Scandinavian Journal of Public Health最新文献

Aims: To identify associations between chronic conditions and eight key health risks (stress, loneliness, sleep, obesity/body mass index, smoking, exercise, alcohol consumption, and fruit intake) and provide a practical descriptive profile of the distribution of health risks within chronic conditions.

Methods: The sample involved 56,988 Danish residents aged over 16 years from three national health surveys (2010/2013), one sociodemographic register, and seven national health registers. Linear and logistic regression models adjusting for socioeconomic variables were used to analyse associations with 14 disease groups and 30 common conditions.

Results: The regression analyses revealed that stress, obesity, and physical inactivity were the most consistently associated health risk factors across disease groups. We identified three groups of health risks with similar strengths of associations. Firstly, one group comprising obesity, stress, and sleep troubles, was significantly linked to 27, 23, and 22 chronic conditions, respectively. Secondly, a group of physical inactivity/loneliness showed moderate associations, linked to 19 and five chronic conditions, particularly mental health conditions; and thirdly, a group of smoking, drinking, and low fruit intake showed the weakest and fewest associations. A descriptive profile showed that anxiety, schizophrenia, attention deficit hyperactivity disorder, headaches and chronic obstructive pulmonary disease were conditions with high proportions of patients experiencing more than four health risks.

Conclusions: The current study provides comparable, hierarchical information on the strength of associations between eight health risks and chronic conditions adjusted for socioeconomic factors. The findings suggest that healthcare professionals, policymakers and public health strategies should place less emphasis on classic behavioural health risks such as smoking and more attention on psychological factors such as stress, sleep problems, and loneliness.

Aim: Identifying disability among children in surveys is important for improving public health initiatives. However, this process is challenging, as different measurement approaches and cut-offs impact prevalence rates. This study aims to assess disability using non-relational and relational models with different cut-offs to reveal the differences in prevalence, and to examine differences in life satisfaction between children with and without disabilities based on the varying measures.

Method: This cross-sectional study used data from 6049 Norwegian children (10-13 years). We assessed non-relational disability using Washington Group questions about functional limitations. We additionally measured perceived barriers in school and leisure for those who reported functional limitations, to assess disability according to the relational model. Different cut-offs were applied for both measures. Linear regression analysis was used to investigate differences in life satisfaction between children with and without disabilities for all measures.

Results: Disability prevalence rates were lower under the relational model compared to the non-relational model across all cut-offs, indicating that many children who were identified as disabled in the non-relational model do not experience hindrances in school or leisure. For example, with the 'often or more' cut-off, the non-relational model showed a 27.6% prevalence, while the relational model showed 8.2%. Life satisfaction was significantly lower among children with disabilities compared to their peers without disabilities, with larger differences observed when using the relational model.

Conclusions: Assessing disability through the relational model provides a nuanced understanding of disability by emphasising societal barriers. Incorporating perceived hindrances in children's daily lives offers valuable insights for public health initiatives and policy making.

Aims: This study provides an off-the-shelf catalogue of prevalence rates of eight health-related risk factors (self-perceived stress, loneliness, sleep quality, obesity/body mass index, smoking, physical exercise, alcohol consumption, and fruit intake) for 199 chronic conditions, disease groups and socioeconomic covariates in Denmark.

Methods: The study population comprised a randomised sample of Danish residents aged 16 years and older (n=56,988). Data were derived from a linkage of three national health surveys (2010, 2013) and seven national health and sociodemographic registers. Means and prevalence rates, including sex and age-standardised estimates, were presented.

Results: The most prevalent health risks were insufficient fruit intake (93.8%), most stressed quartile (20.5%), smoking daily (17.2%), physical inactivity (16.6%), obesity (15.0%), very bothered by sleep (9.7%), drinking more than recommended (8.7%), and 'often feels lonely' (5.5%). Chronic conditions with the highest mean numbers of health risks were mental disorders (disease group F; mean = 2.6), diseases of the digestive system (K; mean = 2.2), neurological diseases (G; mean = 2.1), musculoskeletal-related diseases (M; mean = 2.0), and respiratory-related diseases (J; mean = 1.9). In comparison, people without a chronic condition had a mean of 1.6 health risks. Marked socioeconomic disparities were also observed, with more risks among groups with lower education and income.

Conclusions: The nationally representative off-the-shelf catalogue provides essential information on eight common health risks across 199 chronic conditions and socioeconomic groups. The findings offer a resource for differentiated healthcare planning, prevention, and research.

Background: Healthcare professionals often face tension between caregiving values and systemic demands for efficiency and economic stability. While caregivers focus on patient well-being, hospital leaders must ensure resource and staff management-roles that can appear contradictory.

Objective: This study explores how both caregivers and leaders in a large Norwegian hospital experience meaning in their work, aiming to identify shared ground for healthcare engagement. Drawing on Hartmut Rosa's resonance theory and Tatjana Schnell's research on meaning in life, we examine how professional experiences foster or hinder resonance-a mode of being characterized by mutual responsiveness and transformation.

Methods: Twelve semi-structured interviews were conducted with nurses, doctors, and leaders using a guide informed by resonance theory. Data were analyzed thematically in a multidisciplinary team.

Results: Four themes emerged: (1) healthcare as a demanding yet meaningful profession, (2) organizational challenges, (3) patient relationships, and (4) teamwork and collegial support. Across roles, participants described systemic pressures that threaten meaningful engagement, but also highlighted moments of deep resonance-particularly in patient care, collaboration, and learning.

Discussion: Resonance and meaning are sustained when work aligns with moral purpose and supports relational and reflective engagement. Both caregivers and leaders seek meaning in their roles, often through shared values and relationships. These findings underscore the need for organizational structures that allow space for resonance, rather than accelerating alienation through excessive control and restructuring.

Conclusions: Caring for meaning represents common ground for caregivers and leaders. A resonance-informed healthcare leadership might strengthen both staff well-being and quality of care.

Aims: We use cognitive tests among military conscripts in Norway to further investigate an association between the Chernobyl fallout and mathematical skills previously reported for school grades both in Norway and in Sweden.

Methods: The Medical Birth Registry of Norway was linked with data from the Norwegian Armed Forces Health Registry on conscript cognitive scores. Average radiation doses were estimated for each municipality and calendar month from May 1986 to April 1989. Dose in the mother's residential municipality in the fifth calendar month of the pregnancy was used as exposure. Total cognitive score among boys was analysed using a natural-experiment design with pregnancy cohorts from years prior to the fallout as reference. Our analysis estimated whether a difference in scores before and during exposure was specific to regions with higher doses. Sub-scores for numerical reasoning were available only for cohorts after 1986. An alternative sibship analysis using younger brothers as reference was therefore performed.

Results: We found no evidence of reduced total cognitive score in areas with relatively higher average radiation doses. Similarly, there was no evidence that numerical reasoning was reduced.

Conclusions: Our analyses did not identify associations between the Chernobyl radioactive fallout in Norway and cognitive abilities, including mathematics skills, among conscripts exposed in utero. Incomplete participation in conscript testing and the possibility of selection bias is a limitation, although conscript participation was not associated with exposure. Differential time trends in cognitive scores in the study period between areas with higher and lower doses may have biased our analysis.

Aims: This study aimed to estimate the associations between preschool-level and individual- level socioeconomic deprivation and later mental disorders among children in a Swedish setting.

Methods: The study used a longitudinal cohort study design including 2678 children, aged 3-5 years in Uppsala Municipality during 2017, with data on individual-level socioeconomic deprivation, and preschool-level socioeconomic deprivation. We followed the children for approximately five and a half years to assess later mental disorders, based on data from the Swedish National Patient Register. Frailty Cox regression models were used to analyse the data.

Results: No associations were observed between preschool-level socioeconomic deprivation and subsequent mental disorders. In terms of individual-level deprivation, children whose parents had lower educational levels had a higher risk of receiving a diagnosis of any mental disorder (hazard ratio (HR: 1.40; 1.04-1.90)) and any attention deficit hyperactivity disorder or conduct disorder (HR: 1.87; 1.24-2.80) during follow-up than children whose parents had higher education levels.

Conclusions: Single individual-level socioeconomic deprivation factors appear to be more important predictors of mental health outcomes in children than preschool-level socioeconomic deprivation. Children growing up in socioeconomically disadvantaged families may constitute a particular risk-group for developing mental disorders. Swedish preschools and child health services could implement appropriate interventions targeting healthy development for these children.

Aims: The aim of this study was to explore how professionals within the child health, education and welfare sectors perceive the process of identification and how they care for children and young people (CYP) living with problematic substance use (PSU) in their families. We also sought to understand the perceptions of engagements and needs of adolescents living with PSU in their families.

Methods: We combine five focus group interviews with professionals and six individual interviews with adolescents. We employ systematic text condensation in a cross-case thematic analysis and discuss our findings, considering Bronfenbrenner's bioecological model.

Results: Professionals face barriers to identifying affected CYP on multiple levels and uncertainty about signs of adversities, corresponding to the experiences of adolescents who emphasise a need for vigilant adults. However, the results also suggest the school setting as an enabling arena for identification, follow-up and interdisciplinary collaboration. Both parties request a community of experience in support groups with peers for CYP and increased knowledge on how substance use affects family members.

Conclusions: School can be an important arena for identifying CYP affected by PSU and interdisciplinary collaboration in the effort to attend to their needs. There is an identified need to educate professionals and CYP on living with substance use in the household and to promote peer support opportunities for CYP.

Aims: Several studies suggest that ethnic minorities are at higher risk of experiencing long COVID compared to majority populations. This study aimed to qualitatively explore the experiences of accessing care, diagnosis and rehabilitation among patients with long COVID in a multiethnic population in Denmark.

Methods: We carried out 18 semi-structured interviews with individuals of Danish, Turkish and Moroccan background who were diagnosed with long COVID. Informants were sampled purposively to secure variation in sex, age, country of origin and immigration status. Our interview guide was developed using the theoretical framework of candidacy. Interviews were transcribed verbatim, member checked and subsequently analyzed using thematic framework analysis and NVivo software.

Results: Our findings show that accessing care and rehabilitation for long COVID was difficult regardless of ethnic background. Following the novelty of COVID-19 and thus uncertainty of long COVID, informants had to self-advocate and navigate established and alternative healthcare services by themselves. Additionally, patients with Moroccan and Turkish minority background had to contend with experiences of differential treatment and of having their motives for seeking help questioned, while also finding it harder to benefit from the rehabilitation measures offered.

Conclusions: Our study demonstrates how the emergence of a new viral disease with unknown long-term sequelae resulted in a group of patients who largely carried the burden of getting better by themselves. Yet patients with an ethnic minority background experienced additional, worrying barriers. More research into relevant diagnosis, care and support for all long COVID patients is needed, especially among ethnic minorities.

Aim: The aim of this study was to identify factors associated with dog-related injuries by analysing data collected from 5908 patients seeking treatment at healthcare facilities in Skaraborg district, Sweden, over the years 2001-2016.

Methods: To describe factors associated with dog-related injuries, we analysed variables from four categories: people, that is, characteristics (gender and ages) of the patients who were injured; the circumstances in which the injuries occurred; the causes and types of injuries caused by dogs (injury mechanisms); and whether the injuries resulted in hospitalisation.

Results: Most injuries occurred in residential settings (58%). Half of the reported injuries (n=2954) were due to dog bites, with the same number of patients who were injured in non-bite-related events, comprising a second group. Injury mechanisms for dog-related injuries other than bites varied, as did locations where the various injuries occurred. However, slightly more than half of all non-bite-related injuries were caused by falls, especially falls on the same level involving slips and trips (n= 831, 55.3% of all fall-related injuries). Dog bites were the primary injury cause for younger groups, while non-bite injuries were the leading injury cause for adults aged 45 years and older.

Conclusions: The study showed that men and younger age groups were more likely to be injured via dog bites, while older women were more likely to be injured by tripping or falling over dogs. These findings imply that separate injury prevention strategies are required to address the different factors associated with both injury types.

Aims: The outbreak of the COVID-19 pandemic and the following lockdown enforced substantial lifestyle changes in people's everyday lives. This study aimed to assess the impacts of the COVID-19 restrictions on the ageing women's mental, social and physical well-being.

Methods: Data were collected through two postal questionnaires. Baseline data were obtained in May-June 2019, prior to the pandemic. A follow-up survey was mailed to 760 eligible participants in August-September 2020; 571 women (75.1%) responded, forming the final cohort. The cohort comprised community-dwelling women born between 1932 and 1941 (mean age 82.5 years). Both surveys assessed health, lifestyle, mood, sleep, and technology use, with the follow-up including pandemic-related items.

Results: Dietary habits improved with increased consumption of fruits, vegetables and fish, and decreased intake of sweets, pastries, alcohol and meat. Sleep quality and perceived sufficiency remained stable, although nighttime awakenings declined (p=0.023). Social interactions decreased for 43.6% of respondents, yet 20.2% reported receiving more support. Functional capacity deteriorated significantly, with reduced ability to climb several floors, run 100 m and cycle (all p<0.001).

Conclusions: Early lockdown was associated with both positive and negative outcomes. Favourable changes included healthier diets and stable sleep quality. Despite reduced face-to-face contact, perceived social support improved for some participants. However, physical functioning declined, underscoring the need to maintain mobility during prolonged restrictions.