Scandinavian Journal of Public Health最新文献

Aims: The Red Noses Culturally-Sensitive Stigma Survey (RN-CSS) contributes to the underexplored research domain of adolescents' stigmatising attitudes and behaviours towards peers with mental health difficulties and mental healthcare services. It also addresses the need for comprehensive and culturally-sensitive tools to assess stigma in this context.

Methods: Drawing on insights from focus groups and building upon the existing Stigma in Global Context-Mental Health Study, we have successfully developed and implemented the first culturally-sensitive stigma survey tailored for school-aged adolescents of different migration/cultural backgrounds. The questionnaire includes an unlabelled case vignette depicting a peer with symptoms of depression and gathers data on various domains, including (1) sociodemographic variables; (2) education-related information; (3) COVID-19; (4) perceptions of mental health difficulties and mental healthcare services (i.e. severity assessment, causal attributions, care recommendations, personal stigma, perceived stigma, and service stigma); (5) subjective wellbeing and familiarity with mental health difficulties; (6) social support; (7) school context; (8) bullying; and (9) knowledge of anti-stigma campaigns.

Results: Our final sample comprises 5075 pupils from 38 secondary schools in Flanders, Belgium.

Conclusions: In this article, we present the study's background and rationale, the development of the questionnaire, and the sampling and recruitment methods employed. Furthermore, we provide a summary of the sample characteristics and preliminary descriptive results of the RN-CSS. Subsequent empirical studies will address the research objectives outlined in this protocol paper. The research opportunities provided by the developed materials and dataset are being discussed.

Aims: Childhood family environment is associated with adulthood health behaviours and cardiovascular health, but limited data are available concerning the relationship between childhood family environment and adulthood haemodynamic determinants of blood pressure. We evaluated how childhood family environment predicts adulthood systemic haemodynamics.

Methods: The sample came from the Cardiovascular Risk in Young Finns Study (n=1554-1620). Childhood family environment (1980) was assessed with four cumulative risk scores: socioeconomic family risk, risky emotional family atmosphere, stressful life events, and parents' risky health behaviours. Haemodynamic outcomes in 2007 (participants being 30-45 year-olds) included stroke volume index, systemic vascular resistance index, cardiac output index and heart rate. Analyses were adjusted for childhood (1980) cardiovascular risk factors (high-density lipoprotein and low-density lipoprotein cholesterol, triglycerides, insulin, body mass index and systolic blood pressure); and adulthood (2007) health behaviours (alcohol consumption, smoking, physical activity); and finally for adulthood cardiovascular risk factors.

Results: When adjusted for age and sex, high socioeconomic family risk predicted lower stroke volume index (P=0.001), higher heart rate (P=0.001) and higher systemic vascular resistance index (P=0.030). These associations remained after controlling for childhood cardiovascular covariates or adulthood health behaviours (P⩽0.02 for all) but diluted after controlling for adulthood cardiovascular risk factors. The other childhood cumulative risk scores (stressful life events, risky emotional atmosphere, or parents' risky health behaviour) did not predict adulthood haemodynamic outcomes.

Conclusions: High childhood socioeconomic family risk predicted adulthood haemodynamic outcomes independently of childhood cardiovascular risk factors and adulthood health behaviours, while other childhood psychosocial adversities were not associated with cardiovascular function in adulthood.

Aims: Sleep problems constitute a significant public health problem due to their high prevalence and impact on mental health and health behaviours, with major consequences for individuals and society. Therefore, the aim of this study was to investigate the association between sleep problems (duration and quality), mental health and health behaviours.

Methods: Cross-sectional data was derived from the 2021 health survey 'How are you?' from the Central Denmark Region. The study population was a stratified random sample of 33,925 respondents aged 16 years or older. We used logistic regression models to analyse the associations between sleep problems and indicators of mental health and health behaviour. The models were adjusted for sex, age, educational attainment, labour market attachment, cohabitation, and indicators of mental health and health behaviour.

Results: A prevalence of around 10% for both short- and long sleep duration and poor sleep quality was found. All were associated with poor mental health-related quality of life, depression, stress, perceived stressors and obesity. In addition, short sleep duration was associated with daily smoking, and long sleep duration was associated with physical inactivity and daily smoking.

Conclusions: Our findings revealed a stronger association between sleep problems and mental health indicators in comparison to health behaviours. We found that sleep duration and sleep quality in broad terms were associated with similar variables within mental health and health behaviour. These findings underline the importance of adopting a comprehensive approach to addressing sleep problems in the context of health promotion, disease prevention, treatment and rehabilitation.

Background: Health and social care staff play a significant role in detecting and reporting abuse among persons with dementia. However, they are often left to their own judgements which can lead to elder abuse not being detected or acted on. The aim was to explore what healthcare and social care staff consider elder abuse, and their experience of elder abuse perpetrated by family members of persons with dementia.

Methods: This mixed-method vignette study was conducted in Sweden during the year 2021. In total 39 staff working in dementia care were included. They first answered the Caregiver Scenario Questionnaire and then participated in a group interview.

Results: An inconsistency was revealed regarding whether a management strategy for behavioural difficulties included in the Caregiver Scenario Questionnaire should be considered an abusive act or not. No participants were able to identify all five abusive behaviour management strategies. Participants described witnessing 101 abusive acts including different types of abuse of a person with dementia, with emotional/psychological abuse and neglect being most common.

Conclusions: Health and social care staff who work close to older persons are able to detect abuse perpetrated by family members. However, inconsistency in defining abusive acts demonstrates the uncertainty in identifying abuse. This may lead to abuse not being identified, but it also creates feelings of inadequacy among staff.

Aims: School non-completion is a public health and educational concern in most countries. This study sought to identify the strongest predictors of the non-completion of upper secondary education based on register data.

Methods: A cross-validated elastic net regression analysis was used to predict school non-completion in a population of 2696 students in the city of Jyväskylä, Finland. The register data included data from the primary social and healthcare register and the educational register.

Results: The non-completion rate was 13.1% (13.4% for males, 12.8% for females). The non-completion of upper secondary education was best predicted by the following seven features (ordered from strongest to weakest): unauthorized absences (odds ratio (OR) = 2.27), out-of-home placement (OR = 2.23), average grade when leaving lower secondary education (OR = 0.73), an anxiety/depression diagnosis (OR = 1.43), visits to child guidance and family counselling centres (OR = 1.17), family poverty (OR = 1.11) and the grade point average in the 5th Grade (OR = 0.95).

Conclusions: Register data can be utilized to find the strongest predictors of school non-completion. Predictors support multidisciplinary actions preventing non-completion by providing both early signals to target actions more specifically and indicators for monitoring the impact of preventative actions.

Aims: To investigate 20-year trends in social participation among the oldest old (77+ years) in Sweden and assess the extent to which changes in educational attainment and functional abilities explain these trends.

Methods: Seven waves of the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) spanning 2002-2021 were used with a repeated cross-sectional design. To analyse the association between time and social participation we employed the Karlson-Holm-Breen method of decomposition. The study focused on informal social participation (contact with friends and family), leisure participation (public or semi-public gatherings), and formal participation (organisational engagement and study circle attendance).

Results: Both leisure and informal participation peaked in 2014 and declined in 2021, influenced by the COVID-19 pandemic, whereas formal participation showed a slight increase in 2021. Total participation increased at least until 2011. Overall, older adults have increased their levels of social participation in recent decades, disregarding the influence of the pandemic. Decomposition analysis revealed that population-level changes in educational attainment and functional abilities explained a substantial portion of the observed trends.

Conclusions: As the proportion of older adults continues to rise, it becomes increasingly important to understand the developments and drivers of behavioural change in the older population. As more people are socially active, there may be increasing differences between those participating and those not - which could lead to increased inequalities. The observed trend in increasing participation, influenced by changes in education and health, emphasises the importance of fostering age-friendly environments and addressing potential social inequalities among older adults.

Aim: High blood pressure (BP) is a key contributor to the burden of disease. This study aimed to assess: a) educational differences across the entire BP distribution, and b) educational differences in the trajectories of BP across the adult life course.

Method: Longitudinal data from the Stockholm Diabetes Prevention Program was analysed using quantile regression and linear mixed effects models. Models were adjusted for age, sex, lifestyle, and BP medication.

Results: Lower educational level was associated with higher systolic BP (SBP) at all follow-up periods. Age and sex adjusted mean SBP was 2.49 (95% confidence interval (CI) 1.10, 3.87), 3.95 (95% CI 2.45, 5.45) and 2.61 (95% CI 1.09, 4.13) mmHg higher for people with pre-secondary education compared with post-secondary at baseline, 10 years and 20 years follow-up, respectively. Quantile regressions revealed that the inequalities could be observed across the entire BP continuum. Longitudinally analysed, people with pre-secondary education had 3.01 (95% CI 1.91-4.11) mmHg higher SBP than those with post-secondary education, age and sex adjusted. No significant convergence or divergence of the educational gaps in SBP was observed. Educational differences remained even after adjusting for lifestyle and BP medication.

Conclusions: These results imply that public health interventions should aim to bring about distributional shifts in blood pressure, rather than exclusively focusing on hypertensive people, if they are to effectively minimize the educational disparities in blood pressure and its consequences.

This debate article discusses the use of fixed effects models for causal analysis, with reference to an article recently published in Scandinavian Journal of Public Health.

Aims: This longitudinal study evaluated the association between childhood family structure and health-related quality of life (HRQoL) at middle age.

Methods: The data on childhood family structure at the age of 14 years ('two-parent family', 'one parent not living at home/no information on father' and 'father or mother deceased') and HRQoL (measured by 15D (15-dimensional)) at the age of 46 were collected from the Northern Finland Birth Cohort 1966 using postal questionnaires. We used the binary logistic regression model to estimate the associations between childhood family structures and the lowest 15D quartile (reference: all other quartiles). The associations were adjusted for offspring mothers' factors during pregnancy (mothers' educational and occupational status).

Results: Of the 6375 participants, the offspring belonging to the 'one parent not living at home/no information on father' family structure subgroup had higher odds ratio of belonging to the lowest 15D quartile than the offspring of 'two-parent families' (adjusted odds ratio (OR) 1.76, 95% confidence interval (CI) 1.31-2.36, p<0.001 for females; adjusted OR 1.86, 95% CI 1.28-2.70, p=0.001 for males). There were no statistically significant associations between the 'father or mother deceased' subgroup and the lowest 15D quartile among the offspring.

Conclusions: A single-parent family origin (due to reasons other than parental death) in childhood was significantly associated with impaired HRQoL at middle age. These results provide new perspectives for understanding the long-standing associations on living in a single-parent family.

Aim: The inclusion of production losses in health care priority setting is extensively debated. However, few studies allow for a comparison of these losses across relevant clinical and demographic categories. Our objective was to provide comprehensive estimates of Norwegian production losses from morbidity and mortality by age, sex and disease category.

Methods: National registries, tax records, labour force surveys, household and population statistics and data from the Global Burden of Disease were combined to estimate production losses for 12 disease categories, 38 age and sex groups and four causes of production loss. The production losses were estimated via lost wages in accordance with a human capital approach for 2019.

Results: The main causes of production losses in 2019 were mental and substance use disorders, totalling NOK121.6bn (32.7% of total production losses). This was followed by musculoskeletal disorders, neurological disorders, injuries, and neoplasms, which accounted for 25.2%, 7.4%, 7.4% and 6.5% of total production losses, respectively. Production losses due to sick leave, disability insurance and work assessment allowance were higher for females than for males, whereas production losses due to premature mortality were higher for males. The latter was related to neoplasms, cardiovascular disease and injuries. Across age categories, non-fatal conditions with a high prevalence among working populations caused the largest production losses.

Conclusions: The inclusion of production losses in health care priority debates in Norway could result in an emphasis on chronic diseases that occur among younger populations at the expense of fatal diseases among older age groups.