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Issues: From extracting insights from large-scale, multimodal data to prevention and support, there is growing interest in theapplications and implications of recent advances in Artificial Intelligence (AI) within the fields of addiction, substance use andmental health, which we refer to as ASUM. However, due to the absence of a structured mapping of AI for ASUM, it remainsunclear how this interest is translated into concrete research results.

Approach: This paper addresses this gap by conducting a bibliometric analysis of AI for ASUM, exploring: (i) the scale of ASUM-related research (number of publications, authors, institutions and countries); (ii) the evolution of ASUM‘s research productivityover time, both in absolute terms and relative to its parent disciplines; (iii) the key topics within ASUM and their interrelations.

Key Findings: Results, supplemented by a comparison of similar fields, show that, while ASUM is an emerging and rapidly ex-panding domain (with a 25-fold increase in research output since 2012, attracting growing attention relative to parent disciplinesas well as appearing to rely on applying more advanced AI methods than related fields), it remains largely fragmented through adispersed group of infrequent contributors.

Implications: An integration of the findings suggests two dominant trajectories through which AI for ASUM is currently beingrealised: as AI-driven analytic support and as innovative research and therapeutic methods (e.g., virtual reality, chatbots).

Conclusions: The paper concludes by situating AI for ASUM as an emerging scientific field, outlining the scientific andpractical challenges and opportunities that are likely to arise, and high-potential research areas open for exploration.

Although free school choice policies are often proposed as strategies to decouple residential and school segregation, research has found that they may actually increase segregation. This study investigates an underexplored aspect of these policies: the role of commuting in influencing school segregation patterns. Using Swedish register data from Stockholm Metropolitan Area, we analyse ethnic and socioeconomic segregation across residential neighbourhoods and upper-secondary schools. We examine students' distances to the nearest schools offering their chosen programs and their actual commuting distances in relation to the schools' characteristics. Our findings reveal that students with immigrant backgrounds, despite living closer to the nearest schools offering their chosen programs than native peers, tend to travel longer distances to attend their chosen schools. For native students, choosing nearby schools is associated with selecting more privileged institutions that have higher proportions of native students and higher average income levels. In contrast, students with immigrant backgrounds often travel longer distances to reach schools with characteristics similar to those attended by native students. These results challenge simplistic assumptions about the segregation-reducing effects of free school choice policies and highlight the complex interplay among the uneven distribution of educational opportunities, home-to-school mobility, and school selection strategies.

Deaths of despair – alcohol-related, drug-related, and suicide mortality – have emerged as a major public health concern strongly linked to socioeconomic disadvantage. Yet much evidence relies on baseline or single-time-point measures and originates from contexts with weak social protection. Two questions remain insufficiently addressed: how work-welfare trajectories are associated with mortality risk, and how risks vary across institutionalised forms of non-employment in welfare-state contexts with strong social protection. Using linked Swedish administrative registers, we analysed 20,281 adults assessed with the Addiction Severity Index (ASI) in municipal social services during 2013-2022 – a population combining severe substance-use problems with prolonged labour-market marginality. We reconstructed annual work-welfare sequences over a ten-year window, identified trajectory clusters using sequence analysis, and estimated cause-specific mortality using Fine-Gray competing-risks models. Five trajectories emerged: employment-attached, welfare-dependent, unstable employment, health-benefit-dependent, and pension-anchored. In adjusted models, the welfare-dependent, unstable-employment, and health-benefit-dependent trajectories showed higher drug-related and non-despair mortality than the employment-attached group. Alcohol-related mortality was higher only in the welfare-dependent trajectory, while suicide risk did not differ across trajectories. Drug-related mortality gradients persisted after adjustment for baseline hospitalisation, time-varying hospitalisation, and self-reported clinical severity. These findings suggest that in a decommodifying welfare-state context, non-employment is not a uniform exposure. Institutionally structured work-welfare trajectories differentiate mortality risk, with gradients concentrated in substance-related deaths rather than suicide. The persistence of trajectory gradients after health-severity adjustment is consistent with sustained marginalisation playing a role in mortality risk beyond individual-level clinical severity, and identifies high-risk subgroups within social-service caseloads for targeted intervention.

Aims: This study examined the association between educational attainment and the risk of deaths of despair among individuals assessed for substance use severity at municipal social services in Sweden. It aimed to determine whether the protective association between education and despair-related mortality risk, commonly observed in broader population studies, also applies to this high-risk, treatment-seeking population.

Methods: We linked data from municipal Addiction Severity Index (ASI) assessments to various population registers. The study population included adults aged 25 years or older who were assessed for substance use severity between 1999 and 2019. Fine–Gray competing risk regression models were employed to examine the association between educational attainment and despair-related mortality, both overall and by subtype (alcohol-related, drug use-related, suicide).

Results: Tertiary education was unexpectedly associated with increased risks of overall despair-related mortality, alcohol-related and drug use-related mortality, after controlling for demographic characteristics, ASI composite scores and substance use onset age. No significant associations were found between education and suicide.

Conclusions: The counterintuitive finding that tertiary education is linked to a greater risk of despair-related mortality among social service users may be attributed to differences between the treatment-seeking population and the general population. Highly educated individuals who seek treatment from municipal social services might have severe substance use and complex psychosocial problems and/or contact social services after exhausting other treatment options. Further research is necessary to understand how educational and socioeconomic factors influence treatment pathways for individuals with severe substance use problems in Sweden and how these different pathways impact health-related outcomes.

The ongoing debate on Swedish municipal housing’s universalist characteristics has focused on declining supply, stricter access criteria, and changing tenant demographics. This study addresses a research gap by examining how Swedish municipal housing queues, prioritizing apartment allocation by registration duration, influence tenant selection. Using a unique dataset from Bostaden, Umeå’s municipal housing company, linked to register data, the study investigates factors influencing housing queue accumulation and usage, with a focus on immigrant background. It further analyses how immigrant background affects the timing of exiting the housing queue to secure apartments. Furthermore, the study explores how the immigrant background of individuals obtaining queue-assigned apartments influences neighbourhood demographics. The findings highlight the substantial challenges faced by immigrants, particularly those from the Global South, in terms of housing queue accumulation, utilization, and neighbourhood attainment. These insights reveal how housing queues, as seniority-based rationing mechanisms, contribute to the perpetuation of housing and socio-spatial inequalities in Swedish cities.

The COVID-19 pandemic caused a global health crisis that affected every aspect of society worldwide. However, the detrimental health effects of the pandemic were not equally distributed across groups and places. Likewise, adherence to preventive measures varied across groups and communities. Having supportive social networks and living in areas with social cohesion—social capital—is believed to protect against adverse consequences of social crises. This mixed method study aims to investigate the bidirectional relationship between social capital and the COVID-19 pandemic, and to analyze the significance of individual and neighborhood social capital for physical and mental health, attitudes toward- and adherence to preventive measures. The specific objectives are to; (1) Investigate the development of neighborhood social capital during the COVID-19 pandemic and to assess whether perceptions on how the pandemic affected life situation and attitudes toward preventive measures differ across neighborhoods with different social capital profiles and population characteristics. (2) Analyze the effects of individual social capital on physical and mental health, as well as attitudes toward and adherence to preventive measures for diverse population sub-groups, living in neighborhoods with different social capital profiles. (3) Analyze how the pandemic and its associated preventive measures impacted people’s access to and utilization of social capital. Sub-study 1 will utilize data from repeated cross-sectional social capital surveys conducted before and after the COVID-19 pandemic, in 2020 and 2024. Data from a cohort who responded to both the post- and the pre-COVID social capital surveys will be linked to population register data on socioeconomic and sociodemographic factors and health registers to be used for the quantitative sub-study 2. A strategic sample of individuals who participated in both the 2020 and the 2024 social capital surveys will be invited to participate in interviews for a subsequent qualitative sub-study 3. This study is carried out in Umeå Municipality, Northern Sweden, where extensive research on social capital, health and social sustainability has been conducted since 2006. The proposed study contributes novel knowledge on how a social crisis affects unequal living conditions between groups and places. This knowledge can provide a basis for what actions are needed to reduce adverse health consequences of social crises.

Bakground: Growing educational disparities in mortality due to suicide, drug overdose, or alcohol-related liver disease – or “deaths of despair” (DoD) – have received increased attention in research and public debate. However, no study has investigated educational differences in despair-related mortality outside of North America. Thus, the aim this study was to investigate changes in the association between academic achievement in compulsory school and subsequent all-cause mortality (ACM) and DoD between 1990 and 2018 in Swedish youths.

Data and methods: Register data on all students graduating from compulsory school in Sweden between 1990 and 2010 were used (N = 2 252 938). Students were followed for a maximum of 8 years using discrete time proportional hazard models. Academic achievement was measured by grades at the end of compulsory school.

Results: ACM declined for medium/high achieving but not for low-achieving youths, while DoD increased slightly for medium/high achieving and markedly for low-achieving youths, resulting in growing achievement-related disparities in both types of mortality. The trends were primarily driven by native-born youth and girls.

Conclusions: The trends in Swedish youths resemble the trends in the American working-age population, but partly contrasts with corresponding trends in other European countries. Future research should investigate if the underlying causes that have been emphasized in the American context – socio-economic transformations and a greater supply of drugs – have also contributed to the Swedish trends.

Rising rates of "deaths of despair" – mortality from suicide, drug overdose, and alcohol-related causes – have contributed to widening educational disparities in mortality. It is not known to what extent the trends are due to selection effects (health causing education, or a third factor causing both) or social causation (education affecting health). This study investigated the relative contribution of selection and causation for these trends, focusing on the recently documented widening achievement-based disparities in mortality among Swedish youths.

To this end, two cohorts of Swedish compulsory school graduates (graduating in 1992–1993 and 2009–2010, respectively) were followed for eight years after graduation using comprehensive administrative data (n = 424,715). Logistic regression models were used to assess the role of pre-graduation selection, while inverse odds ratio-weighting was used to assess mediation by post-graduation socioeconomic disadvantages.

Roughly half of the association between low achievement and all-cause and despair-related mortality within cohorts was due to selection. However, selection effects did not explain the widening disparities over time. Socioeconomic mediators accounted for most of the remaining disparities within cohorts as well as of for most of the increase in these disparities over time. Overall, social causation was more important than selection in explaining the widening educational disparities in all-cause and despair-related mortality.

We conclude that low academic achievement increasingly constrains life-course prospects of Swedish youths, amplifying its adverse health consequences. These findings highlight the need for lower barriers in the education system and for viable educational and employment pathways for low-achieving students in an increasingly knowledge-intensive labor market. 

Background: The Addiction Severity Index (ASI) assesses respondents' biopsychosocial problems in seven addiction-related domains (mental health, family and social relations, employment, alcohol use, drug use, physical health, and legal problems). This study examined the association between the seven ASI composite scores and re-employment in a sample of Swedish adults screened for risky alcohol and drug use who were without employment at assessment.

Methods: We conducted a retrospective cohort analysis of employment outcomes among 6502 unemployed adults living in Sweden who completed an ASI assessment for risky alcohol and drug use. The study linked ASI scores to annual tax register data. The primary outcome was employment, defined as having earnings above an administrative threshold. We used Cox proportional hazard models to estimate the association between time to re-employment and ASI composite scores, controlling for demographic characteristics.

Results: Approximately three in ten individuals in the sample regained employment within five years. ASI composite scores suggested widespread biopsychosocial problems. Re-employment was associated with lower ASI composite scores for mental health (estimate: 0.775, 95 % confidence interval: 0.629–0.956), employment (estimate: 0.669, confidence interval: 0.532–0.841), drug use (estimate: 0.628, confidence interval: 0.428–0.924), and health (estimate: 0.798, confidence interval: 0.699–0.912).

Conclusions: This study suggests that several ASI domains may provide information on the complex factors (i.e., mental health, health, drug use) associated with long-term unemployment for people with risky substance use.

Background: In Sweden, as in other countries, individuals with immigrant backgrounds are disproportionately represented within the incarcerated population. This study examined the association between immigrant background and future incarceration for individuals assessed for illicit substance use severity, while considering their prior incarceration history.

Methods: Using data from Swedish Addiction Severity Index (ASI) assessments linked to register data from Statistics Sweden, we employed Zero-Inflated Negative Binomial (ZINB) regression models to analyse differences in incarceration histories within five years before and after ASI assessments based on immigrant backgrounds. Additionally, Cox proportional-hazard models were used to assess the likelihood of post-assessment incarceration among these groups.

Results: Immigrant background was positively associated with pre- and post-assessment incarceration. First- and second-generation immigrants from the Global South had longer periods of incarceration in the five years before assessments compared to native Swedes. Post-assessment, first-generation immigrants showed longer periods of incarceration. Survival analyses supported these findings, indicating a higher risk of prolonged post-assessment incarceration among all immigrant groups, particularly first-generation immigrants from the Global South.

Conclusion: Among individuals assessed for illicit drug use within Swedish municipalities, those with immigrant backgrounds faced higher incarceration risks, even after controlling for substance use severity and prior incarceration. Tailored interventions and support systems are vital to prevent re-entry into the criminal justice system. Timely actions can break re-offending cycles, redirecting paths away from reoffending and towards legal reintegration, thereby reducing incarceration and recidivism rates.