Scandinavian Journal of Public Health最新文献

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.

Aims: To explore the components that influence health and wellbeing of gender minority forced migrants residing in Sweden.

Methods: Qualitative exploratory study based on semi-structured interviews with gender minority forced migrants recruited through a combination of convenience, purposeful and snowball sampling. Guided by the levels in the social ecological model, transcripts were analysed with systematic text condensation in a collaborative process between experts by lived experience, researchers and clinical psychologist.

Results: Participants expressed resilience and hope about their future. Loneliness was a major issue contributing to health burdens and peer support was highly appreciated. Barriers hindering access to health services and judgemental behaviours among health professionals were described. Affirming support through empathy, trust, safety, confidentiality, continuity and respect was highlighted as essential in health services. While societal openness and safety for gender minority individuals was appreciated, participants faced an uncertain asylum process and unmet basic needs.

Conclusions: Gender minority forced migrants show resilience and appreciate the newfound societal safety. However, they find themselves in the margins of society and encounter various multi-layered challenges. Loneliness is a public health concern that could be addressed through peer support, which is highly desired and valued. Ensuring access to affirming health services should be a prioritized area for researchers, professionals, stakeholders and policy-makers.

Objective: Social inequality in mortality has increased in many countries worldwide and does not appear to be levelling off. Denmark is no exception, and the latest developments are presented in this short communication.

Methods: Trends in life expectancy and changes in the shape of the age-at-death distribution are calculated from nationwide register data on income and education linked to mortality data.

Results: Since 1987, the difference in life expectancy between the lowest and highest income quartiles has increased by 5.4 years for men and by 2.0 years for women. The difference in life expectancy (at age 30) between education groups has also increased. The latest developments indicate a decline in life expectancy for men and women in the lowest income quartile and with the shortest education.

Conclusions: Reducing social inequality in health and mortality has been on the agenda for successive Danish governments for more than 20 years, but social inequality in life expectancy is still increasing.

Aims: Active commuting to school (ACS), a source of physical activity (PA), has declined in many countries over recent decades. This study investigates ACS and the factors associated with it among Finnish children and adolescents across two generations: those born between 1965-74 and 1998-2010. We also explore potential generational differences in these associations.

Methods: School commuting was self-reported by 2075 participants of the ongoing population-based Young Finns Study in 1983 (generation 1 (G1), aged 9-18, 52% female), and by their 1137 offspring in 2018 (generation 2 (G2), aged 8-20, 53% female). Factors associated with ACS and the moderating effect of generation on these associations were examined using generalized estimating equation models for clustered binary data, for summer and winter seasons separately.

Results: A greater distance to school (p < 0.001) and belonging to G2 (p ⩽ 0.049) were negatively associated with ACS during both seasons. High parental leisure-time PA (p ⩽ 0.025 for both seasons) and urban living area (p < 0.001 for summer) were positively associated with ACS. Generation moderated the associations of school grade and parental income with ACS in the summer (p ⩽ 0.015). Among G1 only, attending lower secondary school (vs. primary school) was negatively associated with ACS, while higher parental income was positively associated with ACS. Neither gender nor parental education was associated with ACS.

Conclusions: ACS was less common among the younger generation. Several correlates of ACS were identified, with generational differences. These findings can inform further research and guide policy decisions to promote ACS and ultimately enhance the PA of children and adolescents.

Aims: The World Health Organization states that physical inactivity is one of the leading behavioural risk factors for disability and mortality in Europe. Social prescribing holds promise as a possible solution by connecting patients from general practice to community-based physical activity. Although research within social prescribing exists, the process of connecting general practice patients to community-based physical activity is not well investigated. This scoping review aimed to summarise and synthesise knowledge on social prescribing provided by health professionals in general practice towards community-based physical activity.

Methods: A systematic search for literature in PubMed, Embase, Scopus, SportsDiscus and other sources was conducted to identify initiatives connecting general practice to community-based physical activity. Semi-structured interviews were then conducted with subject-specific national experts. Finally, preliminary findings from the literature and the interviews were used in a co-creation process with experts to synthesise and finalise the results of a thematic analysis across data sources.

Results: Based on 19 records, five expert interviews and subsequent co-creation, we identified three themes: (a) barriers and facilitators, (b) organisational perspectives and (c) value-based considerations.

Conclusions: This review illuminates the complex nature of social prescribing programmes that connect general practice patients to community-based physical activity in Denmark. It also presents practical and fundamental considerations when applying social prescribing across different settings.

Aims: Multifactorial falls prevention programmes (MFFPs) can prevent falls and fall-related injuries. We aimed to study MFFP patients' mortality compared with their sex-, age- and residence-matched population-based controls.

Methods: This study is a Finnish single-centre retrospective register-based controlled cohort study of a total of 527 home-dwelling MFFP patients and their 3:1 age-, sex- and residence-matched population-based controls (n = 1581), who had not attended the MFFP.

Results: During the follow-up, the cumulative mortality of all patients was 40.4, and of controls 39.1 %. Hazard ratio was 0.82 (95% confidence interval 0.68 to 0.99), p= 0.041. Case patients had a 2.7 times greater risk to die due to accidents, but they had a lower risk to die due to dementia, compared with the control group. The 72-years-old or older participants had a lower mortality rate than the controls during follow-up.

Conclusions: The MFFP seems to relate to a lower all-cause mortality when comparing MFFP patients with their age-, sex- and residence-matched controls. However, the MFFP did not seem to relate to a lower injury-related mortality. The relationship between the MFFP and lower all-cause mortality seemed to be strongest in the patients aged 72 years or older. Due to the study setting and population-based control group, it is difficult to draw solid conclusions and further studies are needed. A randomized controlled trial comparing the MFFP with standard care would give better insight on the effectiveness of a MFFP on mortality.

Aims: This study examines the evidence for similar increases in psychosomatic complaints among 15-year-olds in the Nordic countries over the period 2002-2022. A distinction is made between the level and shape of these time trends.

Methods: A dataset from the Health Behaviour in School-aged Children survey from 2002 to 2022 was used. Time trends for psychosomatic complaints were analysed for five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden.

Results: A significant increase in psychosomatic complaints over the last two decades was found among 15-year-old boys and girls in all countries, especially among girls. The shapes of the time trends were very similar for adolescents in all Nordic countries. There were significant differences in the time trends between the countries. Here, the countries with high or low levels of psychosomatic complaints in 2022 were largely the same as those with high or low levels of psychosomatic complaints years earlier.

Conclusions: The high degree of similarity observed in the shapes of the time trends for psychosomatic complaints among Nordic adolescents, as evidenced by this study, suggests that explanations for the observed increases in these psychosomatic complaints should be sought in conditions common to the five countries. However, country-specific explanations are more likely to be candidates for understanding differences in the levels of these time trends. The potential for differentiation between shapes and levels using the aggregate technique when comparing countries also provides an opportunity to empirically examine country-general and country-specific explanations for trends in measures in other areas of research.

Background: We review the literature on the social impacts of diseases, defined as the social consequences of having a disease on the people around the patient, such as spouses, caregivers and offspring. The two objectives of this study are to summarise the social outcomes commonly associated with diseases and to compare the social impact across a range of diseases.

Methods: A systematic review of the social impact of disease in Nordic countries was conducted using PubMed, PsycINFO and Google Scholar (PROSPERO registration number CRD42022291796). All articles that met the inclusion criteria were reviewed. We tabulated all outcomes and diseases studied, and synthesised the evidence based on the perspectives of patients, spouse/caregiver and offspring.

Results: A total of 135 studies met the eligibility criteria, covering 76 diseases and 39 outcomes. From the patient's perspective, diseases impact divorce and marriage rates, social functioning, likelihood of committing a crime and being a victim of crime. From the caregiver's perspective, diseases affect their health-related quality of life and physical and psychological health. From the offspring's perspective, diseases impact their development, health and social adversities in later life. Diseases generally had negative social impacts, but there were some diseases associated with positive impacts.

Conclusions: The review provides a useful summary and gross comparison of the social impact of different diseases. The social impact of diseases can be large and significant. Thus, it should be considered when policymakers are setting priorities across disease areas.

Aims: We examined the patterns of healthcare utilisation for drug use disorders (DUDs) and charges related to narcotics among young refugees in Norway considering the role of sex, country of origin and condition of arrival (accompanied versus unaccompanied minors).

Methods: Based on national registers, sex-stratified Cox regression models were used to estimate hazard ratios to assess the risk of being charged with a narcotics offence and the use of healthcare services related to DUDs. The sample consisted of 15,068 young refugees and 573,241 young Norwegians born in Norway to two Norwegian-born parents. All of the young people in the sample were born between 1983 and 1994. The follow-up period was from January 2008 to December 2015.

Results: Compared with their Norwegian peers, both male and female refugees showed either a similar or lower risk of receiving healthcare for DUDs. However, male refugees showed an increased risk of being charged with a narcotic offence, except those from Afghanistan and the former Yugoslavia. Accompanied male refugees were at a higher risk of being charged, while unaccompanied male refugees showed a lower risk.

Conclusions: Young male refugees generally had a higher risk of being charged for narcotic offences while showing a similar risk of receiving healthcare for DUDs compared to Norwegian-born young people. However, young men from Afghanistan and the former Yugoslavia deviated from this pattern. This may be partially explained by the length of time spent in Norway. The results add support to previous qualitative studies suggesting that punitive drug policies may disproportionately affect men from minority groups. Further research controlling for parental household-level factors is warranted.