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Introduction Social determinants of health have not been intensively studied in Russia, even though the health divide has been clearly demonstrated by an increased mortality rate among those with low education. A comparative analysis of social health determinants in countries with different historical and economic backgrounds may provide useful evidence for addressing health inequalities. We aimed to assess socioeconomic determinants of self-rated health in St. Petersburg as compared to Estonia and Finland. Methods Data for women aged 18-44 were extracted from existing population-based surveys and analysed. In St. Petersburg the data were originally collected in 2003 (response rate 68%), in Estonia in 2004-2005 (54%), and in Finland in 2000-2001 (86%). The study samples comprised 865 women in St. Petersburg, 2141 in Estonia and 1897 in Finland. Results Self-rated health was much poorer in St. Petersburg than in Estonia or Finland. High education was negatively associated with poor self-rated health in all the studied populations; it was (partially) mediated via health behaviour and limiting long-term illness only in Estonia and Finland, but not in St. Petersburg. High personal income and employment did not associate with poor self-rated health among St. Petersburg women, as it did in Estonia and Finland. In St. Petersburg housewives rather than employed women had better self-rated health, unlike the two other areas. Conclusion Women's self-rated health in St. Petersburg varied similarly by education but differently by income and employment as compared to Estonia and Finland. Education is likely the most meaningful dimension of women's socioeconomic position in St. Petersburg. More research is needed to further clarify the pathways between socioeconomic position and health in Russia. [ABSTRACT FROM AUTHOR]

We compared the reasons for postponing first birth in the three neighbouring areas of St Petersburg (Russia), Estonia and Finland. Data from three population-based surveys among women aged 18-44 years in St Petersburg (response rate 67%); Estonia (54%) and Finland (63%) in the early 2000s were used and analysed with logistic regressions. Childbearing intentions and reasons for postponing parenthood differed between both study areas and age groups. The proportion of women aged 35-44 still planning to have children was highest in Estonia. In the two post-Soviet areas, job insecurity increased postponement intentions among women aged 18-34 years. Enrolment in education was an important reason for postponement among women below 35 years in Estonia and aged 25-34 years in St Petersburg. In Finland, poor economic situation in the youngest age group and desire to advance a career among all women were important reasons to postpone birth. The importance of prolonged education and job insecurity for the timing of births in St Petersburg and Estonia suggests that governments should improve family policy measures to encourage childbearing among the young. In Finland policies to support the reconciliation of family and career and to increase permanent employment could promote parenthood among well-educated women. [ABSTRACT FROM AUTHOR]

The special norms in testing for HIV infection are not typical of testing or screening for other diseases. In four European countries, we studied health professionals’ views on HIV testing This study is based on cross-sectional surveys of two groups of health professionals: presidents of selected health professional societies and head physicians and nurses of selected hospital clinics in Belgium, Estonia, Finland, and Portugal in 2008. A common structured semi-anonymous questionnaire was used in the four countries. The number of societies responding varied from five to 10 and for hospital clinics from six to 18; the response rates were from 32% to 100% and 41% to 100%, respectively. Opinions on whether HIV testing is like any other test and on the value of specific approaches in HIV testing varied both within and between countries. Some professionals thought that HIV testing is different from the testing of other infectious diseases; others thought that such an exceptional approach may be a disservice to people and to the health system. Many professionals thought that HIV testing should not be thought of only from the point of view of the individual to be tested, but also from that of other people (potential patients). Obligatory testing was considered appropriate in certain circumstances. Generally, more HIV testing in health care was called for. Normalization of HIV testing, i.e., considering it like any other diagnostic test, is unlikely to meet much opposition from health professionals. Larger surveys are needed to confirm the results. [ABSTRACT FROM PUBLISHER]

Objectives To compare the risk factors of self-reported abortion in St Petersburg, Estonia and Finland, which are neighbouring areas having different abortion rates. Methods Data from four population-based questionnaire surveys (Finland 1992 and 1999; St Petersburg 2003; Estonia 2004) were used. With the exception of the 1992 Finnish survey (based on interviews) all were postal surveys. There were 1070 respondents in Finland (78% and 52% response rates), 1147 (68%) in St Petersburg, and 5190 (54%) in Estonia. Results The prevalence of self-reported abortions was highest among women in St Petersburg and among the two oldest age groups of Russian-speaking Estonians. In all areas women with a history of abortion were more likely to have low education, children, a history of multiple partners and to have had their first intercourse when younger than 18 years. Insufficient use of reliable contraception, both at first and last intercourse, was the only risk factor that was more common in St Petersburg and in Estonia than in Finland. In Estonia, more Estonian than Russian-speaking women used reliable contraceptives. Conclusion The comparison of three areas suggests that high abortion rates are related to low contraceptive use and not to other risky sexual behaviour. [ABSTRACT FROM AUTHOR]

Background: Very little data are available on the natural course or level of disturbance of vasomotor symptoms among middle-aged women. Using readily collected trial data we studied the persistence of vasomotor symptoms among untreated women., Methods: In a trial comparing combined hormone therapy to placebo or no treatment (control groups), a cohort of women aged 50-59 at recruitment were followed annually by questionnaires. Women in the control groups (n = 486) were grouped by the number of years followed, with the prevalence and severity of symptoms calculated both cross-sectionally and longitudinally., Results: About two thirds of the women (67%) reported vasomotor symptoms and half (46%) bothersome symptoms at recruitment. In the cross-sectional analysis, their prevalence declined between recruitment and 1-year follow-up (32% bothersome symptoms) and 2-year follow-up (27%). Thereafter it remained about the same level. In the longitudinal analysis, there was a notable variation in the prevalence of disturbing vasomotor symptoms over time, time entering the study and the compliance to the surveys. In the two groups having most follow-up times, the proportion of women with bothersome symptoms first increased and then decreased., Conclusions: There was a notable variability in the development of disturbing vasomotor symptoms over time in a selected group of women aged 50-59. Population-based follow-up studies of untreated women would be useful to estimate the symptom burden.