Logo: to the web site of Uppsala University

Aim: Exposure to family violence is a significant public health concern, linked to negative outcomes in both childhood and adulthood. This study investigates the prevalence of family violence witnessed by adolescents in Sweden and explores its association with socioeconomic factors.

Methods: Data from the population-based survey Life and Health in Youth conducted in 2023 was used, including 3704 adolescents aged 15-18 years. It examines three forms of family violence: threats of violence, abusive language and physical/sexual violence. Results: The findings reveal that 19% of adolescents reported having witnessed at least one type of family violence, with girls reporting higher rates than boys. Socioeconomic deprivation, particularly perceived family economic stress, was strongly correlated with witnessing family violence. Adolescents who experienced economic stress were more often reporting exposure to threats of violence (adjusted odds ratio (adjOR) = 2.84) and multi-type victimisation (adjOR = 2.81). These results indicate that socioeconomic factors are important to consider when supporting adolescents in vulnerable situations.

Conclusions: One in five adolescents reported having witnessed any type of family violence. This study provides insights into the association between socioeconomic deprivation and adolescent exposure to family violence within the Swedish context. Adolescents with these experiences should be recognised by professionals in the health sector, welfare services and educational system due to their particularly vulnerable situation

Background

Physical inactivity is a major public health concern worldwide. Psychological distress is linked to physical inactivity, which increases the risk of several diseases. Women tend to be more physically inactive than men. Moreover, physical inactivity increases with age in both sexes. Therefore, this study aimed to investigate the association between psychological distress and physical inactivity in adults aged ≥ 65 years, the role of psychosocial factors and explore sex-based differences.

Methods

This study included 14,213 older adults, comprising 7,069 women (52%) (median age = 75 years), who responded to a survey questionnaire sent to a random population sample in Mid-Sweden in 2022. The response rate in the population aged ≥ 65 years was 61%. The association between psychological distress as defined by the Kessler-6 and physical inactivity (< 150 min/week of physical activity) was analyzed using binary logistic regression, adjusting for sex, age, country of birth, educational level, and psychosocial factors.

Results

Overall, 30% of the participants reported psychological distress, and 45% were physically inactive. Psychological distress and physical inactivity were significantly associated (p < 0.001), being more common among women (p < 0.001). In the fully adjusted model, the Odds Ratio (OR) for physical inactivity was 1.46 (95% confidence interval (CI) 1.43–1.50) for women and 1.70 (95% CI: 1.65–1.74) for men regarding moderate psychological distress and 2.87 (95% CI: 2.72–3.04) for women and 2.43 (95% CI: 2.28–2.58) for men regarding serious psychological distress. Not participating in social activities in the last 12 months was associated with physical inactivity in both women and men.

Conclusions

Psychological distress is significantly associated with physical inactivity among older adults. Participation in social activities was identified as an essential factor in addressing physical inactivity. Social connections and physical inactivity are important factors to consider when supporting older adults’ mental health. Public health interventions should promote and raise awareness of physical and mental health as well as the social dimensions of aging, while also considering age and sex-based differences.

Psychosocial risk factors, such as socioeconomic disadvantage and having close relatives with severe health conditions (RSHCs), may negatively impact an adolescent's life. This study aimed to investigate the associations between adolescent experiences with RSHCs (no, one or several RSHCs), parental working status (PWS) (both parents working (both PW) or having >= 1 parent not working (>= 1 PNW)) and the composite variable of RSCHs/PWS in relation to self-reported poor mental health. In 2020, population-based data on 15-18-year-olds (n = 3509) were collected from schools in S & ouml;rmland, Sweden. Relationships between the composite variable of RSCHs/PW and poor mental health were determined through logistic regression analyses in three different models. Odds ratios (ORs) are separately reported for girls and boys. Girls reporting several RSHCs/>= 1 PNW displayed an OR of 5.05 (95% CI 2.82-9.04) in comparison with the reference group with no RSCHs/both PW when adjusting for grade and ethnicity. The corresponding OR for boys was 2.26 (95% CI 1.46-3.49). Further adjustments for protective factors for mental health attenuated the associations with poor mental health. In conclusion, adolescents with RSHC experiences in combination with parental unemployment are at increased risk of developing their own poor mental health, making this group particularly vulnerable.

Adolescents' lives are negatively influenced by experiences of close relatives having severe health conditions. This study aimed to investigate the associations between adolescents' experiences of close relatives with severe health conditions (RSHCs) and poor mental health and non-suicidal self-injury (NSSI). Cross-sectional population-based data on 15-18-year-olds (n = 3483) in Sormland, Sweden, were used to analyse the associations between RSHC experiences, such as physical illness, mental illness, addiction/gambling disorders, or death, and poor mental health and NSSI. Logistic regression models (odds ratios) were generated for having one or multiple types of RSHC experiences in different combinations, adjusting for background factors and protective factors for mental health, and stratifying by gender. Adolescents reporting multiple types of RSHC experiences had significantly increased odds ratios for poor mental health (1.74-3.07) or NSSI (1.83-3.02) compared with peers without such experiences. Adjustments for mental health protective factors attenuated the associations with poor mental health or NSSI. These associations remained significant among girls with multiple types of RSHC experiences, while boys' vulnerabilities included having a relative who had died or had an addiction/gambling disorder. In conclusion, adolescents with RSHC experiences are at increased risk of poor mental health and NSSI. This vulnerability is most pronounced among girls with multiple RSHC experiences and especially for NSSI.

Adolescents with close relatives having severe health conditions or who have died (RSHC) are vulnerable, and this has long-term influences on their lives and health. This study investigated how adolescents with RSHC experiences reported having poor mental health and protective factors and the combined influence of these compared to their peers who had not had these experiences. A cross-sectional school-based survey among students aged 15-18 years (N = 3410) in S & ouml;rmland, Sweden, was used to analyse the association between poor mental health and experiences from having one or several RSHC experiences with physical illness, mental illness, or substance abuse/gambling disorder, as well as having relatives who have died. Logistic regression models were performed, adjusting for background factors, and protective factors against poor mental health related to school, home relations, safety in everyday life, and lifestyle were assessed. Adolescents with one RSHC experience had an OR of 1.45 (95% CI: 1.23-1.72) for poor mental health, and those with several RSHC experiences had an OR of 2.35 (95% CI: 1.94-2.84) compared to those with no RSHC experiences. The greatest OR for poor mental health was seen among adolescents with the combination of several RSHC experiences and few protective factors against poor mental health (18.83; 95% CI: 11.86-29.91). Adolescents with RSHC experiences have increased odds of poor mental health compared to adolescents without these experiences, especially those with several RSHC experiences and few protective factors. When meeting adolescents with RSHC experiences, supporting their key protective factors may play an important role in improving mental health.

Poor school-related well-being may influence adolescents' school performance and lifestyle. Adolescents having disabilities or ADHD are in a vulnerable situation for having poor school-related well-being, compared to adolescents not having disabilities. We used cross-sectional data from a school-based survey among 15-18-year-olds (N = 4071) in Sormland, Sweden, to analyse the association between poor school-related well-being and disabilities or ADHD. The analyses were carried out by logistic regression models, adjusting for background factors, school-related factors, and health-compromising behaviours. Adolescents having disabilities (n = 827) or ADHD (n = 146) reported that their disability had a negative influence on school. Compared to peers without disability, those having disabilities had an increased chance (OR = 1.40 95% CI: 1.17-1.68) of poor school-related well-being. The corresponding OR was doubled for adolescents reporting ADHD (2.23 95% CI: 1.56-3.18). For the ADHD group, the adjOR for poor school-related well-being remained significant (1.67 95% CI: 1.13-2.50) after adjustments for school-related factors and health-compromising behaviours, but not for the disability group. In conclusion, adolescents having ADHD are a particularly vulnerable group at school, having a greater risk of poor school-related well-being. Schools should actively work to achieve school satisfaction for adolescents having disabilities, to ensure that all students have similar opportunities for favourable development, health and achievement of their academic goals.

OBJECTIVE: Case-fatality rates (CFRs) for myocardial infarction (MI) and ischaemic stroke (IS) have decreased over time due to better prevention, medication and hospital care. It is unclear whether these improvements have been equally distributed according to socioeconomic position (SEP) and sex. The aim of this study is to analyse differences in short-term and long-term CFR for MI and IS by SEP and sex between the periods 1990-1994 to 2005-2009 for the entire Swedish population.

DESIGN: Population-based cohort study based on Swedish national registers.

METHODS: We used logistic regression and flexible parametric models to estimate short-term CFR (death before reaching the hospital or on the disease event day) and long-term CFR (1 year case-fatality conditional on surviving short-term) across five distinct SEP groups, as well as CFR differences (CFRDs) between SEP groups for both MI and IS from 1990-1994 to 2005-2009.

RESULTS: Overall short-term CFR for both MI and IS decreased between study periods. For MI, differences in short-term and long-term CFR between the least and most favourable SEP group were generally stable, except in long-term CFR among women; intermediate SEP groups mostly managed to catch up with the most favourable SEP group. For IS, short-term CFRD generally decreased compared with the most favourable group; but long-term CFRD were mostly stable, except for an increase for older subjects.

CONCLUSION: Despite a general decline in CFR for MI and IS across all SEP groups and both sexes as well as some reductions in CFRD, we found persistent and even increasing CFRD among the least advantaged SEP groups, older patients and women. We speculate that targeted prevention rather than treatment strategies have the potential to reduce these inequalities.