, 619-626 p.Article in journal (Refereed)
    Abstract [en]

    To determine the prevalence of adolescent smoking in the Russian ederation and examine what factors are associated with it. ata were drawn from Round 13 of the Russia Longitudinal Monitoring urvey (RLMS) carried out in 2004. The sample consists of 815 dolescents (430 boys, 385 girls) aged 14-17 years who answered uestions about their health behaviours. moking was more prevalent among boys than girls (26.1 vs. 5.7%). aternal smoking and adolescent alcohol use were associated with smoking mong both sexes. The self-assessment of one's socioeconomic position as nfavourable was associated with girls' smoking, while living in a isrupted family, physical inactivity and having a low level of elf-esteem were predictive of boys' smoking. he family environment appears to be an important determinant of dolescent smoking in Russia. In particular, boys and girls may be odelling the negative health behaviour lifestyles of their parents, ith unhealthy behaviours clustering. Efforts to reduce adolescent moking in Russia must address the negative effects emanating from the arental home whilst also addressing associated behaviours such as lcohol use.

  • 19. 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, 1416-1421 p.Article 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.

  • 20. 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, 223-234 p.Article 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.

  • 21. 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, 1103- p.Article in journal (Refereed)
  • 22. 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, S71-S71 p.Article in journal (Other academic)
  • 23.
    Leinsalu, Mall
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Kaposvári, Csilla
    Kunst, Anton E
    Is income or employment a stronger predictor of smoking than education in economically less developed countries?: A cross-sectional study in Hungary2011In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, 97- p.Article in journal (Refereed)
    Abstract [en]

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

  • 24.
    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, 512-525 p.Article 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.

  • 25.
    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).
    Tekkel, Mare
    Kunst, Anton E
    Social determinants of ever initiating smoking differ from those of quitting: a cross-sectional study in Estonia.2007In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 17, no 6, 572-578 p.Article in journal (Refereed)
    Abstract [en]

    While educational level was the strongest predictor of ever initiating regular smoking, smoking cessation was related more directly to aspects of social disadvantage originating in adult life. To be effective, tobacco control interventions should not only target lower educated, but also those in material disadvantage.

  • 26. Lipsicas, Cendrine Bursztein
    et al.
    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).
    Apter, Alan
    De Leo, Diego
    Kerkhof, Ad
    Lönnqvist, Jouko
    Michel, Konrad
    Renberg, Ellinor Salander
    Sayil, Isik
    Schmidtke, Armin
    van Heeringen, Cornelis
    Vaernik, Airi
    Wasserman, Danuta
    Attempted suicide among immigrants in European countries: an international perspective2012In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 47, no 2, 241-251 p.Article in journal (Refereed)
    Abstract [en]

    This study compares the frequencies of attempted suicide among immigrants and their hosts, between different immigrant groups, and between immigrants and their countries of origin. The material, 27,048 persons, including 4,160 immigrants, was obtained from the WHO/EURO Multicentre Study on Suicidal Behaviour, the largest available European database, and was collected in a standardised manner from 11 European centres in 1989-2003. Person-based suicide-attempt rates (SARs) were calculated for each group. The larger immigrant groups were studied at each centre and compared across centres. Completed-suicide rates of their countries of origin were compared to the SARs of the immigrant groups using rank correlations. 27 of 56 immigrant groups studied showed significantly higher, and only four groups significantly lower SARs than their hosts. Immigrant groups tended to have similar rates across different centres. Moreover, positive correlation between the immigrant SAR and the country-of-origin suicide rate was found. However, Chileans, Iranians, Moroccans, and Turks displayed high SARs as immigrants despite low suicide rates in the home countries. The similarity of most immigrant groups' SARs across centres, and the correlation with suicidality in the countries of origin suggest a strong continuity that can be interpreted in either cultural or genetic terms. However, the generally higher rates among immigrants compared to host populations and the similarity of the rates of foreign-born and those immigrants who retained the citizenship of their country of origin point to difficulties in the acculturation and integration process. The positive correlation found between attempted and completed suicide rates suggests that the two are related, a fact with strong implications for suicide prevention.

  • 27. Mackenbach, Johan P
    et al.
    Stirbu, Irina
    Roskam, Albert-Jan R
    Schaap, Maartje M
    Menvielle, Gwenn
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). National Institute for Health Development, Tallinn, Estonia .
    Kunst, Anton E
    Socioeconomic inequalities in health in 22 European countries2008In: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 358, no 23, 2468-2481 p.Article in journal (Refereed)
    Abstract [en]

    We observed variation across Europe in the magnitude of inequalities in health associated with socioeconomic status. These inequalities might be reduced by improving educational opportunities, income distribution, health-related behavior, or access to health care.

  • 28. Magnusson, Sara
    et al.
    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).
    Sweden: Income and suicide2010In: Psychological Reports, ISSN 0033-2941, E-ISSN 1558-691X, Vol. 107, no 1, 157-162 p.Article in journal (Refereed)
    Abstract [en]

    Previous publications have reported two conflicting patterns describing the relationship between income and suicide in Sweden; positive and negative. Methodologically the studies have differed, and the analysis has been limited to a few areas. To better understand the relationship, a nationwide, cross-sectional, ecological study of the 290 municipalities in Sweden was planned. OLS regression analyses showed the overall and female suicide rates were negatively related to income, while the effect on male suicide rates was not statistically significant. The results confirm earlier findings of a negative relationship between income and suicide.

  • 29. McKee, M
    et al.
    Balabanova, D
    Akingbade, K
    Pomerleau, J
    Stickley, Andrew
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Rose, R
    Haerpfer, C
    Access to water in the countries of the former Soviet Union2006In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 120, no 4, 364-372 p.Article in journal (Refereed)
    Abstract [en]

    Background: During the Soviet period, authorities in the USSR invested heavily in collective farming and modernization of living conditions in rural areas. However, many problems remained, including poor access to many basic amenities such as water. Since then, the situation is likely to have changed; economic decline has coincided with migration and widening social inequalities, potentially increasing disparities within and between countries. Aim: To examine access to water and sanitation and its determinants in urban and rural areas of eight former Soviet countries. Methods: A series of nationally representative surveys in Armenia, Belarus, Georgia, Moldova, Kazakhstan, Kyrgyzstan, Russia and Ukraine was undertaken in 2001, covering 18,428 individuals (aged 18+ years). Results: The percentage of respondents Living in rural areas varied between 27 and 59% among countries. There are wide urban-rural differences in access to amenities. Even in urban areas, only about 90% of respondents had access to cold running water in their home (60% in Kyrgyzstan). In rural areas, less than one-third had cold running water in their homes (44% in Russia, under 10% in Kyrgyzstan and Moldova). Between one-third and one-half of rural respondents in some countries (such as Belarus, Kazakhstan and Moldova) obtained their water from welts and similar sources. Access to hot running water inside the homes was an exception in rural households, reflecting the tack of modern heating methods in villages. Similarly, indoor access to toilets is common in urban areas but rare in rural areas. Access to all amenities was better in Russia compared with elsewhere in the region. Indoor access to cold water was significantly more common among rural residents Living in apartments, and in settlements served by asphalt roads rather than dirt roads. People with more assets or income and living with other people were significantly more likely to have water on tap. In addition, people who had moved in more recently were more likely to have an indoor water supply. Conclusions: This was the largest single study of its kind undertaken in this region, and demonstrates that a significant number of people living in rural parts of the former Soviet Union do not have indoor access to running water and sanitation. There are significant variations among countries, with the worse situation in central Asia and the Caucasus, and the best situation in Russia. Access to water strongly correlates with socio-economic characteristics. These findings suggest a need for sustained investment in rebuilding basic infrastructure in the region, and monitoring the impact of living conditions on health.

  • 30. Menvielle, Gwen
    et al.
    Stirbu, Irina
    Roskam, Albert-Jan
    Schaap, Maartje M.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). National Institute for Health Development, Tallinn, Estonie .
    Kunst, Anton E.
    Mackenbach, Johan P.
    Les inégalités socials de mortalité en Europe: [Socioeconomic inequalities in mortality in Europe]2009In: M S.Médecine Sciences, ISSN 0767-0974, E-ISSN 1958-5381, Vol. 25, no 2, 192-196 p.Article in journal (Refereed)
  • 31. Murphy, Adrianna
    et al.
    Roberts, Bayard
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    McKee, Martin
    Social Factors Associated with Alcohol Consumption in the Former Soviet Union: A Systematic Review2012In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 47, no 6, 711-718 p.Article in journal (Refereed)
    Abstract [en]

    Aims: Alcohol consumption is a major cause of premature mortality in countries of the former Soviet Union (fSU). Despite the unique social profile of the region, we could find no published systematic review of studies of social factors and alcohol consumption in formerly Soviet countries. We aim to critically review the current evidence for social factors associated with alcohol consumption in the fSU and to identify key gaps in the literature. Methods: We searched MEDLINE, EMBASE and Global Health databases for cross-sectional, case-control, longitudinal or qualitative studies of demographic, socio-economic, psycho-social and contextual factors associated with alcohol consumption, in any language, published from 1991 until 16 December 2011. Additional studies were identified from the references of selected papers and expert consultation. Our review followed PRISMA guidelines for the reporting of systematic reviews. Results: Our search strategy resulted in 26 articles for review. Although there is strong evidence in the literature that males and smokers in the fSU are more likely to engage in hazardous alcohol consumption, findings regarding other social factors were mixed and there were almost no data on the association of contextual factors and alcohol consumption in this region. Conclusion: This review highlights the extremely limited amount of evidence for social factors associated with heavy alcohol consumption in the fSU. Given the unique social environment of countries of the fSU, future research should take these factors into account in order to effectively address the high levels of alcohol-related mortality in this region.

  • 32.
    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).
    Social Theories of Suicide2009In: Oxford Textbook of Suicidology and Suicide Prevention / [ed] Danuta Wasserman and Camilla Wasserman, Oxford: Oxford University Press , 2009, 139-147 p.Chapter in book (Other academic)
  • 33.
    Mäkinen, Ilkka Henrik
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Reitan, Therese C.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Continuity and Change in Russian Alcohol Consumption from Tsars to Transition2006In: Social history (London), ISSN 0307-1022, E-ISSN 1470-1200, Vol. 31, no 2, 160-179 p.Article in journal (Refereed)
  • 34.
    Mäkinen, Ilkka Henrik
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Suicide Mortality and Agricultural Rationalization in Post-War Europe2006In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 41, no 6, 429-434 p.Article in journal (Refereed)
    Abstract [en]

    Background The relationship between agricultural rationalization and suicide mortality has been little researched. On the basis of the hypothesis that agricultural rationalization leads to more suicide, this study investigated whether a general relationship could be found between structural change in agriculture and suicide mortality in post-war Europe. Method Due to the expected small size of the effect, the data were deliberately collected so as to maximize the variation in the independent variable. Annual national-level data on suicide mortality, the percentage of the work force in agricultural employment, and the unemployment level were collected from those countries and 10-year periods where the structural changes (reductions in employment) in agriculture between 1950 and 1995 had been most and least pronounced. In order to avoid confounders, the annual changes in the variables’ values were correlated with each other, adding a control for the level of unemployment, and allowing for lagged effects. Results The annual changes in the levels of agricultural employment and those of suicide mortality did not covary at all. Controlling for unemployment levels did not change this, nor could any lagged effects be found. Conclusions At the most general level, no causal relation between agricultural rationalization and suicide mortality was detected. This lack of a universal relation does not, however, preclude the possibility of the relationship existing given certain socio-historical circumstances.

  • 35.
    Mäkinen, Ilkka Henrik
    et al.
    Södertörn University College, School of Social Sciences, Sociology. Södertörn University College, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Wasserman, Danuta
    Labour Market, Work Environment and Suicide2009In: Oxford Textbook of Suicidology and Suicide Prevention / [ed] Danuta Wasserman and Camilla Wasserman, Oxford: Oxford University Press , 2009, 221-229 p.Chapter in book (Other academic)
  • 36. O'Hara, Sarah
    et al.
    Gentile, Michael
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Household Incomes in Central Asia: The Case of Post-Soviet Kazakhstan2009In: Eurasian geography and economics, ISSN 1538-7216, E-ISSN 1938-2863, Vol. 50, no 3, 327-347 p.Article in journal (Refereed)
    Abstract [en]

    Two European geographers present the findings of a sizeable survey (n = 7,5 15) providing a detailed geographical analysis of household incomes and reliance on personal subsidiary garden plots across Kazakhstan. The authors focus on assessing the extent to which Kazakhstan's rising GDP during the post-Soviet period has coincided with an increase in the general population's personal income and ability to secure adequate food supplies for personal consumption. The fine geographical scale of analysis of the survey data (significantly less coarse than oblast-level data) enabled them to identify regions characterized by "trickle-down" income, largely centered on the country's two main urban centers and areas of resource exploitation. The patterns revealed in the paper have relevance to the debate concerning the uneven distribution of benefits from resource exploitation (notably oil and gas) to Kazakhstan's population.

  • 37. O'Hara, Sarah
    et al.
    Ivlevs, Artjoms
    Gentile, Michael
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    The Impact of Global Economic Crisis on Remittances in the Commonwealth of Independent States2009In: Eurasian geography and economics, ISSN 1538-7216, E-ISSN 1938-2863, Vol. 50, no 4, 447-463 p.Article in journal (Refereed)
    Abstract [en]

    Two European geographers and an economist analyze the impact of the 2008-2009 global economic recession on remittances in the Commonwealth of Independent States. Drawing on balance-of-payments data as well as information on money transfers to and from the region, they detail the annual growth of remittances since 2001, illustrating the growing importance of this income stream to a number of countries in the region. Using quarterly data, they then provide details of the impact of the financial crisis on remittances starting with the 2007 credit crunch and intensifying with the collapse of global markets in 2008. Based on the impact of the 1998 Russian Crisis, they suggest that by 2012, remittances to the region could fall to only one-third the 2008 level, and that a return to pre-crisis levels of remittances could take almost a decade.

  • 38. Oja, Leila
    et al.
    Matsi, Ardo
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Estonian Health Interview Survey 2006: Methodological report2008Report (Other academic)
  • 39. Plug, Iris
    et al.
    Hoffmann, Rasmus
    Artnik, Barbara
    Bopp, Matthias
    Borrell, Carme
    Costa, Giuseppe
    Deboosere, Patrick
    Esnaola, Santi
    Kalediene, Ramune
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Lundberg, Olle
    Martikainen, Pekka
    Regidor, Enrique
    Rychtarikova, Jitka
    Strand, Bjorn Heine
    Wojtyniak, Bogdan
    Mackenbach, Johan P
    Socioeconomic inequalities in mortality from conditions amenable to medical interventions: do they reflect inequalities in access or quality of health care?2012In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, 346Article in journal (Refereed)
    Abstract [en]

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

  • 40. Razvodovsky, Y
    et al.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Suicide in urban and rural regions of Belarus, 1990-20052009In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 123, no 1, 27-31 p.Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the occurrence of suicide in urban and rural regions of Belarus in the post-Soviet Period. Study design: Unlinked cross-sectional study using data drawn from four time points. Methods: Age- and gender-specific suicide data for urban and rural regions of Belarus were obtained from the Belarus Ministry of Statistics for the years 1990, 1995, 2000 and 2005. The data were recalculated into seven age categories and then directly standardized. Poisson regression models were used to assess changes ill urban-rural suicide rate ratios across the four time points. Results: Between 1990 and 2000, the suicide rate rose sharply in Belarus. It started to reduce after 2000, but in 2005 it was still much higher than its initial level. The same was true for urban and rural suicide rates and for male Suicide rates in all regions combined. However, after 1995, there was a divergence between gender-specific rates in urban and rural areas. A small reduction in urban suicide rates for both genders contrasted with a sharp increase in suicide rates among trien and women in rural areas. By 2005, although suicide rates had fallen from their 2000 level for both genders in urban and rural locations, the decrease was much smaller in rural areas. These changes resulted in a deteriorating rural-urban suicide ratio across the period 1990-2005, with suicide rates among nearly every rural male age group remaining extreme after 1995. Although it is probable that a deteriorating social and economic situation has underpinned increasing suicide rates in all regions, there may be factors that are specific to rural locations, such as increasing social isolation and poor provision of medical services, that account for the extreme suicide rates now being recorded there. Conclusion: By 2005, Belarus had one of the highest suicide rates in the world. This now requires urgent intervention by the necessary authorities to ameliorate this situation in urban and, especially, rural locations.

  • 41.
    Roberts, Bayard
    et al.
    London School of Hygiene and Tropical Medicine, London, UK.
    Gilmore, Anna
    University of Bath, Bath, UK.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). London School of Hygiene and Tropical Medicine, London, UK / University of Tokyo, Tokyo, Japan.
    Rotman, David
    Belarussian State University, Minsk, Belarus.
    Prohoda, Vladimir
    Lomonosov Moscow State University, Moscow, Russia.
    Haerpfer, Christian
    Aberdeen University, Aberdeen, Scotland.
    McKee, Martin
    London School of Hygiene and Tropical Medicine, London, UK.
    Changes in Smoking Prevalence in 8 Countries of the Former Soviet Union Between 2001 and 20102012In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 102, no 7, 1320-1328 p.Article in journal (Refereed)
    Abstract [en]

    Objectives. We sought to present new data on smoking prevalence in 8 countries, analyze prevalence changes between 2001 and 2010, and examine trend variance by age, location, education level, and household economic status. Methods. We conducted cross-sectional household surveys in 2010 in Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine. We compared smoking prevalence with a related 2001 study for the different countries and population subgroups, and also calculated the adjusted prevalence rate ratios of smoking. Results. All-age 2010 smoking prevalence among men ranged from 39% (Moldova) to 59% (Armenia), and among women from 2% (Armenia) to 16% (Russia). There was a significantly lower smoking prevalence among men in 2010 compared with 2001 in Belarus, Kazakhstan, Kyrgyzstan, and Russia, but not for women in any country. For all countries combined, there was a significantly lower smoking prevalence in 2010 than in 2001 for men aged 18 to 39 years and men with a good or average economic situation. Conclusions. Smoking prevalence appears to have stabilized and may be declining in younger groups, but remains extremely high among men, especially those in lower socioeconomic groups. (Am J Public Health. 2012;102:1320-1328. doi:10.2105/AJPH.2011.300547)

  • 42. Roberts, Bayard
    et al.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Balabanova, Dina
    Haerpfer, Christian
    McKee, Martin
    The persistence of irregular treatment of hypertension in the former Soviet Union2012In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 66, no 11, 1079-1082 p.Article in journal (Refereed)
    Abstract [en]

    Background Hypertension is one of the leading causes of avoidable mortality in the former Soviet Union (fSU). In previous work, the authors described patterns of irregular hypertension treatment in eight countries of the fSU in 2001. This paper presents new data on changes in the use of hypertension treatment in the same countries. Methods Using household survey data from 18 420 (2001) and 17 914 (2010) respondents from Armenia, Azerbaijan (2010 only), Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine, the authors describe changes in rates of irregular treatment use (less than daily) between 2001 and 2010. Multivariate logistic regression was also used to analyse the characteristics associated with irregular treatment. Results Irregular treatment was extremely high at 74% in 2001 and only fell to 68% in 2010 (all countries combined). Irregular treatment remained particularly high in 2010 in Armenia (79%), Kazakhstan (73%) and Moldova (73%). Recurring characteristics associated with irregular treatment included gender (men), younger age, higher fitness levels, and consuming alcohol and tobacco. Conclusions Irregular hypertension treatment continues to be a major problem in the countries of the fSU and requires an urgent response.

  • 43. Roberts, Bayard
    et al.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Balabanova, Dina
    McKee, Martin
    Irregular treatment of hypertension in the former Soviet Union2012In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 66, no 6, 482-488 p.Article in journal (Refereed)
    Abstract [en]

    Background The USSR failed to establish a modern pharmaceutical industry and lacked the capacity for reliable distribution of drugs. Patients were required to pay for outpatient drugs and the successor states have inherited this legacy, so that those requiring long-term treatment face considerable barriers in receiving it. It was hypothesised that citizens of former Soviet republics requiring treatment for hypertension may not be receiving regular treatment. Aims To describe the regularity of treatment among those diagnosed with hypertension and prescribed treatment in eight countries of the former Soviet Union, and explore which factors are associated with not taking medication regularly. Methods Using data from over 18 000 respondents from eight former Soviet countries, individuals who had been told that they had hypertension by a health professional and prescribed treatment were identified. By means of multivariate logistic analysis the characteristics of those taking treatment daily and less than daily were compared. Results Only 26% of those prescribed treatment took it daily. The probability of doing so varied among countries and was highest in Russia, Belarus and Georgia, and lowest in Armenia ( although Georgia's apparent advantage may reflect low rates of diagnosis). Women, older people, those living in urban areas, and nonsmokers and non-drinkers were more likely to take treatment daily. Conclusions A high proportion of those who have been identified by health professionals as requiring hypertension treatment are not taking it daily. These findings suggest that irregular hypertension treatment is a major problem in this region and will require an urgent response.

  • 44. Roberts, Bayard
    et al.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Gasparishvili, Alexander
    Haerpfer, Christian
    McKee, Martin
    Changes in household access to water in countries of the former Soviet Union2012In: Journal of Public Health, ISSN 2198-1833, E-ISSN 1613-2238, Vol. 34, no 3, 352-359 p.Article in journal (Refereed)
    Abstract [en]

    Background Evidence from the Early 2000s quantified limited coverage of household water supplies in countries of the former Soviet Union. The study objectives were to measure changes in access to piped household water in seven of these countries between 2001 and 2010 and examine how these varied by household economic status. Methods Cross-sectional household sample surveys were conducted in 2010 in Armenia, Belarus, Georgia, Kazakhstan, Moldova, Russia and Ukraine. Data on household piped water were compared with a related 2001 study and descriptive, regression and relative risk analyses applied. Results Increases in access to piped water in the home between 2001 and 2010 were recorded in urban and rural areas of all countries, except Kazakhstan. Access remains lower in rural areas. The relative risk of urban households not having piped water in 2010 compared with 2001 diminished by one-third for households with a bad/very bad economic situation [rate ratio (RR): 0.66] and by half for wealthier households (RR: 0.48). In rural areas, the declines were 15% for households with a bad/very bad economic situation (RR: 0.85) and 30% for wealthier households (RR: 0.69). Conclusions Despite encouraging increases in access to piped water, there remain significant gaps for rural and poorer households.

  • 45. Roberts, Bayard
    et al.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Murphy, Adrianna
    Kizilova, Kseniya
    Bryden, Anna
    Rotman, David
    Haerpfer, Christian
    McKee, Martin
    Patterns of Public Support for Price Increases on Alcohol in the Former Soviet Union2012In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 47, no 4, 473-478 p.Article in journal (Refereed)
    Abstract [en]

    Aims: To measure levels of public support for price increases on beer and spirits in nine former Soviet Union countries and to examine the characteristics influencing such support. Methods: Cross-sectional surveys were conducted in 2010 with 18,000 respondents aged 18+ in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Descriptive and multivariate logistic regression analyses were used. Results: The lowest level of support for price increases on beer were in Georgia (men 5%, women 9%) and Armenia (men 5%, women 11%); and the highest were in Kyrgyzstan (men 30%, women 38%), Azerbaijan (men 27%, women 37%) and Russia (men 23%, women 34%). The lowest levels of support for price increases on spirits were Armenia (men 8%, women 14%) and Georgia (men 14%, women 21%); and the highest were in Kyrgyzstan (men 38%, 47% women) and Moldova (men 36%, women 43%). Characteristics associated with supporting price increases included gender (women), higher education, good economic situation, lower alcohol consumption and greater knowledge of harmful alcohol behaviour. Conclusion: Alcohol price increases are an effective means to reduce hazardous alcohol use. Despite opposition in some groups, there is evidence of public support for alcohol price increases in the study countries.

  • 46. Roberts, Bayard
    et al.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Petticrew, Mark
    McKee, Martin
    The influence of concern about crime on levels of psychological distress in the former Soviet Union2012In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 66, no 5, 433-439 p.Article in journal (Refereed)
    Abstract [en]

    Background Previous studies suggest that the fear of crime is associated with worse mental health, with social capital potentially having a mediating influence. However, no studies could be identified on this issue in countries of the former Soviet Union, despite them experiencing increasing rates of crime and profound social change. The aim of this study is to explore the relationship between concern about crime and levels of psychological distress in eight countries of the former Soviet Union. Methods Cross-sectional surveys were conducted in eight former Soviet countries using a standardised questionnaire containing items on psychological distress and concern about five criminal activities. Regression analysis was used to investigate the association between concern about criminal activities and psychological distress. Separate regression models were run to explore the influence of social capital on this relationship. Results The first model (excluding social capital) produced significant positive coefficients of association for all five types of criminal activity with psychological distress, with a range from 0.39 (95% CI 0.24 to 0.54) for suffering abuse because of nationality to 0.56 (95% CI 0.42 to 0.70) for being sexually molested. The second model (including social capital) also showed significant associations for all five criminal activities, but coefficients were slightly smaller. Conclusion This study provides preliminary evidence of a relationship between fear of crime and psychological distress in the study countries, with possibly a small mediating influence of social capital. Further studies are required to explore the relationship between fear of crime, social capital and mental health in the region.

  • 47.
    Rodin, Johnny
    Södertörn University, Centre for Baltic and East European Studies (CBEES). Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Fertility Intentions and Risk Management: Exploring the Fertility Decline in Eastern Europe During Transition2011In: Ambio, ISSN 0044-7447, E-ISSN 1654-7209, Vol. 40, no 2, 221-230 p.Article in journal (Refereed)
    Abstract [en]

    Between 1985 and 1995, fertility in Eastern Europe declined from 2.2 children per woman to merely 1.5 on region-average. Previous research has emphasized mainly the economic turmoil during transition or the influx of new ideas regarding fertility and family relations. This article suggests that applying a risk management perspective on fertility patterns may put additional light on the reasons behind the fertility decline in post-communist Europe. The complexity of modern social systems has made people increasingly dependent on the state for risk evaluation and risk management. The article formulates the hypothesis that transition itself disrupted the mental models that helped people to navigate among the risks associated to having and raising children. Left to their own devices, women in Eastern Europe became more inclined to postpone childbirth or discard this option altogether.

  • 48.
    Rojas, Yerko
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Carlson, Per
    Mid Sweden University.
    Too poor to binge?: An examination of economic hardship and its relation to alcohol consumption patterns in Taganrog, Russia2008In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 36, no 3, 330-333 p.Article in journal (Refereed)
  • 49. Schaap, M. M.
    et al.
    Kunst, Anton E.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). National Institute for Health Development, Tallinn, Estonia .
    Regidor, Enrique
    Ekholm, Ola
    Dzurova, D.
    Helmert, Uwe
    Klumbiene, Jurate
    Santana, P.
    Mackenbach, Johan P.
    Effect of nationwide tobacco control policies on smoking cessation in high and low educated groups in 18 European countries2008In: Tobacco Control, ISSN 0964-4563, E-ISSN 1468-3318, Vol. 17, no 4, 248-255 p.Article in journal (Refereed)
    Abstract [en]

    Background: Recently a scale was introduced to quantify the implementation of tobacco control policies at country level. Our study used this scale to examine the potential impact of these policies on quit ratios in European countries. Special attention was given to smoking cessation among lower educational groups. Methods: Cross-sectional data were derived from national health surveys from 18 European countries. In the analyses we distinguished between country, sex, two age groups (25-39 and 40-59 years) and educational level. Age-standardised quit ratios were calculated as total former-smokers divided by total ever-smokers. In regression analyses we explored the correlation between national quit ratios and the national score on the Tobacco Control Scale (TCS). Results: Quit ratios were especially high (> 45%) in Sweden, England, The Netherlands, Belgium and France and relatively low (< 30%) in Lithuania and Latvia. Higher educated smokers were more likely to have quit smoking than lower educated smokers in all age-sex groups in all countries. National score on the tobacco control scale was positively associated with quit ratios in all age-sex groups. The association of quit ratios with score on TCS did not show consistent differences between high and low education. Of all tobacco control policies of which the TCS is constructed, price policies showed the strongest association with quit ratios, followed by an advertising ban. Conclusion: Countries with more developed tobacco control policies have higher quit ratios than countries with less developed tobacco control policies. High and low educated smokers benefit about equally from the nationwide tobacco control policies.

  • 50. Schaap, Maartje M
    et al.
    Kunst, Anton E
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, 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 countries2009In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 68, no 7, 1271-1278 p.Article in journal (Refereed)
    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.

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