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The aim of the paper is to analyse if alcohol consumption could explain the scarring effect of youth unemployment on later depressive symptoms.The analyses are based on the 24-year follow-up of school leavers in a municipality in Northern Sweden (the Northern Swedish Cohort). Four-way decomposition analyses were performed to analyse if alcohol use at age 30 years could mediate and/or moderate the effect of youth unemployment (ages 18/21 years) on depressive symptoms in later adulthood (age 43 years).Excessive alcohol use at early adulthood (age 30 years) mediates 18% of the scarring effect of youth unemployment on depressive symptoms in later adulthood. The scarring effect was seen among both those with and without excessive alcohol use. Youth unemployment leads to poor mental health later in life and part of these relations are explained by excessive alcohol consumption in early adulthood. Policy interventions should target the prevention of youth unemployment for reaching a lower alcohol consumption and better mental health. [ABSTRACT FROM AUTHOR]

Aims: The aim of the present study was to investigate associations between occupational gender composition, psychosocial work factors and mild to severe depression in Swedish women and men with various educational backgrounds. Methods: The study included 5560 participants from two waves of the Swedish Longitudinal Occupational Survey of Health, an approximately representative sample of the Swedish working population. Odds ratios (OR) and 95% confidence intervals of mild to severe depression in 2014 were estimated for five strata of occupational gender composition with >20-40%, >40-60%, >60-80% and >80-100% women, using 0-20% women as the reference. Analyses were stratified by gender and education. Job strain, organisational injustice, poor social support and effort-reward imbalance in 2012 were added in separate models, and changes in OR of mild to severe depression for strata of occupational gender composition were evaluated. Results: Among women, the odds of mild to severe depression did not vary by occupational gender composition. Among men with low to intermediate education, the odds were higher in the stratum with >80-100% women, and among men with high education, the odds were higher in strata with >20-40% and >60-80% women. Psychosocial work factors affected the odds ratios of mild to severe depression, but most of the variation remained unexplained. Conclusions: Odds of mild to severe depression appeared to vary by occupational gender composition among Swedish men but not women. This variation seemed only to a small extent to be explained by psychosocial work factors. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the association between life-course exposure to snus and prevalence of the metabolic syndrome and its components in adulthood. Design and method: Tobacco habits at baseline (age 16) and three follow-ups (ages 21, 30 and 43) were assessed among 880 participants in a population-based cohort in Northern Sweden. Presence of the metabolic syndrome at age 43 was ascertained using the International Diabetes Federation criteria. Odds ratios and CIs for risk of the metabolic syndrome and its components by snus use at 16, 21, 30 and 43 years were calculated using logistic regression. Cumulative snus use was defined as number of life periods (1–4) with current snus use. Results: At age 43, 164 participants (18.6%) were current snus users. We found no association between exclusive snus use at the ages of 16, 21, 30 and 43 years and the metabolic syndrome at age 43 years. Snus use (among non-smokers) was associated with raised triglycerides and high blood pressure in crude analysis, but not in multivariable models. There was no association between cumulative snus use and risk of the metabolic syndrome. Cumulative snus use was associated with central obesity, raised triglycerides and impaired fasting glucose/diabetes mellitus type 2 in crude analyses, but not after adjustments. Conclusions: The health consequences of snus exposure from adolescence to mid-adulthood do not seem to include increased risk of the metabolic syndrome or its components. The cardio-metabolic risk of dual exposure to snus and cigarettes may warrant further attention. [ABSTRACT FROM AUTHOR]

Proposed theories to explain gender inequality in the labor market and family, such as gender specialization within families and gender segregation in the labor markets, lack consideration for individual preferences. Preference theory accounts for individual choice and gendered preferences but has been substantially criticized, indicating a need for further research. This study uses Swedish longitudinal data to explore how preferences for work and family relate to behavior. We explore three critical issues raised in previous research: gender differences in preferences; the relationship between work and family changes and subsequent preferences; how preferences relate to work and family behaviors. Our results showed small general gender differences in preferences, although women had a stronger preference for both children and work than men. Changes in work status were further related to changes in work preferences, while changes in family status were related to changes in family preferences. Moreover, preferences had poor predictive power in relation to work and family behaviors. Our results indicate that preferences do not explain gender inequality in Sweden. The relationship between preferences and behaviors seems bidirectional and preferences and behavior within the family sphere has little to do with preferences and behavior within the work sphere. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Aim: Although health effects of social relationships are well-researched, long-term health consequences of adolescent family as well as peer relationships are poorly understood. The aim of the study was to explore the prospective importance of parental and peer social relationships in adolescence on internalising and functional somatic symptoms in adulthood. Methods: Data were drawn from four waves of the Northern Swedish Cohort Study, response rate 94.3%, N=1001. Outcome variables were internalising and functional somatic symptoms at the ages of 21, 30 and 42. Relationship variables at age 16 were poor parental contact and three indicators of poor peer relationships. Associations were assessed in multivariate ordinal logistic regressions with adjustment for confounders and baseline health. Results: Results show that the main relationships-related predictors of adult internalising symptoms were self-rated poor peer relationships in terms of spending time alone during after-school hours and poor parental relationship. Functional somatic symptoms on the other hand were most strongly associated with poor parental contact and not being happy with classmates at age 16. Conclusions: The quality of parental and peer relationships in adolescence predicts adult mental and functional somatic health as much as 26 years later, even when accounting for confounders and adolescent symptomatology. This study extends past research by exploring how both adolescent parental and peer relationships (self-reported as well as teacher reported) predict adult self-reported health. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to analyse the relationship between early unemployment (ages 16–21 years) and adult hypertension after controlling for earlier hypertension, unemployment in adult life, risk factors for hypertension and confounders. Methods: A cohort of 927 (86.6% of the original cohort) 9th grade school-leavers was followed from 1981 until 2008. Data were collected through questionnaires, health examinations, and national registers. Univariate and multivariate logistic regression were used as primary statistical methods. Results: At ages 21 and 43, hypertension was significantly more prevalent among men than women (p < .001). Unemployment between the ages of 16 and 21 was related to hypertension at age 43 among women but not men. The odds ratio (OR) was persistently high (OR 3.16 [95% confidence interval 1.45–6.89]) after controlling for late unemployment, hypertension at age 16, risk factors for hypertension and confounders. There was no significant relationship between exposure to early unemployment and hypertension at age 21 for women or men. Conclusions: From a public health perspective, youth unemployment is a societal problem in need of more attention and intervention in order to prevent long-term adverse health outcomes. [ABSTRACT FROM PUBLISHER]

Aim: To examine social capital across life and functional somatic symptoms in middle-age, according to life-course models of cumulative risk and sensitive periods. Methods: Data from the 26-year prospective study the Northern Swedish Cohort enabled complete case analyses on 940 individuals (451 women and 489 men) participating in questionnaire surveys at ages 16, 21, 30 and 42. Social capital was operationalized at the individual level, comprising items on social participation, social influence and social support. Functional somatic symptoms were a summary measure of self-reported physical symptoms, palpitation and sleeping difficulties occuring during the 12 months prior to the data collection. Linear regression was used as the main statistical method, examining the relationship between functional somatic symptoms at age 42 and social capital across life. Results: Lower levels of social capital accumulated over the life course were associated with higher levels of functional somatic symptoms at age 42, for both women and men. Social capital was, especially among adolescent men, related to functional somatic symptoms at age 42, independently of social capital later in life and baseline material circumstances. Conclusions: The health impact of poor social capital may be due to accumulation across the life course and to adolescence being a particularly sensitive period. It is relevant for preventive work to acknowledge effects of social capital throughout life. [ABSTRACT FROM PUBLISHER]

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. [ABSTRACT FROM PUBLISHER]

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

Background: The importance of social and avoidable determinants of depressive symptoms has been increasingly recognized in public health research. However, when it comes to determinant of gender differences in depressive symptoms the focus is predominantly on biological unavoidable determinants. Thus, there is a need for more focus on gendered social determinants of health. The aim of this study was to analyse the importance of gender relations for depressive symptoms after taking socioeconomic factors and earlier depressive symptoms into account in the Northern Swedish cohort. Methods: A 26-year follow-up study of a cohort of all school leavers in a middle-sized industrial town in Northern Sweden was performed from age 16 until age 42. Of those still alive of the original cohort, 94% participated during the whole period and answered extensive questionnaires. Exposure was measured as socioeconomic status, financial strain, perceived gender inequity in the couple relationship and division of responsibility for domestic work. The outcome was depressive symptoms at age 42, while depressive symptoms were controlled at age 30. Results: In multivariate logistic regression analyses significant relations between financial strain and, among women only, also perceived gender equity in the couple relationship and depressive symptoms after adjustment for earlier health status, as well as for all other exposure measures. Conclusions: Financial strain, and among women, also gender inequity in the couple relationship was related to depressive mood. There is a need to pay more attention to gender relations in future research on social determinants of depressive mood. [ABSTRACT FROM PUBLISHER]

Aim: To investigate whether type of employment was related to work characteristics and health status at age 42 adjusted for health status at age 30 and whether gender moderates the associations. Methods: Questionnaire data was used from a 27-year follow-up study of school-leavers carried out in Luleå in the north of Sweden (response rate 94%). The study population consisted of 877 (47.8% women) working respondents. Data were analysed by means of t-tests, ANOVAs, and multiple linear regression analyses. Results: Men were more often self-employed, while more women had temporary types of employment. Moreover, men reported more control over work and less emotional exhaustion than women. Compared to permanently employed, self-employed (men and women) perceived more control over work and better health status (p<0.01). Self-employed men also reported more demands and social support (p<0.05). People in temporary types of employment, however, reported less job control, as well as lower health status (only men) (p<0.01). Poor self-reported health and emotional exhaustion were significantly (p<0.05) associated with poor work characteristics (more demands, lower job control, and lower support). Conclusions: No direct associations between type of employment and health were found for women and men. However we find indications of an influence of type of employment on work and thereupon health, with job control playing an important role. [ABSTRACT FROM PUBLISHER]

Gender-specific medicine, a new and increasingly influential ethos within medical research and practice, has received little critical attention to date. The objective of this article is to critically examine the attributes of gender-specific medicine as imparted by its advocates. Through a critical discourse analysis of its two leading academic journals, we identify five interrelated discourses: of male/female difference; of hegemonic biology; of men’s disadvantages; of biological and social reductionism; and of the fragmented body. Together these comprise a master discourse of the ‘gender-specific body’. The discourse of the ‘gender-specific body’ is discussed in relation to the current neoliberal political agenda which frames healthcare as a market good and locates health and illness in individual bodies rather than in the wider social arrangements of society. We argue that the ‘gender-specific body’ threatens not only to turn back the clock to a vision of the biological body as fixed and determinate, but to extend this ever deeper into the social imagination. Lost in the process is any meaningful sense of the human body as a relatively open system which develops in interaction with its social world. We propose that, as it gains momentum, the ‘gender-specific body’ is likely progressively to circumscribe our thinking about the health of women and men in potentially problematic ways. [ABSTRACT FROM PUBLISHER]

Aims: The aim of this study was to investigate whether temporary employment was related to non-optimal self-rated health and psychological distress at age 42 after adjustment for the same indicators at age 30, and to analyze the effects of job insecurity, low cash margin and high job strain on this relationship. Methods: A subcohort of the Northern Swedish Cohort that was employed at the 2007 follow-up survey (n = 907, response rate of 94%) was analyzed using data from 1995 and 2007 questionnaires. Results: Temporary employees had a higher risk of both non-optimal self-rated health and psychological distress. After adjustment for non-optimal self-rated health at age 30 and psychological distress at age 30 as well as for sociodemographic variables, the odds ratios decreased but remained significant. However, after adjustment for job insecurity, high job strain and low cash margin the odds ratio dropped for non-optimal self-rated health but remained significant for psychological distress. Conclusions: Temporary employment may have adverse effects on self-rated health and psychological health after adjustment for previous health status and sociodemographic variables. Our findings indicate that low cash margin and job insecurity may partially mediate the association between temporary employment and health status. [ABSTRACT FROM PUBLISHER]

Aims: There is a lack of empirical studies assessing the possible impact of active labour market programmes (ALMP) on health. The aim of this study was to analyze whether participation in ALMP, in contrast to being unemployed and not participating in ALMP (UNALMP), was related to mental health at different ages. Methods: The study was carried out in a medium-sized industrial town in the north of Sweden. The cohort, consisting of all 1,083 pupils who attended or should have attended the last year of compulsory school in 1981, was followed up at the ages of 16, 18, 21 and 30. Data on 381 individuals at age 21, and 281 at age 30 were used in the study. The main health measurement was psychological symptoms among participants of ALMP in contrast to UNALMP at ages 21 and 30, and was analyzed by propensity score matching method (PSM) and multivariate logistic regression. Results: Generally, ALMP had higher scores of psychological symptoms than UNALMP. Nevertheless, participation in ALMP was not related to mental health. Due to methodological shortages our results have to be interpreted with caution. Adjustment for either all background selection variables or the propensity score in multivariate logistic regression showed similar associations, suggesting that propensity score could be used to adjust for background selection variables. Conclusions: There is a need for more well-designed studies, using a theoretical framework, within the field, that are based on larger samples. [ABSTRACT FROM PUBLISHER]

Aims: To analyse predictors among pupils leaving compulsory school for smoking and high alcohol consumption as adults. Methods: A prospective cohort study in which all pupils (N=1083) in the last year of compulsory school were followed for 14 years. The data were collected through repeated comprehensive self-administered questionnaires. Results: Smoking was better predicted than alcohol intake. The best predictors were earlier high alcohol intake and earlier smoking. Among other predictors, low grades, poor teachers' prognoses and early unemployment pointed to unfavourable health habits, mainly smoking. Conclusions: It is possible already at school to identify risk groups for future smoking and high alcohol consumption. [ABSTRACT FROM AUTHOR]

Aims: This study analysed the effects of psychosocial factors at school on pupils' health and self-worth from a longitudinal perspective. Methods: A three-year prospective study was started in 1994, including 533 pupils (261 girls, 272 boys) from 25 different classes in grades 3 and 6. With age-adjusted questionnaires the changes in self-perceived health were compared with changes in psychosocial school environmental factors. Results: The girls in the older cohort reported a negative health development with decreased self-worth and increased somatic and psychological symptoms. Significant gender differences in ill health, but not in self-worth, developed, especially in the older cohort. A multiple regression analysis showed that a negative development of psychosocial factors at school, measured as control, demand, and classmate problems, was associated with poorer health and self-worth among the pupils. A trichotomization of the psychosocial variables at school indicated a possible causal relationship between psychosocial factors and ill health and self-worth. Conclusions: The negative development in pupils' health and self-worth could partly be explained by the more unfavourable psychosocial environment that prevails at school at the senior level. The public health implications of our study can be summarized as the need for schools to improve pupils' social situation at school in relation to their work situation as well as to pay special attention to the school situation of girls at senior level. [ABSTRACT FROM AUTHOR]

The aim of our study was to focus on women's networks in the Swedish county of Jämtland, and to analyse the relationship between network activities and the perceived health among the network participants, as well as participation in the community among its residents. Questionnaires were distributed to all 68 women's networks and 60 responded. The results show that the network activities correlate with an improved perception of health, as well as with increased participation in the community among the residents. The more support, influence, self-reliance and trust in the future experienced by the networks through their work, the better the health among the participants in the network. The greater the self-reliance, trust in the future, amount of network-related unpaid work and new jobs, the better the participation among the community residents. Despite its limitations, our study suggests that women's networks could have an important role in health promotion within the framework of the new public health. The network model, with its bottom-up strategy, could be useful in public health, provided that networking is not used to fill a gap when there are cuts in the public sector. [ABSTRACT FROM AUTHOR]

The aim of this study was to review the literature about possible barriers to recognition and intervention regarding women exposed to sexualized violence, in their interactions with the health care system. The barriers, as reported by the health care staff, were: lack of education; the stereotype of a “typical battered woman”; too close identification with the victim/abuser; time constraints; fear of offending the victim/abuser; and feelings of hopelessness and non-responsibility. The barriers, as reported by the victims, were: negative experiences of and structural limitations within the health care system; fear of retaliation from the abusive partner; and psychological effects of the normalization process. We conclude that the barriers within the health care sector have to be dealt with on three different levels: the structural level in order to diminish male power in society; the organizational level in order to initiate screening and to allow the staff time for dealing with the victims; and on the individual level, health care staff need to acquire the knowledge and skills to enable them to address sexualized violence. [ABSTRACT FROM AUTHOR]

Investigates the risk of future unemployment among young people experiencing early unemployment in Sweden. Examination of the influence of the risk on health status; Comparison of risk of people experiencing early unemployment with those in Youth Opportunities Programs; Influence of health status and health behavior on the risk of unemployment.

The issues raised in this editorial and exemplified within a number of the studies reported in this issue indicate new directions for public health, directions which take feminist scholarship, both outside and within the medical framework, into account. The changing potential of feminist public health, as derived from the articles in this issue, can be summarised within the following issues: new research areas, positioning women as actors, development of theoretical frameworks, reflexive theory of science, interplay between sex and gender, gender-sensitive methods, diversities among women/men, pro-feminist research on men's health and using the results for change. Thus, feminist public health represents a shift towards the new public health, with holistic and multidisciplinary activities, based on theoretical pluralism, multiple perspectives and collective actions with the aim of improving the health of gender-subordinated groups. [ABSTRACT FROM AUTHOR]

The issues raised in this editorial indicate that public health research must embrace the advances made in the understanding of gender and other power dynamics, which influence the social distribution of health and illness among the population. Furthermore, it is crucial to recognize that social research (including that in health) is part of the social fabric - not separable from - the processes of power. Thus, a power perspective in public health can bring a more comprehensive and subtle understanding of the multiple and contradictory elements of gender and other relations of power that impact on the health status of populations. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine whether the large investments in vocational rehabilitation made in Sweden during the 1990s had improved the level of return to work for young employees and to study the factors predicting return to work. The study population comprised all employees under 30 years of age whose reports on work-related disorders were under consideration at regional social insurance offices in Västerbotten county in 1990 and 1994 (n = 266). Between these years, increased efforts were made by the Swedish government to improve vocational rehabilitation. Data was collected from the register and by means of questionnaires. It was found that employees with musculoskeletal disorders were more likely to return to work during periods of intensive vocational rehabilitation. No increase in the level of return to work was apparent if all disorders were considered. Men showed a higher level of return to work than women, although women were better educated. [ABSTRACT FROM AUTHOR]

Sexual risk-taking can lead to serious consequences. This study addressed the question of how sexual risk-taking was influenced by unemployment. A cohort of 1060 adolescents were followed from their last term in compulsory, school and five years ahead until the age of 21. Sexual risk-taking, defined as unprotected intercourse without wishing to conceive, was studied with the help of a questionnaire at the beginning and at the end of the period. For men there was a positive correlation between the length of unemployment and increase in risk-taking during the period, but for women there was a (statistically non-significant) negative correlation. In a logistic regression analysis, having children also had a significant effect on increased risk-taking among men. Unemployment thus implies increased sexual risk-taking among adolescent men. [ABSTRACT FROM PUBLISHER]

The aim of this one-year investigation of school accidents is to obtain more knowledge for preventive work. In the agegroup 7–19 years, 547 injuries were registered, mainly at three hospitals. The incidence rate was 25 per 1000 boys and 20 per 1000 girls per year. Most injuries occurred in intermediate and upper secondary school among boys and in upper school among girls. The relative risk of school injury compared with spare-time injury was 1.8 for boys and 2.6 for girls of compulsory school age. Most injuries occurred in sports area (boys: 34%, girls: 46%). The incidence of sports injuries showed no gender differences. The highest incidence rate was found in senior school girls. Twenty-five percent of all injuries were caused by other pupils, intentional violence being one important mechanism. Head injuries were more common among school injuries compared with spare-time injuries. [ABSTRACT FROM PUBLISHER]