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  • 1.
    Gustafsson, Per E.
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Theorell, Töres
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Life-course accumulation of neighborhood disadvantage and allostatic load: empirical integration of three social determinants of health frameworks2014In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 104, no 5, p. 904-910Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: We examined if the accumulation of neighborhood disadvantages from adolescence to mid-adulthood were related to allostatic load, a measure of cumulative biological risk, in mid-adulthood, and explored whether this association was similar in women and men.

    METHODS: Data were from the participants in the Northern Swedish Cohort (analytical n = 818) at ages 16, 21, 30, and 43 years in 1981, 1986, 1995, and 2008. Personal living conditions were self-reported at each wave. At age 43 years, 12 biological markers were measured to operationalize allostatic load. Registered data for all residents in the cohort participants' neighborhoods at each wave were used to construct a cumulative measure of neighborhood disadvantage. Associations were examined in ordinary least-squares regression models.

    RESULTS: We found that cumulative neighborhood disadvantage between ages 16 and 43 years was related to higher allostatic load at age 43 years after adjusting for personal living conditions in the total sample (B = 0.11; P = .004) and in men (B = 0.16; P = .004), but not in women (B = 0.07; P = .248).

    CONCLUSIONS: Our findings suggested that neighborhood disadvantage acted cumulatively over the life course on biological wear and tear, and exemplified the gains of integrating social determinants of health frameworks.

  • 2. Heikkila, Katriina
    et al.
    Fransson, Eleonor I.
    Nyberg, Solja T.
    Zins, Marie
    Westerlund, Hugo
    Westerholm, Peter
    Virtanen, Marianna
    Vahtera, Jussi
    Suominen, Sakari
    Steptoe, Andrew
    Salo, Paula
    Pentti, Jaana
    Oksanen, Tuula
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Marmot, Michael G.
    Lunau, Thorsten
    Ladwig, Karl-Heinz
    Koskenvuo, Markku
    Knutsson, Anders
    Kittel, France
    Jockel, Karl-Heinz
    Goldberg, Marcel
    Erbel, Raimund
    Dragano, Nico
    DeBacquer, Dirk
    Clays, Els
    Casini, Annalisa
    Alfredsson, Lars
    Ferrie, Jane E.
    Singh-Manoux, Archana
    Batty, G. David
    Kivimaki, Mika
    Job Strain and Health-Related Lifestyle: Findings From an Individual-Participant Meta-Analysis of 118 000 Working Adults2013In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 103, no 11, p. 2090-2097Article in journal (Refereed)
    Abstract [en]

    Objectives. We examined the associations of job strain, an indicator of work-related stress, with overall unhealthy and healthy lifestyles. Methods. We conducted a meta-analysis of individual-level data from 11 European studies (cross-sectional data: n = 118 701; longitudinal data: n = 43 971). We analyzed job strain as a set of binary (job strain vs no job strain) and categorical (high job strain, active job, passive job, and low job strain) variables. Factors used to define healthy and unhealthy lifestyles were body mass index, smoking, alcohol intake, and leisure-time physical activity. Results. Individuals with job strain were more likely than those with no job strain to have 4 unhealthy lifestyle factors (odds ratio [OR] = 1.25; 95% confidence interval [CI] = 1.12, 1.39) and less likely to have 4 healthy lifestyle factors (OR = 0.89; 95% CI = 0.80, 0.99). The odds of adopting a healthy lifestyle during study follow-up were lower among individuals with high job strain than among those with low job strain (OR = 0.88; 95% CI = 0.81, 0.96). Conclusions. Work-related stress is associated with unhealthy lifestyles and the absence of stress is associated with healthy lifestyles, but longitudinal analyses suggest no straightforward cause-effect relationship between work-related stress and lifestyle.

  • 3. Hosseinpoor, Ahmad R
    et al.
    Stewart Williams, Jennifer A
    University of Newcastle, New South Wales, Australia.
    Gautam, Jeny
    Posarac, Aleksandra
    Officer, Alana
    Verdes, Emese
    Kostanjsek, Nenad
    Chatterji, Somnath
    Socioeconomic inequality in disability among adults: a multicountry study using the World Health Survey2013In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 103, no 7, p. 1278-1286Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: We compared national prevalence and wealth-related inequality in disability across a large number of countries from all income groups.

    METHODS: Data on 218,737 respondents participating in the World Health Survey 2002-2004 were analyzed. A composite disability score (0-100) identified respondents who experienced significant disability in physical, mental, and social functioning irrespective of their underlying health condition. Disabled persons had disability composite scores above 40. Wealth was evaluated using an index of economic status in households based on ownership of selected assets. Socioeconomic inequalities were measured using the slope index of inequality and the relative index of inequality.

    RESULTS: Median age-standardized disability prevalence was higher in the low- and lower middle-income countries. In all the study countries, disability was more prevalent in the poorest than in the richest wealth quintiles. Pro-rich inequality was statistically significant in 43 of 49 countries, with disability prevalence higher among populations with lower wealth. Median relative inequality was higher in the high- and upper middle-income countries.

    CONCLUSIONS: Integrating equity components into the monitoring of disability trends would help ensure that interventions reach and benefit populations with greatest need.

  • 4.
    Högberg, U
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Bergström, E
    Suffocated prone: the iatrogenic tragedy of SIDS.2000In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 90, no 4, p. 527-31Article in journal (Refereed)
    Abstract [en]

    Epidemiologic research has shown that prone sleeping is a major risk factor for sudden infant death syndrome (SIDS). In a public health review from Sweden, we explored the historical background of the SIDS epidemic, starting with the view of the Catholic Church that sudden infant deaths were infanticides and ending with the slowly disseminated recommendation of a prone sleeping position during the 1960s, 1970s, and 1980s. The story of the SIDS epidemic illustrates a pitfall of preventive medicine--the translation of health care routines for patients to general health advice that targets the whole population. False advice, as well as correct advice, may have a profound effect on public health because of the many individuals concerned. Preventive measures must be based on scientific evidence, and systematic supervision and evaluations are necessary to identify the benefits or the harm of the measures. The discovery of the link between prone sleeping and SIDS has been called a success story for epidemiology, but the slow acceptance of the causal relationship between prone sleeping and SIDS illustrates the weak position of epidemiology and public health within the health care system.

  • 5. Sorensen, Julie A
    et al.
    Jenkins, Paul L
    Emmelin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Earle-Richardson, Giulia B
    May, John J
    The social marketing of safety behaviors: a quasi-randomized controlled trial of tractor retrofitting incentives2011In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 101, no 4, p. 678-684Article in journal (Refereed)
    Abstract [en]

    Objectives. We assessed the effect of social marketing incentives on dispositions toward retrofitting and retrofitting behavior among farmers whose tractors lacked rollover protective structures.

    Methods. From 2006 to 2007, we conducted a quasi-randomized controlled trial with 391 farm owners in New York and Pennsylvania surveyed before and after exposure to 1 of 3 tractor retrofitting incentive combinations. These combinations were offered in 3 trial regions; region 1 received rebates; region 2 received rebates, messages, and promotion and was considered the social marketing region; and region 3 received messages and promotion. A fourth region served as a control.

    Results. The social marketing region generated the greatest increases in readiness to retrofit, intentions to retrofit, and message recall. In addition, postintervention stage of change, intentions, attitudes, subjective norms, and perceived behavioral control levels were higher among farmers who had retrofitted tractors.

    Conclusions. Our results showed that a social marketing approach (financial incentives, tailored messages, and promotion) had the greatest influence on message recall, readiness to retrofit tractors, and intentions to retrofit tractors and that behavioral measures were fairly good predictors of tractor retrofitting behaviors.

  • 6. Tolstrup, Janne S
    et al.
    Hvidtfeldt, Ulla A
    Flachs, Esben Meulengracht
    Spiegelman, Donna
    Heitmann, Berit L
    Bälter, Katarina
    Goldbourt, Uri
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Biobank Research. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Knekt, Paul
    Liu, Simin
    Pereira, Mark
    Stevens, June
    Virtamo, Jarmo
    Feskanich, Diane
    Smoking and risk of coronary heart disease in younger, middle-aged, and older adults2014In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 104, no 1, p. 96-102Article in journal (Refereed)
    Abstract [en]

    Objectives. We investigated associations of smoking and coronary heart disease (CHD) by age. Methods. Data came from the Pooling Project on Diet and Coronary Heart Disease (8 prospective studies, 1974-1996; n = 192 067 women and 74 720 men, aged 40-89 years). Results. During follow-up, 4326 cases of CHD were reported. Relative to never smokers, CHD risk among current smokers was highest in the youngest and lowest in the oldest participants. For example, among women aged 40 to 49 years the hazard ratio was 8.5 (95% confidence interval [CI] = 5.0, 14) and 3.1 (95% CI = 2.0, 4.9) among those aged 70 years or older. The largest absolute risk differences between current smokers and never smokers were observed among the oldest participants. Finally, the majority of CHD cases among smokers were attributable to smoking. For example, attributable proportions of CHD by age group were 88% (40-49 years), 81% (50-59 years), 71% for (60-69 years), and 68% (70+ years) among women who smoked. Conclusions. Among smokers, the majority of CHD cases are attributable to smoking in all age groups. Smoking prevention is important, irrespective of age.

  • 7. Wesseling, C.
    et al.
    Crowe, J.
    Hogstedt, C.
    Jakobsson, K.
    Lucas, Rebekah
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Hothaps Program, Umeå University.
    Wegman, D. H.
    The epidemic of chronic kidney disease of unknown etiology in Mesoamerica: a call for interdisciplinary research and action2013In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 103, no 11, p. 1927-1930Article in journal (Refereed)
  • 8. Wesseling, Catharina
    et al.
    Crowe, Jennifer
    Hogstedt, Christer
    Jakobsson, Kristina
    Lucas, Rebekah
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Wegman, David
    Chronic Kidney Disease in Central America: The Big Picture Response2014In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 104, no 7, p. e9-e10Article in journal (Refereed)
  • 9. Wesseling, Catharina
    et al.
    Crowe, Jennifer
    Hogstedt, Christer
    Jakobsson, Kristina
    Lucas, Rebekah
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Wegman, David H.
    Chronic Kidney Disease Among Agricultural Workers in Central America response2014In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 104, no 3, p. e1-e2Article in journal (Refereed)
1 - 9 of 9
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