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Virtanen, P., Nummi, T., Janlert, U. & Hammarström, A. (2024). Psychosocial conditions during school-age as determinants of long-term labour market attachment: a study of the Northern Swedish Cohort from the 1980s to the 2020s. BMC Public Health, 24(1), Article ID 191.
Open this publication in new window or tab >>Psychosocial conditions during school-age as determinants of long-term labour market attachment: a study of the Northern Swedish Cohort from the 1980s to the 2020s
2024 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 24, no 1, article id 191Article in journal (Refereed) Published
Abstract [en]

Background: This study, conducted on a Swedish population cohort, explores how internalized (depressive and functional somatic) and externalized (smoking, drinking, truancy, vandalism, delinquency) mental health symptoms, as well as close interpersonal relations (family climate and school connectedness) reported during adolescence, influence the work-life course up to late midlife.

Methods: We examined repeated measurements of labour market status from age 16 to 56 using sequence analyses. We identified five different labour market attachment (LMA16-56) trajectories, namely ‘strong,’ ‘early intermediate,’ ‘early weak,’ ‘late weak,’ and ‘constantly weak.’ Multinomial logistic regressions were employed to relate each of the nine determinants to the identified trajectories.

Results: When compared to the risk of ‘strong’ LMA16-56, adversity in all conditions, except for vandalism, entailed a higher risk of the ‘constantly weak’ trajectory. Moreover, all conditions, except for functional somatic symptoms, entailed a higher risk of the ‘late weak’ LMA16-56. The risk of the ‘early intermediate’ LMA16-56 was non-significant across all the conditions.

Conclusions: This study contributes to existing knowledge through its novel exploration of labour market attachment and the revelation of the significance of proximal interpersonal relationships in attachment outcomes. Additionally, the study reaffirms the importance of externalizing behaviour, while suggesting that internalized symptoms in adolescence might have a less influential, though not negligible, role. These results underscore the importance of addressing acting out behaviour and nurturing human relationships during compulsory basic education, when the entire age group is still within reach. This approach aims not only to reduce frictions in the school-to-work transition but also to prevent midlife labour market attachment problems that may arise with delayed intervention.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Cohort study, Externalised symptoms, Family climate, Internalised symptoms, Labour market, Latent class analysis, School connectedness, Sequence analysis, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-220003 (URN)10.1186/s12889-023-17611-6 (DOI)001143989500005 ()38229043 (PubMedID)2-s2.0-85182489551 (Scopus ID)
Funder
Swedish Research Council Formas, 259–2012-37Forte, Swedish Research Council for Health, Working Life and Welfare, 2011−0445
Available from: 2024-02-01 Created: 2024-02-01 Last updated: 2024-02-01Bibliographically approved
Ziaei, S. & Hammarström, A. (2023). The relationship between interpersonal violence in adulthood and mental health: a longitudinal study based on the Northern Swedish Cohort. BMC Public Health, 23(1), Article ID 637.
Open this publication in new window or tab >>The relationship between interpersonal violence in adulthood and mental health: a longitudinal study based on the Northern Swedish Cohort
2023 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, no 1, article id 637Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Longitudinal studies evaluating the negative effects of exposure to interpersonal violence in the adulthood on the mental health of both women and men are scarce. Using longitudinal data, we evaluated the relationship between the last year experience of violence and functional somatic and depressive symptoms at the ages of 30 and 43 among participants (n = 1006; 483 women and 523 men) in the Northern Swedish Cohort. Further, the relationship between cumulative exposure to violence over a decade and mental health symptoms among participants was evaluated.

METHODS: Participants' experience of interpersonal violence and symptoms of functional somatic and depressive symptoms were evaluated with standard questionnaires at the ages of 30 and 43. General linear models were used to evaluate the relationship between the experience of interpersonal violence and mental health symptoms among the participants. The interactions between gender and violence on functional somatic and depressive symptoms were evaluated separately, and models in which the interaction was significant, were split by gender.

RESULTS: We found that the last year experience of violence at the age of 30 was related to current functional somatic symptoms among all participants and depressive symptoms only among men, (β Adj for the experience of any violence among men: 0.21; CI: 0.12-0.29; Vs. among women: 0.06; CI: -0.04-0.16, p for interaction = 0.02). At the age of 43, last year experience of violence was related to both functional somatic and depressive symptoms in both genders. Finally, a cumulative relationship between the experience of violence over time and mental health symptoms was observed in all participants.

CONCLUSIONS: Our findings revealed that while the relationship between the experience of interpersonal violence and mental health symptoms may differ among men and women and with age, the experience of violence can be negatively related to the mental health in both genders.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Gender, Interpersonal violence, Longitudinal study, Mental health, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-206777 (URN)10.1186/s12889-023-15525-x (DOI)000983889000005 ()37013550 (PubMedID)2-s2.0-85151696163 (Scopus ID)
Funder
Swedish Research Council Formas, 259-2012-37
Available from: 2023-04-26 Created: 2023-04-26 Last updated: 2023-09-05Bibliographically approved
Hammarström, A., Bean, C., Pingel, R., Janlert, U., Westerlund, H., Östergren, P. O. & Virtanen, P. (2023). Why does youth unemployment lead to scarring of depressive symptoms in adulthood? The importance of early adulthood drinking. Scandinavian Journal of Public Health
Open this publication in new window or tab >>Why does youth unemployment lead to scarring of depressive symptoms in adulthood? The importance of early adulthood drinking
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2023 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim: The aim of the paper is to analyse if alcohol consumption could explain the scarring effect of youth unemployment on later depressive symptoms.

Methods: The analyses are based on the 24-year follow-up of school leavers in a municipality in Northern Sweden (the Northern Swedish Cohort). Four-way decomposition analyses were performed to analyse if alcohol use at age 30 years could mediate and/or moderate the effect of youth unemployment (ages 18/21 years) on depressive symptoms in later adulthood (age 43 years).

Results: Excessive alcohol use at early adulthood (age 30 years) mediates 18% of the scarring effect of youth unemployment on depressive symptoms in later adulthood. The scarring effect was seen among both those with and without excessive alcohol use.

Conclusions: Youth unemployment leads to poor mental health later in life and part of these relations are explained by excessive alcohol consumption in early adulthood. Policy interventions should target the prevention of youth unemployment for reaching a lower alcohol consumption and better mental health.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
alcohol drinking, depressive symptoms, life-course epidemiology, scarring, Youth unemployment
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-219324 (URN)10.1177/14034948231208472 (DOI)38153038 (PubMedID)2-s2.0-85181206365 (Scopus ID)
Funder
Swedish Research Council, 259-2012-37Forte, Swedish Research Council for Health, Working Life and Welfare, 2011-0445
Available from: 2024-01-12 Created: 2024-01-12 Last updated: 2024-01-12
Haukenes, I. & Hammarström, A. (2023). Workplace gender composition and sickness absence: a register-based study from Sweden. Scandinavian Journal of Public Health
Open this publication in new window or tab >>Workplace gender composition and sickness absence: a register-based study from Sweden
2023 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aims: This study aimed to examine the association between gender composition in the workplace and sickness absence days during a one-year period. Methods: The study population was drawn from the Northern Swedish Cohort (wave 3; 2007) by Statistics Sweden and consisted of all participants belonging to a specific workplace (n=837) as well as all co-workers at the workplace of the participants (n=132,464; 67,839 women and 64,625 men). Exposure was the gender composition of the workplace, and outcome was cumulative sickness absence days (⩾90 days or not) during 2007, provided through a link to the Database for Health Insurance and Labour Marked Studies of Statistics Sweden. Covariates were gender, age, educational level and branch of industry from the same data source. We performed descriptive analyses and multivariable regression analyses. Results: Workers in extremely female-dominated workplaces had a significantly higher risk of cumulative sickness absence days (⩾90 days) compared with gender-equal workplaces (fully adjusted odds ratio (OR)=1.27; 95% confidence interval (CI) 1.09–1.48), whereas those working in extremely and moderately male-dominated workplaces had a significantly lower sickness absence risk (OR=0.62 and 0.66, respectively). Stratified by gender, the higher absence risk at female-dominated workplaces was fully explained by variation in branches of industry. Women working in extremely male-dominated workplaces had a significantly lower absence risk (OR=0.75), as did men working in moderately male-dominated workplaces (OR=0.78). Conclusions: Workplaces dominated by women had a significantly higher risk of days lost to sickness absence compared to gender-equal workplaces. Stratified by gender, this higher risk was explained by branch of industry.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
absenteeism, gender, gender composition, gender segregated workplaces, labour market, registry, sick days, Sick leave, Sweden, workplace
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-211811 (URN)10.1177/14034948231176108 (DOI)2-s2.0-85162960923 (Scopus ID)
Available from: 2023-07-11 Created: 2023-07-11 Last updated: 2023-07-11
Veldman, K., Pingel, R., Hallqvist, J., G Bean, C. & Hammarström, A. (2022). How does social support shape the association between depressive symptoms and labour market participation: a four-way decomposition. European Journal of Public Health, 32(1), 8-13
Open this publication in new window or tab >>How does social support shape the association between depressive symptoms and labour market participation: a four-way decomposition
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2022 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 32, no 1, p. 8-13Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Little is known about factors that may explain the association between depressive symptoms and poor labour market participation (LMP). The aim of this study is to examine the mediation and interaction effects of social support on the association between depressive symptoms and LMP.

METHODS: Data were used from 985 participants (91% of the initial cohort) of the Northern Swedish Cohort, a longitudinal study of Swedish participants followed from adolescence throughout adulthood. Depressive symptoms were measured at age 16, social support at age 21 and LMP from age 30 to 43. Poor LMP was defined as being unemployed for a total of 6 months or more between the ages of 30 and 43. A four-way decomposition approach was applied to identify direct, mediation and interaction effects, together and separately.

RESULTS: Both depressive symptoms during adolescence and social support at young adulthood were associated with poor LMP [odds ratio (OR) = 1.70, 95% confidence interval (CI) 1.17-2.47 and OR = 2.56, 95% CI 1.78-3.68 respectively]. The association between depressive symptoms and poor LMP was partially mediated by a lack of social support. No interaction effect of a lack of social support was found.

CONCLUSION: The results suggest that depressive symptoms influence not only later LMP but also the intermediary level of social support, and in turn influencing later LMP. Recommendations for public health are to detect and treat depressive symptoms at an early stage and to focus on the development of social skills, facilitating the increased availability of social support, thereby improving future LMP.

Place, publisher, year, edition, pages
Oxford University Press, 2022
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-192367 (URN)10.1093/eurpub/ckab185 (DOI)000769817600005 ()34871391 (PubMedID)2-s2.0-85123969609 (Scopus ID)
Funder
Swedish Research Council, 259-2012-37
Available from: 2022-02-11 Created: 2022-02-11 Last updated: 2023-09-05Bibliographically approved
Norström, F. & Hammarström, A. (2022). Methodological perspectives on the study of the health effects of unemployment – reviewing the mode of unemployment, the statistical analysis method and the role of confounding factors. BMC Medical Research Methodology, 22(1), Article ID 199.
Open this publication in new window or tab >>Methodological perspectives on the study of the health effects of unemployment – reviewing the mode of unemployment, the statistical analysis method and the role of confounding factors
2022 (English)In: BMC Medical Research Methodology, E-ISSN 1471-2288, Vol. 22, no 1, article id 199Article in journal (Refereed) Published
Abstract [en]

Introduction: Studying the relationship between unemployment and health raises many methodological challenges. In the current study, the aim was to evaluate the sensitivity of estimates based on different ways of measuring unemployment and the choice of statistical model.

Methods: The Northern Swedish cohort was used, and two follow-up surveys thereof from 1995 and 2007, as well as register data about unemployment. Self-reported current unemployment, self-reported accumulated unemployment and register-based accumulated unemployment were used to measure unemployment and its effect on self-reported health was evaluated. Analyses were conducted with G-computation, logistic regression and three estimators for the inverse probability weighting propensity scores, and 11 potentially confounding variables were part of the analyses. Results were presented with absolute differences in the proportion with poor self-reported health between unemployed and employed individuals, except when logistic regression was used alone.

Results: Of the initial 1083 pupils in the cohort, our analyses vary between 488–693 individuals defined as employed and 61–214 individuals defined as unemployed. In the analyses, the deviation was large between the unemployment measures, with a difference of at least 2.5% in effect size when unemployed was compared with employed for the self-reported and register-based unemployment modes. The choice of statistical method only had a small influence on effect estimates and the deviation was in most cases lower than 1%. When models were compared based on the choice of potential confounders in the analytical model, the deviations were rarely above 0.6% when comparing models with 4 and 11 potential confounders. Our variable for health selection was the only one that strongly affected estimates when it was not part of the statistical model.

Conclusions: How unemployment is measured is highly important when the relationship between unemployment and health is estimated. However, misspecifications of the statistical model or choice of analytical method might not matter much for estimates except for the inclusion of a variable measuring health status before becoming unemployed. Our results can guide researchers when analysing similar research questions. Model diagnostics is commonly lacking in publications, but they remain very important for validation of analyses.

Place, publisher, year, edition, pages
BioMed Central, 2022
Keywords
Biased estimates, G-computation, Labour market, Propensity score weighting, Unemployment
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-198290 (URN)10.1186/s12874-022-01670-1 (DOI)000828611700003 ()35864450 (PubMedID)2-s2.0-85134498495 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2011-0839
Available from: 2022-08-01 Created: 2022-08-01 Last updated: 2024-01-17Bibliographically approved
Berg, N., Nummi, T., Bean, C. G., Westerlund, H., Virtanen, P. & Hammarström, A. (2022). Risk factors in adolescence as predictors of trajectories of somatic symptoms over 27 years. European Journal of Public Health, 32(5), 696-702
Open this publication in new window or tab >>Risk factors in adolescence as predictors of trajectories of somatic symptoms over 27 years
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2022 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 32, no 5, p. 696-702Article in journal (Refereed) Published
Abstract [en]

Background: Somatic symptoms among adolescents are common, yet little is known about long-term trajectories of somatic symptoms and the factors in adolescence that shape them. We examined individual, family and school-based factors at age 16 as predictors of trajectories of somatic symptoms over 27 years.

Methods: Participants from the Northern Swedish Cohort (n = 1001) responded to questions about individual factors (e.g. health behaviours), family factors (e.g. contact with parents, social and material adversity) and school satisfaction at age 16; as well as 10 somatic symptoms at ages 16, 18, 21, 30 and 43. Teacher assessments at age 16 included overall ability at school and peer relations. Age 16 predictors of somatic symptom trajectory group membership were analysed using multinomial logistic regression.

Results: Poor contact with mother and poor school satisfaction were significant predictors of adverse symptom trajectories among both men and women. Low birth weight and low parental academic involvement were contributing factors for women, while smoking and social adversity were more relevant factors for men.

Conclusions: Our findings emphasize the importance of a holistic approach that considers the unique contributions of individual, family and school-based factors in the development of trajectories of somatic symptoms from adolescence to middle age.

Place, publisher, year, edition, pages
Oxford University Press, 2022
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-203693 (URN)10.1093/eurpub/ckac081 (DOI)000833499500001 ()35904464 (PubMedID)2-s2.0-85153287614 (Scopus ID)
Funder
Swedish Research Council Formas, 259-2012-37Forte, Swedish Research Council for Health, Working Life and Welfare, 2011-0445
Available from: 2023-01-19 Created: 2023-01-19 Last updated: 2023-09-20Bibliographically approved
Hammarström, A. (2021). Commentary on Bishop & Almquist: Beyond a descriptive life-course epidemiology. Addiction, 116(3), 641-642
Open this publication in new window or tab >>Commentary on Bishop & Almquist: Beyond a descriptive life-course epidemiology
2021 (English)In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 116, no 3, p. 641-642Article in journal, Editorial material (Refereed) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
Context, descriptive, ecosocial, inference to the best explanation, life-course epidemiology, theoretical framework
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-179506 (URN)10.1111/add.15363 (DOI)000606814200001 ()33432672 (PubMedID)2-s2.0-85099228582 (Scopus ID)
Available from: 2021-02-05 Created: 2021-02-05 Last updated: 2021-03-17Bibliographically approved
Gunnarsdóttir, H., Hensing, G. & Hammarström, A. (2021). Poor school connectedness in adolescence and adulthood depressiveness: a longitudinal theory-driven study from the Northern Sweden Cohort. European Journal of Public Health, 31(4), 797-802
Open this publication in new window or tab >>Poor school connectedness in adolescence and adulthood depressiveness: a longitudinal theory-driven study from the Northern Sweden Cohort
2021 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 31, no 4, p. 797-802Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Foundations for mental health are laid early in family and school life. Family climate embraces the emotional connections within a family, and school connectedness embraces both functional and affective dimensions of relationship with school. Based on the lack of theory-driven and longitudinal epidemiological studies addressing public mental health, the aim of this longitudinal study was to investigate the associations between adolescents' school connectedness, family climate and depressiveness in adulthood, by relying on Bronfenbrenner's ecological theory.

METHODS: The data are from the Northern Swedish Cohort, and the sample consists of 481 women and 526 men born in 1965 who participated in data collection at age 16, 21, 30 and 43. The generalized linear model method with random intercepts was used to examine the associations between family climate and school connectedness and depressiveness in adulthood.

RESULTS: Poor school connectedness was associated with depressiveness in adulthood [β = 0.038 (95% CI 0.018-0.058) P ≤ 0.001], but poor family climate was not [β = 0.014 (95% CI -0.004-0.032)]. No difference in associations was observed between those experiencing social/material adversities in adolescence.

CONCLUSIONS: This study shows that poor school connectedness in adolescence can affect depressiveness in adulthood. The study confirms the complex processes that determine mental health and proposes a theoretical approach appealing to public mental health research. In addition, this study concludes that more life-course studies are needed to advance the knowledge of the mechanisms behind the associations between family climate and school connectedness and depressiveness in adulthood.

Place, publisher, year, edition, pages
Oxford University Press, 2021
Keywords
adolescent, emotions, adult, climate, epidemiologic studies, mental health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-182270 (URN)10.1093/eurpub/ckab027 (DOI)000711227200027 ()33846734 (PubMedID)2-s2.0-85118314916 (Scopus ID)
Funder
Swedish Research Council Formas, 259-2012-37
Available from: 2021-04-16 Created: 2021-04-16 Last updated: 2022-01-11Bibliographically approved
Hammarström, A., Lundman, B. & Norberg, A. (2021). The importance of having a paid job: Gendered experiences of health and ill-health in daily life among middle-aged women and men. BMC Public Health, 21(1), Article ID 2023.
Open this publication in new window or tab >>The importance of having a paid job: Gendered experiences of health and ill-health in daily life among middle-aged women and men
2021 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, no 1, article id 2023Article in journal (Refereed) Published
Abstract [en]

Background: More gender-theoretical studies are needed to gain a deeper understanding of what life circumstances make people sick or improve their health. The aim of the study was to gain a deeper understanding of social determinants of health by exploring gendered experiences in daily life among middle-aged women and men using the theory of gender relations.

Methods: Individual interviews with nine men and women were performed, focusing on what made them feel good or bad. Qualitative content analysis was used to analyse the data.

Results: A major theme in our interviews was the gendered health-promoting experiences related to having a job, which involved becoming someone, feeling appreciated at work and having control over work. Having good family relations was also health-promoting, in terms of supportive relations and becoming a parent. Ill-health was related to gendered adverse conditions at work (accidents, monotonous and stressful work tasks, being bullied) and in domestic life (demands, destructive partner relations, having children with problems).

Conclusions: Gendered determinants of health and ill-health were identified in both working and domestic life. Public health policy needs to challenge the gender order in society, which defines the gendered structure of the labour market as well as the gendered relations in domestic life.

Place, publisher, year, edition, pages
BioMed Central, 2021
Keywords
Domestic work, Gender relations, Paid work, Social determinants of health
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nursing
Identifiers
urn:nbn:se:umu:diva-189615 (URN)10.1186/s12889-021-12034-7 (DOI)000715034600006 ()34742259 (PubMedID)2-s2.0-85118711139 (Scopus ID)
Funder
Swedish Research Council Formas, 259–2012-37Region VästerbottenForte, Swedish Research Council for Health, Working Life and Welfare, 2011–0445
Available from: 2021-11-17 Created: 2021-11-17 Last updated: 2023-08-28Bibliographically approved
Projects
Developing a tool for analysing gender equity in health care - a gender theoretical approach to Swedish hospital-based health care [2009-05839_VR]; Umeå UniversityUnemployment and scarring - a life course analyses of the health consequences in adult age of youth unemployment in different economic trade cycles [2011-00445_Forte]; Umeå UniversityHow are sex, gender and health interwoven? Theoretical development in a Northern European context [2011-05478_VR]; Uppsala UniversityMental health in adolescence and the paths ahead. An ecological life course approach to mental health trajectories into adulthood [2012-37_Formas]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4095-7961

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