Scandinavian Journal of Public Health

The aim of this study was to investigate the prevalence and determinants of self-reported neck or shoulder pain (NSP) and low back pain (LBP) among 12-18-year-olds. A questionnaire was mailed to a nationally representative sample of 11,276 12-, 14-, 16- and 18-year-olds in 1991. The response rate was 77%. NSP was perceived at least once a week by 15% of 12-18-year-olds and LBP by 8%. Both symptoms were more prevalent among girls than among boys, and the prevalence increased with age. Among the determinants investigated, the number of perceived psychosomatic symptoms had the strongest association with NSP and LBP. Our study confirmed the co-morbidity of NSP and LBP, and indicated that NSP is more frequent than believed among 16-18-year-old girls. The strong association of psychosomatic symptoms with NSP and LBP suggests that the latter two pain states could be more psychosomatic than nosiceptive in character.

The aim of this study was to ascertain the possible influence of attending various kinds of cultural events or visiting cultural institutions as a determinant of survival. A cohort of individuals aged 25-74 years from a random sample were interviewed by trained non-medical interviewers in 1982 and 1983. The interviews covered standard-of-living variables. Our independent variables covered visiting cultural institutions and attendance at cultural events, reading books or periodicals, and music making. The non-response rate was about 25%. The cohort was followed with respect to survival for 14 years up to 31st December 1996. The background covariates that were used for control purposes were age, sex, cash buffer, educational standard, long-term disease, smoking, and physical exercise. Our setting was the Swedish survey of living conditions among the adult Swedish population aged 25-74 years. About 10,609 individuals were interviewed in 1982 and 1983. The outcome measure was survival until 31st December 1996. In all, 916 men and 600 women died during this period. We found a higher mortality risk for those people who rarely visited the cinema, concerts, museums, or art exhibitions compared with those visiting them most often. The significant relative risks ranging between RR 1.14 (95% CI. 1.01-1.31) of attending art exhibitions, and RR 1.42 (CI. 1.25-1.60) of attending museums, when adjusting for the nine other variables. Visits to the cinema and concerts gave significant RR in between. We could not discern any beneficial effect of attending the theatre, church service or sports event as a spectator or any effect of reading or music making. Our conclusion is that attendance at certain kinds of cultural events may have a beneficial effect on longevity

Results of earlier studies suggest that the health of the Swedish-speaking minority in Finland is better than that of the sociodemographically similar Finnish-speaking population. The causes of differences are unknown. The main aim of the study referred was to investigate whether differences in perceived health according to linguistic group were present in a nation-wide representative sample (n=5,230) of schoolchildren aged 11, 13 and 15 years. A further aim was to determine whether differences could be attributed to socioeconomic background, social relationships or health behaviour. The study is part of the international Health Behaviour in School-aged children (HBSC) survey. The perceived health of Swedish-speaking children (n=1,699) proved to be better than that of Finnish-speaking children (n=3,531). In multivariate logistic regression models the differences could not be attributed to underlying associations with any variable studied. The health advantage of Swedish-speaking children essentially could not be related to known risk factors.

Background and objectives: Safety education often targets parental risk perception. Predictors of risk perception, however, are not well known, thus limiting the feasibility of effective safety education. Accordingly, in this study, a range of predictors of maternal risk perception were examined. Methods: A random sample of 870 mothers in northern Sweden was included in the study. Three different questionnaires, with scenarios of a burn injury, a bicycle injury in the home environment, and a bicycle injury in traffic, were completed by the subjects. Multiple linear regression models tested the possible influence of causal attributions, normative beliefs, and sociodemographic and behaviour-related variables on mothers' risk perception. Results: Only 14-23% of the variance in mothers' risk perception could be explained by the multivariate models. Causal attribution to the child was found to be the most important predictor of maternal risk perception. Conclusion: Present theoretical models give few clues about how to design educational models that might influence risk perception. To make safety education more effective, other modifiable factors that influence parental safety behaviour, such as subjective norms and self-efficacy, might be better targets.

Background: Social differences in mortality rates reported in Denmark gave rise to the present study of health expectancy in different socioeconomic groups. Methods: Data on health status and occupation were derived from Health Interview Surveys. Information on occupation and deaths is register data. Health expectancy in each socioeconomic group was calculated using Sullivan's method. Results: Among 30-year-old men, high-level salaried employees had the longest expected lifetime in perceived good health, 41 years, which amounts to 89% of life expectancy, compared to 34 years (73%) for farmers, 32 years (73%) for unskilled workers, and 19 years (56%) for economically inactive men. Expected lifetime in perceived good health for high-level salaried female employees from age 30 was 46 years (91% of life expectancy). The lowest was found for assisting spouses, 36 years (71%) and economically inactive women, 25 years (56%). Large differences were also found when data on long-standing illness were used. Conclusion: The differences between socioeconomic groups are greater for health expectancy than for life expectancy.

Objectives: The aim of this study was to investigate whether psychosocial resources explain socioeconomic differences in smoking cessation and its maintenance. Methods: A subpopulation of 11,837 individuals from the Malmö Diet and Cancer Study interviewed in 1992-94, age range 45-64 years, was investigated in this cross-sectional study. A multivariate logistic regression model was used to assess relative risks of having stopped smoking, adjusting for age, country of origin, previous/ current diseases, and marital status. Results: An odds ratio of 1.9 (1.4-2.5; 95% CI) for men and 2.0 (1.4-2.7; 95% CI) for women of having stopped smoking was found for higher non-manual employees when compared with unskilled manual workers. A decrease in these odds ratios was found when social participation was introduced into the model. The other three social network and social support variables were non-significant. Conclusion: High social participation is a predictor of maintenance of smoking cessation. It seems possible to interpret parts of the socioeconomic differences in smoking cessation and its maintenance as a consequence of differing social network resources and social capital between socioeconomic groups.

Background: This study aimed to estimate the proportion of an unselected population in an urban community (Bergen, Norway) that was exposed to physical violence during the preceding year, and to determine the proportion seeking medical treatment and pressing legal charges.

Method: A structured telephone interview was performed as part of monthly opinion polls.

Results: During a one-year period in 1997/1998, 3,005 residents of Bergen were interviewed. Of these, 41 (1.4%) had been exposed to physical violence during the preceding year; 10 (24%) of them had sought medical treatment, and 16 (39%) had pressed legal charges. The majority of the victims had been treated at Bergen Accident and Emergency Department. The interviewees knew about a total of 347 other people who had been assaulted during the preceding year. Of these assault victims, 224 (65%) sought medical treatment and 181 (52%) pressed legal charges, according to the respondents.

Conclusion: A high proportion of the assault victims did not seek medical treatment and did not press legal charges.

Objective: The emphasis of this study is on the relative mortality of 45 - 74-year-old men and women in Denmark in 1943-92, following economic and political changes that have affected the social meaning of gender over the last 50 years, and which have diminished former sex differences in health behaviour. Methods: Sex ratios of total mortality and mortality from major non-sex-specific causes of death were calculated on computerized mortality data from the Danish National Cause of Death Register that covers all deaths in Denmark since 1943. Results: In the early 1940s the sex ratio of all-cause mortality was low, 1.0-1.1, it increased to a peak level in the late 1970s and early 1980s, but has since decreased due to an increase in female mortality and a more favourable trend in male mortality. Conclusion: Gender equality, employment, and economic autonomy may have beneficial health effects on both men and women, but the effects are inconsistent. The trend in smoking is the major explanatory factor for the more recent trends in gender differentials in mortality in Denmark.

The aim of this study was to review the literature about possible barriers to recognition and intervention regarding women exposed to sexualized violence, in their interactions with the health care system. The barriers, as reported by the health care staff, were: lack of education; the stereotype of a ``typical battered woman''; too close identification with the victim/abuser; time constraints; fear of offending the victim/abuser; and feelings of hopelessness and non-responsibility. The barriers, as reported by the victims, were: negative experiences of and structural limitations within the health care system; fear of retaliation from the abusive partner; and psychological effects of the normalization process. We conclude that the barriers within the health care sector have to be dealt with on three different levels: the structural level in order to diminish male power in society; the organizational level in order to initiate screening and to allow the staff time for dealing with the victims; and on the individual level, health care staff need to acquire the knowledge and skills to enable them to address sexualized violence.

Objectives: To present a critical review and evaluate recent reports investigating sitting-while-at-work as a risk factor for low back pain (LBP). Methods: The Medline, Embase and OSH-ROM databases were searched for articles dealing with sitting at work in relation to low back pain for the years 1985-97. The studies were divided into those dealing with sitting-while-working and those dealing with sedentary occupations. Each article was systematically abstracted for core items. The quality of each article was determined based on the representativeness of the study sample, the definition of LBP, and the statistical analysis. Results: Thirty-five reports were identified, 14 dealing with sitting-while-working and 21 with sedentary occupations. Eight studies were found to have a representative sample, a clear definition of LBP and a clear statistical analysis. Regardless of quality, all but one of the studies failed to find a positive association between sitting-while-working and LBP. High quality studies found a marginally negative association for sitting compared to diverse workplace exposures, e.g. standing, driving, lifting bending, and compared to diverse occupations. One low quality study associated sitting in a poor posture with LBP. Conclusions: The extensive recent epidemiological literature does not support the popular opinion that sitting-while-at-work is associated with LBP.