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Broström, Göran
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Publications (10 of 55) Show all publications
Edvinsson, S. & Broström, G. (2017). Life course and long-term perspectives of social inequality in mortality among elderly and adults in Northern Sweden 1801–2013. In: : . Paper presented at IUSSP XXVIII, 2017 International Population Conference, Cape Town, South Africa, 29 October – 4 November 2017.
Open this publication in new window or tab >>Life course and long-term perspectives of social inequality in mortality among elderly and adults in Northern Sweden 1801–2013
2017 (English)Conference paper, Published paper (Other academic)
Abstract [en]

We investigate the development of social inequality in Swedish mortality over the life course in the elderly and adult population during the mortality transition. The study focuses on two main questions, the first relate to the long-term change in social differences in mortality. The second question is whether socio-economic position have less impact on the elderly population compared to population in working age and if the age pattern of social inequalities has changed from the 19th century to the present. Furthermore, in this study we consider possible gender-specific patterns in this process. The development of mortality in different social classes is analysed according to both total mortality and major cause-of-death categories. For the later periods, we also compare the results from the class-based analysis with other measures of social position, in this case income and education. Focus is on mortality in the Skellefteå and Umeå regions in northern Sweden 1851-2013. The study is based on the historical population data from the Demographic Data Base, Umeå University and modern population register data from Statistics Sweden.

Keywords
Adult mortality, old age mortality, social inequality, northern Sweden
National Category
Other Social Sciences
Research subject
Population studies; Historical Demography
Identifiers
urn:nbn:se:umu:diva-141173 (URN)
Conference
IUSSP XXVIII, 2017 International Population Conference, Cape Town, South Africa, 29 October – 4 November 2017
Funder
Swedish Research Council, 349-2008-6592Swedish Research Council, 421-2012-892
Available from: 2017-10-26 Created: 2017-10-26 Last updated: 2018-09-03Bibliographically approved
Norberg, M., Malmberg, G., Ng, N. & Broström, G. (2015). Use of moist smokeless tobacco (snus) and the risk of development of alcohol dependence: a cohort study in a middle-aged population in Sweden.. Drug And Alcohol Dependence, 149, 151-157
Open this publication in new window or tab >>Use of moist smokeless tobacco (snus) and the risk of development of alcohol dependence: a cohort study in a middle-aged population in Sweden.
2015 (English)In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 149, p. 151-157Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Convincing evidence shows that smoking is associated with alcohol dependence (AD) and a positive correlation between snus and alcohol consumption was previously shown in cross-sectional studies. We performed a longitudinal evaluation of the risk of snus users to develop AD.

METHODS: A cohort study in Västerbotten County, Sweden, linked individual data on socioeconomic situation and health survey data from 21,037 men and women (46.5% men). AD was defined by the CAGE questionnaire and evaluated at baseline 1991-1997 and again after 10 years. The risk of developing AD was assessed using logistic regression analysis and propensity score matching.

RESULTS: 2370 men and 430 women used snus and were without AD at baseline. Over the 10-year period, 499 men and 257 women developed AD, among whom 191 and 26, respectively, were baseline snus users. The crude relative risks of AD for male and female snus users compared to non-users were 1.8 with 95% CI (1.5, 2.2) and 2.9 (2.0, 4.3), respectively. Adjusted logistic regression showed a positive dose-response relationship between snus use and risk of AD. Analyses involving propensity score matching revealed 33 and 17 new cases of AD in men and women, respectively, after 10 years given 1000 men and 1000 women without AD had been baseline snus users rather than non-users. Results for current, previous and never smokers were similar.

CONCLUSIONS: The use of snus is prospectively associated with an increased risk of AD with a dose-response relationship that is independent of smoking status.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-101164 (URN)10.1016/j.drugalcdep.2015.01.042 (DOI)000351799200021 ()25707707 (PubMedID)881251 (Local ID)881251 (Archive number)881251 (OAI)
Available from: 2015-03-23 Created: 2015-03-23 Last updated: 2019-02-15Bibliographically approved
Broström, G. (2012). Event History Analysis with R. Boca Raton: CRC Press
Open this publication in new window or tab >>Event History Analysis with R
2012 (English)Book (Other academic)
Place, publisher, year, edition, pages
Boca Raton: CRC Press, 2012. p. 236
Keywords
Event history analysis, survival analysis
National Category
Probability Theory and Statistics
Research subject
Mathematical Statistics
Identifiers
urn:nbn:se:umu:diva-55467 (URN)978-1-4398-3164-9 (ISBN)9781439831670 (e-book PDF) (ISBN)
Available from: 2012-05-16 Created: 2012-05-16 Last updated: 2018-06-08Bibliographically approved
Edvinsson, S. & Broström, G. (2012). Old age, health and social inequality: exploring the social patterns of mortality in 19th Century Northern Sweden. Demographic Research, 26, 23
Open this publication in new window or tab >>Old age, health and social inequality: exploring the social patterns of mortality in 19th Century Northern Sweden
2012 (English)In: Demographic Research, ISSN 1435-9871, Vol. 26, p. 23-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND

Social position is one of the major determinants of health. Less is known about its effect in historical contexts. Previous studies have shown surprisingly small effects of social class in working age populations. Not much is known about social differences in health among the elderly in history.

OBJECTIVE

The present paper analyses social differences in health among the elderly (60+) in the Sundsvall region in northern Sweden during the 19th century. We investigate whether social mortality differences are particularly apparent in old age when unpropertied groups lost their most important asset for survival: their capacity to work.

METHODS

The data, representing 9,535 fatal events, are analysed using a Cox regression model, assuming proportional hazards.

RESULTS

Social class had no significant effect for women during the pre-industrial period, while only those with unknown social position had higher mortality among men. During the industrial period female mortality was lowest in the skilled working class and highest in the upper class. Social position was not significant for men in the full model. Urban mortality was 30% higher for women and 59% higher for men during the pre-industrial period compared to the peripheral parishes.

CONCLUSIONS

The results lead us to question the accepted 'fact' of social health differences as a historical constant. Higher social position did not lead to better survival, and social differences in mortality did not increase in old age, despite the fact that the elderly were a highly vulnerable group. Instead, the spatial aspects of mortality were important, particularly during the pre-industrial period.

Keywords
19th century, life course, old age mortality, social differences in mortality, Sundsvall region, Sweden
National Category
Economic History
Research subject
Economic History
Identifiers
urn:nbn:se:umu:diva-45755 (URN)10.4054/DemRes.2012.26.23 (DOI)000305807800001 ()
Available from: 2011-08-16 Created: 2011-08-16 Last updated: 2018-06-08Bibliographically approved
Holmberg, H. & Broström, G. (2012). On statistical methods for clustering: A case study on infant mortality, northern Sweden, 1831-1890. Biodemography and Social Biology, 58, 173-184
Open this publication in new window or tab >>On statistical methods for clustering: A case study on infant mortality, northern Sweden, 1831-1890
2012 (English)In: Biodemography and Social Biology, ISSN 1948-5565, E-ISSN 1948-5573, Vol. 58, p. 173-184Article in journal (Refereed) Published
Abstract [en]

This article considers the interfamily clustering of infant mortality (defined as mortal- ity during the first year of life). We developed and evaluated statistical tools to detect clustering and a measure to quantify excess clustering for nineteenth-century data from Skellefteå, Sweden. The detection was performed using the standard methods of gener- alized linear models and logistic regression. The index of clustering was constructed by comparing the observed numbers of families with specific numbers of deaths to the cor- responding observed numbers, after correcting for explanatory variables. To the best of our knowledge, no clustering index of this kind has ever been created.

Place, publisher, year, edition, pages
Routledge: , 2012
National Category
Probability Theory and Statistics
Research subject
Statistics; Statistics
Identifiers
urn:nbn:se:umu:diva-61338 (URN)10.1080/19485565.2012.720446 (DOI)000310960800007 ()
Available from: 2012-11-09 Created: 2012-11-09 Last updated: 2018-06-08Bibliographically approved
Bengtsson, T. & Broström, G. (2011). Famines and mortality crises in 18th to 19th century southern Sweden. Genus: Journal of Population Sciences, 67(2), 119-139
Open this publication in new window or tab >>Famines and mortality crises in 18th to 19th century southern Sweden
2011 (English)In: Genus: Journal of Population Sciences, ISSN 2035-5556, Vol. 67, no 2, p. 119-139Article in journal (Refereed) Published
Abstract [en]

Causality is an important but complicated issue, not only within social sciences in general but also within economic and historical demography. Here we are dealing with two different, but related, problems of causality. The first is to what extent the impact of food prices on mortality is biased when selecting on years with mortality crises. The second concerns the problem of mixing factors that directly and indirectly have an impact on mortality. Dealing with the first problem, we compare the effects of food prices on child and adult mortality when selecting on mortality crises with a standard approach without selection. When dealing with the second problem we use the additive hazards model, in combination with dynamic path analysis, which allows for investigating the mediating effect of intermediate covariates in a causal framework. We use individual level data from the Scanian Economic Demographic Database for five rural parishes for the period 1766 to 1865. Data on food prices refers to the local area of these parishes. The statistical analyses are performed in the R statistical computing environment, especially with the aid of the package eha. The main findings are that selecting on mortality crises created a large bias in the direction of overestimating the impact of food prices and that that the direct effects of food prices are dominating.

Place, publisher, year, edition, pages
Rome: Università degli Studi di Roma La Sapienza, 2011
National Category
Other Social Sciences not elsewhere specified
Identifiers
urn:nbn:se:umu:diva-49348 (URN)
Available from: 2011-11-09 Created: 2011-11-09 Last updated: 2018-06-08Bibliographically approved
Broström, G. & Holmberg, H. (2011). Generalized linear models with clustered data: fixed and random effects models. Computational Statistics & Data Analysis, 55(12), 3123-3134
Open this publication in new window or tab >>Generalized linear models with clustered data: fixed and random effects models
2011 (English)In: Computational Statistics & Data Analysis, ISSN 0167-9473, E-ISSN 1872-7352, Vol. 55, no 12, p. 3123-3134Article in journal (Refereed) Published
Abstract [en]

The statistical analysis of mixed effects models for binary and count data is investigated. In the statistical computing environment R, there are a few packages that estimate models of this kind. The packagelme4 is a de facto standard for mixed effects models. The packageglmmML allows non-normal distributions in the specification of random intercepts. It also allows for the estimation of a fixed effects model, assuming that all cluster intercepts are distinct fixed parameters; moreover, a bootstrapping technique is implemented to replace asymptotic analysis. The random intercepts model is fitted using a maximum likelihood estimator with adaptive Gauss–Hermite and Laplace quadrature approximations of the likelihood function. The fixed effects model is fitted through a profiling approach, which is necessary when the number of clusters is large. In a simulation study, the two approaches are compared. The fixed effects model has severe bias when the mixed effects variance is positive and the number of clusters is large.

Keywords
Bernoulli distribution, Gauss-Hermite quadrature, Laplace approximation, Implicit derivation, Profiling, Poisson distribution
National Category
Probability Theory and Statistics
Research subject
Statistics
Identifiers
urn:nbn:se:umu:diva-40018 (URN)10.1016/j.csda.2011.06.011 (DOI)
Funder
Riksbankens Jubileumsfond, 2005-0488
Available from: 2011-02-14 Created: 2011-02-14 Last updated: 2018-06-08Bibliographically approved
Norberg, M., Malmberg, G., Ng, N. & Broström, G. (2011). Who is using snus? - Time trends, socioeconomic and geographic characteristics of snus users in the ageing Swedish population. BMC Public Health, 11, 929
Open this publication in new window or tab >>Who is using snus? - Time trends, socioeconomic and geographic characteristics of snus users in the ageing Swedish population
2011 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, p. 929-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The prevalence of smoking in Sweden has decreased in recent decades, and is now among the lowest in the world. During the same period, the use of Swedish moist oral snuff, a smokeless tobacco called snus, has increased. Few studies have evaluated time trends of the socioeconomic and geographic characteristics of snus users in Sweden. This paper contributes to filling that gap.

METHODS: This study utilized the Linnaeus Database, which links national registers with comprehensive individual data on socioeconomic status (SES) to health data from a large ongoing health survey, the Västerbotten Intervention Programme (VIP). The VIP targets the entire middle-aged population of Västerbotten county at ages 40, 50 and 60 years with yearly cross-sectional surveys including self-reported data on tobacco habits. Time trends of snus use among 92,563 VIP-participants across different areas of residence and smoking groups were investigated graphically. Logistic regression was performed to estimate the associations between SES and geographical variables and current use versus non-use of snus.

RESULTS: Overall, in parallel to decreasing smoking, the increasing trend of snus use in this middle-aged population continues, particularly in 40-year-olds. In both genders, the highest prevalence of snus use was observed among previous smokers. The prevalence of snus use also increased over time among smokers, and was consistently higher compared to those who had never smoked. Among males - both those who had never smoked and previous smokers - low education (OR 1.21, 95%CI 1.06-1.40 and OR 1.28, 95%CI 1.14-1.43), living alone (OR 1.16, 95%CI 1.07-1.27 and OR 1.13, 95%ci 1.04-1.23), low income and living in rural areas was associated with using snus, while this was not seen among male current smokers. Among women, living alone was associated with using snus irrespective of smoking habits. Among female smokers, the OR for snus use increased with higher education.

CONCLUSIONS: A disadvantaged social profile and also higher prevalence in rural areas is observed among male snus users who had never smoked or were previous smokers. Among male smokers there was no association between SES and use of snus. The prevalence of snus use among women is increasing, but is still considerably lower than that of men. The association between snus and SES characteristics is less pronounced among women, although snus is clearly linked to living alone. These patterns should be taken into consideration in tobacco control policies.

Place, publisher, year, edition, pages
London: BioMed Central, 2011
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-51861 (URN)10.1186/1471-2458-11-929 (DOI)22169061 (PubMedID)881251 (Local ID)881251 (Archive number)881251 (OAI)
Available from: 2012-02-03 Created: 2012-02-03 Last updated: 2019-02-15Bibliographically approved
Broström, G. & Bengtsson, T. (2009). Do conditions in early life affect old-age mortality directly and indirectly?: Evidence from 19th-century rural Sweden. Social Science and Medicine, 68(9), 1583-1590
Open this publication in new window or tab >>Do conditions in early life affect old-age mortality directly and indirectly?: Evidence from 19th-century rural Sweden
2009 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 68, no 9, p. 1583-1590Article in journal (Refereed) Published
Abstract [en]

Previous research has shown that the disease load experienced during the birth year, measured as the infant mortality rate, had a significant influence on old-age mortality in nineteenth-century rural Sweden. We know that children born in years with very high rates of infant mortality, due to outbreaks of smallpox or whooping cough, and who still survived to adulthood and married, faced a life length several years shorter than others. We do not know, however, whether this is a direct effect, caused by permanent physical damage leading to fatal outcomes later in life, or an indirect effect, via its influence on accumulation of wealth and obtained socio-economic status. The Scanian Demographic Database, with information on five rural parishes in southern Sweden between 1813 and 1894, contains the data needed to distinguish between the two mechanisms. First, the effects of conditions in childhood on obtained socio-economic status as an adult are analyzed, then the effects of both early-life conditions and socio-economic status at various stages of life on old-age mortality. By including random effects, we take into account possible dependencies in the data due to kinship and marriage. We find that a high disease load during the first year of life had a strong negative impact on a person's ability to acquire wealth, never before shown for a historical setting. This means that it is indeed possible that the effects of disease load in the first year of life indirectly affect mortality in old age through obtained socio-economic status. We find, however, no effects of obtained socio-economic status on old-age mortality. While the result is interesting per se, constituting a debatable issue, it means that the argument that early-life conditions indirectly affect old-age mortality is not supported. Instead, we find support for the conclusion that the effect of the disease load in early-life is direct or, in other words, that physiological damage from severe infections at the start of life leads to higher mortality at older ages. Taking random effects at family level into account did not alter this conclusion.

Place, publisher, year, edition, pages
Elsevier, 2009
Keywords
Sweden, Historical demography, Old age, Mortality, Early-life conditions, Socio-economic status (SES), Life course
National Category
Sociology
Identifiers
urn:nbn:se:umu:diva-23048 (URN)10.1016/j.socscimed.2009.02.020 (DOI)
Available from: 2009-05-26 Created: 2009-05-26 Last updated: 2018-06-08Bibliographically approved
Bengtsson, T. & Broström, G. (2009). Mortality crises in rural southern Sweden 1766-1860. In: Satomi Kurosu, Tommy Bengtsson, and Cameron Campbell (Ed.), Satomi Kurosu, Tommy Bengtsson, and Cameron Campbell (Ed.), Demographic Responses to Economic and Environmental Crises. Paper presented at IUSSP Seminar, May 21-23, 2009, Reitaku University, Kashiwa, Japan (pp. 1-16). Paper presented at IUSSP Seminar, May 21-23, 2009, Reitaku University, Kashiwa, Japan. Kashiwa, Japan: IUSSP
Open this publication in new window or tab >>Mortality crises in rural southern Sweden 1766-1860
2009 (English)In: Demographic Responses to Economic and Environmental Crises / [ed] Satomi Kurosu, Tommy Bengtsson, and Cameron Campbell, Kashiwa, Japan: IUSSP , 2009, p. 1-16Chapter in book (Other (popular science, discussion, etc.))
Place, publisher, year, edition, pages
Kashiwa, Japan: IUSSP, 2009
Identifiers
urn:nbn:se:umu:diva-31796 (URN)
Conference
IUSSP Seminar, May 21-23, 2009, Reitaku University, Kashiwa, Japan
Available from: 2010-02-16 Created: 2010-02-16 Last updated: 2018-06-08Bibliographically approved
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