umu.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Publications (10 of 142) Show all publications
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.
Open this publication in new window or tab >>Decomposition of gendered income-related inequalities in multiple biological cardiovascular risk factors in a middle-aged population
2018 (English)In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 17, article id 102Article in journal (Refereed) 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.

Keywords
Cardiovascular risk factors, Decomposition analysis, Income inequality, Middle age, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-150576 (URN)10.1186/s12939-018-0804-2 (DOI)000438822600001 ()30005665 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-2725Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-0451Swedish Research Council, 2008-7491
Available from: 2018-08-13 Created: 2018-08-13 Last updated: 2018-08-15Bibliographically approved
Namatovu, F., Strandh, M., Ivarsson, A. & Nilsson, K. (2018). Effect of childhood coeliac disease on ninth grade school performance: evidence from a population-based study. Archives of Disease in Childhood, 103(2), 143-148
Open this publication in new window or tab >>Effect of childhood coeliac disease on ninth grade school performance: evidence from a population-based study
2018 (English)In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 103, no 2, p. 143-148Article in journal (Refereed) Published
Abstract [en]

Background: Coeliac disease might affect school performance due to its effect on cognitive performance and related health consequences that might increase school absenteeism. The aim of this study was to investigate whether children with coeliac disease performed differently on completion of ninth grade in school compared with children without coeliac disease.

Methods: Analysis was performed on a population of 445 669 children born in Sweden between 1991 and 1994 of whom 1767 were diagnosed with coeliac disease. School performance at ninth grade was the outcome and coeliac disease was the exposure. Other covariates included sex, Apgar score at 5 min, small for gestational age, year of birth, family type, parental education and income.

Results: There was no association between coeliac disease and school performance at ninth grade (adjusted coefficient -2.4, 95% CI 5.1 to 0.4). A weak association was established between late coeliac diagnosis and higher grades, but this disappeared after adjusting for parent socioeconomic conditions. Being small for gestational age affected performance negatively (adjusted coefficient -6.9, 95% CI 8.0 to 5.7). Grade scores were significantly lower in children living with a single parent (adjusted coefficient -20.6, 95% CI 20.9 to 20.2), compared with those with married/cohabiting parents. A positive association was found between scores at ninth grade and parental education and income.

Conclusion: Coeliac disease diagnosis during childhood is not associated with poor school performance at ninth grade.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
Keywords
achievement, celiac, disease, education, grades, income, performance and school
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-139901 (URN)10.1136/archdischild-2017-312830 (DOI)000424019400011 ()28844065 (PubMedID)
Available from: 2017-09-26 Created: 2017-09-26 Last updated: 2018-06-09Bibliographically approved
Norström, F., van der Pals, M., Myléus, A., Hammarroth, S., Högberg, L., Isaksson, A., . . . Carlsson, A. (2018). Impact of Thyroid Autoimmunity on Thyroid Function in 12-year-old Children With Celiac Disease. Journal of Pediatric Gastroenterology and Nutrition - JPGN, 67(1), 64-68
Open this publication in new window or tab >>Impact of Thyroid Autoimmunity on Thyroid Function in 12-year-old Children With Celiac Disease
Show others...
2018 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 67, no 1, p. 64-68Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Celiac disease (CD) is associated with thyroid autoimmunity and other autoimmune diseases. However, data are lacking regarding the relationship between thyroid autoimmunity and thyroid function, especially in regard to CD. Our aim was to investigate the impact of thyroid autoimmunity on thyroid function in 12-year-old children with CD compared to their healthy peers.

METHODS: A case-referent study was conducted as part of a CD screening of 12-year-olds. Our study included 335 children with CD and 1,695 randomly selected referents. Thyroid autoimmunity was assessed with antibodies against thyroid peroxidase (TPOAb). Thyroid function was assessed with thyroid stimulating hormone and free thyroxine.

RESULTS: TPOAb positivity significantly increased the risk of developing hypothyroidism in all children. The odds ratios (with 95% confidence intervals) were: 5.3 (2.7-11) in healthy 12-year-olds, 10 (3.2-32) in screening-detected CD cases, 19 (2.6-135) in previously diagnosed CD cases, and 12 (4.4-32) in all CD cases together. Among children with TPOAb positivity, hypothyroidism was significantly more common (odds ratio 3.1; 95% CI 1.03-9.6) in children with CD (10/19) than in children without CD (12/46).

CONCLUSIONS: The risk of thyroid dysfunction due to thyroid autoimmunity is larger for those with CD than their healthy peers. Our study indicate that a gluten-free diet does not reduce the risk of thyroid dysfunction. Further studies are required for improved understanding of the role of the gluten-free diet for the risk of autoimmune diseases in children with CD.

National Category
Public Health, Global Health, Social Medicine and Epidemiology Gastroenterology and Hepatology
Research subject
Epidemiology
Identifiers
urn:nbn:se:umu:diva-144634 (URN)10.1097/MPG.0000000000001903 (DOI)000441421500019 ()29373441 (PubMedID)
Available from: 2018-02-08 Created: 2018-02-08 Last updated: 2018-09-11Bibliographically approved
Lindholm, L., Ivarsson, A., Löfgren, C., Meili, K., Nygren, L., Pulkki-Brännström, A.-M. & Sahlen, K.-G. (2018). Nytt sätt att mäta livskvalitet öppnar för effektivare insatser. Dagens samhälle (31), pp. 26-26
Open this publication in new window or tab >>Nytt sätt att mäta livskvalitet öppnar för effektivare insatser
Show others...
2018 (Swedish)In: Dagens samhälle, ISSN 1652-6511, no 31, p. 26-26Article in journal, News item (Other (popular science, discussion, etc.)) Published
Keywords
perspektiv, välfärd, kvalitet, forskning
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
urn:nbn:se:umu:diva-154101 (URN)
Note

Publicerad online med rubriken "Forskare: Mät välfärdens kvalitet i antal "goda år"!"

Available from: 2018-12-14 Created: 2018-12-14 Last updated: 2018-12-18Bibliographically approved
Myléus, A., Stenhammar, L., Högberg, L., Browaldh, L., Daniels, I.-M., Fagerberg, U. L., . . . Ivarsson, A. (2018). Questionnaire showed that Swedish paediatric clinics complied well with the revised European guidelines for diagnosing coeliac disease. Acta Paediatrica
Open this publication in new window or tab >>Questionnaire showed that Swedish paediatric clinics complied well with the revised European guidelines for diagnosing coeliac disease
Show others...
2018 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim: In 2012, revised criteria for diagnosing childhood coeliac disease were published bythe European Society for Paediatric Gastroenterology, Hepatology and Nutrition andincorporated into the revised Swedish guidelines the same year. These made it possible, incertain cases, to diagnose coeliac disease without taking small bowel biopsies. This surveyassessed the extent to which the new guidelines were implemented by Swedish paediatricclinics two years after their introduction.

Methods: In October 2014, we distributed a paper questionnaire including five questionson diagnostic routines to the 40 paediatric clinics in university or regional hospitals inSweden that perform small bowel biopsies.

Results: All 36 (90%) clinics that responded used anti-tissue transglutaminase antibodiesas the initial diagnostic test and some also used serological markers. Most clinics (81%)used endoscopy and took multiple duodenal biopsies, whereas only a few (19%)occasionally employed a suction capsule. Almost all clinics (86%) omitted taking smallbowel biopsies in symptomatic children with repeatedly high coeliac serology and positivegenotyping, thereby avoiding the need for invasive endoscopy under anaesthesia.

Conclusion: The 2012 Swedish Paediatric Coeliac Disease Diagnostic Guidelines hadbeen widely accepted and implemented in routine health care two years after theirintroduction.

Keywords
Coeliac disease, Diagnosis, Guidelines, Small bowel biopsies, Survey
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-154663 (URN)10.1111/apa.14669 (DOI)
Available from: 2018-12-21 Created: 2018-12-21 Last updated: 2019-01-09
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
Open this publication in new window or tab >>Are health inequalities rooted in the past? Income inequalities in metabolic syndrome decomposed by childhood conditions
Show others...
2017 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no 2, p. 223-233Article in journal (Refereed) 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.

Keywords
Metabolic syndrome, Early-life conditions, Income inequality, Decomposition analysis, Life course
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-126888 (URN)10.1093/eurpub/ckw186 (DOI)000398086400009 ()27744345 (PubMedID)
Available from: 2016-10-19 Created: 2016-10-19 Last updated: 2018-06-09Bibliographically approved
Eriksson, M., Lindgren, U., Ivarsson, A. & Ng, N. (2017). Child health and place: How is neighborhood social capital associated with child health injuries?. Paper presented at 10th European Public Health Conference Sustaining resilient and healthy communities Stockholm, Sweden 1–4 November 2017. European Journal of Public Health, 27(Suppl_3), 41-41
Open this publication in new window or tab >>Child health and place: How is neighborhood social capital associated with child health injuries?
2017 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no Suppl_3, p. 41-41Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Child health inequalities can be explained by social determinants of health, including neighborhood social capital. Swedish research about place effects on children's health is limited. This project aims to contribute to knowledge on how neighborhood social capital may influence child health in the Swedish context. The overall research questions were: What is the incidence rate of child injuries in the living environments among boys and girls? What are the associations between neighborhood social capital and child injuries?

Methods: Child injury data from the Umeå SIMSAM Lab were utilized, with data from all children 0-12 years of age, living in Umeå municipality during 2006-2009. Individual child injury and residential area data were linked to a neighborhood social capital index, where 49 defined neighborhoods were assigned a score from low- high in social capital, based on people’s perceptions about their neighborhoods. Individual, household and neighborhood demographic and socioeconomic variables (country of birth, educational level, income and family type) were also extracted from the Umeå SIMSAM lab. Logistic regression analyses were conducted to analyze factors associated with child injury.

Results: We observed 3930 injury events that occurred in the living environments, experienced by 24 000 children who lived in 14 767 households within 49 neighborhoods. The incidence rate of child injuries was about 72.5/1000 for boys and 60/1000 for girls. The odds for child injures was lower in neighborhoods with high social capital compared to neighborhoods with low social capital (OR 0.87 95%CI 0.80-0.95) after controlling for demographic and socioeconomic factors at individual, household and neighborhood level. The protective effects of neighborhood social capital were stronger for girls than boys.

Conclusions: Neighborhood social capital may have a protective effect on child injuries and especially so for girls.

Key messages:

  • Neighborhood conditions have a significant influence on child health inequalities in the Swedish context, including inequalities in child injuries.
  • Mobilization of neighborhood social capital might be good investment for reducing child injuries.
Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2017
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-143148 (URN)10.1093/eurpub/ckx187.104 (DOI)000414389800084 ()
Conference
10th European Public Health Conference Sustaining resilient and healthy communities Stockholm, Sweden 1–4 November 2017
Available from: 2017-12-20 Created: 2017-12-20 Last updated: 2018-06-09Bibliographically approved
Chaparro, M. P., de Luna, X., Häggström, J., Ivarsson, A., Lindgren, U., Nilsson, K. & Koupil, I. (2017). Childhood family structure and women's adult overweight risk: A longitudinal study. Scandinavian Journal of Public Health, 45(5), 511-519
Open this publication in new window or tab >>Childhood family structure and women's adult overweight risk: A longitudinal study
Show others...
2017 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 5, p. 511-519Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this study was to investigate whether women's adult overweight and obesity risk was associated with their childhood family structure, measured as their mothers' marital status history, during the women's first 18 years of life.

METHODS: Using linked register data, we analyzed 30,584 primiparous women born in Sweden in 1975 who were between 19-35 years of age when their height and pre-pregnancy weight was recorded. The outcomes were women's overweight/obesity (body mass index (BMI) ≥ 25 kg/m(2)) and obesity (BMI ≥ 30 kg/m(2)) and the predictor was mothers' marital status history, which was summarized using sequence analysis. We carried out nested logistic regression models adjusting for women's age and maternal sociodemographic characteristics.

RESULTS: Mothers' marital status history was summarized into six clusters: stable marriage, stable cohabitation, married then divorcing, cohabiting then separating, varied transitions, and not with father. In fully adjusted models and compared with women whose mothers belonged to the stable marriage cluster: (1) women whose mothers belonged to the other marital status clusters had higher odds of overweight/obesity (odds ratio (OR) ranging 1.15-1.19; p < 0.05); and (2) women whose mothers belonged to the stable cohabitation (OR = 1.31; 95% confidence interval (CI) = 1.14-1.52), cohabiting then separating (OR = 1.23; 95% CI = 1.01-1.49), varied transitions (OR = 1.24; 95% CI = 1.11-1.39), and not with father (OR = 1.24; 95% CI = 1.00-1.54) clusters had higher odds of obesity.

CONCLUSIONS: Women whose mothers were not in stable marriage relationships had higher odds of being overweight or obese in adulthood. The finding that even women raised in the context of stable cohabitation had higher odds of being overweight or obese is intriguing as these relationships are socially accepted in Sweden.

Keywords
family structure, marital status, overweight, obesity, Sweden, sequence analysis
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-135030 (URN)10.1177/1403494817705997 (DOI)000404652000007 ()28482752 (PubMedID)
Available from: 2017-05-16 Created: 2017-05-16 Last updated: 2018-06-09Bibliographically approved
Weinehall, L. & Ivarsson, A. (2017). Har donationen gjort nytta?: slutredovisning av Centerpartiets donation till Umeå universitet för utveckling av globalt forskningssamarbete. Umeå: Umeå universitet
Open this publication in new window or tab >>Har donationen gjort nytta?: slutredovisning av Centerpartiets donation till Umeå universitet för utveckling av globalt forskningssamarbete
2017 (Swedish)Report (Other academic)
Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2017. p. 19
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-148225 (URN)
Available from: 2018-05-30 Created: 2018-05-30 Last updated: 2018-06-09Bibliographically approved
Häggström, J., Sampaio, F., Eurenius, E., Pulkki-Brännström, A.-M., Ivarsson, A., Lindkvist, M. & Feldman, I. (2017). Is the Salut Programme an effective and cost-effective universal health promotion intervention for parents and their children?: a register-based retrospective observational study. BMJ Open, 7(9), Article ID e016732.
Open this publication in new window or tab >>Is the Salut Programme an effective and cost-effective universal health promotion intervention for parents and their children?: a register-based retrospective observational study
Show others...
2017 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 9, article id e016732Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: This study investigates the effectiveness and cost-effectiveness of the Salut Programme, a universal health promotion intervention, compared with care-as-usual, over the periods of pregnancy, delivery and the child's first 2 years of life.

METHOD: We adopted a register-based retrospective observational design using existing data sources with respect to both exposures and outcomes. Health outcomes and costs were compared between geographical areas that received care-as-usual (non-Salut area) and areas where the programme was implemented (Salut area). We included mothers and their children from both the Salut and non-Salut areas if: (1) the child was born 2002-2004 (premeasure period) or (2) the child was born 2006-2008 (postmeasure period). The effectiveness study adopted two strategies: (1) a matched difference-in-difference analysis using data from all participants and (2) a longitudinal analysis restricted to mothers who had given birth twice, that is, both in the premeasure and postmeasure periods. The economic evaluation was performed from a healthcare and a limited societal perspective. Outcomes were clustered during pregnancy, delivery and birth and the child's first 2 years.

RESULTS: Difference-in-difference analyses did not yield any significant effect on the outcomes. Longitudinal analyses resulted in significant positive improvement in Apgar scores, reflecting the newborn's physical condition, with more children having a normal Apgar score (1 min +3%, 5 min +1%). The cost of the programme was international dollar (INT$)308/child. From both costing perspectives, the programme yielded higher effects and lower costs than care-as-usual, being thus cost-saving (probability of around 50%).

CONCLUSIONS: Our findings suggest that the Salut Programme is an effective universal intervention to improve maternal and child health, and it may be good value for money; however, there is large uncertainty around the cost estimates.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2017
Keywords
Child Health, Cost-effectiveness, Health Promotion, Intervention Effectiveness, Maternal Health, Universal Intervention
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-139899 (URN)10.1136/bmjopen-2017-016732 (DOI)000412650700155 ()28939578 (PubMedID)
Available from: 2017-09-26 Created: 2017-09-26 Last updated: 2018-06-09Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8944-2558

Search in DiVA

Show all publications