BackgroundIll health is a risk factor and a consequence of unemployment, which might vary depending on the national rate of unemployment. We investigated the long-term effect of youth unemployment on mental health and explored the possible interaction during periods of high (economic crisis) and low (non-crisis) unemployment rates.MethodsA register-linked population-based cohort study was conducted including individuals aged 17–24 years. The crisis cohort (n=6410) took part in the Labour Force Survey during the economic crisis (1991–1994) in Sweden and the non-crisis cohort (n=8162) took part in the same survey before the crisis (1983–1986). Follow-up was 19 years. Adjusted HRs and 95% CIs for an inpatient care discharge mental diagnosis with employed people as the reference group were calculated by Cox regressions models.ResultsIn fully adjusted models, <3 months (HR: 1.69; 95% CI 1.14 to 2.49), 3–6 months (2.19; 1.43 to 3.37) and >6 months (2.70; 1.71 to 4.28) of unemployment were associated with increased risks of getting a mental diagnosis in the crisis cohort. In the non-crisis cohort the risks were: 1.92; 1.40 to 2.63, 2.60; 1.72 to 3.94 and 3.33; 2.00 to 5.57, respectively. No interactions between labour force status and level of unemployment were found.ConclusionsYouth unemployment is related to mental health problems, independent of the overall national rate of unemployment, which is important as the youth unemployment rates are currently at stable high level.
Aim To test (i) whether the harmful effects of average volume of alcohol consumption (AC) and heavy episodic drinking (HED) differ by socio‐economic position (SEP), and (ii) if so, to what extent such differential effects can be attributed to an unequal distribution of harmful levels and patterns of drinking, health, life‐style and social factors. Design A longitudinal cohort study with baseline in 2002 or 2006, with record‐linkage to national registers. Setting Stockholm County, Sweden. Participants A total of 37 484 individuals, aged 25–70 years, responding to the survey in 2002 or 2006. Measurements The outcome of alcohol‐related health problems was obtained from the National Patient Register and Cause of Death Register using the Swedish index diagnoses related to alcohol use. Self‐reported information on occupational class (measure of SEP), AC, HED as well as other health‐related factors were extracted from the surveys. Average follow‐up time was 13.3 years. Findings During follow‐up, a total of 1237 first‐time events of alcohol‐related health problems occurred. After initial adjustments, heavy drinking appeared to be more harmful to individuals with low SEP compared with high SEP (P = 0.001). Differences in HED frequency explained the largest part of the differential effect of AC. Engaging in weekly HED was more harmful to individuals with low SEP (P = 0.031) than high SEP. Differences in AC, together with other factors, explained a large part of the differential effect of HED. Conclusions The greater adverse impact of alcohol consumption on health in Sweden on people with lower socio‐economic position may be largely attributable to higher prevalence of heavy episodic drinking, as well as other behavioral and social risk factors.
This study found that the number of people who are active commuters is modest and other modes of transportation are preferred. Several facilitating and impeding factors associated with active commuting were also found, indicating the importance of applying a broad health-promoting approach to encouraging active commuting.
AimTo examine whether exposure to increased alcohol availability in utero is associated with later alcohol-related health problems.MethodRegister-linked population-based longitudinal study using data from a natural experiment setting, including 363 286 children born 1965–71. An experimental alcohol policy change was piloted in two regions of Sweden in 1967–68, where access to strong beer increased for 16–20 year old. Children exposed in utero to the policy change were compared to children born elsewhere in Sweden (excluding a border area), and to children born before and after the policy change. The outcome was obtained from the National Hospital Discharge Register using the Swedish index of alcohol-related inpatient care. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated by Cox regression analysis.ResultsThe results suggest that children conceived by young mothers prior to the policy change but exposed to it in utero had a slightly increased risk of alcohol-related health problems later in life (HR 1.26, 95% CI 0.94-1.68). A tendency towards an inverse association was found among children conceived by older mothers (HR 0.88, 95% CI 0.74-1.06).ConclusionResults obtained from a natural experiment setting found no consistent evidence of long-term health consequences among children exposed in utero to an alcohol policy change. Some evidence however suggested an increased risk of alcohol-related health problems among the exposed children of young mothers.
AimTo test if being exposed to increased alcohol availability during adolescence is associated with an increased risk of receiving disability pension due to all‐cause, alcohol use disorders and mental disorders.DesignRegister‐based population‐based study using a natural experiment setting, the alcohol policy change in Sweden (1967–68), with increased access to strong beer in a narrow time window and geographical area. The individuals exposed to the policy change were compared with non‐exposed individuals living in the rest of Sweden, excluding a border area.SettingSweden.ParticipantsA total of 518 810 individuals (70 761 in the intervention group; 448 049 in the control group) born 1948–1953, aged 14–20 years during the policy change.MeasurementsDate and diagnosis of the outcome variable of disability pension due to all‐cause, alcohol use disorders and mental disorders were obtained from the Swedish National Social Insurance Agency database from 1971 to 2013. Individual and family level socio‐demographic and health‐related covariates, as well as a regional level covariate, were included.FindingsCompared with the control group, adolescents exposed to the alcohol policy change were at an increased risk of receiving disability pension due to all‐causes [hazard ratio (HR) = 1.09, 95% confidence interval (CI) = 1.07–1.11], alcohol use disorders (HR = 1.17, 95% CI = 1.05–1.30) and mental disorders (HR = 1.19, 95% CI = 1.15–1.23).ConclusionIn Sweden, a natural experiment with a 43‐year follow‐up suggests that exposure to increased alcohol availability during adolescence is associated with an increased risk of receiving a disability pension due to all‐cause, alcohol use disorder and mental disorder diagnoses.
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