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Biomedical subjects

J I Elstad

Publications and source records attributed to J I Elstad.

11 recordsLinked to original sources
PubMed2001

[Small changes in health differences in the Nordic countries during the 1980s and 1990s].

The study examined changes over time in health inequality in Denmark, Finland, Norway and Sweden. Data derive from comparable interview surveys carried out in 1986/87 and 1994/95. Limiting long-standing illness and perceived ill health were analysed regarding age, gender; educational attainment, and employment status. Age adjusted prevalence rates were calculated. Changes in differences in health were found in education and employment status groups. There was little or no change in the prevalence of ill health during the time period studied. Despite social and economic changes differences in health remained broadly stable in the examined countries.

Age Factors↗
PubMed2001

Recent changes in social structure and health inequalities in Norway.

AIM: The article explores whether changes in social structure from the mid-1980s to the mid-1990s have been accompanied by any changes in ill health, both in the general population and in the association between socioeconomic positions and ill health. DATA AND METHODS: Data were derived from four interview surveys conducted by Statistics Norway: The Health Surveys from 1985 and 1995 and the Surveys of Level of Living from 1987 and 1995. These surveys provide nationwide representative samples of the adult population. The analyses are confined to the population between 25 and 64 years of age. Simple cross-tabulations, age-standardized cross-tabulations, and logistic regression analysis were used. In addition, a more genuine measure of inequality was calculated--the so-called concentration index. RESULTS: In the examined period, the educational level of the population gradually improved, and more people had white collar jobs. On the other hand, the decade was a turbulent one in economic terms, and more people experienced unemployment and early retirement from work during the early 1990s than during the preceding period. Nevertheless, levels of ill health, as measured in terms of self-reported limiting long-standing illness and global self-perceived health, were only marginally altered. Also, health differentials according to socioeconomic positions were only trivially changed during this period. CONCLUSION: In the mid-1990s, as in the mid-1980s, lower socioeconomic positions, such as unemployment and early retirement, only basic education, and workers' occupations, are generally connected to poorer health. No substantial change in this association is detected in this period.

Adult↗
PubMed2001

Health-related mobility, health inequalities and gradient constraint. Discussion and results from a Norwegian study.

BACKGROUND: Recent studies have argued that health-related mobility does not widen social class health differentials, but rather moderates them. This is termed gradient constraint. This paper examines gradient constraint from a theoretical and empirical angle. METHODS: How health-related mobility influences social class health differentials is discussed using hypothetical models. In a Norwegian survey with data on intergenerational mobility (N = 1,853 males aged 30-69 years), mean health and height values for different subsections of the sample were analysed. RESULTS: When initial social class health differences are large and mobility widespread, health-related mobility may lead to smaller differentials, but the result depends on how closely mobility varies with health. This empirical study found non-significant increases in height and health differentials from class of origin to class of destination. The interpretation has to consider effects of both social mobility and social causation. Health is measured in the post-mobility situation and the effects of social mobility and social causation are difficult to separate from each other for most of the health indicators analysed. However, this limitation does not apply to height which is not influenced by social causation during adulthood. In these data mobility did not reduce the height differential. CONCLUSION: Health-related mobility can either lead to smaller or larger social class health differentials. The specific effects of social mobility cannot be determined without knowing how social causation has interfered. The intergenerational mobility process analysed in this paper does not show gradient constraint as regards the height differential between the worker and higher occupational categories.

Adult↗
PubMed1996

Inequalities in health related to women's marital, parental, and employment status--a comparison between the early 70s and the late 80s, Norway.

Studies indicate that inequalities in women's health are associated with women's marital, parental and employment status. The causal mechanisms which generate these inequalities are linked to social change at the macro level. The present study asks whether patterns of ill-health according to women's statuses have changed during recent decades in Norway. Five national surveys 1968-91 are analyzed, using number of long-standing diseases as an indicator of health. The results indicate that health differences between full-time employed women and other employment statuses have increased during the 70s and 80s. As regards marital and parental status, the observed changes are not significant. The findings suggest that important causal mechanisms generating health differences related to marital status are located in the private sphere. The interpretation of the widening health gap between employed and non-employed women focuses both on developments which have made it easier to combine employment and family duties, on new norms which favour the self-esteem of employed women, and on health selection processes connected to welfare state developments.

Adult↗
PubMed1994

[Self-reported fibromyalgia among women aged 36-55 years].

In a mailed questionnaire to a sample of Norwegian women 36-55 years of age, 4.4% reported having fibromyalgia. Women with fibromyalgia often had multiple health problems. Compared with other women, more of them reported nervousness, migraine and tiredness. They had many consultations with medical practitioners, but were also frequent users of alternative medicine. Recovery from fibromyalgia was seldom reported. Women with fibromyalgia had especially poor self-rated health status. Many were receiving a disability pension, and the proportion of exists from the labour market was clearly higher among women with fibromyalgia than among women with other chronic diseases. As in the case of many other long-lasting diseases the prevalence of fibromyalgia was somewhat higher in lower than in higher socio-economic groups.

Adult↗
PubMed1994

Women's priorities regarding physician behavior and their preference for a female physician.

Studies report that women have diverging preferences for physician gender. The present study explores some aspects of how women's preferences for physician gender are formed. Using data from a postal survey among Norwegian women, the association between preferences for physician gender and women's priorities regarding physician behavior is examined. Women who, in particular, value their physicians' democratic attitudes tend to prefer female physicians, in contrast to those who prefer a more dominating physician role. Surprisingly, women who especially emphasize the caring qualities of their physicians, do not have strong preferences for a female physician.

Adult↗
PubMed1992

[What does the higher concentration of general practitioners mean for fee-for-service reimbursement].

The density of general practitioners has increased steadily in Norway. By the end of 1989, there were 1,339 inhabitants per general practitioner. General practitioners are partly remunerated per item of service, i.e., by reimbursement from the National Insurance Fund and partly by patient co-payment. The article analyses the connection between density of general practitioner and level of fee-for-service reimbursement. The average general practitioner received about 60% higher fee-for-service reimbursement in 1989 than in 1985. This increase is markedly higher than the nominal changes in the tariff. The increase was somewhat higher in areas with a relatively low density of general practitioners. Also, in each of the years 1985-1989, the average fee-for-service reimbursement was slightly higher in areas with a low density of general practitioners. The variations have only a slight impact on the gross revenues of general practitioners. Three models explaining the use of general medical services are outlined. The results can be interpreted in the light of changes in health, changes in health-related behaviour, and supplier-induced demand. Since only aggregate data are available, it is difficult to further explore possible explanations.

Fees, Medical↗
PubMed1990

Health services and decentralized government: the case of primary health services in Norway.

Decentralized forms of government are becoming more common in Western European countries. The effects of decentralization of public health services are explored in this article. In 1984 the Norwegian Municipal Health Act allocated the responsibility for primary health care to the municipalities. Based on data from a sample of 70 municipalities, the author shows that the number of primary health service personnel has expanded considerably during 1984-88, but the distribution of services has not become more equitable. Though the formal role of local politicians in the decision-making process has increased, the health sector officers and the Municipal Executives have in practice controlled the evolution of the municipal health services. The author concludes that decentralization does not necessarily lead to more democracy, and that an equitable distribution of public health services becomes more difficult to attain.

Decision Making, Organizational↗