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F Diderichsen

Publications and source records attributed to F Diderichsen.

At least 55 records · Page 3Linked to original sources
PubMed1997

Trends in occupational mortality among middle-aged men in Sweden 1961-1990.

BACKGROUND: Many European countries have in recent decades reported growing socioeconomic differentials in mortality. While these trends have usually paralleled high unemployment and increasing income disparities, Sweden had low unemployment and narrowing income differences. This study describes trends, 1961-1990, in total and cardiovascular mortality among men, 45-69 years of age, in major occupational classes in Sweden. METHODS: From census data four cohorts were created from those enumerated in 1960, 1970, 1980 and 1985. Through record linkage with the Swedish cause of death registry the mortality in each cohort was followed for 5-10 years. Age-standardized mortality trends 1961-1990 were calculated for occupational groups, categorized according to sector of the economy. RESULTS: The increase in mortality among middle-aged men in Sweden 1965-1980 was mainly a result of increasing cardiovascular mortality among industrial workers and farmers. In the 1980s the trend for these groups changed into a last decrease in mortality similar to that for non-manual occupations for the whole period. Consequently the rate ratio for industrial workers in comparison with men having a professional/managerial type of occupation increased from 0.98 to 1.43. The slowest decrease is now found among unqualified occupations in services and transportation. CONCLUSIONS: While Sweden, during the period studied, had narrowing income differentials and low unemployment this result points to the importance of working conditions in understanding trends and distribution of male adult mortality.

Aged↗
PubMed1997

Socioeconomic differentials in misclassification of height, weight and body mass index based on questionnaire data.

BACKGROUND: The purpose of this study was to analyse misclassification of height, weight and body mass index (BMI), derived from mail questionnaires, and its dependency on socioeconomic factors. METHODS: A random sample of 4442 adults aged 18-84 years, living in Stockholm county, Sweden, were in 1984-1985 asked about their height and weight. A few months later 3208 of these adults participated in a health examination that included measures of height and weight. In this study we have used occupational class as the socioeconomic indicator. We have used sensitivity as a measure of misclassification of height, weight and BMI. RESULTS: The difference in mean measured height between socioeconomic groups I and III was 2.7 cm for men and 2.0 cm for women. The mean difference in measured height between socioeconomic groups I and III was higher for men than for women in all age groups. The mean difference between self-reported and measured height was 0.6 cm for men and 0.79 cm for women. For weight, the corresponding difference was -0.74 kg for men and -1.64 kg for women. Women's BMI was more underestimated than men's (-0.85 for women, -0.40 for men). When using self-reported height and weight for calculating BMI, 81% of the men and 78% of the women were classified correctly, but only 61% of the obese men and 55% of the obese women were identified. The BMI was underestimated in all socioeconomic groups. Manual workers had a lower proportion of underweight, compared to professionals and intermediate non-manual workers, while the objective measure showed the inverse relationship. The prevalence of overweight and obesity in men was 42% higher in socioeconomic group III compared with group I with self-reported data compared with 28% when measured. Underestimation of BMI was highest among women, the obese, the elderly, and male non-manual workers and female manual workers. CONCLUSIONS: Our study shows that socioeconomic differences in height, when using self-reported information, involve an underestimation. This means that the height differences between socioeconomic groups in Sweden may actually be higher than that reported by individuals in surveys. The socioeconomic differences in underweight tend to be underestimated for men, as well as obesity for women, when using self-reported information. The socioeconomic differences in overweight and obesity are shown to be overestimated for men.

Adolescent↗
PubMed1996

The impact of major transformations of a production process on age-related accident risks: a study of an iron-ore mine.

This paper describes a study of whether accident risks were equally distributed across age categories among a population of mining workers whose work activities were suspected to be age-impaired. The impairment factors in focus are the transformation of production technology during the 80s and consequent changes in job content. It was hypothesized that the combined effect of these factors might lead accident risks, both non-specific (aggregated) and specific (by kind), to increase with age. Accident risk ratios (ARRs), however, proved to be higher for younger workers than older ones, in both the non-specific and the specific cases. However, two accident patterns (specific risks) also show relatively high ARRs among workers in their 40s (and even 30s), results that might be explained by particular exposures and/or age-related performance problems. The findings suggest that technological changes designed to increase productivity and reduce staffing levels more rapidly affect efficiency and productivity than they do accident occurrence, and that they penalize young workers in the first instance.

Accidents, Occupational↗
PubMed1996

Inequalities in health: the interaction between socio-economic and personal circumstances.

This longitudinal study utilizes a data set from the Survey of Living Conditions conducted by Statistics Sweden (SCB) during the years 1980-1981 and 1988-1989. It comprises a representative sample of the employed Swedish population (2,861 individuals) between the ages of 20 and 65. The objective of the study is to analyse the interaction between socio-economic and personal circumstances in explaining inequalities in health. It is based on a theoretical framework which presupposes that inequalities in health are likely to be explained by a complicated process involving a multitude of factors. At the same time, differential exposures and differential responses to risk factors between socio-economic classes for certain health outcomes are determined. The joint effect on general health status, seven years later, of being a manual worker and having reported psychosomatic symptoms is 113% greater than would have been expected on the assumption of additivity of the singular effects of these variables. It is suggested that it is necessary to highlight in further research the complex interactions and pathways between factors associated with health outcomes to improve our understanding of the causal processes involved and determine appropriate preventive measures.

Adult↗
PubMed1996

How to evaluate interaction between causes: a review of practices in cardiovascular epidemiology.

To increase the knowledge of interaction or synergy between risk factors in an important task in medical research. Still, current literature in cardiovascular epidemiology reflects major misconceptions as how to evaluate interaction. This paper presents Rothman's model of causation from which strict empirical criteria of interaction can be derived. In principle, the method to apply consists of comparing risk differences for one risk factor of interest across strata of the other. Commonly used but incorrect approaches are exemplified and discussed. These include reporting risk of disease among those with combined exposure, comparing relative risks for one exposure after stratification by level of the other, and including an interaction term in the regression model and drawing conclusions from its P-value.

Cardiovascular Diseases↗
PubMed1996

The prediction of different experiences of longterm illness: a longitudinal approach in Sweden.

STUDY OBJECTIVE: To analyse the role played by socioeconomic factors and self rated general health in the prediction of the reporting of severe longterm illness, and the extent to which these factors explain social class differences in the reporting of such illness. DESIGN: Analysis of panel data from the survey of living conditions, conducted by Statistics Sweden over the years 1979-81 and 1986-89. SETTING: A random sample of the Swedish population, interviewed in 1979-81 and then re-interviewed in 1986-89. PARTICIPANTS: A representative sample of 3889 employed Swedish people, aged 16-65 years. MAIN RESULTS: Socioeconomic and individual factors predict severe longterm illness regardless of the kind of reported disorder from which the subject suffers. The main predictive factor involved is health self rated as fair/poor, but exposure to high physical job demands proved to be the main explanation of the role played by socioeconomic class. There was a significant interaction effect between self rated general health and physical job demands with regard to the experience of severe illness. CONCLUSIONS: The results of the study strengthen the hypothesis that manual workers are not only more exposed to causes of illness that have important individual and social consequences, but also to the personal factors that determine different experiences of illness. Interaction between these two kinds of factors (job demands and self rated health) suggests that socioeconomic and individual factors play different but complementary roles in the causal process leading to the experience of severe longterm illness.

Adult↗
PubMed1996

Social inequalities in the experience of illness in Sweden: a "double suffering".

This paper analyses the factors involved in differences in the experience of long-term illness (severe and non-severe illness), as measured in terms of self-reported frequency and intensity of symptoms. The study has a cross-sectional design. It uses a database from the Survey of Living Conditions of Statistics Sweden, and treats a representative sample of the employed Swedish population (n = 13,501), aged between 16 and 65, interviewed over the period 1986-89. The results show that male manual workers report more non-severe and severe illness than non-manual workers, and that manual and lower-level non-manual female workers report more severe illness, but not non-severe illness, than intermediate/higher-level non-manual working females. The observed class differences in experience of severity of illness are partly explained by the factors investigated (job demands, personal economic difficulties, smoking daily, weak social network) in the case of men, and virtually entirely in the case of women. Other ill-health dimensions, such as self-rated general health and impaired working capacity, prove to be related to severity of illness, the latter being more strongly associated with experience of severe illness than the former irrespective of social class. The results lend support to the hypothesis that manual classes are subjected to what might be called "double suffering"; they have more long-term illnesses and also experience these illnesses with greater intensity and frequency.

Adolescent↗
PubMed1995

Short-term and long-term sick-leave in Sweden: relationships with social circumstances, working conditions and gender.

The primary aim of the study was to analyse similarities and differences between repeated spells of short-term sick-leave (more than 3 spells of less than 7 days' duration in a 12-month period) and long-term absence through sickness (at least 1 spell of more than 59 days' duration in a 12-month period) in relation to variables representing certain social circumstances and aspects of the work situation. Particular attention was paid to gender differences. The study, which had a cross-sectional design, employed data from the surveys of living conditions (ULF) conducted by Statistics Sweden over the period 1986-89. The study group comprised 13,828 employed persons between the ages of 16 and 65. The results suggested the existence of a common mechanism by which a variety of factors are related to the taking of both repeated short spells and long-term sick-leave; gender differences with regard to the effect of working conditions on the taking of sick-leave may be incorrectly estimated if factors related to occupational structure are not taken into consideration; a less than additive effect of physical job demands and repeated short spells of sick-leave on subjective health was found.

Absenteeism↗
PubMed1993

[Evaluation of current rehabilitation activities. Problems and choice of methods].

The evaluation of rehabilitation potential is discussed in the context of the recent allocation by the Riksdag of substantial funds for rehabilitation purposes, a measure designed to generate savings to social insurance at least comparable to the allocation. In the article are discussed the difficulties involved in assessing the impact of such political measures, when at the same time the chances of people being able to return to work after extended sick leave are reduced owing to the recession. An evaluation model is presented which, in addition to variables related to monetary savings to the community, incorporates indicators capable of identifying gains due to a rehabilitation programme that are important determinants of the changes of target groups returning to a productive and meaningful life.

Cost Allocation↗
PubMed1993

Socioeconomic differences in smoking in an urban Swedish population. The bias introduced by non-participation in a mailed questionnaire.

Stockholm Health of the Population Study is a cross-sectional study carried out from 1984-85. Postal questionnaires, telephone interviews and health interviews were used to get information from a sample of 5,199 persons, 18-64 years of age, on health status, risk exposures, healthcare consumption and social factors. Non-participation with respect to the postal questionnaire was 36.8%. With subsequent telephone interviews and an invitation to a health interview, non-participation was reduced to 17.8%. The estimated prevalence of daily smoking increased from 36.1% to 38.7. The non-responders had a higher prevalence of daily smoking in all sub-groups. This effect of the efforts to reduce non-participation differed socially. The prevalence of smoking for men, 40-64 years of age, who were reached by telephone was 60.3%. Male professionals and intermediate non-manual workers, 40-64 years of age reached by telephone had a prevalence of smoking, which was twice as high as for the responders of the questionnaire (62.5 and 26.8%, respectively). In the younger age-group, non-responders had the same socioeconomic pattern in smoking as the responders. Independent of socioeconomic group, there was a tendency of ill or disabled smokers to respond more quickly than healthy smokers. Using a postal questionnaire with a high non-response rate might lead to an overestimation of socioeconomic differences and an underestimation of smoking prevalence.

Adolescent↗
PubMed1992

The relationship between stressful working conditions and high alcohol consumption and severe alcohol problems in an urban general population.

The relationship between 15 measures of stressful working conditions and high alcohol consumption (35 g 100% ethanol per day or more for men and 25 g or more for women) was studied, using cross-sectional data from a general population survey of 1344 males and 1494 females; the ages 25-64 years in metropolitan Stockholm in 1984. In a longitudinal component of the study, hospitalization and mortality with alcohol-related diagnosis was assessed during 1984-90, and also the association between previous experience of unemployment and high alcohol consumption. Some of the associations, expressed as age-adjusted odds ratios, were positive and some were negative when high alcohol consumption was the endpoint, but there was a clear variation by sex and social class. Generally the positive associations were stronger among male non-manual employees. Among males, there was a clear association between stressful working conditions and subsequent risk of severe medical alcohol-related problems, but the precision of the estimates was low due to low number of cases. The odds ratio was 6.18 (95% confidence interval 1.86, 20.61) for twisted working positions and 6.74 (95% confidence interval 1.67, 27.19). Previous unemployment among males was associated with increased risk for high alcohol consumption, with an odds ratio of 5.71 (95% CI 1.39, 15.97) among those who had been unemployed more than once, and 1.67 (95% CI 0.76, 3.64) among those who had been unemployed once during the previous 5 years. Those and other increased odds ratios were lower when subjects with an alcohol diagnosis at inpatient care during 1980-84 were excluded in the analyses. On the whole, our findings are not conclusive. The strong, but imprecise associations between stressful working conditions and severe alcohol problems, are however challenging, and warrants further studies, preferably with longitudinal design and repeated measurements of both working condition and alcohol habits.

Adult↗