[Resources for health services for the aged could be distributed better. High income reflects better health].
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Biomedical subjects
Publications and source records attributed to O Lundberg.
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This study has measured physical function in a nationally representative sample of persons aged 77 to 98 (N = 508) in 1992. Three measures of function are used: activities of daily living (ADL), an index of mobility, and performance tests. These are used as outcomes and analyzed in relation to variables gathered in a survey in 1968. Variables from 1968 include education, mobility, smoking, and an index of circulation problems. All four variables predict some limitations in physical function in old age. However, there are different patterns of predictors found for the three outcome measures. All three outcomes are associated with age, education, and previous circulation problems. ADL limitations are also associated with poor previous mobility and smoking; mobility limitations are also associated with sex and smoking; performance limitations are also associated with sex.
The test-retest reliability of self-rated health is analysed and compared with the reliability of health questions phrased more as well as less precisely. Differences in reliability between men and women and between age groups are also assessed. The study is based on 204 and 409 re-interviews from the 1991 Swedish Level of Living Survey and the 1989 Survey of Living Conditions respectively. The results show that the reliability of self-rated health is as good as or even better than that of most of the more specific questions. Only an indicator of high blood pressure showed significantly higher reliability. The reliability of self-rated health is good in all subgroups studied, and is even excellent among older men. It is concluded that the good overall reliability of self-rated health found in this study is in line with previous results concerning the validity of people's assessments of their general health as well as results concerning the basis upon which they make these judgements.
Only a few studies on the effect of environmental factors on height are based on adults and none, that we could find, relates adult height to both economic and psycho-social conditions in childhood. The aim of this study is to investigate whether four indicators of economic and psycho-social conditions during childhood are related to a variation in adult height and whether these factors can explain the variation in height between men and women from different childhood classes. The study is based on data derived from a study of living conditions in Sweden conducted in 1991. Beside childhood socio-economic group, indicated by father's occupation, we employ four indicators of economic and psycho-social conditions during the childhood period, previously employed elsewhere. These are economic hardship, large family, dissension in the family and disunited family during childhood. The prevalence of short stature differs significantly by three of the four indicators on economic and psycho-social childhood conditions. It is also more common if the person has grown up in a disunited family, but this effect is not significant. The proportion of short persons also varied significantly by childhood socio-economic group. On the whole, short stature in adulthood seems to be a reflection of a number of adverse conditions in childhood, both economic, status related and psycho-social, and can, consequently, be seen as summing up the whole childhood period rather than merely reflecting differences in nutrition or any other specific condition.
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The relationship between physical ability and social class in later life was explored through an interview survey conducted on a nationally representative sample of persons aged 77-98 (N = 537). Physical ability was measured with activities of daily living, an index of mobility, and performance tests. Social class was measured according to previous occupation. Physical function was found to be correlated with social class, that is, former white-collar workers had better function than blue-collar workers. The differences were significant for all three measures of physical function.
The elderly, and especially the oldest old, have generally been overlooked in research on social class inequalities in health. On the basis of nationally representative data from Sweden for the age group 77 to 98 (N=537), we have been able to demonstrate clear differences in health between social classes. These inequalities were found both for men and women. It should be noticed, however, that the patterns of class differences varied depending on the health indicator used. The often employed global measure of self-rated health showed the smallest class gradient when controlling for age and sex, whereas larger differences were found with more concrete and descriptive measures such as peak flow rate.
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A 57 year-old woman was hospitalized because of a sternal fracture inflicted during a car accident. During the following two weeks she became breathless and was readmitted after having syncope, induced by exertion. A perfusion scan of the lungs showed pulmonary emboli in both the lower lobes. After anti-coagulation treatment her symptoms faded, but the ultrasonographic signs of pulmonary hypertension persisted for nearly four months. The probable mechanism behind the pulmonary embolism was transmural contusion of the right ventricle, leading to a mural thrombus which eventually became detached. The authors review the literature and discuss problems connected to the diagnostic criteria for cardiac contusion, as well as delayed complications, of which pulmonary embolism is a potentially lethal condition.
The aim was to explore the relationships between indicators of economic and social problems in childhood on the one hand and illness and mortality in adulthood on the other. In 1968 a representative sample of the Swedish population born 1906-1951 were interviewed about their childhood living conditions, among other things. Four indicators of adverse childhood living conditions were included. Two of these reflect economic circumstances (economic hardship; a large family, defined as four or more siblings), and two reflect social conditions (broken family; conflicts in the family). In 1981, 13 years later, this sample was re-interviewed. This allows for illness in 1981 to be related to reports of childhood conditions given in 1968. A follow-up of mortality for the period 1981-1984 was also conducted. When one controls for age, sex and father's social class, those exposed to economic as well as social problems during childhood are found to have a considerably higher risk of being ill as adults. Of the four factors analysed, conflicts in the family during upbringing is that most strongly related to illness later in life, as well as with mortality. Having a broken family, and, to some extent, economic hardship during childhood, are also clearly associated with illness later in life. These results also hold true when all four factors are included simultaneously in the model, and remain relatively unchanged when controlling for mental illness in 1968.(ABSTRACT TRUNCATED AT 250 WORDS)
1905 smokers were investigated from a random sample of 4424 persons among the Swedish population interviewed in 1974 and 1981. On average, 28% of those smoked in 1974 had stopped smoking by 1981. A multivariate method was used to study whether socioeconomic and demographic factors, tobacco consumption level or health contributed to changes in smoking behaviour. Most successful in smoking cessation were senior salaried employees (35% quit), well educated persons (33% quit) and those who smoked less than ten cigarettes per day (36% quit). On the other hand, only 20% of divorced parents with children succeeded in smoking cessation. Tobacco consumption turned out to be the most important variable for explaining the variance. The probability of smoking cessation increased by 40% if one smoked less than 10 cigarettes per day. The low explained variance, 6%, of this multivariate approach indicates, however, that socioeconomic factors have only marginal effects on the decision to stop smoking. It seems more likely that many factors, e.g. demographic, socioeconomic, motivational, self-efficacy, social and therapeutic support, nicotine dependence etc. act together in a complex way.
One of the most important issues for research on social class inequalities in health are the causes behind such differences. So far, the debate on class inequalities in health has mainly been centred around hypotheses on artefactual and selectional processes. Although most contributors to this branch of research have argued in favour of causal explanations, these have gained very little systematic scrutiny. In this article, several possible causal factors are singled out for empirical testing. The effect of these factors on class differences in physical and mental illness is studied by means of logit regressions. On the basis of these analyses, it is shown that physical working conditions are the prime source of class inequality in physical illness, although economic hardship during upbringing and health related behaviours also contribute. For class inequality in mental illness these three factors plus weak social network are important. In sum, a large part of the class differences in physical as well as mental illness can be understood as a result of systematic differences between classes in living conditions, primarily differences in working conditions.
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Health differences between social classes are greater in Britain than in Sweden, but persist in both countries despite central Government interventions aimed at the reduction of such differences.