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Baroudi, M., Petersen, S., Namatovu, F., Annelie, C., Ivarsson, A. & Norström, F. (2019). Preteen children’s health related quality of life in Sweden: changes over time and disparities between different sociodemographic groups. BMC Public Health, 19, Article ID 139.
Open this publication in new window or tab >>Preteen children’s health related quality of life in Sweden: changes over time and disparities between different sociodemographic groups
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2019 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, article id 139Article in journal (Refereed) Published
Abstract [en]

Background: Assessing disparities in health-related quality of Life (HRQoL) is important as a part of health-related disparities in the society. The aim of this study was to explore HRQoL among 12-year-olds in Sweden in terms of differences between years 2005 and 2009 and disparities related to sociodemographic background.

Methods: During the school years 2005 and 2009, a total of 18,325 sixth grade students in Sweden were invited to a celiac disease screening study; 13,279 agreed to participate. Jointly with the celiac screening, the children answered a questionnaire that included EuroQol 5 Dimensions-youth (EQ-5D-Y) and their parents responded to separate questionnaires about their own and their child’s country of birth, family structure, their employment status, occupation, and education. In total 11,009 child-parent questionnaires were collected. Logistic regression was used to study differences in HRQoL between 2005 and 2009, and between various sociodemographic subgroups.

Results: Compared with 2005, children in 2009 reported more pain (OR: 1.20, 95% CI: 1.1–1.3) and more mood problems (OR: 1.35, 95% CI: 1.2–1.5). In general, girls reported more pain and mood problems and had more disparities than boys. There were no significant differences based on parents’ occupation, however, children of parents with low or medium education levels reported less “mood problems” than those of parents with high education levels (OR: 0.65, 95% CI: 0.46–0.92) and (OR: 0.84, 95% CI: 0.73–0.96), respectively. A slight variation was seen in HRQoL between children with different migration background. Girls living in small municipalities reported more pain (OR: 1.51, 95% CI: 1.14–2.01), and problems performing usual activities (OR: 3.77, 95% CI: 2.08–6.84), compared to girls living in large municipalities. In addition, children living with two parents had less mood problems than children living in other family constellations.

Conclusion: More children reported pain and mood problems in 2009 compared with 2005. To study future trends, health outcomes among children in Sweden should continue to be reported periodically. More efforts should be invested to increase the awareness of health-related disparities as highlighted in this study especially for girls living in small municipalities and children of parents with high education level.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Preteen children health, Health inequity, Quality of life, HRQoL, Sociodemographic disparities
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-155944 (URN)10.1186/s12889-019-6429-6 (DOI)000457471800001 ()30704442 (PubMedID)
Funder
Swedish Research Council, 521-2004-7093Swedish Research Council, 521-2007-2953Swedish Research Council Formas, 222-2004-1918Swedish Research Council Formas, 222-2007-1394
Available from: 2019-02-01 Created: 2019-02-01 Last updated: 2019-02-25Bibliographically approved
Myléus, A., Stenhammar, L., Högberg, L., Browaldh, L., Daniels, I.-M., Fagerberg, U. L., . . . Ivarsson, A. (2019). Questionnaire showed that Swedish paediatric clinics complied well with the revised European guidelines for diagnosing coeliac disease. Acta Paediatrica, 108(6), 1140-1143
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
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2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 6, p. 1140-1143Article in journal (Refereed) Published
Abstract [en]

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

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

Results: All 36 (90%) clinics that responded used anti-tissue transglutaminase antibodies as 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 small bowel biopsies in symptomatic children with repeatedly high coeliac serology and positive genotyping, thereby avoiding the need for invasive endoscopy under anaesthesia.

Conclusion: The 2012 Swedish Paediatric Coeliac Disease Diagnostic Guidelines had been widely accepted and implemented in routine health care two years after their introduction.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
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)000467867900026 ()30496613 (PubMedID)2-s2.0-85058447406 (Scopus ID)
Available from: 2018-12-21 Created: 2018-12-21 Last updated: 2019-06-19Bibliographically approved
Eurenius, E., Richter Sundberg, L., Vaezghasemi, M., Silfverdal, S.-A., Ivarsson, A. & Lindkvist, M. (2019). Social-emotional problems among three-year-olds differ based on the child's gender and custody arrangement. Acta Paediatrica, 108(6), 1087-1095
Open this publication in new window or tab >>Social-emotional problems among three-year-olds differ based on the child's gender and custody arrangement
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2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 6, p. 1087-1095Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this study was to investigate mental health with respect to social-emotional problems among three-year-olds in relation to their gender, custody arrangements and place of residence.

METHODS: A cross-sectional population-based design was used, encompassing 7,179 three-year-olds in northern Sweden during the period 2014-2017 from the regional Salut Register. Descriptive and comparative analyses were performed based on parents' responses on the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE), supplemented with items on gender, custody arrangement and place of residence.

RESULTS: Parental-reported social-emotional problems were found in almost 10% of the children. Boys were reported to have more problems (12.3%) than girls (5.6%) (p<0.001). Parents were most concerned about children's eating habits and interactions at mealtimes. Parents not living together reported more problems among their children than those living together (p<0.001). When stratifying by custody arrangement, girls in rural areas living alternately with each parent had more problems compared to those in urban areas (p<0.008).

CONCLUSION: Gender and custody arrangements appear to be important factors for social-emotional problems among three-year-olds. Thus, such conditions should receive attention during preschool age, preferably by a systematic preventive strategy within Child Health Care.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
ages and stages questionnaires, cross-sectional study, emotional and behavioural problems, mental health, preschool child
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-154007 (URN)10.1111/apa.14668 (DOI)000467867900018 ()30496622 (PubMedID)2-s2.0-85058852765 (Scopus ID)
Available from: 2018-12-11 Created: 2018-12-11 Last updated: 2019-06-19Bibliographically approved
Ivarsson, A., Eurenius, E., Lindkvist, M. & Richter Sundberg, L. (2019). Socioemotionell förmåga hos treåringar: Resultat från en befolkningsbaserad studie i Västerbottens län. Brookes Publishing Company
Open this publication in new window or tab >>Socioemotionell förmåga hos treåringar: Resultat från en befolkningsbaserad studie i Västerbottens län
2019 (Swedish)Report (Other academic)
Abstract [sv]

Det övergripande målet för svensk barnhälsovård är att främja barns hälsa, trygghet och utveckling samt ge stöd i föräldraskapet. Barn i Sverige är i hög grad fysiskt friska i internationell jämförelse, men det finns indikationer på att den psykiska ohälsan har ökat hos barn och ungdomar under de senaste decennierna. Kunskapen om förekomst av, och bakomliggande faktorer, till psykisk ohälsa hos förskolebarn är dock otillräcklig. Syftet med denna studie är därför att undersöka treåringars socioemotionella förmåga med avseende på könsskillnader och boende i stad eller på landsbygd i Västerbottens län.

Förskolebarns psykiska hälsa undersöks systematiskt

I denna studie har instrumentet Ages and Stages Questionnaires: Social-Emotional (ASQ:SE) använts för att undersöka föräldrars rapporterade socioemotionella förmåga hos treåringar. ASQ:SE 36-månadersversion delas rutinmässigt ut till föräldrar inför treårsbesöket på barnavårdscentraler i Västerbottens län sedan 2013. ASQ:SE är ursprungligen utvecklat i USA och mäter barns socioemotionella förmåga inom sju domäner: självreglering, följsamhet, kommunikation, adaptiv förmåga, autonomi, affekt och social interaktion. Socioemotionell förmåga i treårsåldern är exempelvis förmåga till samspel med vuxna och jämnåriga samt förmåga att med stöd av förälder reglera egna känslor. Betydande avvikelser i den socioemotionella förmågan vid denna ålder kan tyda på att barnet har en sårbarhet som kan leda till fortsatta och ibland mer allvarliga socioemotionella problem.

Generellt god psykisk hälsa men fler problem bland pojkar

Svaren från majoriteten av föräldrarna indikerar god socioemotionell förmåga hos barnen, dock hade nästan en av tio treåringar föräldrarapporterade socioemotionella problem, med ASQ:SE-poäng över gränsvärdet 59. Problemen var dubbelt så vanliga bland pojkar (12 procent) som bland flickor (6 procent) (p <0,001). Det fanns inga signifikanta skillnader i socioemotionell förmåga mellan barn bosatta i städer i jämförelse med barn bosatta på landsbygden. Skillnaderna mellan könen var dock kvarstående oberoende av geografisk hemvist. Domänerna autonomi och följsamhet innehöll de frågor för vilka flest föräldrar rapporterade svårigheter, detta gällde för både pojkar och flickor.

Slutsats

Studien har ökat förståelsen för socioemotionell förmåga hos treåringar i Sverige. Den förstärker vikten av att identifiera problem i tidig ålder och att beakta könsskillnader. Redan i förskoleåldern bör socioemotionell förmåga uppmärksammas, helst genom en systematisk strategi inom barnhälsovården

Place, publisher, year, edition, pages
Brookes Publishing Company, 2019. p. 36
Series
Rapport från Folkhälsomyndigheten
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-159192 (URN)
Available from: 2019-05-21 Created: 2019-05-21 Last updated: 2019-06-10Bibliographically approved
Eriksson, M., Lindgren, U., Ivarsson, A. & Ng, N. (2019). The effect of neighbourhood social capital on child injuries: a gender-stratified analysis. Health & Place, 60, Article ID 102205.
Open this publication in new window or tab >>The effect of neighbourhood social capital on child injuries: a gender-stratified analysis
2019 (English)In: Health & Place, Vol. 60, article id 102205Article in journal (Refereed) Published
Abstract [en]

We designed a longitudinal retrospective cohort study to analyse the associations between neighbourhood social capital and child injures. Register data from the Umeå Simsam Lab in Sweden was used to measure child injuries and demographic and socioeconomic factors at individual, household and neighbourhood level. A social capital score from a previous survey was used to measure neighbourhood social capital. We conducted a three-level multilevel negative binomial regression analysis, with children (level 1, N = 77,193) nested within households (level 2, N = 10,465), and households nested within neighbourhoods (level 3, N = 49). The incidence rate of child injuries was lower in high social capital neighbourhoods. When controlling for factors at individual, household and neighbourhood levels, living in a high social capital neighbourhood was protective of injuries among girls, but not among boys. Promoting social capital in local neighbourhoods could be seen as a prevention strategy for injuries among girls.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Child injury, Social capital, Neighbourhood effects, Gender, Longitudinal analysis
National Category
Pediatrics Public Health, Global Health, Social Medicine and Epidemiology Social Work
Identifiers
urn:nbn:se:umu:diva-163497 (URN)10.1016/j.healthplace.2019.102205 (DOI)31546173 (PubMedID)
Available from: 2019-09-23 Created: 2019-09-23 Last updated: 2019-10-31Bibliographically approved
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: 2019-01-31Bibliographically 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
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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: 2019-05-21Bibliographically 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
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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: 2019-02-27Bibliographically approved
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
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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
Projects
CELIAC DISEASE. HAS THE TIME COME FOR PRIMARY PREVENTION AND MASS SCREENING? Evaluation of the Swedish epidemic and post-epidemic cohorts at twelve-years-of-age. [2011-03248_VR]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8944-2558

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