Scandinavian Journal of Public Health最新文献

Aims: The COVID-19 pandemic provided a unique opportunity to assess how infected patients viewed risk. We investigated whether cases infected early in the pandemic had assessed the risk to be lower, been more exposed and took fewer precautions to prevent infection.

Methods: We asked first-wave Norwegian COVID-19 patients (n = 88) to recall how they had thought about risk of infection, exposure in potential infectious situations and their compliance to infection control measures early in the pandemic. Answers from this group were compared WITH emergency room patients with non-pulmonary complaints (n = 75) and with a nationally representative sample (n = 4083).

Results: Both patient groups saw the risk as lower than did the representative sample. Contact with infected people was more frequent for the COVID-19 patients than for the other patients. More of the COVID-19 patients had travelled abroad immediately before the outbreak. COVID-19 patients complied less with the infection control measures than did the representative sample. The COVID-19 patients agreed less than the other patients with a statement that they had 'complied in general'.

Conclusions: Risk-behaviour was overrepresented among the first COVID-19 patients. Potential memory artefacts should be considered when interpreting the results.

Aims: This study aimed to investigate how hospitals navigate financial coverage of healthcare for undocumented migrants, given the present laws and regulations in Norway.

Methods: This qualitative study used an explorative approach. We collected and studied hospital guidelines for registering and invoicing foreign patients, and interviewed hospital staff from two university hospitals, and undocumented migrants at one non-governmental clinic in Oslo. The first author collected 14 documents and conducted 14 semi-structured, in-depth interviews. The project team used a thematic-analysis-inspired approach to identify patterns of shared meaning in the guidelines and interviews.

Results: We found that the hospital guidelines did not account for undocumented migrants. The staff had to navigate between the guidelines and practical implications of undocumented migrant patients not having a resident permit and thus lacking a Norwegian identity number, bank card, or address. We found discrepancies between different staff's expected roles in the registration of patients and in the assessment of patients' ability to pay. The guidelines presumed an active patient and required documentation, which undocumented migrants had difficulty meeting.

Conclusions: The underlying assumption of patients being documented in routines led to a process of othering of undocumented patients and thereby reproducing their marginalised position in the health system, hence depriving them of the right to 'health care that is absolutely necessary and cannot wait'. We recommend that hospitals increase staff's knowledge and capacity to ensure undocumented migrants' right to healthcare.

Aims: People with intellectual disability experience stark health inequalities, often because of poor access to mainstream healthcare. This scoping review aimed to identify factors that influence access to healthcare for people with intellectual disability using Levesque and colleagues' comprehensive framework of healthcare access.

Method: This review followed Joanna Briggs Institute guidelines. Articles were identified and retrieved from CINAHL, PsycINFO, PubMed and EMBASE. Two reviewers completed abstract and full-text screening, addressing any conflicts at each stage. Data was extracted and coded deductively, according to the supply (healthcare provider) and demand (healthcare seeker) dimensions of Levesque and colleagues' framework.

Results: Following search and screening, 66 references were included for review. Barriers to healthcare were more frequently identified in the literature compared to facilitators, with most information relating to supply-side dimensions. Barriers were related to inaccessible health information, low health literacy, stigma and discrimination by healthcare providers, and lack of organisational support, training and resourcing in both healthcare and support sectors. Facilitators often involved specialist workforces, strong interpersonal skills among healthcare providers, and advocacy from supporters. Importantly, findings indicated that both sociohistorical processes and support networks are necessary to understanding access experiences for people with intellectual disability.

Conclusions: Greater efforts are required internationally to ensure the health rights of people with intellectual disability, to eliminate discrimination, and provide the support and resources necessary for all stakeholders to facilitate healthcare access. Models of healthcare access for people with intellectual disability should consider both the role of supporters and the sociohistorical context within which healthcare access occurs.

Aims: Social cohesion has been reported to influence various health outcomes positively. However, inconsistent results were reported regarding the effects of social cohesion dimensions on the COVID-19 mortality rate (MR). Most studies have indicated that trust in civil services but not participating in social activities reduces COVID-19 mortality, possibly because of the highly contagious nature of this disease. In this study, we investigated how the effects of various dimensions of social cohesion on COVID-19 MR vary across different phases of the pandemic.

Methods: This study used data from 86 countries participating in the 2017-2020 World Values Survey. The measures of social cohesion were identified by aggregating responses to the country level. COVID-19 MR was calculated-using data from the European Centre for Disease Prevention and Control-separately for three distinct periods during the pandemic: 13 January 2020-8 November 2020; 9 November 2020-5 September 2021; and 6 September 2021-20 June 2022. An exploratory factor analysis (EFA) was conducted to identify the dimensions of social cohesion, and negative binomial regression models were constructed to analyze data for each period.

Results: The EFA results revealed three dimensions of social cohesion: social participation and inclusion, health service equality, and trust in civil services and democracy. COVID-19 MR was negatively associated with trust in civil services and democracy during the early two periods and with social participation and inclusion during the late period.

Conclusions: Each social cohesion dimension uniquely contributed to reducing the COVID-19 MR in different pandemic periods.

Aims: To explore whether a family-based intervention with playful activities among overweight and obese Norwegian children promoted moderate to vigorous and light physical activity compared with a waiting list control group, and to examine whether gross motor competence, isometric body mass index and motivational factors, as reported by the children and their parents, could explain changes observed during a six-month observation.

Methods: A non-randomized cluster-controlled trial with 131 participants, 76 in the intervention group. Participants were aged 6-12 years, and 55 were boys. We performed linear regressions to compare the intervention and the control groups and adjusted linear models to examine predictors for outcomes with the groups merged into one cohort.

Results: We could not demonstrate any intervention effect from the family-based activities. Moderate to vigorous physical activity levels were satisfactory at the start and were maintained during the observation period. None of the predictors could explain outcome status at six months, nor residual change of moderate to vigorous physical activity during the observation. We revealed that parental educational attainment, parental autonomous motivation and the participants' experience of social support impacted light physical activity negatively after six months. Parental education also impacted the residual change of light physical activity negatively during the observation.

Conclusions: The present family-based intervention to improve physical activity among overweight and obese children was ineffective. Baseline activity levels were already satisfactory. Paradoxically, factors such as parental socioeconomic status, autonomous motivation and self-reported support from parents and peers may be associated with diminished physical activity in such contexts. These unexpected findings need to be validated in further studies.

Aims: CUSTOM is a culturally sensitive diabetes self-management education and support programme tailored to Urdu, Turkish and Arabic-speaking people in Denmark. The aim of this study was twofold: first, to examine the functional social support perceived by CUSTOM participants before and after the intervention; and, second, to explore how participants' structural social support affected the physical and mental health benefits of the intervention.

Methods: The participants were people with type 2 diabetes whose primary language was Urdu, Arabic or Turkish (n = 73). Outcomes included A1C, body fat percentage, diabetes distress, well-being and functional social support. Changes were observed between baseline and six months after participation in a single-group pre-test/post-test design. The Cochran-Armitage trend test was used to assess pre-post differences in functional social support. The role of structural social support was assessed using moderation regression analysis.

Results: Participants reported higher availability of functional social support after the programme (p < 0.05), although the change in loneliness was not significant. In addition, cohabitating with adult children increased the average body fat percentage reduction achieved following the programme, while living with a partner lowered the average body fat percentage reduction achieved. The intervention was particularly successful in improving diabetes distress among those with weak structural social support.

Conclusions: Culturally sensitive diabetes self-management education and support can improve social support among people with an ethnic minority background. The structure of social relations may influence the benefit of culturally sensitive diabetes self-management education and support. Future programmes should include family members and other social relations more actively, drawing attention to both positive and negative aspects of social relations.

Aims: The aim of the present study was to analyse trends in full breastfeeding for at least 4 months across socioeconomic position in Denmark over a 17-year-long period from 2002 to 2019 using parental education as the indicator of socioeconomic position.

Methods: The study used data on full breastfeeding collected between 2002 and 2019 by community health nurses in the collaboration Child Health Database, n=143,075. Data were linked with five categories of parental education from population registers. Social inequality was calculated as both the relative (odds ratio) and absolute social inequality (slope index of inequality). A trend test was conducted to assess changes in social inequality over time.

Results: A social gradient in full breastfeeding was found for the entire study period. The odds ratio for not being fully breastfed for at least 4 months ranged from 3.30 (95% confidence interval 2.83-3.84) to 5.09 (95% confidence interval 4.28-6.06) during the study period for infants of parents with the lowest level of education (primary school) compared with infants of parents with the highest level of education (5+ years of university education). The slope index of inequality was between -38.86 and -48.81 during the entire study period, P=0.80. This indicated that both the relative and absolute social inequality in full breastfeeding to at least 4 months of age was unchanged in the study period from 2002 to 2019.

Conclusions: This study showed a persistent relative and absolute social inequality in full breastfeeding for at least 4 months from 2002 to 2019 in Denmark.

Objective: To investigate the longevity of a large sample of Olympic Games participants, considering the interaction between different types of sports and medal awards.

Methodolgy: Data scraping from Wikipedia and Wikidata allowed us to collect a sample of 102,993 famous athletes. We selected 20 of the most populated disciplines to make the groups comparable. We conducted a comparison of life duration on a subset of 17,194 elite athletes, predominantly male, dead at the time of analysis.

Results: Olympic medalists' lifespan was shorter than non-medalists. Athletes in such disciplines as boxing, weightlifting, ice hockey, cycling, football, swimming, and wrestling lived significantly shorter lives than the mean of the group of athletes. In contrast, the duration of life in athletes involved in athletics, rowing, fencing, artistic gymnastics, shooting, cross-country skiing, sailing, and equestrian sports was highest compared with the mean of the group.

Conclusions: Disciplines classified as engaging mostly power were linked to shorter lifespans, whereas those involving predominantly skill were associated with longer life durations. The interaction of being a medalist and sport was found to be significant. Medalists in the disciplines of athletics, basketball, boxing, equestrian sports, wrestling, and water polo had significantly shorter lives (the final item was insignificant after correction for multiple comparisons). Olympic achievement was linked to length of life in mainly individual, not team, sports.

Aims: The sense of coherence scale has been shown to have an epidemiological relationship with mortality. This study aimed to investigate how the three components of sense of coherence (meaningfulness, comprehensibility and manageability) and the individual items of these components relate to mortality.

Methods: Eastern Finnish men (n=2315) aged 42-60 years at baseline in the 1980s completed a 12-item sense of coherence scale and were followed for 25 years, on average, until death or until the end of 2019. Hazard ratios for mortality were calculated using two models: one adjusted for age and the second for an additional 12 mortality risk factors.

Results: Of the three sense of coherence components, only meaningfulness was associated with all-cause mortality, and in the fully adjusted model, those in the weakest tertile had a 1.14 (95% confidence interval 1.01-1.29, P=0.042) times higher hazard ratio for mortality than those in the strongest tertile. Of the individual sense of coherence items, only the first question, 'How often do you have the feeling that you really don't care about what is going on around you?', was associated with all-cause mortality, and in the fully adjusted Cox model, the hazard ratio of weak versus strong was 1.18 (95% confidence interval 1.03-1.36, P=0.020).

Conclusions: The sense of coherence component related to meaningfulness, including its first item, 'Caring about what goes on around you', plays a significant role in the association with mortality among middle-aged men in Eastern Finland. This item should be considered a noteworthy patient-reported variable when predicting mortality in public health settings.

Aims: To examine age-group and birth-cohort trends in perceived work ability in Finland in 2000-2020 and make projections of perceived work ability up to 2040 based on the observed birth-cohort development. Methods: Ten population-representative cross-sectional surveys conducted in Finland between 2000 and 2020 were used (overall N = 61,087, range 817-18,956). Self-reported estimates of current work ability in relation to the person's lifetime best on a scale from zero to ten (0-10) were classified into three groups: limited (0-5), intermediate (6-7), and good (8-10). Multiple imputation was used in projecting work ability. Results: Examining past trends by 5-year birth-cohorts born between 1961 and 1995 showed that work ability has declined steadily over time among older birth-cohorts, while in the two younger cohorts a stable development before 2017 and a steep decline between 2017 and 2020 was seen. Trends by 5-year age groups showed a declining trend of good work ability among 20-44-year-olds, a stable trend among 45-54-year-olds, and an improving trend among 55-year-olds and older was observed for the period 2000-2020. Among the under 55-year-olds the prevalence of good work ability ended up around 75% and at 68% among the 55-59-year-olds, 58% among the 60-69-year-olds and 49% among the 70-74-year-olds in 2020. Birth-cohort projections suggested a declining work ability in the future among all age groups included (30-74 years). By 2040, the prevalence of good work ability is projected to decline by 10 to 15 percentage points among 45-74-year-olds. Conclusions: The projections suggest declining work ability in the future. Efforts to counteract the decline in work ability are needed.