Browsing by Subject "Trends"

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  • Lahelma, Eero; Pietilainen, Olli; Pentala-Nikulainen, Oona; Helakorpi, Satu; Rahkonen, Ossi (2019)
    Health inequalities exist across countries and populations, but little is known about their long-term trends and even less about factors shaping the trends. We examined the magnitude of absolute and relative educational inequalities in self-rated health over 36 years among Finnish adults, considering individual covariates and macro-economic fluctuations. Our data were derived from representative annual cross-sectional surveys in 1979-2014 conducted among adult men and women. Participants aged 25-64 were included and nine periods used (n = 8870-14235). Our health outcome was less-than-good self-rated health (SRH) and our socioeconomic indicator was completed years of education as a continuous variable. Educational inequalities in self-rated health were analysed using the relative index of inequality (RII) and the slope index of inequality (SII). Nine time-variant sociodemographic and health-related covariates were included in the analyses. Linear trends suggested stable or slightly curvilinear overall trends in both absolute and relative health equalities over 36 years. Among men, absolute and relative inequalities narrowed immediately after economic recession in Finland in 1993-1994. Among women, inequalities narrowed during financial crisis in 2008-2009. Adjusting for most covariates reduced the magnitude of inequalities throughout the nine periods, but affected little the temporal patterning of health inequalities. Educational inequalities in self-rated health remained during 36 years in Finland. While among men and women health inequalities narrowed during and after recessions, they widened soon back to the pre-recession level. The perseverance of the trends calls for novel and powerful measures to tackle health inequalities.
  • Lu, FeiFei; Kozak, Robert; Toppinen, Anne Maarit Kristiina; D'amato, Dalia; Wen, Zuomin (2017)
    With the international community's increasing concern for social and environmental problems, the fulfilment and disclosure of corporate social responsibility (CSR) has been advocated and promoted across the world. Forestry companies, which are particularly sensitive to environmental and social issues, are increasingly developing and improving their levels of CSR disclosure. However, information on emerging country contexts is still lacking. To fill this gap, this study focuses on Chinese forestry companies' CSR disclosure and introduces new disclosure indices through content analysis of annual reports by listed companies between 2011 and 2015. It then builds a correlation analysis of the factors influencing these companies' disclosure indices in order to gain a better understanding of the current situation for CSR implementation by forestry companies in emerging economies like China. Although context-specific, our findings can provide a reference for researchers and policy makers, and promote sustainable development via improved CSR disclosure by forestry companies, especially in developing regions.
  • Sulander, Tommi (2005)
    The main purpose of this study was to examine trends and associations of functional ability and health behaviour among a national sample of elderly people in Finland from the 1985 to 2003. Furthermore, sociodemographic variation of functional ability and health behaviour were assessed. Biennial surveys on health behaviour among 65-79-year-old Finnish population were used to study 13 232 men and women from 1985 to 2003. Response rate has surpassed 80 % on average. Self-reported activities of daily living were used to study functional ability. Indicators of health behaviour were diet, smoking, use of alcohol, physical activity and also body mass index. Furthermore chronic diseases were controlled for when examining associations between functional ability with health behaviours. Sociodemographic variation was studied through age groups, main occupation before retirement and marital status. Age adjusted trends and, logistic and ordinal regression analyses were computed to derive the results. The study revealed improving functional ability from the mid- 1980s to the shift of the millennium. Finnish elderly today eat healthier and smoke slightly less, but use more alcohol and are more often obese than their age-mates couple of decades ago. Healthy diet, smoking, alcohol consumption and obesity were most prevalent among youngest of the respondents. Former farmers had lowest prevalence of healthy diet and highest prevalence of obesity. Former office employees used more alcohol than others. Married elderly had higher prevalence of healthy diet and lower prevalence of smoking than non-married. Smoking, higher use of alcohol, unhealthy diet, physical inactivity and obesity were associated with inferior functional ability. These behaviours and chronic diseases were found to be mediating factors for sociodemographic differences in functional ability. Improving functional ability together with some improvements in health behaviour indicates healthier years for future elderly people. Despite these improvements, sub-group disparities are still evident. These disparities together with information on rising prevalence of alcohol use and obesity are challenges for public health.
  • Matricciani, Lisa; Bin, Yu Sun; Lallukka, Tea; Kronholm, Erkki; Dumuid, Dorothea; Paquet, Catherine; Olds, Tim (2017)
    Sleep is important for the physical, social and mental well-being of both children and adults. Over the years, there has been a general presumption that sleep will inevitably decline with the increase in technology and a busy 24-hour modern lifestyle. This narrative review discusses the empirical evidence for secular trends in sleep duration and the implications of these trends. (c) 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
  • Mackenbach, Johan P.; Valverde, Jose Rubio; Bopp, Matthias; Brønnum-Hansen, Henrik; Costa, Giuseppe; Deboosere, Patrick; Kalediene, Ramune; Kovács , Katalin; Leinsalu, Mall; Martikainen, Pekka; Menvielle, Gwenn; Rodriguez-Sanz, Maica; Nusselder, Wilma J. (2019)
    Socioeconomic inequalities in mortality are a challenge for public health around the world, but appear to be resistant to policy-making. We aimed to identify European countries which have been more successful than others in narrowing inequalities in mortality, and the factors associated with narrowing inequalities. We collected and harmonised mortality data by educational level in 15 European countries over the last 25 years, and quantified changes in inequalities in mortality using a range of measures capturing different perspectives on inequality (e.g., 'relative' and 'absolute' inequalities, inequalities in 'attainment' and 'shortfall'). We determined which causes of death contributed to narrowing of inequalities, and conducted country- and period-fixed effects analyses to assess which country-level factors were associated with narrowing of inequalities in mortality. Mortality among the low educated has declined rapidly in all European countries, and a narrowing of absolute, but not relative inequalities was seen in many countries. Best performers were Austria, Italy (Turin) and Switzerland among men, and Spain (Barcelona), England and Wales, and Austria among women. Ischemic heart disease, smoking-related causes (men) and amenable causes often contributed to narrowing inequalities. Trends in income inequality, level of democracy and smoking were associated with widening inequalities, but rising health care expenditure was associated with narrowing inequalities. Trends in inequalities in mortality have not been as unfavourable as often claimed. Our results suggest that health care expansion has counteracted the inequalities widening effect of other influences.
  • Kotkansalo, Anna; Leinonen, Ville; Korajoki, Merja; Salmenkivi, Jyrki; Korhonen, Katariina; Malmivaara, Antti (2019)
    Background The incidence of surgery for degenerative cervical spine disease (DCSD) has risen by almost 150% in the USA in the last three decades and stabilized at slightly over 70 operations/100,000 people. There has been significant regional variation in the operation incidences. We aim to assess the diagnosis-based, age-adjusted trends in the operation incidences and the regional variation in Finland between 1999 and 2015. Methods Data from the Finnish Hospital Discharge Register (FHDR), the Cause of Death Register, and the registers of the Social Insurance Institution were combined to analyze all the primary operations for DCSD or rheumatoid atlanto-axial subluxation (rAAS). Combinations of the operative and the diagnosis codes were used to classify the patients into five diagnostic groups. Results A total of 19,701 primary operations were included. The age-adjusted operation incidence rose from 21.0 to 36.5/100,000 people between 1999 and 2013 and plateaued thereafter. The incidence of surgery for radiculopathy increased from 13.1 to 23.3 operations/100,000 people, and the incidence of surgery for DCM increased from 5.8 to 7.0 operations/100,000 people. The rise was especially pronounced in surgery for foraminal stenosis, which increased from 5.3 to 12.4 operations/100,000 people. Of the five diagnostic groups, only operations for rAAS declined. Operations increased especially in the 40- to 65-year-old age group. The overall operation incidences varied from 18.3 to 43.1 operations/100,000 people between the university hospitals. Conclusions The age-adjusted incidence of surgery for DCSD has risen in Finland by 76%, but the rise has plateaued. Surgery for radiculopathy, especially for foraminal stenosis, increased more steeply than surgery for degenerative medullopathy, with vast regional differences in the operation incidences.
  • Saviluoto, Anssi; Björkman, Johannes; Olkinuora, Anna; Virkkunen, Ilkka; Kirves, Hetti; Setala, Piritta; Pulkkinen, Ilkka; Laukkanen-Nevala, Paivi; Raatiniemi, Lasse; Jäntti, Helena; Iirola, Timo; Nurmi, Jouni (2020)
    Background: Helicopter Emergency Medical Services (HEMS) play an important role in prehospital care of the critically ill. Differences in funding, crew composition, dispatch criteria and mission profile make comparison between systems challenging. Several systems incorporate databases for quality control, performance evaluation and scientific purposes. FinnHEMS database was incorporated for such purposes following the national organization of HEMS in Finland 2012. The aims of this study are to describe information recorded in the database, data collection, and operational characteristics of Finnish HEMS during 2012-2018. Methods: All dispatches of the six Finnish HEMS units recorded in the national database from 2012 to 2018 were included in this observational registry study. Five of the units are physician staffed, and all are on call 24/7. The database follows a template for uniform reporting in physician staffed pre-hospital services, exceeding the recommended variables of relevant guidelines. Results: The study included 100,482 dispatches, resulting in 33,844 (34%) patient contacts. Variables were recorded with little or no missing data. A total of 16,045 patients (16%) were escorted by HEMS to hospital, of which 2239 (2%) by helicopter. Of encountered patients 4195 (4%) were declared deceased on scene. The number of denied or cancelled dispatches was 66,638 (66%). The majority of patients were male (21,185, 63%), and the median age was 57.7 years. The median American Society of Anesthesiologists Physical Scale classification was 2 and Eastern Cooperative Oncology Group performance class 0. The most common reason for response was trauma representing 26% (8897) of the patients, followed by out-of-hospital cardiac arrest 20% (6900), acute neurological reason excluding stroke 13% (4366) and intoxication and related psychiatric conditions 10% (3318). Blunt trauma (86%, 7653) predominated in the trauma classification. Conclusions: Gathering detailed and comprehensive data nationally on all HEMS missions is feasible. A national database provides valuable insights into where the operation of HEMS could be improved. We observed a high number of cancelled or denied missions and a low percentage of patients transported by helicopter. The medical problem of encountered patients also differs from comparable systems.
  • Saviluoto, Anssi; Björkman, Johannes; Olkinuora, Anna; Virkkunen, Ilkka; Kirves, Hetti; Setälä, Piritta; Pulkkinen, Ilkka; Laukkanen-Nevala, Päivi; Raatiniemi, Lasse; Jäntti, Helena; Iirola, Timo; Nurmi, Jouni (BioMed Central, 2020)
    Abstract Background Helicopter Emergency Medical Services (HEMS) play an important role in prehospital care of the critically ill. Differences in funding, crew composition, dispatch criteria and mission profile make comparison between systems challenging. Several systems incorporate databases for quality control, performance evaluation and scientific purposes. FinnHEMS database was incorporated for such purposes following the national organization of HEMS in Finland 2012. The aims of this study are to describe information recorded in the database, data collection, and operational characteristics of Finnish HEMS during 2012–2018. Methods All dispatches of the six Finnish HEMS units recorded in the national database from 2012 to 2018 were included in this observational registry study. Five of the units are physician staffed, and all are on call 24/7. The database follows a template for uniform reporting in physician staffed pre-hospital services, exceeding the recommended variables of relevant guidelines. Results The study included 100,482 dispatches, resulting in 33,844 (34%) patient contacts. Variables were recorded with little or no missing data. A total of 16,045 patients (16%) were escorted by HEMS to hospital, of which 2239 (2%) by helicopter. Of encountered patients 4195 (4%) were declared deceased on scene. The number of denied or cancelled dispatches was 66,638 (66%). The majority of patients were male (21,185, 63%), and the median age was 57.7 years. The median American Society of Anesthesiologists Physical Scale classification was 2 and Eastern Cooperative Oncology Group performance class 0. The most common reason for response was trauma representing 26% (8897) of the patients, followed by out-of-hospital cardiac arrest 20% (6900), acute neurological reason excluding stroke 13% (4366) and intoxication and related psychiatric conditions 10% (3318). Blunt trauma (86%, 7653) predominated in the trauma classification. Conclusions Gathering detailed and comprehensive data nationally on all HEMS missions is feasible. A national database provides valuable insights into where the operation of HEMS could be improved. We observed a high number of cancelled or denied missions and a low percentage of patients transported by helicopter. The medical problem of encountered patients also differs from comparable systems.
  • Ruokolainen, Otto; Heloma, Antero; Jousilahti, Pekka; Lahti, Jouni; Pentala-Nikulainen, Oona; Rahkonen, Ossi; Puska, Pekka (2019)
    ObjectivesSmoking is declining, but it is unevenly distributed among population groups. Our aim was to examine the socio-economic differences in smoking during 1978-2016 in Finland, a country with a history of strict tobacco control policy.MethodsAnnual population-based random sample data of 25-64-year-olds from 1978 to 2016 (N=104,315) were used. Response rate varied between 84 and 40%. In addition to logistic regression analysis, absolute and relative educational differences in smoking were examined.ResultsSmoking was more prevalent among the less educated but declined in all educational groups during the study period. Both absolute and relative differences in smoking between the less and highly educated were larger at the end of the study period than at the beginning. Cigarette price seemed to have a larger effect on the smoking among the less educated.ConclusionsSocio-economic differences in smoking among the Finnish adult population have increased since the 1970s until 2016. Further actions are needed, especially focusing on lower socio-economic positions, to tackle inequalities in health. They should include support for smoking cessation and larger cigarette tax increases.
  • Hale, Jo Mhairi; Schneider, Daniel C.; Gampe, Jutta; Mehta, Neil K.; Myrskyla, Mikko (2020)
    Background: Accumulating evidence suggests risk of cognitive impairment is declining in high-income countries. Much of this research uses longitudinal surveys in which learning over repeated tests may bias results. We analyze trends in cognitive impairment in the United States, accounting for prior test experience and selective mortality. Methods: We use the Health and Retirement Study, a population-based, nationally representative panel dataset and include individuals ages 50 years and older in 1996-2014 (n = 32,784). We measure cognitive impairment and dementia using standard cutpoints of the modified Telephone Interview for Cognitive Status. We estimate logistic regression models for any impairment and dementia over time, adjusting for age, sex, and race/ethnicity, comparing models with and without adjustment for practice effects and education. We examine heterogeneity in trends by age, sex, race/ethnicity, and education. Results: Models not controlling for test experience suggest that risk of cognitive impairment and dementia decreased over the study period. Controlling for test experience reverses the trend. In our primary models, prevalence of any cognitive impairment increased for women from 18.7% to 21.2% (annual change 0.7%, 95% confidence interval [CI], 0.1%, 1.3%) and for men from 17.6% to 21.0% (annual change 1.0%, CI, 0.5%, 1.4%). For dementia, women's annual increase was 1.7% (CI, 0.8%, 2.6%) and men's 2.0% (CI, 1.0%, 2.9%). If not for education, the increase would have been stronger. Increased risk was particularly rapid for Latinas, the least educated, and older ages. Conclusions: Risk of cognitive impairment increased from 1996 to 2014. Uncovering determinants of increasing cognitive impairment risk should become a research priority. See video abstract:.