Browsing by Subject "socioeconomic factors"

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  • Knaappila, Noora; Marttunen, Mauri; Fröjd, Sari; Lindberg, Nina; Kaltiala-Heino, Riittakerttu (2019)
    Background: Scientific literature suggests that the prevalence of delinquency amongst adolescents has decreased internationally in past decades. However, whether this change is consistent across all socioeconomic groups has not yet been studied. Objective: The aim of this study was to examine changes in delinquency amongst Finnish adolescents according to socioeconomic status between 2000 and 2015. Method: A population-based school survey was conducted biennially amongst 14-16-year-old Finns between 2000 and 2015 (n = 761,278). Distributions for delinquency and socioeconomic adversities (low parental education, not living with both parents and parental unemployment in the past year) were calculated using crosstabs. Associations between delinquency, time, and socioeconomic adversities were studied using binomial logistic regression results shown by odds ratios with 95 % confidence intervals. Results: Delinquency was positively associated with all three socioeconomic adversities studied and cumulative socioeconomic adversity. Although the prevalence of delinquency varied only slightly between 2000 and 2015 in the overall population, it increased significantly amongst adolescents with most socioeconomic adversities. Conclusions: The findings indicate that socioeconomic differences in delinquency have increased amongst Finnish adolescents in past decades. Delinquency prevention and intervention programs should take socioeconomic adversities into account.
  • Löfgren, Maja; Hirvikangas, Roope; Snäll, Johanna; Uittamo, Johanna (Helsingin yliopisto, 2019)
    Objectives Odontogenic infections are potentially life threatening especially in immunocompromised patients. The study aimed to investigate predisposing factors for the severity of odontogenic infections, particularly hospital admission and inflammatory parameters. Materials and Methods A prospective clinical study and a questionnaire survey were designed and implemented. The outcome variable was hospitalization, and secondary outcome variables were inflammatory parameters C-reactive protein (CRP) value, white blood cell (WBC) count and body temperature. The primary predictor variables were treatment delay, preceding visits to health services before referral to hospital, focus of infection identified before referral, site of infection focus, postoperative infection because of elective tooth extraction, and previous treatment of infection. Explanatory variables were age, gender, current smoking, heavy alcohol use, disease history and education. Results A total of 88 patients were included to the analysis. Patients’ disease history in general was not significant for hospitalization or infection parameters. Lower education level associated with hospitalization (p=0.033) and leucocytosis was significantly higher in basic level educated patients (p=0.036). In addition, leucocytosis correlated significantly with mandibular infections (p=0.008), previously unidentified infection focus (p=0.010), and with infection due to an elective tooth extraction (p=0.026). Elderly patients were not more prone to more severe infections. Neither gender, current smoking nor heavy alcohol use proved significant for infection severity. Conclusions and clinical relevance Lower education elevates the risk for hospitalization and severe odontogenic infections. Lack of regular dental care or economic challenges can explain this finding.
  • Haukkala, Ari (2002)
    The aim of this study was to examine how depressive symptoms and cynical hostility are related to socioeconomic status (SES), smoking cessation, obesity. In spring 1992, randomly selected subjects (N=3404) aged 25 to 64, from four areas in Finland participated in a survey. Smokers from the annual Finnish health behavior surveys between 1989 and 1994 were used as another data source (N=4483). Hostility and depression have been proposed as mediators between SES and poor health. It was found that cynical hostility was less prevalent among respondents in higher SES groups but that expression of anger was reported more often among higher SES groups. Divergent results with regard to socioeconomic status require more accurate hostility concepts. SES differences in smoking prevalence is a major cause for SES differences in health. No significant differences in motivation to quit smoking between smokers in different SES groups was found in this study. However, smokers in higher SES groups were more likely to believe that they were able to quit smoking. Negative emotions such as depression and anger play an important role in addiction to smoking. Here, a cognitive aspect of depression was also related to smoking cessation. Smokers of both genders with elevated depressive symptoms had lowered self-efficacy in smoking cessation but depressed female smokers were more willing to quit smoking than other female smokers. Cynical distrust was related to lower self-efficacy in cessation. In relation to weight, depressive symptoms had moderate association with obesity and central obesity. Higher cynical distrust scores were related to higher BMI except among well-educated females. However, cynical distrust scores were not related to weight gain or loss, but depressive symptoms predicted both weight gain and loss. Increasing SES differences in smoking and obesity are important issues in public health. Psychosocial factors, such as depression and hostility, are not easy targets for the diminishment of SES differences in obesity and smoking. However, knowledge about these psychosocial factors contributes to our understanding about how to change health related behaviors. Furthermore, by examining SES differences in psychosocial factors we can increase our understanding of how psychosocial environments can influence health.
  • Folkersma, Liisa Karoliina (Helsingfors universitet, 2011)
    The aim of this thesis is to examine migration of educated Dominicans in light of global processes. Current global developments have resulted in increasingly global movements of people, yet people tend to come from certain places in large numbers rather than others. At the same time, international migration is increasingly selective, which shows in the disproportional number of educated migrants. This study discovers individual and societal motivations that explain why young educated Dominicans decide to migrate and return. The theoretical framework of this thesis underlines that migration is a dynamic process rooted in other global developments. Migratory movements should be seen as a result of interacting macro- and microstructures, which are linked by a number of intermediate mechanisms, meso-structures. The way individuals perceive opportunity structures concretises the way global developments mediate to the micro-level. The case of the Dominican Republic shows that there is a diversity of local responses to the world system, as Dominicans have produced their own unique historical responses to global changes. The thesis explains that Dominican migration is importantly conditioned by socioeconomic and educational background. Migration is more accessible for the educated middle class, because of the availability of better resources. Educated migrants also seem less likely to rely on networks to organize their migrations. The role of networks in migration differs by socioeconomic background on the one hand, and by the specific connections each individual has to current and previous migrants on the other hand. The personal and cultural values of the migrant are also pivotal. The central argument of this thesis is that a veritable culture of migration has evolved in the Dominican Republic. The actual economic, political and social circumstances have led many Dominicans to believe that there are better opportunities elsewhere. The globalisation of certain expectations on the one hand, and the development of the specifically Dominican feeling of ‘externalism’ on the other, have for their part given rise to the Dominican culture of migration. The study also suggests that the current Dominican development model encourages migration. Besides global structures, local structures are found to be pivotal in determining how global processes are materialised in a specific place. The research for this thesis was conducted by using qualitative methodology. The focus of this thesis was on thematic interviews that reveal the subject’s point of view and give a fuller understanding of migration and mobility of the educated. The data was mainly collected during a field research phase in Santo Domingo, the Dominican Republic in December 2009 and January 2010. The principal material consists of ten thematic interviews held with educated Dominican current or former migrants. Four expert interviews, relevant empirical data, theoretical literature and newspaper articles were also comprehensively used.
  • Korhonen, Kaarina; Einiö, Elina; Leinonen, Taina; Tarkiainen, Lasse; Martikainen, Pekka (2020)
    Objectives To assess the association between multiple indicators of socioeconomic position and dementia-related death, and to estimate the contribution of dementia to socioeconomic differences in overall mortality at older ages. Design Prospective population-based register study. Setting Finland. Participants 11% random sample of the population aged 70-87 years resident in Finland at the end of year 2000 (n=54 964). Main outcome measure Incidence rates, Kaplan-Meier survival probabilities and Cox regression HRs of dementia mortality in 2001-2016 by midlife education, occupational social class and household income measured at ages 53-57 years. Results During the 528 387 person-years at risk, 11 395 individuals died from dementia (215.7 per 10 000 person-years). Lower midlife education, occupational social class and household income were associated with higher dementia mortality, and the differences persisted to the oldest old ages. Compared with mortality from all other causes, however, the socioeconomic differences emerged later. Dementia accounted for 28% of the difference between low and high education groups in overall mortality at age 70+ years, and for 21% of the difference between lowest and highest household income quintiles. All indicators of socioeconomic position were independently associated with dementia mortality, low household income being the strongest independent predictor (HR=1.24, 95% CI 1.16 to 1.32), followed by basic education (HR=1.14, 1.06 to 1.23). Manual occupational social class was related to a 6% higher hazard (HR=1.06, 1.01 to 1.11) compared with non-manual social class. Adjustment for midlife economic activity, baseline marital status and chronic health conditions attenuated the excess hazard of low midlife household income, although significant effects remained. Conclusion Several indicators of socioeconomic position predict dementia mortality independently and socioeconomic inequalities persist into the oldest old ages. The results demonstrate that dementia is among the most important contributors to socioeconomic inequalities in overall mortality at older ages.
  • Tanaka, Hirokazu; Nusselder, Wilma J.; Bopp, Matthias; Bronnum-Hansen, Henrik; Kalediene, Ramune; Lee, Jung Su; Leinsalu, Mall; Martikainen, Pekka; Menvielle, Gwenn; Kobayashi, Yasuki; Mackenbach, Johan P. (2019)
    Background We compared mortality inequalities by occupational class in Japan and South Korea with those in European countries, in order to determine whether patterns are similar. Methods National register-based data from Japan, South Korea and eight European countries (Finland, Denmark, England/Wales, France, Switzerland, Italy (Turin), Estonia, Lithuania) covering the period between 1990 and 2015 were collected and harmonised. We calculated age-standardised all-cause and cause-specific mortality among men aged 35-64 by occupational class and measured the magnitude of inequality with rate differences, rate ratios and the average inter-group difference. Results Clear gradients in mortality were found in all European countries throughout the study period: manual workers had 1.6-2.5 times higher mortality than upper non-manual workers. However, in the most recent time-period, upper non-manual workers had higher mortality than manual workers in Japan and South Korea. This pattern emerged as a result of a rise in mortality among the upper non-manual group in Japan during the late 1990s, and in South Korea during the late 2000s, due to rising mortality from cancer and external causes (including suicide), in addition to strong mortality declines among lower non-manual and manual workers. Conclusion Patterns of mortality by occupational class are remarkably different between European countries and Japan and South Korea. The recently observed patterns in the latter two countries may be related to a larger impact on the higher occupational classes of the economic crisis of the late 1990s and the late 2000s, respectively, and show that a high socioeconomic position does not guarantee better health.
  • Salonsalmi, Aino; Mauramo, Elina; Lahelma, Eero; Rahkonen, Ossi; Pietiläinen, Olli (2021)
    There are persisting socioeconomic differences in cardiovascular diseases, but studies on socioeconomic differences in the initiation of cardiovascular medication are scarce. This study examined the associations between multiple socioeconomic circumstances and cardiovascular medication. The Helsinki Health Study baseline survey (2000-2002) of 40-60-year-old employees was linked with cardiovascular medication data from national registers. The analyses included 5805 employees concerning lipid medication and 4872 employees concerning hypertension medication. Medication purchases were followed for 10 years. The analyses were made using logistic regression, and the odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated for childhood, conventional and material socioeconomic circumstances. Low parental education showed an association with lipid medication among women only (OR 1.34, 95% CI 1.11-1.61), whereas childhood economic difficulties showed more widespread associations. Low education and occupational class were associated with an increased risk of both hypertension (education: OR 1.58, 1.32-1.89; occupational class: 1.31, 1.08-1.59) and lipid medication (education: 1.34, 1.12-1.61; occupational class: 1.38, 1.13-1.67). Rented housing (1.35, 1.18-1.54 for hypertension medication; 1.21, 1.05-1.38 for lipid medication) and current economic difficulties (1.59, 1.28-1.98 for hypertension medication; 1.35, 1.07-1.71 for lipid medication) increased the risk. Several measures of socioeconomic circumstances acting at different stages of the life course were associated with cardiovascular medication, with individuals in disadvantageous socioeconomic circumstances having elevated risks.
  • Knaappila, Noora; Marttunen, Mauri; Fröjd, Sari; Lindberg, Nina; Kaltiala-Heino, Riittakerttu (2019)
  • Frederiksen, Line Elmerdahl; Mader, Luzius; Feychting, Maria; Mogensen, Hanna; Madanat-Harjuoja, Laura; Malila, Nea; Tolkkinen, Anniina; Hasle, Henrik; Winther, Jeanette Falck; Erdmann, Friederike (2019)
    Substantial improvements in childhood cancer survival have resulted in a steadily increasing population of childhood cancer survivors. Whereas somatic late effects have been assessed in many studies, less is known about the impact of childhood cancer on socioeconomic outcomes in survivors. The aim of this article was to evaluate and summarise the evidence on the socioeconomic conditions of childhood cancer survivors and to identify survivors at particular risk of adverse socioeconomic outcomes. An extensive literature search of three electronic databases was conducted. Of 419 articles identified, 52 met the inclusion criteria. All the selected articles were appraised for quality, and findings were summarised in a narrative synthesis. Childhood cancer survivors were at higher risk of adverse socioeconomic outcomes with regard to educational achievement, income and social security benefits than the general population or a sibling comparison group. The risks for unemployment and a lower occupational position were significantly increased only for survivors of a central nervous system tumour. Notably, survivors of central nervous system tumours, survivors treated with cranial radiotherapy and those diagnosed at younger age independent of cancer type were determinants of particular adverse socioeconomic outcomes. Given the increasing population of childhood cancer survivors, targeted follow-up interventions and support strategies addressing not only the somatic and psychiatric late effects but also the socioeconomic difficulties that some childhood cancer survivors face is of high importance to reduce social inequity, and ensure a high quality of life after childhood cancer.