uu.seUppsala University Publications
Change search
Refine search result
123 1 - 50 of 140
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the 'Create feeds' function.
  • 1.
    Bean, Christopher
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. School of Psychology, University of Adelaide, Australia.
    Pingel, Ronnie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Berg, Noora
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Hallqvist, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Hammarström, Anne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    A 4-way decomposition analysis of poor social relations and depressive symptoms over the life-course2017In: European Journal of Public Health, Volume 27, Issue suppl_3, 2017Conference paper (Refereed)
  • 2.
    Bengs, Carita
    et al.
    Umeå universitet, Sociologiska institutionen.
    Johansson, Eva
    Umeå universitet, Allmänmedicin.
    Danielsson, Ulla EB
    Umeå universitet, Allmänmedicin.
    Lehti, Arja
    Umeå universitet, Allmänmedicin.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Gendered portraits of depression in Swedish newspapers2008In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 18, no 7, 962-973 p.Article in journal (Refereed)
    Abstract [en]

    Mass media are influential mediators of information, knowledge, and narratives of health and illness. In this article, we report on an examination of personal accounts of illness as presented in three Swedish newspapers, focusing on the gendered representation of laypersons' experiences of depression. A database search identified all articles mentioning depression during the year 2002. Twenty six articles focusing on personal experiences of depression were then subjected to a qualitative content analysis. We identified four themes: displaying a successful facade, experiencing a cracking facade, losing and regaining control, and explaining the illness. We found both similarities and differences with regard to gendered experiences. The mediated accounts of depression both upheld and challenged traditional gender stereotypes. The women's stories were more detailed, relational, emotionally oriented, and embodied. The portrayal of men was less emotional and expressive, and described a more dramatic onset of depression, reflecting hegemonic patterns of masculinity.

  • 3.
    Berg, Noora
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public Health. National Institute for Health and Welfare, Finland.
    Kiviruusu, Olli
    National Institute for Health and Welfare, Finland.
    Huurre, Taina
    National Institute for Health and Welfare, Finland.
    Lintonen, Tomi
    Finnish Foundation for Alcohol Studies.
    Virtanen, Pekka
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. University of Tampere.
    Hammarström, Anne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Associations between unemployment and heavy episodic drinking from adolescence to midlife in Sweden and Finland.2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360XArticle in journal (Refereed)
  • 4.
    Berg, Noora
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public Health. National Institute for Health and Welfare, Finland.
    Kiviruusu, Olli
    National Institute for Health and Welfare, Finland.
    Huurre, Taina
    National Institute for Health and Welfare, Finland.
    Lintonen, Tomi
    Finnish Foundation for Alcohol Research.
    Virtanen, Pekka
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. University of Tampere.
    Hammarstöm, Anne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Unemployment and heavy episodic drinking from adolescence to midlife in Sweden and Finland2017In: 10th European Public Health Conference Sustaining resilient and healthy communities Stockholm, Sweden 1–4 November 2017, 2017, Vol. 27, ckx187.673Conference paper (Other academic)
  • 5.
    Bohlin, Anna
    et al.
    Umeå universitet, Allmänmedicin.
    Ahlgren, Christina
    Umeå universitet, Sjukgymnastik.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Gustafsson, Per E.
    Umeå universitet, Allmänmedicin.
    Perceived gender inequality in the couple relationship and musculoskeletal pain in middle-aged women and men2013In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, no 8, 825-831 p.Article in journal (Refereed)
    Abstract [en]

    Aims: Musculoskeletal pain is a major health problem, especially in women, and is partially determined by psychosocial factors. The aim of the present study was to investigate whether gender inequality in the couple relationship was related to musculoskeletal pain. Methods: Participants (n=721; 364 women and 357 men) were all individuals living in a couple relationship in the Northern Swedish Cohort, a 26-year Swedish cohort study. Self-administered questionnaire data at age 42 years comprised perceived gender inequality in the couple relationship and musculoskeletal pain (in three locations, summarised into one score and median-split), concurrent demographic factors, psychological distress, and previous musculoskeletal pain at age 30 years. Associations were examined using logistic regression. Results: Gender inequality was positively associated with symptoms of musculoskeletal pain in the total sample, remaining significant after addition of possible confounders and of previous musculoskeletal pain. Separate adjustment for concurrent psychological distress attenuated the association but not below significance. The association was present and of comparable strength in both women and men. Conclusions: Gender inequality in the couple relationship might contribute to the experience of musculoskeletal pain in both women and men. The results highlight the potential adverse bodily consequences of living in unequal relationships.

  • 6.
    Brydsten, Anna
    et al.
    Umeå universitet, Epidemiologi och global hälsa.
    Hammarström, Anne
    Umeå universitet, Epidemiologi och global hälsa.
    San Sebastian, Miguel
    Umeå universitet, Epidemiologi och global hälsa.
    The impact of economic recession on the association between youth unemployment and functional somatic symptoms in adulthood: a difference-in-difference analysis from Sweden2016In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 16, 230Article in journal (Refereed)
    Abstract [en]

    Background: The impact of macroeconomic conditions on health has been extensively explored, as well as the relationship between individual unemployment and health. There are, however, few studies taking both aspects into account and even fewer studies looking at the relationship in a life course perspective. In this study the aim was to assess the role of macroeconomic conditions, such as national unemployment level, for the long-term relationship between individual unemployment and functional somatic symptoms (FSS), by analysing data from two longitudinal cohorts representing different periods of unemployment level in Sweden.

    Methods: A difference-in-difference (DiD) analysis was applied, looking at the difference over time between recession and pre-recession periods for unemployed youths (age 21 to 25) on FSS in adulthood. FSS was constructed as an index of ten self-reported items of somatic ill-health. Covariates for socioeconomics, previous health status and social environment were included.

    Results: An association was found in the difference of adult FSS between unemployed and employed youths in the pre-recession and recession periods, remaining in the adjusted model for the pre-recession period. The DiD analysis between unemployed youths showed that men had significantly lower adult FSS during the recession compared to men in the pre-recession time.

    Conclusions: Adulthood FSS showed to be significantly lower among unemployed youths, in particular among men, during recession compared to pre-recession times. Since this is a fairly unexplored research field, more research is needed to explore the role of macroeconomic conditions for various health outcomes, long-term implications and gender differences.

  • 7.
    Brydsten, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public Health. Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Hammarström, Anne
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Strandh, Mattias
    Umeå universitet, Institutionen för socialt arbete.
    Johansson, Klara
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Youth unemployment and functional somatic symptoms in adulthood: results from the Northern Swedish cohort2015In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 25, no 5, 796-800 p.Article in journal (Refereed)
    Abstract [en]

    Background: Little is known about the possible long-term health consequences of youth unemployment. Research indicates that unemployment may lead to socioeconomic downward mobility and mental health problems, but we still lack knowledge of the long-term health consequences of youth unemployment. This article examines the potential long-term association between youth unemployment and functional somatic symptoms in adulthood. 

    Methods: The ‘Northern Swedish cohort’ was used with data from five data collections, from 1981 (age 16) until 2007 (age 42). Youth unemployment was measured as months in unemployment between age 16 and 21, and health outcome as functional somatic symptoms (an index of 10 items of self-reported symptoms). Linear regression was used to analyse the relationship between months in youth unemployment and functional somatic symptoms at age 21 and age 42, stratified for women and men and adjusted for potential confounders, such as time spent in education at age 21 and later unemployment between age 21 and 42. 

    Results: Youth unemployment was significantly related to functional somatic symptoms at age 21 for men after controlling for confounders, but not for women. Among men, the association remained for functional somatic symptoms at age 42, after controlling for confounders. 

    Conclusions: Adolescence seems to be a sensitive period during which unemployment could have remaining health effects in adulthood, at least for men, though assumptions of causality are tentative and more research is needed.

  • 8.
    Brännlund, Annica
    et al.
    Umeå universitet, Sociologiska institutionen.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Higher education and psychological distress: a 27-year prospective cohort study in Sweden2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 2, 155-162 p.Article in journal (Refereed)
    Abstract [en]

    Aims: Research identifies a positive link between education and a reduction of psychological distress, but few studies have analysed the long-term impact of education on psychological distress. This study followed the same cohort for 27 years, investigating the association between education and adult psychological distress. Further, it discuss whether the link can be understood through the mediating mechanisms of social and labour-market resources, furthermore, if the mechanisms operate differently for men and women. Method: A 27-year prospective cohort study was performed at ages 16, 18, 21, 30 and 43. The cohort consisted of all students (n = 1083, of which 1001 are included in this study) in their final year of compulsory school in Sweden. Data were collected through comprehensive questionnaires (response rate 96.4%), and analysed with OLS regression, with psychological distress at age 21, 30 and 43 as dependent variable. Baseline psychological distress, measures of social and labour-market resources, and possible educational selection factors were used as independent variables. To compare the overall magnitude of educational differences, a kappa index was calculated. Results: A positive relation between higher education and less psychological distress was found. When becoming older this relation weakens and a link between social and labour-market resources and psychological distress is observed, indicating that education in a long-term perspective operates through the suggested mechanisms. Additionally, the mechanisms work somewhat differently for men than for women: labour-market resources were significant for men and social resources were important for women. Conclusions: Main findings: higher education is positively linked to less psychological distress, and the link can somewhat be understood through the mechanisms of social and labour-market resources.

  • 9.
    Brännlund, Annica
    et al.
    Umeå universitet, Sociologiska institutionen.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Strandh, Mattias
    Umeå universitet, Sociologiska institutionen.
    Education and health-lifestyle among men and women in Sweden: a 27-year prospective cohort study2013In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, no 3, 284-292 p.Article in journal (Refereed)
    Abstract [en]

    Background: Previous research has found a positive association between health-behaviour and health. Only a few longitudinalstudies have been performed, and as far as we found, none have followed a cohort for 27 years. Methods: This study used acohort study, the “Northern Swedish Cohort”, which consisted of all graduates, n = 1080, from a compulsory school in aSwedish town. Data were collected with a comprehensive questionnaire; response rate 96.4%. Health-behaviour was analysedwith binary logistic regression, with health-behaviour at age 21, 30 and 43 years as dependent variable. Besides baselinehealth-behaviour, gender, somatic and psychological health and socioeconomic background, the analyses were adjustedfor work situation and social network. Results: The main findings were that education reduces the probability of unhealthybehaviour over the life course, which held after controlling for early life health-behaviour and possible confounders. Thegeneral education effect on health-behaviour was stronger among men than among women. Conclusions: Higher educationreduces the probability of unhealthy behavior. Thus, investments in higher education should be an important public goal.

  • 10.
    Christianson, Monica
    et al.
    Umeå universitet, Institutionen för omvårdnad.
    Aléx, Lena
    Umeå universitet, Institutionen för omvårdnad.
    Fjellman-Wiklund, Anncristine
    Umeå universitet, Sjukgymnastik.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Lundman, Berit
    Umeå universitet, Institutionen för omvårdnad.
    Sex and gender traps and springboards: a focus group study among gender researchers in medicine and health sciences2012In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 33, no 8, 739-755 p.Article in journal (Refereed)
    Abstract [en]

    We explored the difficulties that gender researchers encounter in their research and the strategies they use for solving these problems. Sixteen Swedish researchers, all women, took part in focus group discussions; the data were analyzed using qualitative content analysis. The problems reported fell into four main categories: the ambiguity of the concepts of sex and gender; traps associated with dichotomization; difficulties with communication; and issues around publication. Categories of suggested problem-solving strategies were adaptation, pragmatism, addressing the complexities, and definition of terms. Here the specific views of gender researchers in medicine and health sciences-"medical insiders"-bring new challenges into focus.

  • 11.
    Danielsson, Ulla EB
    et al.
    Umeå universitet, Allmänmedicin.
    Bengs, Carita
    Umeå universitet, Sociologiska institutionen.
    Lehti, Arja
    Umeå universitet, Allmänmedicin.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Johansson, Eva E
    Umeå universitet, Allmänmedicin.
    Struck by lightning or slowly suffocating: gendered trajectories into depression2009In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 10, no 1, 56- p.Article in journal (Refereed)
    Abstract [en]

    Background: In family practice depression is a common mental health problem and one with marked gender differences; women are diagnosed as depressed twice as often as men. A more comprehensive explanatory model of depression that can give an understanding of, and tools for changing, this gender difference is called for. This study explores how primary care patients experience, understand and explain their depression.

    Methods: Twenty men and women of varying ages and socioeconomic backgrounds diagnosed with depression according to ICD-10 were interviewed in-depth. Data were assessed and analyzed using Grounded Theory.

    Results: The core category that emerged from analysis was "Gendered trajectories into depression". Thereto, four categories were identified – "Struck by lightning", "Nagging darkness", "Blackout" and "Slowly suffocating" – and presented as symbolic illness narratives that showed gendered patterns. Most of the men in our study considered that their bodies were suddenly "struck" by external circumstances beyond their control. The stories of study women were more diverse, reflecting all four illness narratives. However, the dominant pattern was that women thought that their depression emanated from internal factors, from their own personality or ways of handling life. The women were more preoccupied with shame and guilt, and conveyed a greater sense of personal responsibility and concern with relationships.

    Conclusion: Recognizing gendered narratives of illness in clinical consultation may have a salutary potential, making more visible depression among men while relieving self-blame among women, and thereby encouraging the development of healthier practices of how to be a man or a woman.

  • 12. Delfabbro, Paul H
    et al.
    Winefield, Helen R
    Winefield, Anthony H
    Hammarström, Anne
    Umeå universitet, Epidemiologi och global hälsa.
    Mid-Adolescent Predictors of Adult Drinking Levels in Early Adulthood and Gender Differences: Longitudinal Analyses Based on the South Australian School Leavers Study.2016In: Journal of addiction, ISSN 2090-7834, Vol. 2016Article in journal (Refereed)
    Abstract [en]

    There is considerable public health interest in understanding what factors during adolescence predict longer-term drinking patterns in adulthood. The aim of this study was to examine gender differences in the age 15 social and psychological predictors of less healthy drinking patterns in early adulthood. The study investigates the relative importance of internalising problems, other risky health behaviours, and peer relationships after controlling for family background characteristics. A sample of 812 young people who provided complete alcohol consumption data from the age of 15 to 20 years (5 measurement points) were drawn from South Australian secondary schools and given a detailed survey concerning their psychological and social wellbeing. Respondents were classified into two groups based upon a percentile division: those who drank at levels consistently below NHMRC guidelines and those who consistently drank at higher levels. The results showed that poorer age 15 scores on measures of psychological wellbeing including scores on the GHQ-12, self-esteem, and life-satisfaction as well as engagement in health-related behaviours such as smoking or drug-taking were associated with higher drinking levels in early adulthood. The pattern of results was generally similar for both genders. Higher drinking levels were most strongly associated with smoking and marijuana use and poorer psychological wellbeing during adolescence.

  • 13. Delfabbro, Paul
    et al.
    Winefield, Tony
    Trainor, Sarah
    Dollard, Maureen
    Anderson, Sarah
    Metzer, Jacques
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Peer and teacher bullying/victimization of South Australian secondary school students: prevalence and psychosocial profiles.2006In: British Journal of Educational Psychology, ISSN 0007-0998, E-ISSN 2044-8279, Vol. 76, no Pt 1, 71-90 p.Article in journal (Refereed)
  • 14.
    Elwer, Sofia
    et al.
    Umeå universitet, Allmänmedicin.
    Alex, Lena
    Umeå universitet, Institutionen för omvårdnad.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Gender (in)equality among employees in elder care: implications for health2012In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 11, no 1Article in journal (Refereed)
    Abstract [en]

    Introduction: Gendered practices of working life create gender inequalities through horizontal and vertical gender segregation in work, which may lead to inequalities in health between women and men. Gender equality could therefore be a key element of health equity in working life. Our aim was to analyze what gender (in) equality means for the employees at a woman-dominated workplace and discuss possible implications for health experiences.

    Methods: All caregiving staff at two workplaces in elder care within a municipality in the north of Sweden were invited to participate in the study. Forty-five employees participated, 38 women and 7 men. Seven focus group discussions were performed and led by a moderator. Qualitative content analysis was used to analyze the focus groups.

    Results: We identified two themes. "Advocating gender equality in principle" showed how gender (in) equality was seen as a structural issue not connected to the individual health experiences. "Justifying inequality with individualism" showed how the caregivers focused on personalities and interests as a justification of gender inequalities in work division. The justification of gender inequality resulted in a gendered work division which may be related to health inequalities between women and men. Gender inequalities in work division were primarily understood in terms of personality and interests and not in terms of gender.

    Conclusion: The health experience of the participants was affected by gender (in) equality in terms of a gendered work division. However, the participants did not see the gendered work division as a gender equality issue. Gender perspectives are needed to improve the health of the employees at the workplaces through shifting from individual to structural solutions. A healthy-setting approach considering gender relations is needed to achieve gender equality and fairness in health status between women and men.

  • 15.
    Elwér, Sofia
    et al.
    Umeå universitet, Allmänmedicin.
    Aléx, Lena
    Umeå universitet, Institutionen för omvårdnad.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Health against the odds: experiences of employees in elder care from a gender perspective2010In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 20, no 9, 1202-1212 p.Article in journal (Refereed)
    Abstract [en]

    Women-dominated elder care in Sweden is a low-paid, low-status job with a high prevalence of sick leave. Our aim was to analyze health experiences of employees in elder care from a gender perspective. All caregiving staff at two establishments providing care to the elderly were invited to participate in the study. A moderator led seven focus group discussions. Qualitative content analysis was used to analyze the transcribed focus groups. We identified two central themes in relation to the employees' health. "Working against the odds" describes gendered workplace stressors of a structural character, to a large extent triggered by societal processes outside the organization. "Making work matter" refers to gendered health resources with a relational character, constructed within the organization. Health-promoting programs directed toward women-dominated workplaces need to include a gender perspective, and focus on creating structural, supportive environments to avoid the negative health effects of the stressors.

  • 16.
    Elwér, Sofia
    et al.
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Hammarström, Anne
    Umeå universitet, Socialmedicin.
    Strandh, Mattias
    Umeå universitet, Institutionen för socialt arbete.
    Gustafsson, Per
    Umeå universitet, Socialmedicin.
    Life course models of economic stress and poor mental health in mid-adulthood: results from the prospective Northern Swedish Cohort2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 8, 833-840 p.Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to analyse the association between economic stress during youth and adulthood, and poor mental health through life course models of (1) accumulation of risk and (2) sensitive period. Methods: The study was based on the Northern Sweden Cohort, a 26-year prospective cohort (N = 1010 in 2007; 94% of those participating in 1981 still alive) ranging from adolescence to middle age. Economic stress was measured at age 16, 21, 30 and 42 years. Two life course models of accumulation of risk and sensitive period were analysed using ordinal regression with internalized symptoms of mental health as outcome. Results: Exposure of economic stress at several life course periods was associated with higher odds of internalized mental health symptoms for both women and men, which supports the accumulated risk model. No support for a sensitive period was found for the whole sample. For men, however, adolescence appears to be a sensitive period during which the exposure to economic stress has negative mental health consequences later in life independently of economic stress at other ages. Conclusion: This study confirms that the duration of economic stress between adolescence and middle age is important for mental health. In addition, the results give some indication of a sensitive period of exposure to economic stress during adolescence for men, although more research is needed to confirm possible gender differences.

  • 17.
    Elwér, Sofia
    et al.
    Umeå universitet, Allmänmedicin.
    Harryson, Lisa
    Umeå universitet, Allmänmedicin.
    Bolin, Malin
    Department of Social Sciences, Mid Sweden University.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Patterns of gender equality at workplaces and psychological distress2013In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 1, e53246- p.Article in journal (Refereed)
    Abstract [en]

    Research in the field of occupational health often uses a risk factor approach which has been criticized by feminist researchers for not considering the combination of many different variables that are at play simultaneously. To overcome this shortcoming this study aims to identify patterns of gender equality at workplaces and to investigate how these patterns are associated with psychological distress. Questionnaire data from the Northern Swedish Cohort (n=715) have been analysed and supplemented with register data about the participants’ workplaces. The register data were used to create gender equality indicators of women/men ratios of number of employees, educational level, salary and parental leave. Cluster analysis was used to identify patterns of gender equality at the workplaces. Differences in psychological distress between the clusters were analysed by chi-square test and logistic regression analyses, adjusting for individual socio-demographics and previous psychological distress. The cluster analysis resulted in six distinctive clusters with different patterns of gender equality at the workplaces that were associated to psychological distress for women but not for men. For women the highest odds of psychological distress was found on traditionally gender unequal workplaces. The lowest overall occurrence of psychological distress as well as same occurrence for women and men was found on the most gender equal workplaces. The results from this study support the convergence hypothesis as gender equality at the workplace does not only relate to better mental health for women, but also more similar occurrence of mental ill-health between women and men. This study highlights the importance of utilizing a multidimensional view of gender equality to understand its association to health outcomes. Health policies need to consider gender equality at the workplace level as a social determinant of health that is of importance for reducing differences in health outcomes for women and men.

  • 18.
    Elwér, Sofia
    et al.
    Umeå universitet, Allmänmedicin.
    Johansson, Klara
    Umeå universitet, Allmänmedicin.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Workplace gender composition and psychological distress: the importance of the psychosocial work environment2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, 241- p.Article in journal (Refereed)
    Abstract [en]

    Background: Health consequences of the gender segregated labour market have previously been demonstrated in the light of gender composition of occupations and workplaces, with somewhat mixed results. Associations between the gender composition and health status have been suggested to be shaped by the psychosocial work environment. The present study aims to analyse how workplace gender composition is related to psychological distress and to explore the importance of the psychosocial work environment for psychological distress at workplaces with different gender compositions.

    Methods: The study population consisted of participants from the Northern Swedish Cohort with a registered workplace in 2007 when the participants were 42 years old (N = 795). Questionnaire data were supplemented with register data on the gender composition of the participants' workplaces divided into three groups: workplaces with more women, mixed workplaces, and workplaces with more men. Associations between psychological distress and gender composition were analysed with multivariate logistic regression analysis adjusting for socioeconomic position, previous psychological distress, psychosocial work environment factors and gender. Logistic regression analyses (including interaction terms for gender composition and each work environment factor) were also used to assess differential associations between psychosocial work factor and psychological distress according to gender composition.

    Results: Working at workplaces with a mixed gender composition was related to a higher likelihood of psychological distress compared to workplaces with more men, after adjustments for socioeconomic position, psychological distress at age 21, psychosocial work environment factors and gender. Psychosocial work environment factors did not explain the association between gender composition and psychological distress.

    Conclusions: The association between gender composition and psychological distress cannot be explained by differences in the perception of the psychosocial work environment and thus the work environment hypothesis is not supported. Workplaces with a mixed gender composition needs further research attention to explain the negative development of psychological distress during working life for both women and men at these workplaces.

  • 19.
    Gilenstam, Kajsa
    et al.
    Umeå universitet, Idrottsmedicin.
    Hammarström, Anne
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Henriksson-Larsén, Karin
    Umeå universitet, Idrottsmedicin.
    Gendered expectations and structural conditions in ice hockeyIn: Research Quarterly for Exercise and Sport, ISSN 0270-1367, E-ISSN 2168-3824Article in journal (Refereed)
    Abstract [en]

    Using player questionnaires (72 women, 42 men) and club staff interviews, this paper provides an analysis of the effect of structural conditions on expectations of support and hindrance. In spite of large structural conditions women and men rated similar levels of support and hindrance. Yet, both women and men believed that the situation in sport was better for men. The adult women’s lower expectations may be an indication of their awareness of their lower status within their sport. When comparisons are made between women and men in sport it is important to consider that gender operates at different levels and may affect conditions as well as expectations

  • 20. Gillander Gådin, Katja
    et al.
    Hammarström, Anne
    Umeå universitet, Epidemiologi och global hälsa.
    A possible contributor to the higher degree of girls reporting psychological symptoms compared with boys in grade nine?2005In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 15, no 4, 380-385 p.Article in journal (Refereed)
    Abstract [en]

    Background: It is a recurrent finding that adolescent girls report psychological symptoms in a higher degree compared with boys. The explanations for this difference vary, but the psychosocial school environment has never been a focus in these explanations. The aim of this study was to analyse whether psychosocial factors at school were associated with a high degree of psychological symptoms among boys and girls in grade nine, with a special focus on sexual harassment.

    Methods: The study was based on a cross-sectional study including 336 pupils (175 girls and 161 boys) in grade nine (about 15 years old), who answered an extensive questionnaire. The non-response rate was negligible (< 1%). Logistic regression analysis was used to analyse whether school-related factors (teacher support, classmate support, sexual harassment), body image, and parental support were associated with a high degree of psychological symptoms.

    Results: Sexual harassment at school was associated with a high degree of psychological symptoms among girls.

    Conclusions: Sexual harassment must be acknowledged as a negative psychosocial school environmental factor of importance for the high degree of psychological ill-health symptoms among girls compared with boys.

  • 21.
    Gillander Gådin, Katja
    et al.
    Umeå universitet, Allmänmedicin.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    A sexual harassment at school - a possible contributor to the higher degree of girls reporting psychological symptoms compared with boys in grade nine?2005In: European Journal of Public Health, Vol. 15, 380-385 p.Article in journal (Other (popular science, discussion, etc.))
  • 22.
    Gustafsson, Per E.
    et al.
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Hammarström, Anne
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Socioeconomic disadvantage in adolescent women and metabolic syndrome in mid-adulthood: an examination of pathways of embodiment in the Northern Swedish Cohort2012In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 74, no 10, 1630-1638 p.Article in journal (Refereed)
    Abstract [en]

    Research indicates that disadvantaged socioeconomic status in childhood or adolescence increases specifically women's risk for developing metabolic syndrome in adulthood. Construing this observation as an expression of embodiment, the present study aims at examining the 'social chain of risk' and the 'reproduction' hypotheses as pathways of this embodiment. Participants were all women in the Northern Swedish Cohort, a 27-year prospective Swedish cohort, with data collection in 1981 at age 16 years (n = 1083, 506 women), and follow-up at age 21, 30 and 43 (n = 482 women) years. The analytical sample was n = 399 women (79% of the original cohort). Socioeconomic disadvantage was defined as parental manual occupation at age 16, and metabolic syndrome according to standardized criteria at age 43. The social chain of risk was operationalized as accumulated social and material adversities at age 16, 21, 30 and 43 years, and reproductive factors by age at menarche, early childbearing (before age 22), and number of children at age 43. In logistic regression with metabolic syndrome as the outcome, the OR for adolescent socioeconomic status was rendered non-significant and reduced by 21.6% after adjustment for cumulative adversity over the life course. Of the reproductive factors, only age at menarche lead to an OR reduction at all (by 43%). Our study suggests that women's embodiment of socioeconomic disadvantage during upbringing is partly explained by adversity over the subsequent life course. Future studies should incorporate the living conditions of women over the life course as a possible pathway whereby early life socioeconomic conditions are embodied. (C) 2012 Elsevier Ltd. All rights reserved.

  • 23.
    Gustafsson, Per E.
    et al.
    Umeå universitet, Allmänmedicin.
    Janlert, Urban
    Umeå universitet, Epidemiologi och global hälsa.
    Theorell, Tores
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Do peer relations in adolescence influence health in adulthood?: Peer problems in the school setting and the metabolic syndrome in middle-age2012In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, no 6, e39385- p.Article in journal (Refereed)
    Abstract [en]

    While the importance of social relations for health has been demonstrated in childhood, adolescence and adulthood, few studies have examined the prospective importance of peer relations for adult health. The aim of this study was to examine whether peer problems in the school setting in adolescence relates to the metabolic syndrome in middle-age. Participants came from the Northern Swedish Cohort, a 27-year cohort study of school leavers (effective n = 881, 82% of the original cohort). A score of peer problems was operationalized through form teachers' assessment of each student's isolation and popularity among school peers at age 16 years, and the metabolic syndrome was measured by clinical measures at age 43 according to established criteria. Additional information on health, health behaviors, achievement and social circumstances were collected from teacher interviews, school records, clinical measurements and self-administered questionnaires. Logistic regression was used as the main statistical method. Results showed a dose-response relationship between peer problems in adolescence and metabolic syndrome in middle-age, corresponding to 36% higher odds for the metabolic syndrome at age 43 for each SD higher peer problems score at age 16. The association remained significant after adjustment for health, health behaviors, school adjustment or family circumstances in adolescence, and for psychological distress, health behaviors or social circumstances in adulthood. In analyses stratified by sex, the results were significant only in women after adjustment for covariates. Peer problems were significantly related to all individual components of the metabolic syndrome. These results suggest that unsuccessful adaption to the school peer group can have enduring consequences for metabolic health.

  • 24.
    Gustafsson, Per E
    et al.
    Umeå universitet, Allmänmedicin.
    Janlert, Urban
    Umeå universitet, Epidemiologi och global hälsa.
    Theorell, Töres
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Is body size at birth related to circadian salivary cortisol levels in adulthood? Results from a longitudinal cohort study.2010In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 10, no 346Article in journal (Refereed)
    Abstract [en]

    Background

    The hypothesis of fetal origins of adult disease has during the last decades received interest as an explanation of chronic, e.g. cardiovascular, disease in adulthood stemming from fetal environmental conditions. Early programming and enduring dysregulations of the hypothalamic-pituitary-adrenal (HPA axis), with cortisol as its end product, has been proposed as a possible mechanism by which birth weight influence later health status. However, the fetal origin of the adult cortisol regulation has been insufficiently studied. The present study aims to examine if body size at birth is related to circadian cortisol levels at 43 years.

    Methods

    Participants were drawn from a prospective cohort study (n = 752, 74.5%). Salivary cortisol samples were collected at four times during one day at 43 years, and information on birth size was collected retrospectively from delivery records. Information on body mass during adolescence and adulthood and on health behavior, medication and medical conditions at 43 years was collected prospectively by questionnaire and examined as potential confounders. Participants born preterm or < 2500 g were excluded from the main analyses.

    Results

    Across the normal spectrum, size at birth (birth weight and ponderal index) was positively related to total (area under the curve, AUC) and bedtime cortisol levels in the total sample. Results were more consistent in men than in women. Descriptively, participants born preterm or < 2500 g also seemed to display elevated evening and total cortisol levels. No associations were found for birth length or for the cortisol awakening response (CAR).

    Conclusions

    These results are contradictory to previously reported negative associations between birth weight and adult cortisol levels, and thus tentatively question the assumption that only low birth weight predicts future physiological dysregulations.

  • 25.
    Gustafsson, Per E
    et al.
    Umeå universitet, Allmänmedicin.
    Janlert, Urban
    Umeå universitet, Epidemiologi och global hälsa.
    Theorell, Töres
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Life-course socioeconomic trajectories and diurnal cortisol regulation in adulthood2010In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 35, no 4, 613-623 p.Article in journal (Refereed)
    Abstract [en]

    Although the health risk of socioeconomic disadvantage over the life-course is fairly established, the mechanisms are less studied. One candidate pathway is long-term dysregulation of cortisol. This study assesses whether socioeconomic trajectories from adolescence to adulthood influences the regulation of cortisol in mid-adulthood, and further investigates the importance of adolescence as a critical period and of accumulation of socioeconomic disadvantage. Participants were drawn from a 27-year prospective cohort study (n = 732, 68% of the original cohort). Information on socioeconomic status (SES) was collected at the ages of 16 (based on parental occupation), 21, 30 and 43 (based on own occupation) years, and at 43 years participants collected one-day salivary cortisol samples at awakening, after 15 min, before lunch and at bedtime. We found that the cortisol awakening response (CAR) differed with respect to SES trajectory; those with stable low or early low/upwardly mobile SES tended to display higher CAR than those with early high/downwardly mobile, highly mobile or stable high trajectories. Further analyses revealed that early low SES was related to higher CAR, and in women low SES was related to lower bedtime cortisol, independently of later SES and potential confounders. We found no support for a linear effect of accumulation of socioeconomic disadvantage. In conclusion, our study gives support for an independent effect of low socioeconomic status early in life, on the regulation of cortisol in adulthood.

  • 26.
    Gustafsson, Per E
    et al.
    Umeå universitet, Allmänmedicin.
    Janlert, Urban
    Umeå universitet, Epidemiologi och global hälsa.
    Theorell, Töres
    Westerlund, Hugo
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Fetal and life course origins of serum lipids in mid-adulthood: results from a prospective cohort study2010In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 10, no 484Article in journal (Refereed)
    Abstract [en]

    Background During the past two decades, the hypothesis of fetal origins of adult disease has received considerable attention. However, critique has also been raised regarding the failure to take the explanatory role of accumulation of other exposures into consideration, despite the wealth of evidence that social circumstances during the life course impact on health in adulthood. The aim of the present prospective cohort study was to examine the contributions of birth weight and life course exposures (cumulative socioeconomic disadvantage and adversity) to dyslipidemia and serum lipids in mid-adulthood.

    Methods A cohort (effective n = 824, 77%) was prospectively examined with respect to self-reported socioeconomic status as well as stressors (e.g., financial strain, low decision latitude, separation, death or illness of a close one, unemployment) at the ages of 16, 21, 30 and 43 years; summarized in cumulative socioeconomic disadvantage and cumulative adversity. Information on birth weight was collected from birth records. Participants were assessed for serum lipids (total cholesterol, low- and high-density lipoprotein cholesterol and triglycerides), apolipoproteins (A1 and B) and height and weight (for the calculation of body mass index, BMI) at age 43. Current health behavior (alcohol consumption, smoking and snuff use) was reported at age 43.

    Results Cumulative life course exposures were related to several outcomes; mainly explained by cumulative socioeconomic disadvantage in the total sample (independently of current health behaviors but attenuated by current BMI) and also by cumulative adversity in women (partly explained by current health behavior but not by BMI). Birth weight was related only to triglycerides in women, independently of life course exposures, health behaviors and BMI. No significant association of either exposure was observed in men.

    Conclusions Social circumstances during the life course seem to be of greater importance than birth weight for dyslipidemia and serum lipid levels in adulthood.

  • 27.
    Gustafsson, Per E
    et al.
    Umeå universitet, Allmänmedicin.
    Janlert, Urban
    Umeå universitet, Epidemiologi och global hälsa.
    Theorell, Töres
    Westerlund, Hugo
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Social and material adversity from adolescence to adulthood and allostatic load in middle-aged women and men: results from the Northern Swedish cohort2012In: Annals of Behavioral Medicine, ISSN 0883-6612, E-ISSN 1532-4796, Vol. 43, no 1, 117-128 p.Article in journal (Refereed)
    Abstract [en]

    Background  Little is known about the theoretically assumed association between adversity exposure over the life course and allostatic load in adulthood.

    Purpose  This study aims to examine whether social and material adversity over the life course is related to allostatic load in mid-adulthood.

    Methods  A 27-year prospective Swedish cohort (N = 822; 77% response rate) reported exposure to social and material adversities at age 16, 21, 30 and 43 years. At age 43, allostatic load was operationalized based on 12 biological parameters.

    Results  Social adversity accumulated over the life course was related to allostatic load in both women and men, independently of cumulative socioeconomic disadvantage. Moreover, social adversity in adolescence (in women) and young adulthood (in men) was related to allostatic load, independently of cumulative socioeconomic disadvantage and also of later adversity exposure during adulthood.

    Conclusion  Exposure to adversities involving relational threats impacts on allostatic load in adulthood and operates according to life course models of cumulative risk and a sensitive period around the transition into adulthood.

  • 28.
    Gustafsson, Per E
    et al.
    Umeå universitet, Allmänmedicin.
    Janlert, Urban
    Umeå universitet, Epidemiologi och global hälsa.
    Theorell, Töres
    Westerlund, Hugo
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Socioeconomic status over the life course and allostatic load in adulthood: results from the Northern Swedish Cohort2011In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 65, 986-992 p.Article in journal (Refereed)
    Abstract [en]

    Background Although several studies have reported rather consistent associations between socioeconomic status (SES) and allostatic load (AL), so far no study has examined the influence of SES over the life course on AL. The aim of the present study was to investigate the association between SES over the life course and AL in mid-adulthood, guided by the conceptual models of cumulative risk, critical period and social chain of risk.

    Methods The sample comprises a 27-year prospective cohort (n=1071) from northern Sweden. Participants (n=855, 79.8%) completed questionnaires at the ages of 16, 21, 30 and 43 years. A health examination was performed at age 43 years after an overnight fast, including physical examination and blood sampling, and participants completed 1-day salivary cortisol sampling (four samples). SES was based on parental occupation at age 16 years and participants' own occupation at ages 21, 30 and 43 years. Information on daily smoking, snuff use, high alcohol consumption and physical inactivity was reported by the participants. An AL index was constructed from tertiles of 12 biological parameters.

    Results Cumulative socioeconomic disadvantage was related to AL in both women and men. The association was largely explained by health behaviours in men, but was independent of health behaviours in women. In women, an association was observed between AL and SES in adolescence, whereas in men only current SES was related to AL, independently of current health behaviours.

    Conclusions SES over the life course influences the level of multi-systemic dysregulation in mid-adulthood, with the strongest support for the cumulative risk model.

  • 29.
    Gustafsson, Per E.
    et al.
    Umeå universitet, Allmänmedicin.
    Janlert, Urban
    Umeå universitet, Epidemiologi och global hälsa.
    Virtanen, Pekka
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    The association between long-term accumulation of temporary employment, the cortisol awakening response and circadian cortisol levels2012In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 37, no 6, 789-800 p.Article in journal (Refereed)
    Abstract [en]

    Temporary employment is an increasingly common contract type, which has not been investigated in a psychoneuroendocrinological context despite previous observations of associations between adverse work and employment conditions and hypothalamic-pituitary-adrenal (HPA) axis dysregulations. The present study aims to examine whether the 12-year accumulation of temporary employment is related to circadian cortisol levels, and if any association is independent of current employment conditions. Participants were drawn from the prospective Northern Swedish Cohort (n = 791, 74% of the original cohort). At age 43 years, retrospective reports of employments over the last 12 years and of current social conditions were collected by questionnaire, and one-day salivary cortisol profile was measured (at awakening, +15 min post-awakening, pre-lunch, bedtime). Results indicated a gradually higher magnitude of the cortisol awakening response (CAR) in subjects with no (0 months in temporary employment; mean CAR = 34%), moderate (1-25 months in temporary employment; mean CAR = 41%) and heavy (>25 months in temporary employment; mean CAR = 51%) exposure (p = .020), remaining after adjustment for potential confounders and for current employment conditions (p = .028). The higher CAR was explained by lower awakening rather than higher post-awakening cortisol levels. Cortisol levels at all times of the day except post-awakening displayed tendencies to negative relations to temporary employment; as indicated by a lower Area Under of Curve (regression coefficient = 5.0%, p = .038 after adjustment). This study thus suggests that the long-term exposure to temporary employment might confer HPA dysregulations in the form of increased dynamics of the CAR and circadian suppression. (C) 2011 Elsevier Ltd. All rights reserved.

  • 30.
    Gustafsson, Per E
    et al.
    Umeå universitet, Allmänmedicin.
    Persson, Mats
    Umeå universitet, Allmänmedicin.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Life course origins of the metabolic syndrome in middle-aged women and men: the role of socioeconomic status and metabolic risk factors in adolescence and early adulthood2011In: Annals of Epidemiology, ISSN 1047-2797, E-ISSN 1873-2585, Vol. 21, no 2, 103-110 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To assess whether body mass index (BMI), blood pressure, and socioeconomic status in adolescence and early adulthood are independently related to the metabolic syndrome in adult women and men.

    METHODS: We based our work on a Swedish prospective cohort study that recruited participants at 16 years of age (N = 1083 at age 16; 403 women and 429 men at age 43, 78% of those still alive [N = 1071]). Blood pressure (BP) and BMI were assessed when participants were 16 and 21 years of age. At age 43, the metabolic syndrome was defined according to the International Diabetes Federation guidelines. Socioeconomic status (SES) was operationalized by the participant (age 21 and 43) or parent's (age 16) occupational status. Information on smoking, snuff, alcohol, and inactivity was collected at age 43.

    RESULTS: In women, SES at age 16 was independently related to the risk of metabolic syndrome. In women and men, BMI at age 16 was related to metabolic syndrome but was attenuated by BMI at age 21, which was significant in the final model; in women systolic BP displayed similar patterns.

    CONCLUSIONS: Our data seem to suggest two independent life course pathways for metabolic syndrome: one metabolic pathway for both women and men operating through BMI (for women also systolic BP) in adolescence and early adulthood, and for women, an apparently independent pathway through adolescent socioeconomic disadvantage. Ann Epidemiol 2011;21:103-110. (C) 2011 Elsevier Inc. All rights reserved.

  • 31.
    Gustafsson, Per E
    et al.
    Umeå universitet, Allmänmedicin.
    Persson, Mats
    Umeå universitet, Allmänmedicin.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Socio-economic disadvantage and body mass over the life course in women and men: results from the Northern Swedish Cohort2012In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, no 3, 322-327 p.Article in journal (Refereed)
    Abstract [en]

    Background: Obesity and body mass in adulthood relate both to current and to childhood socio-economic status, particularly in women, but the underlying life course processes are not known. This study aims at examining whether the life course socio-economic status—body mass association in women and men is explained by the cumulative risk or adolescent sensitive period models whether associations are similar at different life course stages; and whether health behaviours explain the associations.

    Methods: A total of 476 women and 517 men participated in this 27-year prospective cohort study (participation rate 93%). Body mass index was assessed at the age of 16 and 43 years and self-reported at the age of 21 and 30 years. Information on socio-economic status by own or parental (age 16 years) occupation, smoking, snuff, alcohol, physical activity and diet was collected at each age.

    Results: In women, cumulative socio-economic status and socio-economic status in adolescence were related to body mass index at the age of 16, 21, 30 and 43 years and to the 27-year change in body mass, independently of health behaviours and for adolescent socio-economic status also of later socio-economic attainment. Associations were generally stronger for body mass at older age. In men, associations were mostly non-significant, although health behaviours contributed strongly to body mass.

    Conclusions: In women, both the sensitive period (in adolescence) and cumulative risk models explain the socio-economic–body mass link. Efforts to reduce the social inequality in body mass in women should be directed at the early life course, but focusing on unhealthy behaviours might not be a sufficient approach.

  • 32.
    Gustafsson, Per E.
    et al.
    Umeå universitet, Allmänmedicin.
    San Sebastian, Miguel
    Umeå universitet, Epidemiologi och global hälsa.
    Janlert, Urban
    Umeå universitet, Epidemiologi och global hälsa.
    Theorell, Töres
    Westerlund, Hugo
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Residential Selection across the Life Course: Adolescent Contextual and Individual Determinants of Neighborhood Disadvantage in Mid-Adulthood2013In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 11, e80241- p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Numerous cross-sectional studies have examined neighborhood effects on health. Residential selection in adulthood has been stressed as an important cause of selection bias but has received little empirical attention, particularly its determinants from the earlier life course. The present study aims to examine whether neighborhood, family, school, health behaviors and health in adolescence are related to socioeconomic disadvantage of one's neighborhood of residence in adulthood.

    METHODS: Based on the prospective Northern Swedish Cohort (analytical N = 971, 90.6% retention rate), information was collected at age 16 years concerning family circumstances, school adjustment, health behaviors and mental and physical health. Neighborhood register data was linked to the cohort and used to operationalize aggregated measures of neighborhood disadvantage (ND) at age 16 and 42. Data was analyzed with linear mixed models, with ND in adulthood regressed on adolescent predictors and neighborhood of residence in adolescence as the level-2 unit.

    RESULTS: Neighborhood disadvantage in adulthood was clustered by neighborhood of residence in adolescence (ICC = 8.6%). The clustering was completely explained by ND in adolescence. Of the adolescent predictors, ND (b = .14 (95% credible interval = .07-.22)), final school marks (b = -.18 (-.26--.10)), socioeconomic disadvantage (b = .07 (.01-.14)), and, with borderline significance, school peer problems (b = .07 (-.00-.13)), were independently related to adulthood ND in the final adjusted model. In sex-stratified analyses, the most important predictors were school marks (b = -.21 (-.32--.09)) in women, and neighborhood of residence (ICC = 15.5%) and ND (b = .20 (.09-.31)) in men.

    CONCLUSIONS: These findings show that factors from adolescence - which also may impact on adult health - could influence the neighborhood context in which one will live in adulthood. This indicates that residential selection bias in neighborhood effects on health research may have its sources in early life.

  • 33.
    Gustafsson, Per
    et al.
    Umeå universitet, Socialmedicin.
    Hammarström, Anne
    Umeå universitet, Socialmedicin.
    San Sebastian, Miguel
    Umeå universitet, Epidemiologi och global hälsa.
    Cumulative contextual and individual disadvantages over the life course and adult functional somatic symptoms in Sweden2015In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 25, no 4, 592-597 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:: Disadvantage, originating in one's residential context or in one's past life course, has been shown to impact on health in adulthood. There is however little research on the accumulated health impact of both neighbourhood and individual conditions over the life course. This study aims to examine whether the accumulation of contextual and individual disadvantages from adolescence to middle-age predicts functional somatic symptoms (FSS) in middle-age, taking baseline health into account.

    METHODS:: The sample is the age 16, 21, 30 and 42 surveys of the prospective Northern Swedish Cohort, with analytical sample size n = 910 (85% of the original cohort). FSS at age 16 and 42, and cumulative socioeconomic disadvantage, social adversity and material adversity between 16 and 42 years were operationalized from questionnaires, and cumulative neighbourhood disadvantage between 16 and 42 years from register data.

    RESULTS:: Results showed accumulation of disadvantages jointly explained 9-12% of FSS variance. In the total sample, cumulative neighbourhood and socioeconomic disadvantage significantly predicted FSS at age 42 in the total sample. In women, neighbourhood disadvantage but not socioeconomic disadvantage contributed significantly, whereas in men, socioeconomic but not neighbourhood disadvantage contributed significantly. In all analyses, associations were largely explained by the parallel accumulation of social and material adversities, but not by symptoms at baseline.

    CONCLUSION:: In conclusion, the accumulation of diverse forms of disadvantages together plays an important role for somatic complaints in adulthood, independently of baseline health.

  • 34.
    Gustafsson-Larsson, Susanne
    et al.
    Umeå universitet, Allmänmedicin.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Health perceptions of local community works: network women describe how flows of energy and space of action generate health and ill health.2005In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 24, no 3, 215-27 p.Article in journal (Refereed)
  • 35.
    Hamberg, Katarina
    et al.
    Umeå universitet, Allmänmedicin.
    Hammarström, Anne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Hovelius, Birgitta
    Johansson, Eva
    Risberg, Gunilla
    Feministiska perspektiv inom medicin och vård1998In: Socialmedicinsk tidskrift, Vol. 75, no 1-2, 2-3 p.Article, review/survey (Other (popular science, discussion, etc.))
  • 36.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    A gender perspective on public health politics.: In the Swedish National Institute of Public Health: Report on Public Health Policy.2005Report (Other (popular science, discussion, etc.))
  • 37.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    A Tool for Developing Gender Research in Medicine: Examples from the Medical Literature on Work Life.2007In: Gender Medicine, ISSN 1550-8579, E-ISSN 1878-7398, Vol. 4S2, S123-S132 p.Article in journal (Refereed)
  • 38.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Det behövs tillämpad genusforskning inom folkhälsoområdet!2008In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 385, no 3, 191-193 p.Article in journal (Other academic)
  • 39.
    Hammarström, Anne
    Enheten för allmänmedicin, Umeå universitet.
    Genusperspektiv på medicinen – två decenniers utveckling av medvetenheten om kön och genus inom medicinsk forskning och praktik2005Report (Other (popular science, discussion, etc.))
  • 40.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    I spänningsfälten mellan biologi och kultur - en vetenskapsanalys av könskonstruktoner vid depression.2004In: Teori- och begreppsutveckling inom medicinsk genusforskning.: Rapport från en workshop., Stockholm: Vetnskapsrådet , 2004Chapter in book (Other (popular science, discussion, etc.))
  • 41.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Public Health questions from a gender perspective: labour market, masculinities and gender-relatd violence.2008Report (Other (popular science, discussion, etc.))
  • 42.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Which is the difference between gender research and research about gender differences?2004In: Body, gender and medicine., Lund: Studentlitteratur , 2004, 79-86 p.Chapter in book (Other (popular science, discussion, etc.))
  • 43.
    Hammarström, Anne
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Umeå universitet, Allmänmedicin.
    Annandale, Ellen
    A Conceptual Muddle: An Empirical Analysis of the Use of 'Sex' and 'Gender' in 'Gender-Specific Medicine' Journals2012In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, no 4, e34193- p.Article in journal (Refereed)
    Abstract [en]

    Background: At the same time as there is increasing awareness in medicine of the risks of exaggerating differences between men and women, there is a growing professional movement of 'gender-specific medicine' which is directed towards analysing 'sex' and 'gender' differences. The aim of this article is to empirically explore how the concepts of 'sex' and 'gender' are used in the new field of 'gender-specific medicine', as reflected in two medical journals which are foundational to this relatively new field. Method and Principal Findings: The data consist of all articles from the first issue of each journal in 2004 and an issue published three years later (n = 43). In addition, all editorials over this period were included (n = 61). Quantitative and qualitative content analyses were undertaken by the authors. Less than half of the 104 papers used the concepts of 'sex' and 'gender'. Less than 1 in 10 papers attempted any definition of the concepts. Overall, the given definitions were simple, unspecific and created dualisms between men and women. Almost all papers which used the two concepts did so interchangeably, with any possible interplay between 'sex' and gender' referred to only in six of the papers. Conclusion: The use of the concepts of 'sex' and gender' in 'gender-specific medicine' is conceptually muddled. The simple, dualistic and individualised use of these concepts increases the risk of essentialism and reductivist thinking. It therefore highlights the need to clarify the use of the terms 'sex' and 'gender' in medical research and to develop more effective ways of conceptualising the interplay between 'sex' and 'gender' in relation to different diseases.

  • 44.
    Hammarström, Anne
    et al.
    Umeå universitet, Allmänmedicin.
    Fjellman-Wiklund, Anncristine
    Umeå universitet, Umeå centrum för genusstudier (UCGS).
    Lindahl, Bernt
    Umeå universitet, Yrkes- och miljömedicin.
    Larsson, Christel
    Umeå universitet, Institutionen för kostvetenskap.
    Ahlgren, Christina
    Umeå universitet, Umeå centrum för genusstudier (UCGS).
    Experiences of barriers and facilitators to weight-loss in a diet intervention: a qualitative study of women in Northern Sweden2014In: BMC Women's Health, ISSN 1472-6874, E-ISSN 1472-6874, Vol. 14, 59- p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is a lack of research about the experiences of participating in weight-reducing interventions. The aim of this study was to explore barriers and facilitators to weight-loss experienced by participants in a diet intervention for middle-aged to older women in the general population in Northern Sweden.

    METHOD: In the intervention the women were randomised to eat either a Palaeolithic-type diet or a diet according to Nordic Nutrition recommendations for 24 months. A strategic selection was made of women from the two intervention groups as well as from the drop-outs in relation to social class, civil status and age. Thematic structured interviews were performed with twelve women and analysed with qualitative content analyses.

    RESULTS: The results showed that the women in the dietary intervention experienced two main barriers - struggling with self (related to difficulties in changing food habits, health problems, lack of self-control and insecurity) and struggling with implementing the diet (related to social relations and project-related difficulties) - and two main facilitators- striving for self-determination (related to having clear goals) and receiving support (from family/friends as well as from the project) - for weight-loss. There was a greater emphasis on barriers than on facilitators.

    CONCLUSION: It is important to also include drop-outs from diet interventions in order to fully understand barriers to weight-loss. A gender-relational approach can bring new insights into understanding experiences of barriers to weight-loss.

  • 45.
    Hammarström, Anne
    et al.
    Umeå universitet, Allmänmedicin.
    Gustafsson, Per E
    Umeå universitet, Allmänmedicin.
    Strandh, Mattias
    Umeå universitet, Sociologiska institutionen.
    Virtanen, Pekka
    Umeå universitet, Epidemiologi och global hälsa.
    Janlert, Urban
    Umeå universitet, Epidemiologi och global hälsa.
    It´s no surprise! Men are not hit more than women by the health consequences of unemployment in the Northern Swedish Cohort2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 2, 187-193 p.Article in journal (Refereed)
    Abstract [en]

    Aims: Research often fails to ascertain whether men and women are equally hit by the health consequences of unemployment. The aim of this study was to analyze whether men’s self-reported health and health behaviour were hit more by unemployment than women’s in a follow-up of the Northern Swedish Cohort.

    Methods: A follow-up study of a cohort of all school leavers in a middle-sized industrial town in northern Sweden was performed from age 16 to age 42. Of those still alive of the original cohort, 94% (n = 1,006) participated during the whole period. A sample was made of participants in the labour force and living in Sweden (n = 916). Register data were used to assess the length of unemployment from age 40 to 42, while questionnaire data were used for the other variables.

    Results: In multivariate logistic regression analyses significant relations between unemployment and mental health/smoking were found among both women and men, even after control for unemployment at the time of the investigation and indicators of health-related selection. Significant relations between unemployment and alcohol consumption were found among women, while few visits to a dentist was significant among men.

    Conclusions: Men are not hit more by the health consequences of unemployment in a Swedish context, with a high participation rate of women in the labour market. The public health relevance is that the study indicates the need to take gendered contexts into account in public health research.

  • 46.
    Hammarström, Anne
    et al.
    Umeå universitet, Allmänmedicin.
    Haukenes, Inger
    Umeå universitet, Allmänmedicin.
    Fjellman Wiklund, Anncristine
    Umeå universitet, Fysioterapi.
    Lehti, Arja
    Umeå universitet, Institutionen för samhällsmedicin och rehabilitering.
    Wiklund, Maria
    Umeå universitet, Fysioterapi.
    Evengard, Birgitta
    Umeå universitet, Infektionssjukdomar.
    Stålnacke, Britt-Marie
    Umeå universitet, Rehabiliteringsmedicin.
    Low-Educated Women with Chronic Pain Were Less Often Selected to Multidisciplinary Rehabilitation Programs2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 5, e97134Article in journal (Refereed)
    Abstract [en]

    Background: There is a lack of research about a potential education-related bias in assessment of patients with chronic pain. The aim of this study was to analyze whether low-educated men and women with chronic pain were less often selected to multidisciplinary rehabilitation than those with high education. Methods: The population consisted of consecutive patients (n = 595 women, 266 men) referred during a three-year period from mainly primary health care centers for a multidisciplinary team assessment at a pain rehabilitation clinic at a university hospital in Northern Sweden. Patient data were collected from the Swedish Quality Registry for Pain Rehabilitation National Pain Register. The outcome variable was being selected by the multidisciplinary team assessment to a multidisciplinary rehabilitation program. The independent variables were: sex, age, born outside Sweden, education, pain severity as well as the hospital, anxiety and depression scale (HADS). Results: Low-educated women were less often selected to multidisciplinary rehabilitation programs than high-educated women (OR 0.55, CI 0.30-0.98), even after control for age, being born outside Sweden, pain intensity and HADS. No significant findings were found when comparing the results between high-and low-educated men. Conclusion: Our findings can be interpreted as possible discrimination against low-educated women with chronic pain in hospital referrals to pain rehabilitation. There is a need for more gender-theoretical research emphasizing the importance of taking several power dimensions into account when analyzing possible bias in health care.

  • 47.
    Hammarström, Anne
    et al.
    Umeå universitet, Allmänmedicin.
    Hensing, H
    Folkhälsofrågor ur ett genusperspektiv.: Arbetsmarknad, maskuliniteter, medikalisering och könsrelaterat våld.2008Report (Other (popular science, discussion, etc.))
  • 48.
    Hammarström, Anne
    et al.
    Umeå universitet, Allmänmedicin.
    Janlert, Urban
    Umeå universitet, Epidemiologi och folkhälsovetenskap.
    An agenda for unemployment research: a challenge for public health.2005In: International Journal of Health Services, ISSN 0020-7314, E-ISSN 1541-4469, Vol. 35, no 4, 765-77 p.Article in journal (Refereed)
  • 49.
    Hammarström, Anne
    et al.
    Umeå universitet, Allmänmedicin.
    Janlert, Urban
    Umeå universitet, Epidemiologi och global hälsa.
    Cohort Profile: The Northern Swedish Cohort2012In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 41, no 6, 1545-1552 p.Article in journal (Refereed)
  • 50.
    Hammarström, Anne
    et al.
    Umeå universitet, Allmänmedicin.
    Janlert, Urban
    Umeå universitet, Epidemiologi och folkhälsovetenskap.
    Do health consequences of unemployment differ among young men and women?2006In: Unemployment and health: International and interdisciplinary perspectives, Bowen Hills , 2006, 135-142 p.Chapter in book (Other academic)
123 1 - 50 of 140
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf