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San Sebastian, M., Mosquera, P. A. & Gustafsson, P. E. (2019). Do cardiovascular disease prevention programs in northern Sweden impact on population health?: An interrupted time series analysis. BMC Public Health, 19, Article ID 202.
Öppna denna publikation i ny flik eller fönster >>Do cardiovascular disease prevention programs in northern Sweden impact on population health?: An interrupted time series analysis
2019 (Engelska)Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, artikel-id 202Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Cardiovascular disease (CVD) is the main cause of morbidity and mortality in Sweden. This study aims to assess the impact of a CVD intervention implemented in 1993 in northern Sweden on the reduction of premature ischemic heart disease (IHD) morbidity and mortality in women and men during the period 1987-2013.

Methods: An ecological controlled interrupted time series design, with pre-intervention period defined as 1987-1993 and post-intervention period 1994-2013 was carried out. For each year, IHD events, stratified by sex, were retrieved from national registers.

Results: Impressive reductions on IHD premature morbidity and mortality were observed to a similar degree in both the intervention county and the other comparison counties across the last 27years. Significant differences in the pre-post intervention trends indicating the intervention group had smaller reductions than expected from its pre-intervention trend and the trend of control counties were found among men for both IHD morbidity and mortality. A similar pattern was observed among women but without significant differences.

Conclusions: Taken together, the data do not support that the intervention has contributed to an additional reduction on IHD morbidity and mortality, above and beyond that which is already seen in neighbouring counties without similar programs.

Ort, förlag, år, upplaga, sidor
BioMed Central, 2019
Nyckelord
Ischemic heart disease, Morbidity, Mortality, Interrupted time series analysis, Intervention, Northern Sweden
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Kardiologi
Identifikatorer
urn:nbn:se:umu:diva-157210 (URN)10.1186/s12889-019-6514-x (DOI)000459132800003 ()30770750 (PubMedID)
Tillgänglig från: 2019-03-26 Skapad: 2019-03-26 Senast uppdaterad: 2019-03-26Bibliografiskt granskad
Szilcz, M., Mosquera, P., San Sebastian, M. & Gustafsson, P. E. (2019). Income inequalities in leisure time physical inactivity in northern Sweden: a decomposition analysis. Scandinavian Journal of Public Health
Öppna denna publikation i ny flik eller fönster >>Income inequalities in leisure time physical inactivity in northern Sweden: a decomposition analysis
2019 (Engelska)Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905Artikel i tidskrift (Refereegranskat) Epub ahead of print
Abstract [en]

AIMS: Increasing income inequalities in leisure time physical inactivity have been reported in the relatively socially equal setting of northern Sweden. The present report seeks to contribute to the literature by exploring the contribution of different factors to the income inequalities in leisure time physical inactivity in northern Sweden.

METHODS: This study was based on the 2014 Health on Equal Terms survey, distributed in the four northernmost counties of Sweden. The analytical sample consisted of 21,000 respondents aged 16-84. Six thematic groups of explanatory variables were used: demographic variables, socioeconomic factors, material resources, family-, psychosocial conditions and functional limitations. Income inequalities in leisure time physical inactivity were decomposed by Wagstaff-type decomposition analysis.

RESULTS: Income inequalities in leisure time physical inactivity were found to be explained to a considerable degree by health-related limitations and unfavourable socioeconomic conditions. Material and psychosocial conditions seemed to be of moderate importance, whereas family and demographic characteristics were of minor importance.

CONCLUSIONS: This study suggests that in order to achieve an economically equal leisure time physical inactivity, policy may need to target the two main barriers of functional limitations and socioeconomic disadvantages.

Ort, förlag, år, upplaga, sidor
Sage Publications, 2019
Nyckelord
Decomposition analysis, income, inequalities, leisure time physical inactivity, northern Sweden
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
Identifikatorer
urn:nbn:se:umu:diva-158197 (URN)10.1177/1403494818812647 (DOI)30632908 (PubMedID)
Tillgänglig från: 2019-04-16 Skapad: 2019-04-16 Senast uppdaterad: 2019-08-15
Mamani-Ortiz, Y., San Sebastian, M., Armaza, A. X., Luizaga, J. M., Illanes, D. E., Ferrel, M. & Mosquera, P. (2019). Prevalence and determinants of cardiovascular disease risk factors using the WHO STEPS approach in Cochabamba, Bolivia. BMC Public Health, 19, Article ID 786.
Öppna denna publikation i ny flik eller fönster >>Prevalence and determinants of cardiovascular disease risk factors using the WHO STEPS approach in Cochabamba, Bolivia
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2019 (Engelska)Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, artikel-id 786Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Cardiovascular diseases (CVDs) are considered the number one cause of death worldwide, especially in low- and middle-income countries, Bolivia included. Lack of reliable estimates of risk factor distribution can lead to delay in implementation of evidence-based interventions. However, little is known about the prevalence of risk factors in the country. The aim of this study was to assess the prevalence of preventable risk factors associated with CVDs and to identify the demographic and socioeconomic factors associated with them in Cochabamba, Bolivia.

Methods: A cross-sectional community-based study was conducted among youth and adults (N = 10,704) with permanent residence in Cochabamba, selected through a multistage sampling technique, from July 2015 to November 2016. An adapted version of the WHO STEPS survey was used to collect information. The prevalence of relevant behavioural risk factors and anthropometric measures were obtained. The socio-demographic variables included were age, ethnicity, level of education, occupation, place of residence, and marital status. Proportions with 95% confidence intervals were first calculated, and prevalence ratios were estimated for each CVD risk factor, both with crude and adjusted models.

Results: More than half (57.38%) were women, and the mean age was 37.89 ± 18 years. The prevalence of behavioural risk factors were: current smoking, 11.6%; current alcohol consumption, 42.76%; low consumption of fruits and vegetables, 76.73%; and low level of physical activity, 64.77%. The prevalence of overweight was 35.84%; obesity, 20.49%; waist risk or abdominal obesity, 54.13%; and raised blood pressure, 17.5%. Indigenous populations and those living in the Andean region showed in general a lower prevalence of most of the risk factors evaluated.

Conclusion: We provide the first CVD risk factor profile of people living in Cochabamba, Bolivia, using a standardized methodology. Overall, findings suggest that the prevalence of CVD risk factors in Cochabamba is high. This result highlights the need for interventions to improve early diagnosis, monitoring, management, and especially prevention of these risk factors.

Ort, förlag, år, upplaga, sidor
BioMed Central, 2019
Nyckelord
WHO STEPS approach, Cardiovascular risk factors, Obesity, Hypertension, Tobacco, Alcohol, Bolivia
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-161716 (URN)10.1186/s12889-019-7064-y (DOI)000472845800006 ()31221119 (PubMedID)
Forskningsfinansiär
Sida - Styrelsen för internationellt utvecklingssamarbete
Tillgänglig från: 2019-08-05 Skapad: 2019-08-05 Senast uppdaterad: 2019-08-05Bibliografiskt granskad
Mosquera, P. A., San Sebastian, M., Ivarsson, A. & Gustafsson, P. E. (2018). Decomposition of gendered income-related inequalities in multiple biological cardiovascular risk factors in a middle-aged population. International Journal for Equity in Health, 17, Article ID 102.
Öppna denna publikation i ny flik eller fönster >>Decomposition of gendered income-related inequalities in multiple biological cardiovascular risk factors in a middle-aged population
2018 (Engelska)Ingår i: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 17, artikel-id 102Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Socioeconomic inequalities in cardiovascular disease seem to widen or endure in Sweden. However, research on inequalities in antecedent cardiovascular risk factors (CVRFs), and particularly what underpins them, is scarce. The present study aimed 1) to estimate income-related inequalities in eight biological cardiovascular risk factors in Swedish middle-aged women and men; and 2) to examine the contribution of demographic, socioeconomic, behavioural and psychosocial determinants to the observed inequalities.

METHODS: Participants (N = 12,481) comprised all 40- and 50-years old women and men who participated in the regional Västerbotten Intervention Programme in Northern Sweden during 2008, 2009 and 2010. All participants completed a questionnaire on behavioural and psychosocial conditions, and underwent measurements with respect to eight CVRFs (body mass index; waist circumference; total cholesterol; high-density lipoprotein cholesterol; low-density lipoprotein cholesterol; triglycerides; systolic/diastolic blood pressure; glucose tolerance). Data on cardiovascular risk, psychosocial and health behaviours were linked to national register data on income and other socioeconomic and demographic factors. To estimate income inequalities in each CVRF concentration indexes were calculated, and to examine the contribution of the underlying determinants to the observed inequalities a Wagstaff-type decomposition analysis was performed separately for women and men.

RESULTS: Health inequalities ranged from small to substantial with generally greater magnitude in women. The highest inequalities among women were seen in BMI, triglycerides and HDL-cholesterol (Concentration index = - 0.1850; - 0.1683 and - 0.1479 respectively). Among men the largest inequalities were seen in glucose regulation, BMI and abdominal obesity (Concentration index = - 0.1661; - 0.1259 and - 0.1172). The main explanatory factors were, for both women and men socioeconomic conditions (contributions ranging from 54.8 to 76.7% in women and 34.0-72.6% in men) and health behaviours (contributions ranging from 6.9 to 20.5% in women and 9.2 to 26.9% in men). However, the patterns of specific dominant explanatory factors differed between CVRFs and genders.

CONCLUSION: Taken together, the results suggest that the magnitude of income-related inequalities in CVRFs and their determinants differ importantly between the risk factors and genders, a variation that should be taken into consideration in population interventions aiming to prevent inequalities in manifest cardiovascular disease.

Nyckelord
Cardiovascular risk factors, Decomposition analysis, Income inequality, Middle age, Sweden
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-150576 (URN)10.1186/s12939-018-0804-2 (DOI)000438822600001 ()30005665 (PubMedID)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2014-2725Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2014-0451Vetenskapsrådet, 2008-7491
Tillgänglig från: 2018-08-13 Skapad: 2018-08-13 Senast uppdaterad: 2019-01-31Bibliografiskt granskad
La Parra-Casado, D., Mosquera, P. A., Vives-Cases, C. & San Sebastian, M. (2018). Socioeconomic Inequalities in the Use of Healthcare Services: Comparison between the Roma and General Populations in Spain. International Journal of Environmental Research and Public Health, 15(1), Article ID 121.
Öppna denna publikation i ny flik eller fönster >>Socioeconomic Inequalities in the Use of Healthcare Services: Comparison between the Roma and General Populations in Spain
2018 (Engelska)Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, nr 1, artikel-id 121Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

This paper explores whether the principles of horizontal and vertical equity in healthcare are met by the Spanish national health system in the case of the Roma and general populations. The 2011/2012 Spanish National Health Survey (n = 21,650) and the 2014 National Health Survey of the Spanish Roma Population (n = 1167) were analyzed. Use of healthcare services was measured in terms of visits to a general practitioner (GP), visits to an emergency department, and hospitalizations. Healthcare need was measured using (a) self-rated health and (b) the reported number of chronic diseases. The Roma reported worse self-rated health and a higher prevalence of chronic diseases. A redistributive effect (increased healthcare service use among Roma and those in lower socio-economic classes) was found for hospitalizations and emergency visits. This effect was also observed in GP visits for women, but not for men. Vertical inequity was observed in the general population but not in the Roma population for GP visits. The results suggest the existence of horizontal inequity in the use of GP services (Roma women), emergency department visits (Roma and general population), and hospitalizations (Roma population) and of vertical inequity in the use of GP services among the general population.

Nyckelord
ethnic groups, social class, Roma, healthcare disparities, Spain
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-145609 (URN)10.3390/ijerph15010121 (DOI)000424121200120 ()
Tillgänglig från: 2018-03-21 Skapad: 2018-03-21 Senast uppdaterad: 2018-06-09Bibliografiskt granskad
Ramadani, R. V., Mosquera, P. A., San Sebastián, M. & Gustafsson, P. E. (2018). The moderating effect of income on the relationship between body mass index and health-related quality of life in Northern Sweden. Scandinavian Journal of Public Health
Öppna denna publikation i ny flik eller fönster >>The moderating effect of income on the relationship between body mass index and health-related quality of life in Northern Sweden
2018 (Engelska)Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905Artikel i tidskrift (Refereegranskat) Epub ahead of print
Abstract [en]

OBJECTIVES: This study aimed to investigate the relationship between body mass index (BMI) and health-related quality of life (HRQoL) and whether this relationship is influenced by the level of income in Northern Sweden. Overweight and obesity are rising major public health problems which also affect HRQoL. While socioeconomic inequalities in health are persisting or increasing in many countries, including Sweden, little attention has been paid to the more complex roles of income in relation to health.

METHODS: Data were drawn from a 2014 cross-sectional survey from Northern Sweden (Health on Equal Terms), comprising individuals aged 20-84 years ( N = 20,082 individuals included for analysis). BMI and HRQoL were self-reported and individual disposable income in 2012 was retrieved from population registers. Multiple linear regressions were performed with HRQoL scores regressed on BMI and income, their interaction and additional covariates.

RESULTS: The underweight, overweight and obesity groups reported significantly lower HRQoL compared to the normal weight group. Moreover, the relationship between BMI and HRQoL varied significantly by level of income, with a stronger association among those with the lowest level of income.

CONCLUSIONS: Income has a role as an effect modifier in the relationship between BMI and HRQoL that can be construed as an indirect income inequality. Efforts to promote HRQoL in populations should consider the different impact of being overweight and obese in different socioeconomic groups.

Ort, förlag, år, upplaga, sidor
Sage Publications, 2018
Nyckelord
obesity, Sweden, health-related quality of life, income, inequality
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-150608 (URN)10.1177/1403494818761418 (DOI)29516787 (PubMedID)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2014- 2725Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2014-0451
Tillgänglig från: 2018-08-14 Skapad: 2018-08-14 Senast uppdaterad: 2019-04-04
Szilcz, M., Mosquera, P. A., Sebastián, M. S. & Gustafsson, P. E. (2018). Time trends in absolute and relative socioeconomic inequalities in leisure time physical inactivity in northern Sweden. Scandinavian Journal of Public Health, 46(1), 112-123
Öppna denna publikation i ny flik eller fönster >>Time trends in absolute and relative socioeconomic inequalities in leisure time physical inactivity in northern Sweden
2018 (Engelska)Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, nr 1, s. 112-123Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

AIMS: The aim was to investigate the time trends in educational, occupational, and income-related inequalities in leisure time physical inactivity in 2006, 2010, and 2014 in northern Swedish women and men.

METHODS: This study was based on data obtained from the repeated cross-sectional Health on Equal Terms survey of 2006, 2010, and 2014. The analytical sample consisted of 20,667 (2006), 31,787 (2010), and 21,613 (2014) individuals, aged 16-84. Logistic regressions were used to model the probability of physical inactivity given a set of explanatory variables. Slope index of inequality (SII) and relative index of inequality (RII) were used as summary measures of the social gradient in physical inactivity. The linear trend in inequalities and difference between gender and years were estimated by interaction analyses.

RESULTS: The year 2010 displayed the highest physical inactivity inequalities for all socioeconomic position indicators, but educational and occupational inequalities decreased in 2014. However, significant positive linear trends were found in absolute and relative income inequalities. Moreover, women had significantly higher RII of education in physical inactivity in 2014 and significantly higher SII and RII of income in physical inactivity in 2010, than did men in the same years.

CONCLUSIONS: The recent reduction in educational and occupational inequalities following the high inequalities around the time of the great recession in 2010 suggests that the current policies might be fairly effective. However, to eventually alleviate inequities in physical inactivity, the focus of the researchers and policymakers should be directed toward the widening trends of income inequalities in physical inactivity.

Ort, förlag, år, upplaga, sidor
Sage Publications, 2018
Nyckelord
Physical inactivity, relative index of inequality, slope index of inequality, socioeconomic inequality, time trend
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-143318 (URN)10.1177/1403494817713123 (DOI)000428758000016 ()28707564 (PubMedID)
Anmärkning

Special Issue

Tillgänglig från: 2017-12-20 Skapad: 2017-12-20 Senast uppdaterad: 2018-06-09Bibliografiskt granskad
Waenerlund, A.-K., Mosquera, P., Gustafsson, P. E. & San Sebastian, M. (2018). Trends in educational and income inequalities in cardiovascular morbidity in middle age in Northern Sweden 1993–2010. Scandinavian Journal of Public Health, Article ID 1403494818790406.
Öppna denna publikation i ny flik eller fönster >>Trends in educational and income inequalities in cardiovascular morbidity in middle age in Northern Sweden 1993–2010
2018 (Engelska)Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, artikel-id 1403494818790406Artikel i tidskrift (Refereegranskat) Epub ahead of print
Abstract [en]

AIMS: Research is scarce regarding studies on income and educational inequality trends in cardiovascular disease in Sweden. The aim of this study was to assess trends in educational and income inequalities in first hospitalizations due to cardiovascular disease (CVD) from 1993 to 2010 among middle-aged women and men in Northern Sweden.

METHODS: The study comprised repeated cross-sectional register data from year 1993-2010 of all individuals aged 38-62 years enrolled in the Västerbotten Intervention Programme (VIP). Data included highest educational level, total earned income and first-time hospitalization for CVD from national registers. The relative and slope indices of inequality (RII and SII, respectively) were used to estimate educational and income inequalities in CVD for six subsamples for women and men, and interaction analyses were used to estimate trends across time periods.

RESULTS: Educational RII and SII were stable in women, while they decreased in men. Income inequalities in CVD developed differently compared with educational inequalities, with RII and SII for both men and women increasing during the study period, the most marked for RII in women rising from 1.52 in the 1990s to 2.62 in the late 2000s.

CONCLUSIONS: The trend of widening income inequalities over 18 years in the middle-aged in Northern Sweden, in the face of stable or even decreasing educational inequalities, is worrisome from a public health perspective, especially as Swedish authorities monitor socioeconomical inequalities exclusively by education. The results show that certain social inequalities in CVD rise and persist even within a traditionally egalitarian welfare regime.

Nyckelord
Inequalities, Sweden, cardiovascular diseases, education, income
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Forskningsämne
folkhälsa; socialmedicin; epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-154002 (URN)10.1177/1403494818790406 (DOI)30113264 (PubMedID)
Tillgänglig från: 2018-12-11 Skapad: 2018-12-11 Senast uppdaterad: 2019-04-04
San Sebastian, M., Mosquera, P. & Gustafsson, P. E. (2018). Whose income is more important: mine, yours or ours? Income inequality and mental health in northern Sweden. European Journal of Public Health, 28(6), 1056-1061
Öppna denna publikation i ny flik eller fönster >>Whose income is more important: mine, yours or ours? Income inequality and mental health in northern Sweden
2018 (Engelska)Ingår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, nr 6, s. 1056-1061Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Three main explanations of the relationship between income and population health have been identified: the absolute, the contextual and the relative income hypotheses. The evidence about their relevance particularly in egalitarian societies is, however, inconsistent. This study aimed to test the three hypotheses in relation to psychological distress in northern Sweden.

Methods: Data come from the 2014 cross-sectional survey from the four northern-most counties in Sweden, and included people aged 25-84 years (n = 21 004). Psychological distress was measured by the General Health Questionnaire-12 and income information came from population registers. Absolute income was operationalized by individual disposable income, contextual income as the municipal-level Gini coefficient and relative income by the Yitzhaki index. Prevalence ratios (PR) were calculated from log-binomial regression analyses.

Results: A gradient in poor mental health was observed across quintiles of individual income, with the poorest substantially more likely to report poor health compared with the highest quintile (PR = 1.56; 95% CI = 1.19, 2.04). Second, municipalities in the quintiles 2-3 of the Gini coefficient had a better mental health compared with those in the most equal municipalities. Third, a gradient in poor mental health across quintiles of relative deprivation was also found, with the most deprived quintile the most likely to report poor health (PR = 1.37; 95% CI = 1.06, 1.76).

Conclusion: This study suggests a strong, moderate and lack of support for the absolute, relative and contextual income effect hypotheses, respectively. Interventions targeting a reduction in the individual income gap may be necessary in order to reduce psychosocial distress differences in northern Sweden.

Ort, förlag, år, upplaga, sidor
Oxford University Press, 2018
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-150577 (URN)10.1093/eurpub/cky110 (DOI)000456673500015 ()29982407 (PubMedID)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2014-2725Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2014- 0451Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2016-00236
Tillgänglig från: 2018-08-13 Skapad: 2018-08-13 Senast uppdaterad: 2019-02-20Bibliografiskt granskad
Mosquera, P. A., San Sebastian, M., Ivarsson, A., Weinehall, L. & Gustafsson, P. E. (2017). Are health inequalities rooted in the past? Income inequalities in metabolic syndrome decomposed by childhood conditions. European Journal of Public Health, 27(2), 223-233
Öppna denna publikation i ny flik eller fönster >>Are health inequalities rooted in the past? Income inequalities in metabolic syndrome decomposed by childhood conditions
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2017 (Engelska)Ingår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, nr 2, s. 223-233Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Early life is thought of as a foundation for health inequalities in adulthood. However, research directly examining the contribution of childhood circumstances to the integrated phenomenon of adult social inequalities in health is absent. The present study aimed to examine whether, and to what degree, social conditions during childhood explain income inequalities in metabolic syndrome in mid-adulthood.

METHODS: The sample (N = 12 481) comprised all 40- and 50-year-old participants in the Västerbotten Intervention Program in Northern Sweden 2008, 2009 and 2010. Measures from health examinations were used to operationalize metabolic syndrome, which was linked to register data including socioeconomic conditions at age 40-50 years, as well as childhood conditions at participant age 10-12 years. Income inequality in metabolic syndrome in middle age was estimated by the concentration index and decomposed by childhood and current socioeconomic conditions using decomposition analysis.

RESULTS: Childhood conditions jointed explained 7% (men) to 10% (women) of health inequalities in middle age. Adding mid-adulthood sociodemographic factors showed a dominant contribution of chiefly current income and educational level in both gender. In women, the addition of current factors slightly attenuated the contribution of childhood conditions, but with paternal income and education still contributing. In contrast, the corresponding addition in men removed all explanation attributable to childhood conditions.

CONCLUSIONS: Despite that the influence of early life conditions to adult health inequalities was considerably smaller than that of concurrent conditions, the study suggests that early interventions against social inequalities potentially could reduce health inequalities in the adult population for decades to come.

Nyckelord
Metabolic syndrome, Early-life conditions, Income inequality, Decomposition analysis, Life course
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-126888 (URN)10.1093/eurpub/ckw186 (DOI)000398086400009 ()27744345 (PubMedID)
Tillgänglig från: 2016-10-19 Skapad: 2016-10-19 Senast uppdaterad: 2018-06-09Bibliografiskt granskad
Projekt
FIIP: Grundläggs ojämlikhet i hälsa tidigare i livet? Ett livsloppsperspektiv på socioekonomisk ojämlikhet i kardiovaskulär o... [2014-02725_Forte]; Umeå universitetVilka är de kollektiva följderna av individuella val? Ett naturligt experiment av vårdvalsreformens betydelse för hälsa och ojämlikheter i hälsa i Sverige [2016-00236_Forte]; Umeå universitet
Organisationer
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0001-7134-8256

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