Scandinavian Journal of Public Health最新文献

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.

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.

Background: Child Health Services plays an important role in identifying at-risk children and intervening early to break negative trends in child health. Sociodemographic risk factors can impact the workload of Child Health Services and affect the possibilities of providing the national child healthcare programme.

Aims: This study aims to present the sociodemographic characteristics of families who are registered within the Child Health Services, as defined by the Child adjusted Care Need Index.

Methods: By collecting personal identification numbers from children six years or younger registered at a child healthcare centre, and combining this with their caregiver's sociodemographic background, this study was able to create a sociodemographic index for each child healthcare centre in Sweden.

Results: The study included 687,543 children and 1,335,540 caregivers from 981 child healthcare centres in Sweden. Approximately 21% of all children in the study population had a caregiver born in Southern or Eastern Europe outside the European Union, or in Africa, Asia, or South America, 7% had single parents, 17% had at least one unemployed caregiver, and 9% had at least one caregiver who had not completed high school. The average input values and the average index values varied widely both between and within the regions.

Conclusions: This study displays a large variation in sociodemographics for child healthcare centres both within and between regions. Since several regions and national agencies in Sweden use the Child adjusted Care Need Index, it is necessary to keep the dispersion in mind.

Aims: Non-communicable diseases (NCDs), including cancer, cardiovascular diseases, diabetes, and chronic respiratory diseases, are responsible for 74% of deaths worldwide (2019). In Europe, they account for over 91% of deaths and 87% of disability-adjusted life years (DALYs). Mental disorders, also considered NCDs, rank seventh globally in terms of DALYs. These burdens are exacerbated by socioeconomic and educational inequalities that shape the distribution of risk factors and cause preventable disparities in health and mortality. This article presents the new Joint Action on Cancer and other NCDs (JA-PreventNCD), outlining its objectives and methodological strategies to tackle inequalities in Europe.

Methods: The JA-PreventNCD started in January 2024. It was launched under the EU4Health Programme for the period of 2021-2027, with a specific focus on social inequalities. Over its four-year span, the initiative will: (1) collect evidence on inequalities in major NCDs and their risk factors; (2) review policies targeting these disparities; (3) provide training based on an equity lens approach; (4) enhance health literacy through multi-level activities.

Conclusions: The JA-PreventNCD initiative represents a crucial opportunity to address health inequalities related to NCDs across Europe. Its findings will contribute to evidence-based health policies and promote sustainable strategies aimed at closing the gaps. Enhanced collaboration among European countries and the exchange of best practices will foster informed policy-making, leading to long-term improvements in public health.

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: Little is known about ethnic disparities in childhood obesity in Europe. We explored the development of ethnic differences in overweight (including obesity) from age 2 to 8 years.

Methods: We collected routine weight and height measures for 604 children from the Norwegian multiethnic, population-based STORK Groruddalen pregnancy and birth cohort (52.6% European, 26.8% south Asian, and 20.5% Middle East/north African ethnic background). Using chi-square tests for trend and binominal logistic regression analyses adjusted for sex and maternal factors, we explored the development of ethnic differences in overweight. For children with south Asian origin, we performed body mass index adjustments considering their relatively higher adiposity.

Results: From age 2 to 8 years, prevalence of overweight was stable in European children (13.1% at 2 years, and 15.1% at 8 years). In children with immigrant background, prevalence increased; from 5.4% to 17.2% in children with south Asian origin, and from 16.2% to 35.8% in children with Middle East/north African background (p for trend < 0.001 in both groups). At age 8 years, the latter group had almost a threefold higher risk of overweight (odds ratio (OR) 2.89; 95% confidence interval 1.54-5.42) compared with European-origin children, while ethnic south Asian children had a double risk (OR 2.07; 1.19-3.59) after adjustments for body composition.

Conclusions: From 2 to 8 years of age, prevalence of childhood overweight increased in children with immigrant background but remained stable in ethnic Europeans. To reduce ethnic disparities in health, effective efforts to prevent obesity in children with immigrant background should start very early in life.

Aims: The aim of this study was to examine the associations between two mental wellbeing (MWB) aspects - subjective wellbeing (SWB) and work-life balance (WLB) - among working women across European countries, further analysing the simultaneous influence of the study participants' family- and work-related roles and responsibilities as well as macro-level context (country or welfare state categorization) on this association. Methods: A sub-set of data on working women (N = 6265) from the European Working Conditions Telephone Survey 2021 were utilized in multi-level mixed model analyses, where SWB measured with the WHO-5 instrument constituted the dependent variable. Results: WLB showed a statistically significant positive association with SWB. The association between European women's SWB and WLB was only slightly weakened when considering the influence of the women's roles and responsibilities in the family context (household structure and age of children) and work context (managerial position and full-time/part-time working arrangement). An effect of the country of residence, but not the five welfare state categories, appeared in relation to SWB in this sample of working women. Conclusions: Mental wellbeing is a multi-component concept and this study contributes to the growing evidence base on two key aspects of MWB and related interrelations among working women across Europe, with implications for public health strategies for promoting MWB.

Study aim: The objective of this scoping review was to explore and summarise emerging themes in existing studies on personal experiences of migrant parents of children with special health and welfare needs and their interaction with health and welfare services in the Nordic countries.

Methods: A comprehensive and systematic search for relevant articles in electronic databases was conducted in PubMed, PsycINFO and Web of Science between 2 April 2023 and 31 May 2023. The scoping review followed identified guidelines in conducting scoping reviews. Out of the initial 1836 study results, 62 studies were read and assessed as full text and a total of 13 studies met the inclusion criteria.

Results: Using thematic analysis, three key thematic categories were identified: (a) Initial responses to having a child with health and welfare challenges; (b) encountering the Nordic health and welfare services; (c) implications on social inclusion. The challenges to participation faced by migrants threatened their wellbeing, impacted their relationships and influenced their coping strategies and opportunities for social inclusion.

Conclusions: The Nordic countries have accessible, affordable and well-equipped infrastructure for health and welfare services compared with the home countries of most migrants. Future research is necessary to explore alternative strategies and spaces to promote participation and involvement of migrant parents of children with special health and welfare needs to inform public health and welfare services development and research.

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: 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.