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Hammarström, Anne
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Publications (10 of 126) Show all publications
Wennberg, M., Gustafsson, P., Wennberg, P. & Hammarström, A. (2016). Irregular eating of meals in adolescence and the metabolic syndrome in adulthood: results from a 27-year prospective cohort. Public Health Nutrition, 19(3), 667-673
Open this publication in new window or tab >>Irregular eating of meals in adolescence and the metabolic syndrome in adulthood: results from a 27-year prospective cohort
2016 (English)In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 19, no 3, p. 667-673Article in journal (Refereed) Published
Abstract [en]

Objective: The objective was to investigate whether irregular eating of meals in adolescence predicts the metabolic syndrome and its components in adulthood, and if any specific meal is of particular importance. Design: Prospective cohort study with 27 years of follow-up. Information on meals (breakfast, school lunch and dinner with family), lifestyle (alcohol consumption, smoking habits, physical activity, consumption of sweets and pastries) at age 16 years was assessed from questionnaires, and presence or not of the metabolic syndrome and its components were defined at age 43 years in 889 participants (82.1 % of total cohort). Logistic regression was used to calculate odds ratios and confidence intervals. Setting: The Northern Swedish Cohort; all school-leavers of the 9th grade in the town Lulea in 1981. Subjects: Adolescents (age 16 years). Results: Irregular eating of meals at age 16 years was associated with higher prevalence of the metabolic syndrome at age 43 years (OR=1.74; 95 % CI 1.12, 2.71), but this was explained by concurrent unhealthy lifestyle at age 16 years. Poor breakfast at age 16 years was the only meal associated with the metabolic syndrome at age 43 years, independent of other meals, BMI (kg/m2) and lifestyle at age 16 years (OR = 1.67; 95 % CI 1.00, 2.80). Conclusions: Irregular eating of meals in adolescence predicted the metabolic syndrome in adulthood, but not independently of BMI and lifestyle in adolescence. Poor breakfast in adolescence was the only specific meal associated with future metabolic syndrome, even after adjustments. Breakfast eating should be encouraged in adolescence.

Place, publisher, year, edition, pages
Cambridge University Press, 2016
Keyword
Irregular eating, Meal, Metabolic syndrome, Life course
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-101984 (URN)10.1017/S1368980015001445 (DOI)000372821000011 ()25936413 (PubMedID)
Available from: 2015-04-18 Created: 2015-04-18 Last updated: 2017-12-04Bibliographically approved
Landstedt, E., Gustafsson, P. E., Johansson, K. & Hammarström, A. (2016). Longitudinal associations between social relationships at age 30 and internalising symptoms at age 42: findings from the Northern Swedish Cohort.. International Journal of Public Health, 61(1), 75-81
Open this publication in new window or tab >>Longitudinal associations between social relationships at age 30 and internalising symptoms at age 42: findings from the Northern Swedish Cohort.
2016 (English)In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 61, no 1, p. 75-81Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Little is known on long-term consequences of poor social relationships in adulthood. The study aimed to examine associations between social relationships at age 30 and internalising symptoms at age 42.

METHODS: Data was drawn from four waves of the Northern Swedish cohort (n = 1001, 94 % response rate). The outcome internalising symptoms was measured by a composite index of depressiveness and anxiety. A cumulative measure was constructed to reflect various aspects of social relationships. Multivariate ordinal logistic regressions were used, controlling for socioeconomic indicators and previous level of internalising symptoms.

RESULTS: An accumulation of poor social relationships indicators at age 30 is related to internalising symptoms at age 42 in women (OR 1.30; CI 1.11-1.52) and men (OR 1.17; CI 1.02-1.36). The associations remained significant after adjustment for covariates.

CONCLUSIONS: Poor quality of social relationships at age 30 can predict internalising symptoms 12 years later in both men and women even when previous mental health as well as financial disadvantage is accounted for. More research is required to further examine pathways and mechanisms as well as suitable interventions.

Keyword
Mental health, Prospective study, Social network, Social integration, Non-work factors
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-103802 (URN)10.1007/s00038-015-0691-x (DOI)000367692400009 ()26024816 (PubMedID)
Available from: 2015-06-01 Created: 2015-06-01 Last updated: 2017-12-04Bibliographically approved
Rajaleid, K., Nummi, T., Westerlund, H., Virtanen, P., Gustafsson, P. E. & Hammarström, A. (2016). Social adversities in adolescence predict unfavourable trajectories of internalized mental health symptoms until middle age: results from the Northern Swedish Cohort.. European Journal of Public Health, 26(1), 23-29
Open this publication in new window or tab >>Social adversities in adolescence predict unfavourable trajectories of internalized mental health symptoms until middle age: results from the Northern Swedish Cohort.
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2016 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 26, no 1, p. 23-29Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Experiencing adversities during upbringing has short-term and long-term effects on mental health. This study aims to explore how social adversities in adolescence predict trajectories of internalized mental health symptoms (IMHS), from adolescence and onward until middle age.

METHODS: Based on 1040 individuals from the Northern Swedish Cohort Study, a community-based cohort with 27 years of follow-up. We applied latent class growth analysis to extract trajectories of IMHS between ages 16 and 43. Multinomial logistic regression was used to study the association of social adversities (residential mobility, residential crowding, parental loss, unemployment of a parent, physical illness of a parent, mental illness or alcohol problems of a parent) in adolescence with IMHS trajectories.

RESULTS: Five trajectory classes were identified: 'very low stable' (26% of the sample), 'low stable' (58%), 'moderate stable' (5%), 'increasing' (8%) and 'high decreasing' (3%). Both in men and women, reporting social adversities at the age of 16 increased the risk of belonging to the classes with less favourable development of IMHS. Reporting adversities was positively associated with the initial level of the IMHS trajectories. Thus it seems that the influence of adversities is more pronounced during the early years of follow-up and is attenuated over time.

CONCLUSION: Experiencing social adversities in adolescence increases the risk of entering unfavourable developmental trajectories of mental health until middle age.

Place, publisher, year, edition, pages
Oxford University Press, 2016
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-107112 (URN)10.1093/eurpub/ckv150 (DOI)000374478800008 ()26275987 (PubMedID)
Available from: 2015-08-18 Created: 2015-08-18 Last updated: 2017-12-04Bibliographically approved
Gustafsson, P., Hammarström, A. & San Sebastian, M. (2015). Cumulative contextual and individual disadvantages over the life course and adult functional somatic symptoms in Sweden. European Journal of Public Health, 25(4), 592-597
Open this publication in new window or tab >>Cumulative contextual and individual disadvantages over the life course and adult functional somatic symptoms in Sweden
2015 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 25, no 4, p. 592-597Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:: Disadvantage, originating in one's residential context or in one's past life course, has been shown to impact on health in adulthood. There is however little research on the accumulated health impact of both neighbourhood and individual conditions over the life course. This study aims to examine whether the accumulation of contextual and individual disadvantages from adolescence to middle-age predicts functional somatic symptoms (FSS) in middle-age, taking baseline health into account.

METHODS:: The sample is the age 16, 21, 30 and 42 surveys of the prospective Northern Swedish Cohort, with analytical sample size n = 910 (85% of the original cohort). FSS at age 16 and 42, and cumulative socioeconomic disadvantage, social adversity and material adversity between 16 and 42 years were operationalized from questionnaires, and cumulative neighbourhood disadvantage between 16 and 42 years from register data.

RESULTS:: Results showed accumulation of disadvantages jointly explained 9-12% of FSS variance. In the total sample, cumulative neighbourhood and socioeconomic disadvantage significantly predicted FSS at age 42 in the total sample. In women, neighbourhood disadvantage but not socioeconomic disadvantage contributed significantly, whereas in men, socioeconomic but not neighbourhood disadvantage contributed significantly. In all analyses, associations were largely explained by the parallel accumulation of social and material adversities, but not by symptoms at baseline.

CONCLUSION:: In conclusion, the accumulation of diverse forms of disadvantages together plays an important role for somatic complaints in adulthood, independently of baseline health.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-102108 (URN)10.1093/eurpub/cku213 (DOI)000359159900011 ()25527526 (PubMedID)
Available from: 2015-04-22 Created: 2015-04-22 Last updated: 2017-12-04Bibliographically approved
Haukenes, I., Hensing, G., Stålnacke, B.-M. & Hammarström, A. (2015). Does pain severity guide selection to multimodal pain rehabilitation across gender?. European Journal of Pain, 19(6), 826-833
Open this publication in new window or tab >>Does pain severity guide selection to multimodal pain rehabilitation across gender?
2015 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 19, no 6, p. 826-833Article in journal (Refereed) Published
Abstract [en]

Background Studies have addressed the effect of multimodal pain rehabilitation (MMR), whereas criteria for selection are sparse. This study examines whether higher scores on musculoskeletal pain measures are associated with selection to MMR, and whether this differs across gender.

Method A clinical population of 262 male and 589 female patients was recruited consecutively during 3 years, 2007-2010. The patients were referred from primary care to a pain rehabilitation clinic in Northern Sweden for assessment and selection to MMR. Register-based data on self-reported pain were linked to patients' records where outcome (MMR or not) was stated. We modelled odds ratios for selection to MMR by higher scores on validated pain measures (pain severity, interference with daily life, pain sites and localized pain vs. varying pain location). Covariates were age, educational level and multiple pain measures. Anxiety and depression (Hospital, Anxiety and Depression Scale) and working status were used in sensitivity tests.

Results Higher scores of self-reported pain were not associated with selection to MMR in multivariate models. Among women, higher scores on pain severity, pain sites and varying pain location (localized pain=reference) were negatively associated with selection to MMR. After adjustment for multiple pain measures, the negative odds ratio for varying location persisted (OR=0.59, 95% CI=0.39-0.89).

Conclusion Higher scores on self-reported pain did not guide selection to MMR and a negative trend was found among women. Studies of referral patterns and decision processes may contribute to a better understanding of the clinical practice that decides selection to MMR.

National Category
Anesthesiology and Intensive Care Neurology Neurosciences
Identifiers
urn:nbn:se:umu:diva-106253 (URN)10.1002/ejp.609 (DOI)000354128300013 ()25366906 (PubMedID)
Available from: 2015-07-13 Created: 2015-07-09 Last updated: 2018-04-18Bibliographically approved
Annandale, E. & Hammarström, A. (2015). Gender Inequality in the Couple Relationship and Leisure-Based Physical Exercise. PLoS ONE, 10(7), Article ID e0133348.
Open this publication in new window or tab >>Gender Inequality in the Couple Relationship and Leisure-Based Physical Exercise
2015 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 7, article id e0133348Article in journal (Refereed) Published
Abstract [en]

Aims: To analyse whether gender inequality in the couple relationship was related to leisure-based physical activity, after controlling for earlier physical activity and confounders. Methods: Data drawn from the Northern Swedish Cohort of all pupils in their final year of compulsory schooling in a town in the North of Sweden. The sample consisted of 772 respondents (n = 381 men, n = 391 women) in the 26-year follow-up (in 2007, aged 42) who were either married or cohabiting. Ordinal regression, for men and women separately, was used to assess the association between gender inequality (measured as self-perceived equality in the couple relationship using dummy variables) and a measure of exercise frequency, controlling for prior exercise frequency, socioeconomic status, the presence of children in the home, and longer than usual hours in paid work. Results: The perception of greater gender equality in the couple relationship was associated with higher levels of physical activity for both men and women. This remained significant when the other variables were controlled for. Amongst men the confidence intervals were high. Conclusions: The results point to the potential of perceived gender equality in the couple relationship to counteract the general time poverty and household burden that often arises from the combination of paid work and responsibility for children and the home, especially for women. The high confidence intervals among men indicate the need for more research within the field with larger samples.

Place, publisher, year, edition, pages
Public library science, 2015
National Category
Gender Studies Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-107296 (URN)10.1371/journal.pone.0133348 (DOI)000358547600086 ()26196280 (PubMedID)
Available from: 2015-08-24 Created: 2015-08-21 Last updated: 2017-12-04Bibliographically approved
Hammarström, A., Lundman, B., Ahlgren, C. & Wiklund, M. (2015). Health and masculinities shaped by agency within structures among young unemployed men in a northern Swedish context. PLoS ONE, 10(5), 1-18, Article ID e0124785.
Open this publication in new window or tab >>Health and masculinities shaped by agency within structures among young unemployed men in a northern Swedish context
2015 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 5, p. 1-18, article id e0124785Article in journal (Refereed) Published
Abstract [en]

The aim of our paper was to explore expressions of life choices and life chances (aspects of agency within structures) related to power and experiences of health among early unemployed adolescent young men during the transition period to adulthood. These expressions of agency within structure were interpreted in the light of Cockerham’s Health Lifestyles Theory. Furthermore, social constructions of masculinities were addressed in our analysis.

Repeated interviews with ten young men in a cohort of school leavers were analyzed with qualitative content analysis.

Cockerham’s model was useful for interpreting our findings and we found disposition to act to be a crucial theoretical tool to capture the will and intentions of participants in relation to health. We developed the model in the following ways: structure and socialization were visualized as surrounding the whole model. Analyses of what enhances or restricts power are important. In addition to practices of health lifestyles, we added experiences of health as outcome as well as emotional aspects in disposition to act. We interpret our findings as constructions of masculinities within certain structures, in relation to choices, habitus and practices.

Qualitative research could contribute to develop the understanding of the agency within structure relationships. Future studies need to pay attention to experiences of health among young people at the margin of the labor market in various milieus – and to analyze these in relation to gender constructions and within the frame-work of agency within structure.

Keyword
unemployment, youth, agency, structure, gender, masculinity
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
urn:nbn:se:umu:diva-103760 (URN)10.1371/journal.pone.0124785 (DOI)000356768100035 ()25954811 (PubMedID)
Funder
Swedish Research Council Formas, 259-2012-37Swedish Research Council, 344-2011-5478
Available from: 2015-05-29 Created: 2015-05-29 Last updated: 2017-12-04Bibliographically approved
Stålnacke, B.-M., Haukenes, I., Lehti, A., Wiklund, A. F., Wiklund, M. & Hammarström, A. (2015). Is there a gender bias in recommendations for further rehabilitation in primary care of patients with chronic pain after an interdisciplinary team assessment?. Journal of Rehabilitation Medicine, 47(4), 365-371
Open this publication in new window or tab >>Is there a gender bias in recommendations for further rehabilitation in primary care of patients with chronic pain after an interdisciplinary team assessment?
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2015 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 4, p. 365-371Article in journal (Refereed) Published
Abstract [en]

Objective: To examine potential gender bias in recommendations of further examination and rehabilitation in primary care for patients with chronic musculoskeletal pain after an interdisciplinary team assessment. Methods: The population consisted of consecutive patients (n=589 women, 262 men) referred during a 3-year period from primary healthcare for assessment by interdisciplinary teams at a pain specialist rehabilitation clinic. Patient data were collected from the Swedish Quality Registry for Pain Rehabilitation. The outcome was defined as the examination or rehabilitation that was specified in the patient's record. Results: Men had a significantly higher likelihood than women of being recommended physiotherapy and radiological examination, and the gender difference was not explained by confounding variables and covariates (age, marital status, ethnicity, education, working status, pain severity, pain interference, pain sites, anxiety and depression). There was no significant gender difference in recommendations to treatment by specialist physician, occupational therapist, psychologist or social worker. Conclusion: Our findings indicate that the interdisciplinary teams in specialist healthcare may discriminate against women with chronic pain when physiotherapy and radiological investigation are recommended. The team's choice of recommendations might be influenced by gendered attitudes, but this field of research needs to be studied further.

Place, publisher, year, edition, pages
Foundation of Rehabilitation Information, 2015
Keyword
chronic pain, rehabilitation, assessment, gender
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-103159 (URN)10.2340/16501977-1936 (DOI)000352753900011 ()25587848 (PubMedID)
Available from: 2015-05-29 Created: 2015-05-18 Last updated: 2017-12-04Bibliographically approved
Elwér, S., Hammarström, A., Strandh, M. & Gustafsson, P. (2015). Life course models of economic stress and poor mental health in mid-adulthood: results from the prospective Northern Swedish Cohort. Scandinavian Journal of Public Health, 43(8), 833-840
Open this publication in new window or tab >>Life course models of economic stress and poor mental health in mid-adulthood: results from the prospective Northern Swedish Cohort
2015 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 8, p. 833-840Article in journal (Refereed) Published
Abstract [en]

Aim: The aim was to analyse the association between economic stress during youth and adulthood, and poor mental health through life course models of (1) accumulation of risk and (2) sensitive period. Methods: The study was based on the Northern Sweden Cohort, a 26-year prospective cohort (N = 1010 in 2007; 94% of those participating in 1981 still alive) ranging from adolescence to middle age. Economic stress was measured at age 16, 21, 30 and 42 years. Two life course models of accumulation of risk and sensitive period were analysed using ordinal regression with internalized symptoms of mental health as outcome. Results: Exposure of economic stress at several life course periods was associated with higher odds of internalized mental health symptoms for both women and men, which supports the accumulated risk model. No support for a sensitive period was found for the whole sample. For men, however, adolescence appears to be a sensitive period during which the exposure to economic stress has negative mental health consequences later in life independently of economic stress at other ages. Conclusion: This study confirms that the duration of economic stress between adolescence and middle age is important for mental health. In addition, the results give some indication of a sensitive period of exposure to economic stress during adolescence for men, although more research is needed to confirm possible gender differences.

Keyword
Life course, accumulation of risk, economic stress, gender, internalized symptoms, longitudinal cohort, mental health, ordinal regression, sensitive period
National Category
Public Health, Global Health, Social Medicine and Epidemiology Sociology
Identifiers
urn:nbn:se:umu:diva-106757 (URN)10.1177/1403494815583420 (DOI)000364636600008 ()26229073 (PubMedID)
Available from: 2015-08-07 Created: 2015-08-07 Last updated: 2017-12-04Bibliographically approved
Virtanen, P., Nummi, T., Lintonen, T., Westerlund, H., Hägglöf, B. & Hammarström, A. (2015). Mental health in adolescence as determinant of alcohol consumption trajectories in the Northern Swedish Cohort. International Journal of Public Health, 63(3), 335-342
Open this publication in new window or tab >>Mental health in adolescence as determinant of alcohol consumption trajectories in the Northern Swedish Cohort
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2015 (English)In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 63, no 3, p. 335-342Article in journal (Refereed) Published
Abstract [en]

The study aimed to analyze whether poor mental health in adolescence predicts heavy alcohol consumption over the long term. Alcohol consumption in the population cohort (n = 1010) was surveyed at the ages of 16, 18, 21, 30 and 42. Utilizing latent class growth analysis, six consumption trajectories ranging from 'Late Onset Low' to 'Early Onset High' were defined and analyzed with respect to internalization (depressiveness and anxiousness) and externalization (truancy and vandalism) at age 16. Poor mental health predicted the Early Onset High trajectory (risk ratios in relation to the compliant trajectory 3.59 for anxiousness, 2.85 for depressiveness, 5.69 for truancy and 7.75 for externalized vandalism). Moreover, significant associations were found for the Early Onset Moderate and Early Onset Low trajectories. This is the first study to show an association between internalized mental health problems in adolescence and lifelong heavy drinking. The study also confirmed a strong association between externalized behavior and heavy drinking, indicating a need of preventive measures in this group. Nevertheless, the analyses demonstrated that most teenagers with mental health problems continue along a reasonable drinking trajectory.

Place, publisher, year, edition, pages
Springer, 2015
Keyword
internalized symptoms, externalized behavior, alcohol consumption, trajectory, analysis
National Category
Public Health, Global Health, Social Medicine and Epidemiology Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-101596 (URN)10.1007/s00038-015-0651-5 (DOI)000350372000006 ()25609507 (PubMedID)
Available from: 2015-04-13 Created: 2015-04-07 Last updated: 2018-01-11Bibliographically approved
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