Scandinavian Journal of Public Health最新文献

Aim: The decline in self-rated health among young people raises concerns for future health outcomes. We examined whether self-rated health in preadolescence predicts hospital contacts and prescription redemption in later adolescence.

Methods: This longitudinal study uses the Danish National Birth Cohort on children born 1996-2002. A questionnaire was distributed to 96,382 11-year-old preadolescents followed from 2010 to 2018. Number of hospital contacts and prescriptions were obtained from Danish registers. Incidence rate ratios (IRRs) were estimated, comparing preadolescents with poor ('Not So Good'/'Poor') and 'Good' self-rated health to those with 'Excellent' self-rated health.

Results: Among the 47,365 (49.1%) 11-year-old participants, 5.3% reported poor self-rated health and 38.3% reported good health. Analyses revealed that children with good self-rated health had higher rates of somatic (IRR, 1.17 [1.14-1.21]) and psychiatric (IRR, 1.63 [1.47-1.81]) hospital contacts. Children with poor self-rated health showed even higher rates, with IRRs of 1.73 [1.62-1.85] for somatic and 3.54 [3.03-4.15] for psychiatric contacts. Additionally, those with good self-rated health had more somatic and psychiatric prescriptions (IRR, 1.25 [1.21-1.30] and 1.75 [1.55-1.97], respectively), whereas children with poor self-rated health had IRRs of 1.67 [1.56-1.80] for somatic and 4.03 [3.39-4.82] for psychiatric prescriptions.

Conclusion: Preadolescents with both good and poor self-rated health show higher rates of hospital contacts and prescription redemption in adolescence, especially pronounced in children with poor self-rated health. This indicates that early-life health perceptions impact long-term wellbeing, particularly psychiatric health. This simple self-rated health measure provides valuable insights for healthcare professionals by aiding in identifying children in need of support and early intervention.

Aims: This longitudinal study investigated the prevalence of and risk factors for loneliness among older new informal caregivers, long-term informal caregivers, former informal caregivers and non-caregivers in selected regions of Finland and Sweden over 5 years.

Methods: A longitudinal sample of 5083 respondents from the Gerontological Regional Database (GERDA) survey data in 2016 and 2021 was used. Bivariate correlation tests and multivariate logistic regression analyses were performed.

Results: Loneliness prevalence rates varied between 6% and 8% in 2016 and increased in all groups, although not significantly among new informal caregivers. In 2021, the prevalence of loneliness varied between 8% and 14%. Among the baseline variables, reporting loneliness, single/unmarried/bereaved civil status, infrequent contact with friends and neighbours, poor self-rated health, depressive symptoms, living in Finland and financial strain increased the likelihood of reporting loneliness in 2021. Among the change variables, being a long-term caregiver, a negative change in civil status, a reduced number of confidants, a negative change in self-rated health and depressive symptoms increased the likelihood of reporting loneliness.

Conclusions: Loneliness increased among all four groups of comparison. Being a long-term caregiver was a significant risk factor for reporting loneliness over time (odds ratio 2.00, 95% confidence interval 1.20-3.35), when controlling for several other social and health-related variables. To develop effective support, future research could address risk factors for loneliness among distinct groups of informal caregivers based on whether the care recipients have neurological or functional health limitations and examine the availability of support measures.

Aims: Doctors have an increased risk of SARS-CoV-2 infection caused by exposure to contagious patients. We aimed to identify which clinical specialities among medical doctors had the highest occupation-related risk of testing positive for SARS-CoV-2, utilizing data for all publicly employed medical doctors in Sweden.

Methods: Data regarding positive SARS-CoV-2 test results and employment for publicly employed doctors in Sweden were divided into three observation periods: 1) 1 February to 31 December 2020, 2) 1 January to 30 June 2021 and 3) 1 July 2021 to 31 March 2022. Individuals were stratified according to occupation clinic and compared with clinical occupations with little to no patient contact. The risk of testing positive for SARS-CoV-2 was estimated using Cox proportional hazards regression, with sex, age and vaccination status as covariates.

Results: The study cohort included all publicly employed doctors in Sweden: 35,028 individuals. In the first period, Infectious Disease doctors had the highest incidence of SARS-CoV-2 positive tests, with an incidence of 20.2 %, compared with 8.7 % in the reference group, and an adjusted hazard ratio of 2.5 (95% confidence interval 2.02-3.04), which decreased during period 2-3. Doctors in Geriatric Medicine had an elevated risk throughout the whole study period.

Conclusions: Our study shows an association between working in a speciality that involves caring for contagious COVID-19 patients, which raises concerns about infection control measures and routines being insufficient to prevent occupational infection in future pandemics.

Aims: The Faroe Islands is a small homogenous archipelago located in the North Atlantic Ocean with no prior study of violence among adults. In an adult population-based sample, we studied physical, sexual and emotional violence and health and socio-economic determinants.

Methods: A population-based cross-sectional survey conducted between November 2020 and February 2021 was based on a newly initiated questionnaire that included 1068 randomly selected individuals aged 18-75.

Results: A total of 34.8% reported exposure to physical violence, 21.8% to sexual violence and 22.3% to emotional violence. A total of 12.6% of the women and 7.6% of the men reported exposure to all three types of violence. The consequences of childhood violence had a more significant effect on the subjects compared to adult-life violence. Additionally, individuals exposed to violence had significantly lower odds of achieving any educational attainment.

Conclusions: Compared to men and after adjustments, women had 50% lower odds of exposure to physical (odds ratio=0.5, p<0.001) and more than three times the odds of exposure to sexual violence (odds ratio=3.1, p<0.001). The odds of emotional violence were sex independent, both unadjusted and adjusted. Moreover, exposure to violence showed a life-long negative impact.

Aims: Cardiopulmonary disease (CPD) is a leading cause of death worldwide. Increasing evidence shows that air pollution and exposure to weather conditions have important contributory roles. Understanding the interaction of these factors is difficult due to the complexity of the relationship between CPD, air pollution, and environmental factors.

Methods: This paper uses regression models and machine learning approaches to explore these relationships, and investigate whether meteorological factors and air pollution have a synergistic effect on CPD. We use daily data from 2009-2018 from four cities representing the heterogenous climate conditions in Norway: the far north, the west coast, mid-Norway, and the south-east.

Results: We demonstrate the importance of the interaction between weather and air pollution associated with higher CPD mortality, as is exposure to air pollution in the form of $\mathrm{NOx}\mathrm{and}$particulate matter. This impact is seasonal. Traffic is also positively related to CPD mortality, which may be caused indirectly through increased pollution. We demonstrate that machine learning outperforms regression models in terms of the accuracy of predicting CPD mortality.

Conclusions: The inclusion of rich lagged structures and interactions between environmental factors are both important but can lead to overfitting of traditional models; since these cities are not large cities by international standards, it is surprising that environmental factors have such obvious impacts on CPD mortality. CPD mortality shows a clear negative trend, implying an improvement in the public health situation.

Aims: This study aimed to identify subgroups of Norwegian retirees with similar trajectories of subjective well-being (SWB) across the retirement transition and to explore how various factors influence these SWB trajectories.

Methods: The study employed growth mixture modelling to analyze longitudinal data, exploring the trajectories of life satisfaction, positive affect and negative affect in retirement transition. It also examined the influence of factors such as demographic, living arrangement, pre-retirement work conditions, individual characteristics and available resources on these SWB trajectories.

Results: Contrary to the hypothesised three distinct SWB trajectories in retirement, the results more strongly support a single group solution for life satisfaction and positive affect. For negative affect, a two-group solution, consisting of one group with stable low and another with stable high negative affect, was preferred. The study identified several predictors of SWB trajectories.

Conclusions: The findings suggest that retirement is a neutral life event with stable SWB trajectories. However, several factors significantly influence whether retirees experience higher or lower SWB in retirement. The findings of this study provide updated insights into the heterogeneity of the retirement experience, as well as highlight important factors for retirement SWB.

Aim: The aim of this study was to explore young people's experiences of resources and strategies for promoting their mental health.

Methods: Individual interviews with 33 people aged 16-25 years were conducted using a method inspired by cognitive interviewing, which combines think aloud techniques with probing questions. The interviews were based on the young people's reflections of the questions in the Swedish national public health survey. Data were analysed with reflexive thematic analysis.

Results: The resources and strategies that the young people in this study described as important for promoting mental well-being are related to societal prerequisites needed to navigate life; to their immediate surroundings, including social interactions; and to the young people themselves. These resources and strategies are presented under the following three themes: prerequisites for navigating life, social interactions on one's own terms, and who I am and what I can do.

Conclusions: Young people have a variety of resources and strategies of their own available for promoting mental well-being. However, they cannot promote mental health just on their own; access to social networks and the opportunity to share thoughts and feelings are central. Further, to promote mental health, young people need good social conditions, knowledge, and support from adults so that the existence they struggle to navigate feels comprehensible, manageable and meaningful.

Aim: A worry regarding young people's physical activity engagement relates to a potentially competing development: the role of screen-based media (SBM) in their everyday lives. The present study aimed to assess time spent on different types of SBM, self-reported moderate-to-vigorous physical activity (MVPA) and physical activity in different domains and their interrelations.

Methods: The study is based on data from 3737 participants aged 11, 13 and 15 years from Norway collected in 2021/2022 as part of the Health Behaviour in School-aged Children collaborative cross-national survey.

Results: The findings revealed high amounts of total SBM time. There were age and gender differences in physical activity, especially with lower levels of active transport during leisure time among girls than among boys. A series of binary logistic regression analyses with adjustment for age, gender and socioeconomic status showed that high levels of total SBM time were negatively associated with involvement in club sports, active school transport, active travel to friends and leisure activities, and 60 min MVPA 5 days/week. Gaming and social media use were also negatively associated with most of the physical activity indicators. All SBM variables were negatively associated with involvement in club sports and 60 min MVPA 5 days/week.

Conclusions: The study demonstrates negative associations between SBM time among adolescents and physical activity in various domains. Actions to facilitate youth physical activity in the digital age seem crucial. Additional studies with nuanced data on these behaviours and longitudinal research design allowing for examining their interrelations over time are needed.

Aim: To investigate the associations between social sustainability factors and people's satisfaction with their local community as a place to live now and in the future.

Methods: This study used data from the Norwegian County Public Health Survey conducted in Viken County, Norway, in 2021 (N = 97,323). The survey included questions concerning physical aspects (e.g. accessibility of services and facilities) and non-physical aspects (civic participation, social support, trust, safety, place attachment and well-being) of social sustainability in local communities. A new outcome variable was constructed to capture people's satisfaction with their local community as a place to live now and in the future. Hierarchical linear regression was applied to examine the relationships between physical and non-physical factors of social sustainability and this outcome.

Results: All included factors were significantly associated with people's satisfaction with their local community as a place to live now and in the future, but the magnitude and direction of these associations varied. Place attachment (β = 0.53), safety (β = 0.15) and well-being (β = 0.11) were the strongest indicators of people's satisfaction with their local community. Non-physical factors accounted for 41% of the variance in people's satisfaction, while physical factors accounted for 14%.

Conclusions: Both physical and non-physical factors are essential for developing socially sustainable communities. This knowledge could be valuable for academics and policymakers, helping them better understand the complex relationships between various aspects of social sustainability and informing the development of socially sustainable local communities.

Aim: Need-based access to health care and social welfare services is an element of health promotion, and it endorses equity and the principles of universalism in society. To explore access to services, this study analyses unmet need for services, barriers that impede access and whether individual characteristics are associated with service access. The study period coincided with the COVID-19-pandemic and health and social services reform in Finland.

Method: The prevalence of subjective unmet need was used as an indicator of service access. Inconvenient opening hours, a difficult journey to the service unit and high user fees were barriers to receiving services. A nationally representative FinSote survey 2018 and 2020 was used in the analyses. Data were examined with multivariate logistic regression models using SPSS.

Results: A high prevalence of unmet need for health care and especially for social welfare services was observed. The prevalence of unmet need increased from 2018 to 2020, but in health care only, and access to social welfare services deteriorated. In particular, women, younger people, those who need income support and those with poor health or quality of life forgo care.

Conclusions: A considerable share of the Finnish population do not receive essential services according to need and face barriers in accessing services. Individual characteristics are associated with perceived unmet need and access barriers despite the ethos of equal opportunities. COVID-19 measures are likely to have worsened the situation. Actions to improve access must urgently be implemented to achieve the policy goals of health promotion, equity in health and universalism.