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Waenerlund, Anna-Karin
Publications (10 of 17) Show all publications
Norström, F., Waenerlund, A.-K., Lindholm, L., Nygren, R., Sahlén, K.-G. & Brydsten, A. (2019). Does unemployment contribute to poorer health-related quality of life among Swedish adults?. BMC Public Health, 19, 1-12, Article ID 457.
Open this publication in new window or tab >>Does unemployment contribute to poorer health-related quality of life among Swedish adults?
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2019 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, p. 1-12, article id 457Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Previous studies have shown that unemployment has negative impacts on various aspects of health. However, little is known about the effect of unemployment on health-related quality of life. Our aim was to examine how unemployment impacts upon health-related quality of life among Swedish adults, and to investigate these effects on population subgroups defined by education level, marital status, previous health, and gender.

METHODS: As part of a cross-sectional study, a questionnaire was sent to 2500 randomly selected individuals aged 20 to 64 years living in Sweden in 2016. The questionnaire included the EuroQol 5 dimensions (EQ-5D) instrument and was answered by 967 individuals (39%). Quality-adjusted life year (QALY) scores were derived from the EQ-5D responses. Of the respondents, 113 were unemployed and 724 were employed. We used inverse probability-weighted propensity scores in our analyses to estimate a risk difference. Gender, age, education level, marital status, and previous health were used as covariates in our analyses.

RESULTS: There was a statistically significant lower QALY score by 0.096 points for the unemployed compared to the employed. There were also statistically significant more problems due to unemployment for usual activities (6.6% more), anxiety/depression (23.6% more), and EQ-5D's Visual Analogue Scale (7.5 point lower score). Grouped analyses indicated a larger negative health effect from becoming unemployed for men, those who are married, and young individuals.

CONCLUSIONS: In our study, we show that the health deterioration from unemployment is likely to be large, as our estimated effect implies an almost 10% worse health (in absolute terms) from being unemployed compared to being employed. This further highlights that unemployment is a public health problem that needs more focus. Our study also raises further demands for determining for whom unemployment has the most negative effects and thus suggesting groups of individuals who are in greatest need for labor market measures.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
EuroQol 5 dimensions, Labor market, Propensity scores, Quality-adjusted life years
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Epidemiology; Public health
Identifiers
urn:nbn:se:umu:diva-158631 (URN)10.1186/s12889-019-6825-y (DOI)000467017800001 ()31035994 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-00647
Available from: 2019-05-03 Created: 2019-05-03 Last updated: 2019-12-04Bibliographically approved
Goicolea, I., Hultstrand Ahlin, C., Waenerlund, A.-K., Marchal, B., Christianson, M., Wiklund, M., . . . San Sebastian, M. (2018). Accessibility and factors associated with utilization of mental health services in youth health centers: a qualitative comparative analysis in northern Sweden. International Journal of Mental Health Systems, 12, Article ID 69.
Open this publication in new window or tab >>Accessibility and factors associated with utilization of mental health services in youth health centers: a qualitative comparative analysis in northern Sweden
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2018 (English)In: International Journal of Mental Health Systems, ISSN 1752-4458, E-ISSN 1752-4458, Vol. 12, article id 69Article in journal (Refereed) Published
Abstract [en]

Background: Youth-friendly health care services can facilitate young people's access to health care services and promote their health, including their mental health. In Sweden, a network of youth health centers exist since the 1970s, incorporated within the public health system. Even if such centers take a holistic approach to youth health, the focus has been in sexual and reproductive health care, and the extent of integrating mental health care services is less developed though it varies notably between different centers. This study aims to analyse the various conditions that are sufficient and/or necessary to make Swedish youth health centers accessible for mental and psychosocial health.

Methods: Multiple case study design, using qualitative comparative analysis to assess the various conditions that makes a youth health center accessible for mental and psychosocial issues and mental health. The cases included 18 youth health centers (from a total of 22) in the four northern counties of Sweden.

Results: In order to enhance accessibility for mental health services, youth health centers need to be trusted by young people. Trust was necessary but not sufficient, meaning that it had to be combined with other conditions: either having a team with a variety of professions represented in the youth health center, or being a youth health center that is both easy to contact and well-staffed with mental health professionals.

Conclusions: Differentiated, first-line services for youth can play an important role in promoting youth mental health if certain conditions are fulfilled. Trust is necessary, but has to be combined with either multidisciplinary teams, or expertise on mental health and easy accessibility.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Access, Mental health, Qualitative comparative analysis, Sweden, Youth, Youth health centers
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Public Health, Global Health, Social Medicine and Epidemiology Nursing
Identifiers
urn:nbn:se:umu:diva-154004 (URN)10.1186/s13033-018-0249-4 (DOI)000450477500001 ()30459827 (PubMedID)
Available from: 2018-12-11 Created: 2018-12-11 Last updated: 2019-01-11Bibliographically approved
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.
Open this publication in new window or tab >>Trends in educational and income inequalities in cardiovascular morbidity in middle age in Northern Sweden 1993–2010
2018 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, article id 1403494818790406Article in journal (Refereed) 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.

Keywords
Inequalities, Sweden, cardiovascular diseases, education, income
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health; Social Medicine; Epidemiology
Identifiers
urn:nbn:se:umu:diva-154002 (URN)10.1177/1403494818790406 (DOI)30113264 (PubMedID)
Available from: 2018-12-11 Created: 2018-12-11 Last updated: 2019-04-04
Baroudi, M., Waenerlund, A.-K., San Sebastian, M. & Goicolea, I. (2017). Assessing the dimensionality of YFHS-Swe; a new questionnaire to assess youth friendliness. 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), 343
Open this publication in new window or tab >>Assessing the dimensionality of YFHS-Swe; a new questionnaire to assess youth friendliness
2017 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no suppl_3, p. 343-Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Ensuring the youth friendliness of health services can increase the utilization of these services and contribute to improve youth’s health. Few validated instruments to assess youth-friendliness exist worldwide and none in Sweden. To assess the youth-friendliness of Swedish youth clinics (differentiated services for youth that exist since the 70s), an adapted version of YFHS WHO+ questionnaire called (YFHS-Swe) was developed. YFHS-Swe proved to have good internal homogeneity and consistency over time. The aim of our study was to perform a psychometric analysis to assure the quality and reliability of the questionnaire, and to assess the dimensionality of YFHS-Swe to identify possible subdomains that might be of importance for policy making.

Methods: YFHS-Swe was answered by 1,110 youths aged 16 to 25 years visiting 20 youth clinics in Northern Sweden between September 2016 and February 2017. YFHS-Swe was assessed using exploratory and confirmatory factor analysis.

Results: Thirteen factors could be identified; ability to get contact; access to sexual and reproductive health (SRH) service; access to psychosocial health services; parental support of SRH services; parental support of psychosocial health services; equity with diverse concerns; equity with legal concerns; fear of exposure; respect; privacy and confidentiality; no judgement; quality of consultation and quality of facility. Except for “quality of facility”, all other twelve factors recorded good α reliability ranging from 0.76 to 0.97, good ρ reliability ranging from 0.77 to 0.97 and acceptable measure of fit (SRMR<0.08).

Conclusions: The YFHS-Swe proved to be credible and suitable for assessing youths-friendliness of the Swedish youth clinics. The identified factors might be of an importance to capture different dimensions of youth friendliness. With some cultural and linguistic adaptations, this instrument can be used in other differentiated youth health services internationally.

Key messages:

  • YFHS-Swe is credible and suitable instrument in the Swedish context and it can be used as a basis for validating other instruments to assess youth-friendliness in other contexts.
  • The dimensions identified of this novel instrument might be of importance in assessing distinct aspects of friendliness in differentiated health services and might be of importance for policy making.
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-143077 (URN)10.1093/eurpub/ckx189.106 (DOI)000414389803212 ()
Conference
10th European Public Health Conference Sustaining resilient and healthy communities Stockholm, Sweden 1–4 November 2017
Available from: 2017-12-15 Created: 2017-12-15 Last updated: 2018-06-09Bibliographically approved
Baroudi, M., Waenerlund, A.-K., San Sebastián, M. & Goicolea, I. (2017). Assessing the dimensionality of YFHS-Swe: a questionnaire to assess youth-friendliness in differentiated health services. Global Health Action, 10(1), Article ID 1380399.
Open this publication in new window or tab >>Assessing the dimensionality of YFHS-Swe: a questionnaire to assess youth-friendliness in differentiated health services
2017 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, no 1, article id 1380399Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to assess the dimensionality of YFHS-Swe and identify possible unique factors in the evaluation of youth-friendliness. YFHS-Swe was answered by 1110 youths aged 16 to 25 years visiting youth clinics in Northern Sweden. Thirteen factors were identified by exploratory factor analysis and except for one factor they all proved to fit well and have good reliability when assessed by the confirmatory factor analysis. The YFHS-Swe proved to be credible and suitable for assessing youth-friendliness of differentiated health services in Sweden. With cultural and linguistic adaptations, it can be used in similar settings internationally.

Place, publisher, year, edition, pages
Abingdon: Taylor & Francis, 2017
Keywords
Youth, friendliness, instrument, health service, psychometric analysis
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
urn:nbn:se:umu:diva-142159 (URN)10.1080/16549716.2017.1380399 (DOI)000417192300001 ()29043946 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-0235
Available from: 2017-11-24 Created: 2017-11-24 Last updated: 2019-03-15Bibliographically approved
Waenerlund, A.-K., Goicolea, I. & Jonsson, F. (2017). Does youth clinics in northern Sweden offer person-centered care?. 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), 528
Open this publication in new window or tab >>Does youth clinics in northern Sweden offer person-centered care?
2017 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no Suppl_3, p. 528-Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: It is especially important for youth that the care is person-centered, responding to the need of the individual which usually will be broader and more complex than the specific health problem they consult in the first place. That in terms of youth health care everything is connected and health care services can be an opportunity to discuss sexual & reproductive SRS issues and mental health issues. The literature show that with young people the reason for consultation can only be an excuse to come to a health care professional. To examine this issue and in an attempt to increase our understanding about youths’s experiences of visiting youth clinics in Sweden overall, the present study compared reasons for the consultation at the youth clinic to the topics attended at the consultation, and by doing so also measuring the level of person-centered care.

Methods: Data from a cross-sectional survey sent out in September 2016 collected from twenty-two youth clinics in the four northern most counties in Sweden, was used in the present study. In total 1223 youth responded to the survey. Chi2 was used to determine significant differences.

Results: Preliminary results shows that of the youth participating in the survey 63.9% got a balanced response to what they asked for, 27.7% were offered more than their initial asked for and 8.4% were offered less than what they asked for. Being offered more than you asked for was not depending on gender, sexual orientation or trans identification. However, on county-level there were differences, where Västernorrland offered more to 35.5%, Jämtland 28.2%, Norrbotten 22.1% and Västerbotten 21.5% of the youth.

Conclusions: The results could be interpreted as a sign that youth clinics offers person-centered care (responding to the needs beyond the specific reason for consultations). In between county difference may be related to differences in organizational systems between counties.

Key messages:

  • Youth clinics in northern Sweden offers person-centred care to young people, by responding to the needs beyond the specific reason for consultation.
  • The level of person centred care offered is dependent on county but not on gender or sexual orientation.
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-143069 (URN)10.1093/eurpub/ckx186.358 (DOI)000414389806032 ()
Conference
10th European Public Health Conference Sustaining resilient and healthy communities Stockholm, Sweden 1–4 November 2017
Available from: 2017-12-15 Created: 2017-12-15 Last updated: 2018-06-09Bibliographically approved
Mosquera, P. A., Waenerlund, A.-K., Goicolea, I. & Gustafsson, P. E. (2017). Equitable health services for the young?: A decomposition of income-related inequalities in young adults' utilization of health care in Northern Sweden. International Journal for Equity in Health, 16, Article ID 20.
Open this publication in new window or tab >>Equitable health services for the young?: A decomposition of income-related inequalities in young adults' utilization of health care in Northern Sweden
2017 (English)In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 16, article id 20Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Despite the goal of the Swedish health system to offer health care according to the principle of horizontal equity, little is known about the equality in access to health care use among young people. To explore this issue, the present study aimed i) to assess horizontal inequity in health care utilization among young people in Northern Sweden; and ii) to explore the contribution of different factors to explain the observed inequalities.

METHODS: Participants (N = 3016 youths aged 16-25 years) came from the "Health on Equal terms" survey conducted in 2014 in the four northernmost counties in Sweden. Concentration indices (C) and horizontal inequity indices (HI) were calculated to measure inequalities in the utilization of two health care services (general practitioners (GP) and youth clinics). The HI was calculated based on health care utilization and variables representing socioeconomic status (household income), health care needs factors and non-need factors affecting health care use. A decomposition analysis was carried out to explain the income-related inequalities.

RESULTS: Results showed a significant positive income-related inequality for youth clinic utilization in women (C = 0.166) and total sample (C = 0.097), indicating that services were concentrated among the better-off. In contrast, general practitioner visits showed inequality pointing toward a higher utilization among less affluent individuals; significant in women (C = -0.079), men (C = -0.101) and pooled sample (C = -0.097). After taking health care needs into consideration, the utilization of youth clinics remained significantly pro-rich in women (HI = 0.121) and total sample (HI = 0.099); and consistently pro-poor for the GP visits in the pooled sample (HI = -0.058). The decomposition analyses suggest that socioeconomic inequalities explain a considerable portion of the pro-rich utilization of youth clinics services among young women. The corresponding analyses for GP visits showed that need factors and socioeconomic conditions accounted for the pro-poor concentration of GP visits.

CONCLUSION: The distribution of GP visits among young people in Northern Sweden slightly favored the low-income group, and thus seems to meet the premises of horizontal equity. In contrast, the findings suggest substantial pro-rich horizontal inequity in the utilization of youth clinics among young women, which are largely rooted in socioeconomic inequalities.

Keywords
Health Inequality, Health care utilization, Horizontal inequity index, Decomposition analysis, Young adults, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-131333 (URN)10.1186/s12939-017-0520-3 (DOI)000392349400001 ()28100232 (PubMedID)
Available from: 2017-02-13 Created: 2017-02-13 Last updated: 2018-06-09Bibliographically approved
Malm, D., Bishop, L., Gustafsson, P., Waenerlund, A.-K. & Goicolea, I. (2017). Validation of a questionnaire to measure youth-friendliness of Swedish youth clinics. Scandinavian Journal of Public Health, 45(4), 366-372
Open this publication in new window or tab >>Validation of a questionnaire to measure youth-friendliness of Swedish youth clinics
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2017 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 4, p. 366-372Article in journal (Refereed) Published
Abstract [en]

Aim: This study presents the validation process of a tool to assess the youth-friendliness of Swedish youth clinics, based on the Youth-Friendly Health Services - World Health Organization Plus (YFHS-WHO+) questionnaire but adapted to the specific context of differentiated services catering only for young people in this country. Methods: The validation process followed five steps: (1) translation, (2) revision by professionals, (3) pretests with young people, (4) back-translation and discussion with the developers of the original YFHS-WHO+ questionnaire and (5) internal consistency and test-retest reliability testing. Results: The final Swedish version, titled Youth-Friendly Health Services-Sweden (YFHS-Swe), differs from the original in terms of adjustments in language and in changes to make it better correspond to the reality of the Swedish youth clinics, while maintaining the meaning and intention of the original questionnaire. The YFHS-Swe questionnaire generated reproducible responses (test-retest coefficient of 0.79 for the total score) and can be considered a measure of a cohesive construct (Cronbach alpha of 0.95 for the total score). Conclusions: The study suggests that the YFHS-Swe questionnaire is a reliable instrument that can be an asset for youth clinics to evaluate their work and make regional and national comparisons between clinics. The YFHS-Swe could also serve as a basis for validating instruments to assess youth-friendliness of differentiated services for young people in other countries.

Keywords
Youth-friendly healthcare services, youth clinics, questionnaire, validation, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-136314 (URN)10.1177/1403494817699479 (DOI)000402148400005 ()28385109 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-0235
Available from: 2017-06-28 Created: 2017-06-28 Last updated: 2018-08-31Bibliographically approved
Thomée, S., Malm, D., Christianson, M., Hurtig, A.-K., Wiklund, M., Waenerlund, A.-K. & Goicolea, I. (2016). Challenges and strategies for sustaining youth-friendly health services: a qualitative study from the perspective of professionals at youth clinics in northern Sweden. Reproductive Health, 13, Article ID 147.
Open this publication in new window or tab >>Challenges and strategies for sustaining youth-friendly health services: a qualitative study from the perspective of professionals at youth clinics in northern Sweden
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2016 (English)In: Reproductive Health, ISSN 1742-4755, E-ISSN 1742-4755, Vol. 13, article id 147Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Youth-friendly health-care services - those that are accessible, acceptable, equitable, appropriate and effective for different youth subpopulations - are beneficial for youth health, but not easy to implement and sustain. Sweden is among the few countries where youth-friendly health-care services have been integrated within the public health system and sustained for a long time. This study explores the challenges and strategies in providing sustainable youth-friendly health-care services, from the perspective of professionals working in youth clinics in northern Sweden.

METHODS: Eleven semi-structured interviews with various health-care professionals working in youth clinics in northern Sweden were conducted. The interviews were transcribed verbatim, and analysed using thematic analysis in relation to the World Health Organization domains of youth friendliness.

RESULTS: Four themes emerged from the analysis of the data: 1) 'Meeting youths on their own terms - the key to ensuring a holistic and youth-centred care' was related to the acceptability and appropriateness of the services; 2) 'Organizational challenges and strategies in keeping professionals' expertise on youth updated' referred to the domain of effectiveness; 3) 'Youth clinics are accessible for those who know and can reach them' was related to the domains of accessibility and equity, and 4) 'The challenge of combining strong directions and flexibility in diverse local realities' focused on the struggle to sustain the youth clinics organization and their goals within the broader health system.

CONCLUSIONS: Professionals working in youth clinics are perceived as motivated, interested and knowledgeable about youth, and the clinics ensure confidentiality and a youth-centred and holistic approach. Challenges remain, especially in terms of ensuring equitable access to different youth subpopulations, improving monitoring routines and ensuring training and competence for all professionals, independently of the location and characteristics of the clinic. Youth clinics are perceived as an indisputable part of the Swedish health system, but organizational challenges are also pointed out in terms of weak clear directives and leadership, heavy workload, local/regional diversity and unequitable distribution of resources.

Keywords
Youth-friendly health-care services, Youth clinics, Thematic analysis, Health professionals, Youth health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-129784 (URN)10.1186/s12978-016-0261-6 (DOI)000390956000001 ()28003025 (PubMedID)
Available from: 2017-01-09 Created: 2017-01-09 Last updated: 2018-06-09Bibliographically approved
Mosquera, P. A., San Sebastian, M., Waenerlund, A.-K., Ivarsson, A., Weinehall, L. & Gustafsson, P. E. (2016). Income-related inequalities in cardiovascular disease from mid-life to old age in a Northern Swedish cohort: a decomposition analysis. Social Science and Medicine, 149, 135-144
Open this publication in new window or tab >>Income-related inequalities in cardiovascular disease from mid-life to old age in a Northern Swedish cohort: a decomposition analysis
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2016 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 149, p. 135-144Article in journal (Refereed) Published
Abstract [en]

While the social determinants of cardiovascular disease (CVD) are fairly well-known, the determinants of socioeconomic inequalities in CVD are scarcely studied and almost completely based on cross-sectional designs in which the changing circumstances across the life course are not taken into account. The present study seeks to incorporate a life course approach to the social determinants of socioeconomic inequalities in CVD. The specific aims were to 1) examine how income-related inequalities in CVD change over two decades of the mid-late life course, and 2) identify the key social determinants of the inequalities at each time period. The cohort (N = 44,039) comprised all individuals aged 40-60 years in 1990 who during 1990-2010 were enrolled in the county-wide preventive effort :"Västerbotten Intervention Program" (VIP). The cohort was followed over these two decades by Swedish population register data linked within the Umeå SIMSAM Lab micro data infrastructure. First-time hospitalization for CVD and mean earned income were used to calculate the concentration index (C) during four periods of 5-6 years. The C for each period was decomposed by sociodemographic factors, using Wagstaff-type decomposition analysis. Results suggest that inequalities in CVD increase gradually from mid-life to old age; from initially non-significant to particularly marked among the elderly. The decomposition showed that, from middle to old age, educational and employment inequalities underwent a transition from initially dominant to a moderate role in explaining the health inequalities, coupled with an increasing importance of age and a stable role of income. In conclusion, the study illustrates the need for incorporating a dynamic life course perspective into research, policy and practice concerned with equity in health.

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Cardiovascular disease, Income inequality, Concentration index, Decomposition. Life course, Cohort design, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-115244 (URN)10.1016/j.socscimed.2015.12.017 (DOI)000369208500015 ()26717560 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Note

Errata Social Science & Medicine (2016) 160 p. 128 DOI:10.1016/j.socscimed.2016.05.031

Available from: 2016-02-02 Created: 2016-02-02 Last updated: 2019-04-26Bibliographically approved
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