Search

The aim was to investigate the association between baseline marital status and mortality using survival (Cox-regression) analysis. This is a prospective cohort study. The public health survey by Scania in 2008 was linked to the Swedish cause of death register. This prospective cohort study includes 12,245 men and 14,969 women aged 18–80 years, and 538 men and 362 women of them died during the 5.3-year follow-up. Unmarried, divorced, and widowed men had significantly higher hazard rate ratios (HRRs) of all-cause mortality than married/cohabitating men. For women, the HRRs of these groups did not significantly differ from those of the married/cohabitating reference group. The results are in accordance with a previous study that only compared those living alone with those cohabitating. • Unmarried, cohabitating, and living alone have often been classified together. • In this study, married/cohabitating, unmarried living alone, divorced, and widowed are separate groups. • Unmarried, divorced, and widowed men all have higher 5-year mortality risk than married/cohabitating men. • No significant differences according to marital status were observed for women. [ABSTRACT FROM AUTHOR]

The objective of the study was to estimate associations between health locus of control (HLC) and mortality. The public health survey in Scania 2008 was linked to the Swedish cause of death register. In this study of 10,757 men and 12,322 women aged 18–80 years, 421 men and 235 women died during the 5.3-year follow-up. Survival analyses were conducted. Respondents with only some or no internal HLC had significantly higher hazard rate ratios (HRRs) compared with respondents with high HLC. For women, the HRRs of those with low HLC did not significantly differ from the reference group after final adjustments for health-related behaviours. HLC is a predictor of mortality, and this association is to an important extent mediated by health-related behaviours. • The association between health locus of control (HLC) and mortality was investigated. • The groups with low internal HLC had significantly higher mortality. • Health behaviours reduced hazard rate ratios (HRRs). • For a small group with no internal HLC, very high HRRs remained. [ABSTRACT FROM AUTHOR]

To investigate associations between sexual identity and low leisure-time physical activity (LTPA). Cross-sectional study. The 2012 public health survey was conducted with a postal questionnaire in southern Sweden with 28,029 respondents, aged 18–80 years. Analyses were conducted with logistic regressions. The prevalence of low LTPA among men and women were as follows: 13.9% and 12.3% among heterosexuals, 26.1% and 18.5% among bisexuals, 19.5% and 15.6% among homosexuals, 26.6% and 18.5% among others. Bisexual men and women and other men had higher odds ratio of low LTPA than heterosexuals in the final models, whereas gay and lesbian participants did not differ. The results should guide health promotion and prevention. • Bisexual men and women reported low leisure-time physical activity (LTPA) to a higher extent than heterosexuals. • Gay and lesbian participants did not report low LTPA to a higher extent than heterosexuals. • Men with other sexual orientation identity reported low LTPA to a higher extent than heterosexuals. • The results are important for health promotion and disease prevention. [ABSTRACT FROM AUTHOR]

Objectives To investigate associations between economic stress in childhood and suicide thoughts and attempts. Study design The 2012 public health survey in Scania, Sweden, is a cross-sectional postal questionnaire study including 28,029 participants, aged 18–80 years. Methods Associations were analyzed in logistic regressions. Results A 12.1% prevalence of men and 15.5% of women had ever experienced suicide thoughts, while 3.2% of men and 5.3% of women had experienced suicide attempt. Roughly 24% had experienced less severe and 8% severe economic problems in childhood. Significant associations between economic stress in childhood and suicide thoughts and attempts remained throughout the age-adjusted and multiple adjusted analyses. Conclusions Economic stress in childhood is associated with self-reported suicide thoughts and suicide attempts in an adult general population. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The aim was to investigate associations between e-cigarette use and social and psychosocial factors and cigarette smoking, alcohol consumption, and narcotics use among adolescents attending 9th grade in primary school and 2nd grade in secondary school. STUDY DESIGN: Cross-sectional study. METHODS: The public health survey among adolescents in Scania in 2016 includes pupils in grades 9 and 2. The associations between e-cigarette use and lifestyle, social and psychosocial factors, and trust were investigated with logistic regressions. RESULTS: In 9th grade, 32% of male pupils and 27% of female pupils had ever used e-cigarettes, and in 2nd grade, 43% of males and 31% of females had ever used e-cigarettes. E-cigarette use was significantly associated with current smoking, snus (a moist powder tobacco product originating in Sweden) use, water pipe use, intensive alcohol consumption, and narcotics and also with psychosocial conditions related to home and parents, peers, and school. CONCLUSIONS: The prevalence of ever e-cigarette use was high among adolescents attending both grades. E-cigarette use was most strongly associated with health-related lifestyles. It was also associated with psychosocial factors such as study difficulties, school stress, problems talking with parents, and generalized trust. [ABSTRACT FROM AUTHOR]

Objective To evaluate the progression of carotid intima-media thickness (IMT) in the common carotid artery (CCA) and the bifurcation over a mean follow-up of 16 years in relation to cardiovascular risk factors. Methods The study population included 3426 middle-aged Swedish men and women participating in the 1991–1994 (baseline) and the 2007–2012 (re-examination) investigation of the cardiovascular cohort of the Malmö Diet and Cancer Study (MDCS). Results There were differences in risk factor patterns in arterial segments in that diabetes and male sex were associated with the progression of IMT in the bifurcation, but not in the CCA, and high-density lipoprotein cholesterol (HDL) was associated with the progression of IMT in the CCA, but not in the bifurcation. Favourable changes in systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL) and HDL during follow-up decreased the IMT progression rate in the CCA. There was a cumulative relationship between traditional cardiovascular risk factors (i.e., regular smoking, LDL/HDL-ratio ≥ 3, hypertension) and IMT progression rates. The odds ratio (OR) of high IMT CCA progression rate (>75th percentile) was 1.0 (reference), 1.4 (95% CI: 1.1, 1.7), 1.7 (95% CI: 1.3, 2.2) and 2.1 (95% CI: 1.4, 3.1), respectively, for individuals with none, one, two, and three risk factors. Conclusion There were differences in the associations between risk factors and progression rate in different arterial segments. Favourable changes in SBP and lipids during the follow-up period were associated with reduced IMT progression rates in the CCA. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the association between marital status and lack of internal health locus of control (HLC), taking economic stress and trust into account. Study design: Cross-sectional study. Methods: The public health survey Skåne 2008 is a postal questionnaire study (55% participation rate). A random sample was invited to participate, and 28,198 individuals aged 18-80 years agreed. Logistic regression models were used to discern associations between marital status and lack of internal HLC. The multiple regression analyses included age, country of birth, education, economic stress and 'horizontal' trust. Results: In total, 33.7% of the men and 31.8% of the women lacked internal HLC. After age-adjustments, the unmarried and divorced men and the widowed women displayed significantly higher odds ratios of lack of internal HLC. The significantly higher odds ratios only remained for unmarried men throughout the multiple analyses. In contrast, divorced women had significantly lower odds ratios of lack of internal HLC than married women after adjustments for economic stress. Conclusions: Health promotion regarding HLC and related behaviours should consider men and women who are not cohabiting. Health promotion should particularly consider unmarried men due to their higher propensity to lack internal HLC. The economic conditions and exposure to economic stress among widowed and divorced women should also be highlighted. [ABSTRACT FROM AUTHOR]

Abstract: Background:: The carotid intima-media thickness (IMT) has been associated with incidence of stroke. Whether this association is independent of carotid plaque is controversial. Methods and results:: The associations among B-mode ultrasound determined common carotid IMT, carotid plaque (focal IMT>1.2mm) and incident stroke, were investigated in 5163 Swedish middle-aged men and women over a median follow-up of 7 years. Age and sex-adjusted carotid IMT, and carotid plaque were significantly (p <0.05) related to future stroke. Adjustment for cardiovascular risk factors generally reduced the hazard rate ratios, however more prominently so with regard to the carotid measure of plaque than with IMT. The associations between carotid IMT and stroke remained after adjustment for presence of carotid plaque, and graded associations between carotid IMT and stroke was found both among those with and without carotid plaque. Conclusions:: In this population-based study, common carotid IMT was associated with incidence of stroke. This relation was independent of presence of carotid plaque. [Copyright &y& Elsevier]

We discuss merging-and-creation as a self-organizing process for scale-free topologies in networks. Three power-law classes characterized by the power-law exponents 3/2, 2 and 5/2 are identified and the process is generalized to networks. In the network context the merging can be viewed as a consequence of optimization related to more efficient signaling. [Copyright &y& Elsevier]

The purpose of this study was to analyse associations between sexual orientation and poor psychological health. This was a cross-sectional study. The 2012 public health survey in Scania, Southern Sweden, is a cross-sectional population-based study with 28,029 participants aged 18–80 years. Logistic regression analyses were performed. The prevalence of poor psychological health (measured using the General Health Questionnaire [GHQ]-12) was 16.3% among men and 22.4% among women. Bisexual men and women had significantly higher odds ratios of poor psychological health throughout the multiple analyses than heterosexual individuals. In contrast, the odds ratios of poor psychological health among gay men and lesbian women were not significantly higher. Respondents with bisexual orientation have increased risk of poor psychological health. • Sexual orientation and psychological health should be studied in population-based studies. • Bisexuals of both sexes, but not gay men or lesbian women, reported poorer psychological health than heterosexuals. • The findings may reflect changes in legal conditions regarding same-sex marriage. [ABSTRACT FROM AUTHOR]

Studies on sociodemographic disparities in Covid-19 vaccination uptake in the general population are still limited and mostly focused on older adults. This study examined sociodemographic differences in Covid-19 vaccination uptake in the total Swedish population aged 18–64 years. National Swedish register data within the SCIFI-PEARL project were used to cross-sectionally investigate sociodemographic differences in Covid-19 vaccination among Swedish adults aged 18–64 years (n = 5,987,189) by 12 October 2021. Using logistic regression models, analyses were adjusted for sociodemographic factors, region of residence, history of Covid-19, and comorbidities. An intersectional analysis approach including several cross-classified subgroups was used to further address the complexity of sociodemographic disparities in vaccination uptake. By 12 October 2021, 76·0% of the Swedish population 18–64 years old had received at least two doses of Covid-19 vaccine, an additional 5·5% had received only one dose, and 18·5% were non-vaccinated. Non-vaccinated individuals were, compared to vaccinated, more often younger, male, had a lower income, were not gainfully employed, and/or were born outside Sweden. The social patterning for vaccine dose two was similar, but weaker, than for dose one. After multivariable adjustments, findings remained but were attenuated indicating the need to consider different sociodemographic factors simultaneously. The intersectional analysis showed a large variation in vaccine uptake ranging from 32% to 96% in cross-classified subgroups, reflecting considerable sociodemographic heterogeneity in vaccination coverage. Our study, addressing the entire Swedish population aged 18–64 years, showed broad sociodemographic disparities in Covid-19 vaccine uptake but also wide heterogeneities in coverage. The intersectional analysis approach indicates that focusing on specific sociodemographic factors in isolation and group average risks without considering the heterogeneity within such groups will risk missing the full variability of vaccine coverage. SciLifeLab / Knut & Alice Wallenberg Foundation, Swedish Research Council, Swedish government ALF agreement, FORMAS. [ABSTRACT FROM AUTHOR]

Background: There is an increasing interest in the potential health benefits of positive psychological states, especially with regard to cardiovascular health. Life satisfaction is thought to be a constituent component of psychological well-being; however, among the few previous studies that have investigated its associations with early stages of the cardiovascular disease process, only one small study has focused on coronary atherosclerosis. The present study aimed to explore associations between life satisfaction and coronary artery disease.Methods: The study used cross-sectional data from SCAPIS Malmö (n = 6251 randomly selected men and women, aged 50-64 years), including assessment of life satisfaction and coronary artery calcification. Adjustments were made for sociodemographic factors, depression, and cardiovascular risk factors as assessed with the SCORE instrument.Results: Higher levels of life satisfaction were associated with lower odds of increased coronary artery calcification. This association persisted after adjusting for sociodemographic factors and depression, but lost significance after adjusting for cardiovascular risk factors. Sub-analyses revealed a significant dose-response relationship between higher life satisfaction and lower grade of coronary calcification in all investigated coronary artery regions.Conclusion: In this population-based sample, life satisfaction was associated with better coronary artery health. However, this association was largely explained by cardiovascular risk factors, indicating that life satisfaction is linked to coronary atherosclerosis through a decreased load of cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Background: Increasing psychosocial stress may underlie contemporary obesity trends. We investigate cross-sectional and prospective associations between negative life events (NLEs) and anthropometric indicators, and whether these are explained by lifestyle, depression and sleeping problems.Methods: Participants in the Swedish INTERGENE cohort answered questions about ten types of NLE, and indicated whether they occurred during the last year or earlier (2001-04, n = 2706). Body mass index (BMI) and waist-to-hip ratio (WHR) were measured at baseline, and at follow-up (2014-16, n = 974). Numbers of recent and distant NLE were related to anthropometric variables using linear models including age, sex, and education, and further adjusted for lifestyle, and psychological problems. Prospective models were adjusted for baseline anthropometric values.Results: Participants reported on average 3.6 types of NLEs, of which 70% were experienced more than one year ago. At baseline, distant but not recent NLEs were associated with higher values of both BMI and WHR. These associations were explained in part by lifestyle and depression assessed at baseline. Recent but not distant NLEs predicted gain in BMI, 0.19 (0.07, 0.30) kg/m2, and WHR, 0.005 (0.002, 0.007), per event and independent of baseline covariates. The largest associations were seen for job insecurity and financial worries, with 0.35 (0.17, 0.52) kg/m2 increase in BMI corresponding to approximately 1.2 kg per event, in both sexes.Conclusion: We observed positive associations between NLEs and weight gain over 13 years including signs of latency and recovery regarding adverse weight development. [ABSTRACT FROM AUTHOR]

Objective: The contemporary increase in psychological distress observed in many countries is, by itself, a public health issue of great concern. The present study aims to investigate associations between self-reported negative emotional states and negative life events, and cardiovascular disease (CVD).Methods: Prospective cohort study based on the Swedish INTERGENE cohort comprising 3614 men and women, aged 25 to 75. Baseline examinations during 2001-2004 included self-rating depression and anxiety scales, life stress, as well as a wide range of physiological and behavioral parameters, which allowed for relevant adjustments. Cox proportion hazard was used to predict incident CVD, CVD mortality as well as all-cause mortality.Results: The results showed a dose-response relationship between depressiveness, anxiety and negative life events on the one hand, and increased risk of CVD. Most of these associations persisted in the fully adjusted models. Furthermore, the youngest age group (25-44 years) generally showed the highest prevalence of psychosocial distress, and also had the highest risks of incident CVD with regard to depression and anxiety.Conclusion: The associations between psychological distress and later life cardiovascular disease calls for enhanced public health efforts aiming at ameliorating psychological health, not least in younger age groups. [ABSTRACT FROM AUTHOR]