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  • 1. Backhans, Mona Christina
    et al.
    Burström, Bo
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Månsdotter, Anna
    Pioneers and laggards: Is the effect of gender equality on health dependent on context?2009In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 68, p. 1388-1395Article in journal (Refereed)
    Abstract [en]

    This study combines data at individual and area level to examine interactions between equality within couples and gender equality in the municipality in which individuals live. The research question is whether the context impacts on the association between gender equality and health. The material consists of data on 37,423 men and 37,616 women in 279 Swedish municipalities, who had their first child in 1978. The couples were classified according to indicators of their level of gender equality in 1980 in the public sphere (occupation and income) and private sphere (child care leave and parental leave) compared to that of their municipality. The health outcome is compensated days from sickness insurance during 1986-1999 with a cut-off at the 85% percentile. Data were analysed using logistic regression with the overall odds as reference. The results concerning gender equality in the private sphere show that among fathers, those who are equal in an equal municipality have lower levels of sick leave than the average while laggards (less equal than their municipality) and modest laggards have higher levels. In the public sphere, pioneers (more equal t han their municipality) fare better than the average while laggards fare worse. For mothers, those who are traditional in their roles in the public sphere are protected from high levels of sick leave, while the reverse is true for those who are equal. Traditional mothers in a traditional municipality have the lowest level of sick leave and pioneers the highest. These results show that there are distinct benefits as well as disadvantages to being a gender pioneer and/or a laggard in comparison to your municipality. The associations are markedly different for men and women.

  • 2. Modin Asper, Michaela
    et al.
    Hallén, Nino
    Lindberg, Lene
    Månsdotter, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Carlberg, Magdalena
    Wells, Michael B.
    Screening fathers for postpartum depression can be cost-effective: an example from Sweden2018In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 241, p. 154-163Article in journal (Refereed)
    Abstract [en]

    Background: Postpartum depression negatively affects the whole family and its prevalence in Sweden ranges between 6-10% for fathers and 13-16% for mothers. However, only mothers in Sweden are currently routinely screened.

    Aim: The aim of this study was to determine if a postpartum depression screening for fathers in Stockholm County could be cost-effective.

    Methods: National Swedish databases were used to find registry data and a literature review was undertaken to identify the model data inputs associated with postpartum depression in Sweden. The generated evidence was used to build a Markov model in TreeAge. One-way and probabilistic sensitivity analyses were performed to account for parameter uncertainties. Alternative scenario analyses were further undertaken to test the assumptions in the base case analysis.

    Results: A postpartum screening for depression in fathers is cost-effective in base case and alternative scenarios. The results indicate that the screening program is associated with lower costs and higher health effects. The results were sensitive to variables of quality adjusted life years for the depressed fathers, probabilities of remission in treatment and no treatment groups and start age and productivity losses. The probabilistic sensitivity analysis resulted in a 70% probability of the postnatal depression screening intervention being cost-effective.

    Limitations: The current study only uses secondary data; therefore future research should assess the cost-effectiveness of screening fathers for depression.

    Conclusion: The postpartum screening intervention for fathers could be cost-effective compared to no screening. Future research should replicate the potential cost-effectiveness for screening fathers for postpartum depression.

  • 3. Månsdotter, Anna
    et al.
    Ekman, Björn
    Feldman, Inna
    Hagberg, Lars
    Hurtig, Anna-Karin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    We Propose a Novel Measure for Social Welfare and Public Health: Capability-Adjusted Life-Years, CALYs2017In: Applied Health Economics and Health Policy, ISSN 1175-5652, E-ISSN 1179-1896, Vol. 15, no 4, p. 437-440Article in journal (Refereed)
  • 4. Månsdotter, Anna
    et al.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Lundberg, Michael
    Health, wealth and fairness based on gender: the support for ethical principles.2006In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, ISSN 0277-9536, Vol. 62, no 9, p. 2327-2335Article in journal (Refereed)
  • 5. Månsdotter, Anna
    et al.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Lundberg, Michael
    Winkvist, Anna
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Parental share in public and domestic spheres: a population study on gender equality, death, and sickness.2006In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 60, no 7, p. 616-620Article in journal (Refereed)
  • 6.
    Månsdotter, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Winkvist, Anna
    Paternity leave in Sweden: costs, savings and health gains.2007In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 82, no 1, p. 102-115Article in journal (Refereed)
  • 7.
    Månsdotter, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Women, men and public health - how the choice of normative theory affects resource allocation.2004In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 69, no 3, p. 351-364Article in journal (Refereed)
  • 8. Månsdotter, Anna
    et al.
    Lundberg, Michael
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    How does gender equality progress link to alcohol care and death?: A registry study of the Swedish parental cohort of 1988/19892012In: Journal of Public Health Policy, ISSN 0197-5897, E-ISSN 1745-655X, Vol. 33, no 1, p. 105-118Article in journal (Refereed)
    Abstract [en]

    This article examines how gender equality during early parenthood (1988-1991) associates with alcohol-related inpatient care or mortality (1992-2006). We categorised all Swedish couples having had a first child together in 1988-1989 (N = 118 595) as traditional, or gender equal, or untraditional based on income and occupational position (bread-winning indicators), parental leave and temporary child care (child-care indicators). Overall, traditional women run lower risk, whereas traditional men and untraditional women (those opposing the traditional division of parenthood responsibilities) run higher risks of alcohol harm than their gender-equal counterparts. Journal of Public Health Policy (2012) 33, 105-118. doi:10.1057/jphp.2011.48; published online 15 September 2011

  • 9. Månsdotter, Anna M
    et al.
    Rydberg, Malin K
    Wallin, Eva
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Andréasson, Sven
    A cost-effectiveness analysis of alcohol prevention targeting licensed premises.2007In: Eur J Public Health, ISSN 1101-1262Article in journal (Refereed)
  • 10.
    Månsdotter, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Nordenmark, Mikael
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    The importance of childhood and adulthood aspects of gendered life for adult mental ill-health symptoms: a 27-year follow-up of the Northern Swedish Cohort2012In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, p. 493-Article in journal (Refereed)
    Abstract [en]

    Background: The increasing gender equality during the 20th century, mainly in the Nordic countries, represents a major social change. A well-established theory is that this may affect the mental health patterns of women and men. This study aimed at examining associations between childhood and adulthood gendered life on mental ill-health symptoms.

    Methods: A follow-up study of a cohort of all school leavers in a medium-sized industrial town in northern Sweden was performed from age 16 to age 42. Of those still alive of the original cohort, 94% (n = 1007) participated during the whole period. Gendered life was divided into three stages according to whether they were traditional or non-traditional (the latter includes equal): childhood (mother's paid work position), adulthood at age 30 (ideology and childcare), and adulthood at age 42 (partnership and childcare). Mental ill-health was measured by self-reported anxious symptoms ("frequent nervousness") and depressive symptoms ("frequent sadness") at age 42. The statistical method was logistic regression analysis, finally adjusted for earlier mental ill-health symptoms and social confounding factors.

    Results: Generally, parents' gendered life was not decisive for a person's own gendered life, and adulthood gender position ruled out the impact of childhood gender experience on self-reported mental ill-health. For women, non-traditional gender ideology at age 30 was associated with decreased risk of anxious symptoms (76% for traditional childhood, 78% for non-traditional childhood). For men, non-traditional childcare at age 42 was associated with decreased risk of depressive symptoms (84% for traditional childhood, 78% for non-traditional childhood). A contradictory indication was that non-traditional women in childcare at age 30 had a threefold increased risk of anxious symptoms at age 42, but only when having experienced a traditional childhood.

    Conclusion: Adulthood gender equality is generally good for self-reported mental health regardless of whether one opposes or continues one's gendered history. However, the childcare findings indicate a differentiated picture; men seem to benefit in depressive symptoms from embracing this traditionally female duty, while women suffer anxious symptoms from departing from it, if their mother did not.

  • 11.
    Trygg, Nadja
    et al.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Gustafsson, Per E
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Månsdotter, Anna
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Languishing in the crossroad?: A scoping review of intersectional inequalities in mental health2019In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 18, article id 115Article, review/survey (Refereed)
    Abstract [en]

    The concept of intersectionality has gradually been introduced to health inequality research, adding depth and breadth to the way inequalities in health are approached. We conducted a scoping review with the purpose to systematically map, describe and analyze the literature about intersectional inequalities in mental health. For eligibility, the study had to analyze and report inequality defined by combinations of socioeconomic position, gender, race/ethnicity, sexual orientation or religion. The mental health outcome had to be measured as self-reported symptoms assessed through validated scales, or disorders assessed through diagnostic interviews. The search strategy was applied in two databases and the screening process yielded 20 studies. The interaction of intersectional positions showed no consistent patterns in mental health across studies, but both synergistic and antagonistic effects were observed. In most studies an absolute measure of inequality was used and few studies analyzed factors potentially explaining the intersectional inequalities. Taken together, the findings of this review highlight the value of assessing intersectional inequalities across population groups for priority setting and action on mental health inequalities.

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