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  • 1.
    Arousell, J.
    et al.
    Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden.
    Carlbom, Aje
    Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA).
    Larsson, E.
    Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden.
    Johnsdotter, Sara
    Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA).
    Essen, B.
    Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden.
    Unintended consequences of gender equality promotion in Swedish contraceptive counselling2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Suppl 1, p. 105-105Article in journal (Other academic)
    Abstract [en]

    Background: Sweden stands out as an interesting example of potential cross-cultural tensions in reproductive healthcare. On the one hand, most people agree that gender equality between men and women should apply to everyone. On the other hand, people in Sweden report a high level of respect for cultural diversity, emphasising people’s ‘right to be different’. The aim of this study was to explore how midwives communicate gender equality perspectives in encounters with non-Western patients, many of whom have migrated from countries expressing less support for gender equality. Methods: Semi-structured individual interviews as well as focus group interviews were conducted in Denmark and Sweden between 2013 and 2016. Carol Bacchi’s ‘What’s the Problem Represented to be’ approach guided the analysis. Findings: We found that it is difficult for health care providers who are ideologically motivated to promote gender equality in clinical encounters, to simultaneously value and tolerate traditions that are considered to uphold gender-unequal structures. The gender equality standard is thus one example of a liberal, egalitarian value that health care providers appeared to give priority to at the expense of others. Conclusions: That the gender equality ideology is given priority is not necessarily undesirable but nevertheless appears to generate unintended consequences. We argue that a high level of ideological persuasion upon female patients may negatively influence their experience of the encounter, and negatively influence women’s possibilities to obtain adequate support in relation to their individual needs. Main messages: Healthcare providers are also part of cultural systems of norms — such as pertinence to gender equality — although these are seldom problematized ‘Reflexivity’ as a working tool can assist healthcare providers to reflect upon how gender equality norms influence clinical encounters.

  • 2.
    Arousell, Jonna
    et al.
    Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden.
    Carlbom, Aje
    Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA).
    Essen, Birgitta
    Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden.
    Is multiculturalism bad for swedish abortion care? Exploring the diversity of religious counselling in public healthcare institutions2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Suppl 1, p. 122-122Article in journal (Other academic)
    Abstract [en]

    Background: Sweden has one of the most liberal abortion laws in the world, granting women extensive rights to make autonomous reproductive decisions. At the same time, Swedish policy-makers are keen to protect society’s religious diversity. This ambition is reflected in decisions to grant religious leaders the possibility to provide ‘spiritual care’ in public hospitals. Through interviews with religious representatives in public healthcare institutions, we asked: In what ways would they counsel a religious woman who is seeking their advice about abortion? And how does this advice correspond with Swedish policies on, and provision of, abortion care? Methods: Individual interviews were conducted with religious representatives of the Swedish Church, the Catholic Church, and the Buddhist and Muslim communities. Interviews took place in 2016 and 2017. Findings: We found that informants saw it as their obligation to provide religious people with abortion advice according to religious norms, giving them limited opportunities to harmonise the content of their counselling with Swedish healthcare laws or regulations. Most informants argued that it was their responsibility to inform women about the wrongdoing of terminating a pregnancy, and to provide suggestions about how women could mitigate the sin in order to gain God’s forgiveness. Conclusion: Informants appeared inclined to deliver religious recommendations on abortion that were more conservative than what is established in the Swedish Abortion Act. Main messages: ‘Spiritual care’ in the question of abortion favours the delivery of religious norms at the possible expense of women’s right to non-judgmental abortion counselling. ‘Spiritual care’ is now an integral part of Swedish healthcare institutions. A critical discussion is needed about the extent to which such services should be in compliance with Swedish laws and public health aims on abortion.

  • 3.
    Arousell, Jonna
    et al.
    Department of Women's and Children's Health (IMCH), Uppsala University, Uppsala, 751 85, Sweden.
    Carlbom, Aje
    Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA).
    Johnsdotter, Sara
    Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA).
    Essén, Birgitta
    Department of Women's and Children's Health (IMCH), Uppsala University, Uppsala, 751 85, Sweden.
    Are 'Low Socioeconomic Status' and 'Religiousness' barriers to minority women's contraceptive use in Sweden and Denmark?: A qualitative interrogation of a common argument in health research2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Suppl 1, p. 121-121Article in journal (Other academic)
    Abstract [en]

    Background: ‘Low socioeconomic status’ and ‘religious barriers’ have been presented as nearly universal explanatory reasons for why minority women are less likely than majority women in Scandinavian countries to use contraception. Recent studies have warned against giving such statistically ‘objective’ theories undue importance in the formulation of clinical recommendations. Drawing on this recent critique, the aim of this study was to qualitatively explore how ‘low socioeconomic status’ and ‘religiousness’ intersect with Muslim minority women’s contraceptive decisions. Methods: Semi-structured interviews were conducted in Denmark and Sweden between 2013 and 2016. Data analysis was inspired by naturalistic inquiry. Findings: We found that a low level of education and low income were not necessarily obstacles for women’s use of contraception, but strong imperatives for women to wait having children until their life circumstances were more stable. Arguments grounded in Islamic dictates on contraception became powerful reasons for women to decide it was religiously correct to postpone having children, in case the financial and emotional resources were not yet at hand. Conclusions: We have shown that the dominant theory about that ‘low socioeconomic status’ and ‘religiousness’ are paramount barriers to minority women’s use of contraception must be challenged. When formulating suggestions for how to provide contraceptive counselling to minority women in Denmark and Sweden, one must also take into account factors such as low financial security as well as religious convictions which can be strong imperatives for women to use contraception. Main messages: The use of broad group-categorisations for understanding individuals’ contraceptive behaviours should be challenged The validity of initiating ‘targeted interventions’ towards large heterogeneous minority groups in Scandinavian contraceptive counselling should be critically discussed

  • 4.
    Birkhed, Dowen
    Malmö högskola, Faculty of Odontology (OD).
    Preventive Dental Care in Sweden for Children, Adults & Elderly2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27Article in journal (Other academic)
    Abstract [en]

    Sweden has a long tradition on prevention of both dental caries and periodontal disease, which has resulted in an improvement of oral health the last 50 years. Today, more or less all patients in Sweden, from early childhood to high age, get individual information by dentists and dental hygienists about: 1) oral hygiene, 2) good dietary habits and 3) use of fluoride toothpaste twice a day. In many areas of the country, population-based preventive programs are carried out at day-care centres, in schools and at home for elderly.

  • 5.
    Björngren Cuadra, Carin
    Malmö högskola, Faculty of Health and Society (HS).
    Right of access to health care for undocumented migrants in EU: a comparative study of national policies2012In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, no 2, p. 267-271Article in journal (Refereed)
    Abstract [en]

    The aim of this article is to characterise policies regarding the right of access to health care for undocumented migrants in the 27 member states of European Union and to identify the extent to which these entitlements are congruent with human rights standards. Methods The study is based on a questionnaire sent to experts, non-governmental organisations and authorities in the member states between April and December 2009, as well as on available reports and official websites. Primary sources were also consulted as regards legislation. Results Right of access to health care differs considerably between member states. States can be grouped into three clusters: in 5 countries undocumented migrants have the right to access care that is more extensive than emergency care; in 12 countries they can only access emergency care; and in 10 countries not even emergency care can be accessed. These variations are independent of the system of financing or the numbers of undocumented migrants present. Rather, they seem to relate to the intersection between practices of control of migration, the main types of undocumented migrants present, and the basic norms of the welfare state – the ‘moral economy’ of the work society. Conclusion International obligations articulated in human rights standards are not fully met in the majority of member states. A more complete understanding of the differing policies might be obtained by considering the relationship between the formal and informal economy, as well as the role of human rights standards within the current ‘moral economy’.

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  • 6.
    Dejin-Karlsson, Elisabeth
    et al.
    Malmö högskola, Faculty of Health and Society (HS).
    Östergren, Per-Olof
    Pychosocial factors, lifestyle and fetal growth. The added value of both pre- and postnatal assessments2003In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 13, no 3, p. 210-217Article in journal (Refereed)
    Abstract [en]

    Background: as well as lifestyle habits during pregnancy have been shown to effect the risk of having a small-for-gestational-age (SGA) child. Most previous studies are based on a single assessment of these exposures, which does not take into account the possibility of different effects during early and late stages of pregnancy. The impact of psychosocial and lifestyle factors on the risk of giving birth to an SGA child (as measured by ultrasound) was examined among 747 nulliparous Swedish women who completed both a prenatal baseline, and a post-partum assessment. Results: Those registering low social participation on both assessments showed increased risk of giving birth to an SGA infant (OR=2.44 and 95% CI: 1.06–5.66), while at one assessment (OR=1.70 and 95% CI: 0.74–3.91). Maternal smoking confirmed by both or one assessments yielded an OR=2.72 and 95% CI: 1.37–5.39 and OR=1.60 and 95% CI: 0.58–4.46, respectively. During early pregnancy, poor instrumental support, maternal smoking, or passive smoking yielded increased risks of SGA, adjusted for confounding (OR=2.39 and 95% CI: 1.11–5.17; OR=2.38 and 95% CI: 1.27–4.49; OR=2.92 and 95% CI: 1.17–7.32, respectively). In late pregnancy, only maternal smoking yielded a significant association (OR=2.34 and 95% CI: 1.24–4.41). Conclusion: Scheduling repeated assessments of psychosocial resources and lifestyle factors during pregnancy yielded additional information. The findings suggest that there can be differential effects of such exposures depending on gestational stage. This information is of importance when designing appropriate intervention strategies for maternal health services as well as for public health relevant policy formulation (e.g. regarding exposure to environmental tobacco during pregnancy).

  • 7.
    Hallmyr, M.
    et al.
    Angered Hosp, Publ Hlth Unit, Gothenburg, Region Vastra G, Sweden.
    Wretlind, Katharina
    Malmö University, Faculty of Odontology (OD).
    Magnusson, M.
    Univ Skovde, Sch Hlth & Educ, Skovde, Sweden; Angered Hosp, Publ Hlth Unit, Gothenburg, Region Vastra G, Sweden.
    Health Equilibrium Methodology (HEM), a digital tool in public health work for health equity2019In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29, p. 206-206Article in journal (Other academic)
  • 8.
    Ivert, Anna-Karin
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Criminology (KR). Lund Univ, Fac Med, Res Unit Social Epidemiol, CRC, Malmo, Sweden.
    Gracia, Enrique
    Univ Valencia, Fac Psychol, Dept Social Psychol, Valencia, Spain.
    Lila, Marisol
    Univ Valencia, Fac Psychol, Dept Social Psychol, Valencia, Spain.
    Wemrell, Maria
    Lund Univ, Fac Social Sci, Dept Gender Studies, Lund, Sweden; Lund Univ, Fac Med, Res Unit Social Epidemiol, CRC, Malmo, Sweden.
    Merlo, Juan
    Ctr Primary Hlth Care Res, Malmo, Sweden; Lund Univ, Fac Med, Res Unit Social Epidemiol, CRC, Malmo, Sweden.
    Does country-level gender equality explain individual risk of intimate partner violence against women? A multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) in the European Union2020In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 30, no 2, p. 293-299, article id ckz162Article in journal (Refereed)
    Abstract [en]

    Gender equality is widely accepted as an important explanatory factor for the occurrence of intimate partner violence (IPV) against women. However, the relationship is not straightforward, as high country-level gender equality is not always associated with lower IPV prevalence. We apply 'multilevel analysis of individual heterogeneity and discriminatory accuracy' (MAIHDA) to (i) quantify the extent to which the country of residence determines individual risk of IPV and (ii) investigate the association between country-level gender equality and individual experience of IPV, and to which extent this association explains the observed between-country differences. Using data from the 2012 European Union Agency for Fundamental Rights survey on violence against women we applied MAIHDA to analyse experiences of physical and sexual IPV among 42 000 women living in the EU. We fitted three consecutive models, and calculated specific individual contextual effects (measures of association) as well as the general contextual effects (measures of variance) and the discriminatory accuracy (DA). Our findings show that the relationship between experiences of IPV and country-level gender equality is weak and heterogeneous. The general contextual effect is small and the DA is low, indicating that country boundaries are rather irrelevant for understanding the individual risk of IPV. Findings from the present study do not imply that that gender equality is unimportant in relation to IPV, but rather that information on country of residence or country-level gender equality does not discriminate very well with regards to individual experiences of IPV in cross-national comparisons.

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  • 9.
    Ivert, Anna-Karin
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Criminology (KR). Unit of Social Epidemiology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Malmö, Sweden.
    Merlo, Juan
    Unit of Social Epidemiology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Malmö, Sweden.
    Gracia, Enrique
    Department of Social Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain.
    Country of residence, gender equality and victim blaming attitudes about partner violence: a multilevel analysis in EU2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no 3, p. 559-564Article in journal (Refereed)
    Abstract [en]

    Background: Intimate partner violence against women (IPVAW) is a global and preventable public health problem.Public attitudes, such as victim-blaming, are important for our understanding of differences in the occurrence of IPVAW, as they contribute to its justification. In this paper, we focus on victim-blaming attitudes regarding IPVAW within the EU and we apply multilevel analyses to identify contextual determinants of victim-blaming attitudes. We investigate both the general contextual effect of the country and the specific association between country level of gender equality and individual victim-blaming attitudes, as well as to what extend a possible general contextual effect was explained by county level gender equality. Methods: We analyzed data from 26 800 respondents from 27 member states of the European Union who responded to a survey on public perceptions of domestic violence. We applied multilevel logistic regression analysis and measures of variance (intra-class correlation (ICC)) were calculated, as well as the discriminatory accuracy by calculating the area under the receiver operator characteristic curve. Results: Over and above individual characteristics, about 15% of the individual variance in the propensity for having victim-blaming attitudes was found at the country level, and country level of gender equality did not affect the general contextual effect (i.e. ICC) of the country on individual victim-blaming attitudes. Conclusion: The present study shows that there are important between-country differences in victim-blaming attitudes that cannot be explained by differences in individual-level demographics or in gender equality at the country level. More research on attitudes towards IPVAW is needed.

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  • 10.
    Karlsson, E
    et al.
    Karolinska Institute.
    Sjögren Forss, Katarina
    Blekinge Institute of Technology.
    Jorgréus, C
    Blekinge Institute of Technology.
    Stjernberg, Louise
    Blekinge Institute of Technology.
    Exercise and factors associated with active commuting2014In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 24, no S2, p. 312-Article in journal (Other academic)
  • 11.
    Klinge, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Swedish Dentistry: Public and Private Dental Care & Education2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no S3, p. 21-21Article in journal (Other academic)
    Abstract [en]

    Data will be presented on the structure of public and private Swedish Dental Care regarding children, adolescents and adults. Also data on services provided and on the epidemiology of current oral/dental health will be shared. An overview on dental education from the different programs will be presented, including outcome of assessment of dental education. Trends in the range of international dental post-graduate education offered by Swedish universities will also be disclosed.

  • 12.
    Magnusson, M.
    et al.
    Angered Hosp, Publ Hlth Unit, SV Hosp Grp, Region Västra Götaland, Sweden; Univ Skövde, Sch Hlth & Educ, Skövde, Sweden.
    Forslund, H. B.
    Univ Gothenburg, Inst Med, Gothenburg, Sweden.
    Berg, C.
    Univ Gothenburg, Dept Food & Nutr & Sport Sci, Gothenburg, Sweden.
    Wretlind, Katarina
    Malmö University, Faculty of Odontology (OD). Publ Dent Serv Västra Götaland, Region Västra Götaland, Sweden.
    Hallmyr, M.
    Angered Hosp, Publ Hlth Unit, SV Hosp Grp, Region Västra Götaland, Sweden.
    Hedstrom, C.
    Angered Hosp, Publ Hlth Unit, SV Hosp Grp, Region Västra Götaland, Sweden.
    Vaughn, L. M.
    Univ Cincinnati, Coll Med, Dept Pediat, Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH USA.
    Health promoting ideas and actions generated by community engagement in an underserved Swedish area2019In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29, no S4, article id ckz186.009Article in journal (Other academic)
    Abstract [en]

    Background: For an intervention to contribute to decreased health gaps, people living in underserved areas must participate in the research-to-action process during the development of the intervention.

    Methods for increased engagement and participation have been developed within the community-based participatory research (CBPR) paradigm. Group Level Assessment (GLA) is a qualitative, participatory methodology that is designed for a large group to generate and evaluate relevant needs and priorities within a lens of action for positive social change. Influence of researchers is tuned down in favour of partnership and impact from the community. Ideally, the process results in participant-driven data and relevant action plans. The aim was to apply GLA to generate reflections on the situation in the community, aligning towards action for change.

    Methods: We applied GLA together with people living in Gårdsten, an underserved Swedish suburb where obesity, caries and other illnesses are prevalent. Residents were recruited by posters and post cards at a community center and by snowball sampling. In total, 47 residents attended at least one of eight GLA sessions held over a five-month time period. The majority were women. Outcomes were reflections, suggestions and actions for change.

    Results: Themes were: resident pride of the area, the importance of communication and of places to meet, a feeling of being abandoned by society, and a desire for more collaboration between schools and parents. Immediate results were a language café and inquiries from the community about information regarding teeth, food and health. When the results were presented for stakeholders in a report and an exhibition, new collaborations were founded and old were refreshed.

    Conclusions: GLA helped residents identify what they thought valuable and relevant concerning health issues and supported them in taking actions to achieve change.

    Key messages:

    • Participatory processes that directly engage community residents can result in fruitful discussions and actions.
    • Methodologies like GLA that support such processes may contribute to closing the health gap. 
  • 13.
    Magnusson, M.
    et al.
    Univ Skonde, Sch Hlth & Educ, Skovde, Region Vastra G, Sweden; Angered Hosp, Publ Hlth Unit, Gothenburg, Region Vastra G, Sweden.
    Hallmyr, M.
    Angered Hosp, Publ Hlth Unit, Gothenburg, Region Vastra G, Sweden.
    Wretlind, Katharina
    Malmö University, Faculty of Odontology (OD).
    Ground pillars of a method for quality assurance of public health work2019In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29Article in journal (Other academic)
  • 14.
    Mangrio, Elisabeth
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Carlson, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Zdravkovic, Slobodan
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Recently arrived refugee families and the experience of having an introduction plan and being in the resettlement process in Sweden: a qualitative study2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 142-142Article in journal (Other academic)
  • 15.
    Mangrio, Elisabeth
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Grahn, M.
    Scania Reg Council, Kristiansand, Sweden.
    Zdravkovic, Slobodan
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Mental health and family composition after migration to Sweden2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 35-36Article in journal (Other academic)
  • 16.
    Otok, R
    et al.
    ASPHER, Brussels, Belgium.
    Stjernberg, Louise
    Blekinge Institute of Technology.
    Undergraduate education in public health in Europe: The positioning of bachelor programmes for public health2014In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 24, no S2, p. 301-Article in journal (Other academic)
    Abstract [en]

    In response to the increased demand from the public health labour market, various bachelor and master programmes have been developed in recent years throughout Europe. As an example, in the European ASPHER survey 18 Schools and Departments of Public Health delivered 977 bachelor degrees per year (2011/12) with a median of 55 per institution. The expectations of – present and potential - employers of professionals, trained in public health, are largely unknown. However, in comparison to the attention paid and the knowledge generated around postgraduate/master education in public health, still relatively little is known about the provision of bachelor degrees. Furthermore, while real efforts have and are made to define professional and academic frameworks, including accreditation schemes for master programmes, the roles, practices and competences for bachelor programmes are somehow blur. This presentation will report on the work of the ASPHER's Working Group on Undergraduate Public Health Education in Europe aiming to promote collaboration initiatives on bachelor programmes across Europe among academic institutions, share best practices and generate knowledge on employability and career progression of public health bachelor graduates. In particular, the results of the survey carried out by ASPHER across over 100 schools of public health in early 2014 will be presented bringing up the current and full picture as regards the undergraduate education in Public Health in Europe.

  • 17.
    Rämgård, Margareta
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Zdravkovic, Slobodan
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Grahn, M.
    Municipal Malmo, Unit Stat & Anal, Malmo, Sweden..
    Schölin, T.
    Avdelningen Reg Utveckling, Malmo, Sweden..
    Holmberg, C. Nagorny
    Novo Nordisk Scandinavia AB, Med Affairs, Malmo, Sweden..
    Annersten Gershater, Magdalena
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Inequalities in diabetes type 2 prevalence in the multicultural city Malmo, Sweden2021In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 31, no S3Article in journal (Other academic)
    Abstract [en]

    Background

    Type-2 diabetes is a progressive disease and very much linked to health equity prerequisites and poverty. Its long-term complications include cardiovascular diseases, blindness, amputation and kidney failure. The aim of the study was to explore diabetes type 2 (T2D) prevalence in Malmö, a socioeconomically diverse and multicultural city with a relatively young population.

    Methods

    The study is a part of the Cities Changing Diabetes project related to the 14 geographical developing areas CTC (Community That Care) in Malmö. The whole city has been divided into 14 areas based on socioeconomical homogeneity as well as shared local area affiliation. Results are obtained from the Patient Administrative System (ICD E11 code) in regional health care as well as from Statistics Sweden.

    Results

    The prevalence of T2D was 4.3% in 2018. It has increased since 2011 mostly noticeable for residents between 18 and 64 years of age. There are considerable differences in T2D prevalence by CTC-areas where the highest observed prevalence rate was 6.4% and the lowest was 2.6%. The areas with the lower prevalence rates have a high level of education as well as high average household income. The opposite is observed in the areas with the highest prevalence rates where the residents have lower educational level as well as low average income. Two of the three CTC-areas with the highest T2D prevalence rates consists of a younger population as compared to the city in general whereas the third consists of the oldest population in the city.

    Conclusions

    The prevalence of T2D has increased during the last decade in Malmö. There are significant differences in T2D prevalence within the city related to contextual and socioeconomic factors. The highest T2D prevalence occurs in the area with the lower income and lower level of education.

    Key messages 

    • Promotive actions need to be specifically targeted at younger populations in the city of Malmö to prevent the increase in type-2 diabetes and its complications.
    • Contextual factors need to be taken into consideration in the development of sustainable primary and secondary preventive actions for type-2 diabetes in community care and the health care system.
  • 18. Schröder-Bäck, Peter
    et al.
    Stjernberg, Louise
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Borg, Ann Marie
    Values and ethics amidst the economic crisis2013In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 23, no 5Article in journal (Other academic)
    Abstract [en]

    The current protracted economic crisis is giving rise to the scarcity of public health resources across Europe. In response to budgetary pressures and the Eurozone public debt crisis, decision-makers resort to a short-term solution: the introduction of austerity measures in diverse policy fields. Health and social policy tend to be easy targets in this regard and budget cuts often include a reduction of healthcare expenditure or social welfare benefits. We suggest incorporating discussions from the field of ethics in policy making processes and in the academic debate on austerity. This includes recognising procedural justice as a social value. On the road to economic recovery, governments are compelled to resort to fiscal consolidation and austerity packages but decisions taken to save our European ships in crisis should be anchored in values such as (procedural) justice, equity and solidarity.

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  • 19.
    Sjögren Forss, Katarina
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Mangrio, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    A scoping review of refugees' experiences of healthcare2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Suppl 1, p. 142-143Article in journal (Other academic)
    Abstract [en]

    Background: During recent years, Europe has faced increased immigration. The growing number of refugees presents huge challenges to the healthcare systems of host countries. However, healthcare professionals are generally unprepared to understand and address the health and care needs of refugees. More information about refugees’ experiences of the healthcare system is urgently needed to improve the quality of healthcare delivered and provide opportunities for better access. The aim of this study was to learn more about refugees’ experience of the healthcare system in their host country. Methods: The study was conducted as a scoping review. A systematic search of articles was done in Medline, Cinahl and Psychinfo. 619 articles were found in the searches. Twenty-six articles were included in the study. Results: The results showed that the communication between the health professionals and the refugees was important but poor language skills were perceived as a barrier for good communication. There was a need for both increased oral and written information about the health care system and the right to health care in the host countries. Supportive health professionals were of great importance for a good interaction between the refugee and the health care system. In some of the studies included, some refugees had felt discrimination due to their low proficiency in the national language, or because of race or accent. There was a perceived need for more culturally appropriate health care for the refugees. Conclusions: Since refugees may be at greater risk of poor mental and physical health compared to the rest of the population, there is an urgent need for improvement in communication, interpretation, support and delivery of a culturally appropriate care.

  • 20.
    Sjögren Forss, Katarina
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Mangrio, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Leijon, M.
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Grahn, M.
    Unit for Statistics and Data, Municipality of Malmö, Malmö, Sweden.
    Zdravkovic, Slobodan
    Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM). Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Physical activity in relation to wellbeing among newly arrived refugees in Sweden2020In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 30, no s5, article id ckaa166.727Article in journal (Other academic)
    Abstract [en]

    BackgroundIn the light of the growing number of refugees that the world has faced during the last years it is reasonable to suggest that the number with both physiological and mental health needs will raise and result in increased public health challenges. Physical activity with its well documented positive impact on both mental and physical health might be one way for refugees to promote health. The importance of investigating participation in physical activity in this group and the impact it might have on their health and wellbeing cannot be underestimated. Few studies exists in the field and therefore, this study aimed to investigate physical activity in relation to mental well-being, vitality, stress and sleep quality among newly arrived refugees in Sweden. 

    MethodsThe study was based on the results from a survey, conducted in 2015 - 2016 among newly arrived adult refugees who spoke Arabic, Pashto, Somali or Dari, participated in a mandatory public integration support programme in the Scania region of Sweden and agreed to participate in the survey. Ultimately 681 participants completed the survey (a response rate of 39,5%). 

    ResultsWe found a significant association between physical activity and mental well-being, vitality, stress and sleep quality among newly arrived refugees.

    ConclusionsNewly arrived refugees need to be informed about the importance of prioritising physical activity for their health and wellbeing, regardless of their external circumstances, and supported in their attempts to do so.

    Key messages There is a significant association between physical activity and mental well-being, vitality, stress and sleep quality among newly arrived refugees.Newly arrived refugees need to be informed about the importance of prioritising physical activity for their health and wellbeing, and supported in their attempts to do so.

  • 21.
    Sjögren Forss, Katarina
    et al.
    Department of Health, Blekinge Institute of Technology; Jönkoping University .
    Stjernberg, Louise
    Department of Health, Blekinge Institute of Technology; Jönkoping University .
    Differences in physical activity patterns among women and men with and without children2012In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, no suppl. 2, p. 133-133Article in journal (Other academic)
    Abstract [en]

    Background Due to health effects from participating in physical activity (PA) it is from a public health perspective important to study how participation PA may change over a lifetime and how different life events impact on the participation. Although studies in the field are sparse, parenthood has been found to be a life event associated with decreased PA, especially among women. We studied physical activities performed among women and men with and without children. Methods This study includes data for from parents-to-be, 224 women and 208 men, from Karlskrona municipality, situated in the south eastern part of Sweden. Data collection was carried out during 2008–2009. When contacting the antenatal clinics in the municipality all expectant parents were asked by the midwife about participation in the study. Respondents completed a questionnaire about age, socioeconomic status, level of education, previous children, smoking and alcohol habits, Body Mass Index, self estimated health, and participation in different kinds of outdoor and indoor recreational PA. We measured the self-reported amount of outdoor recreational PA undertaken during the last year. Results Both women and men without children performed more outdoor and indoor PA compared to those who had children. Women walked significantly more (p = 0.017) than men irrespective of whether or not they had children. Women with children participated in significantly more gardening (p = 0.009) and winter sports (p = 0.013) than women without children, and women without children participated in significantly more PA indoors (p = 0.001) than women with children. Men with children participated in significantly more gardening (p = 0.001) than men without children, and men without children participated in significantly more PA indoors (p = 0.006). Conclusions Becoming a parent is a life event that affects participation in PA, both concerning duration and the kind of activities performed. To gain deeper understanding and more insight about reasons for these changed patterns of PA as well as the effects on the outcome of the parents health in a short- and long term would be important to follow prospectively.

  • 22.
    Sjögren Forss, Katarina
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Stjernberg, Louise
    Department of Health Sciences, The Swedish Red Cross University College.
    Physical activity among parents during pregnancy and 8 months postpartum compared to pre-pregnancy2020In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 30, no s5, p. V849-V849, article id ckaa166.858Article in journal (Other academic)
    Abstract [en]

    BackgroundAs there is incontrovertible evidence of the essential prerequisite of regular physical activity it is also important to understand how different life change events may impact individual's participation in physical activity. Pregnancy and the transition to parenthood have been found to be life change events associated with decreased physical activity among women however, the examination of changes of physical activity in the male parent during this major life change event has been largely neglected in scientific literature and a significant research gap can be found. In the light of this, this longitudinal study aimed to follow changing physical activity patterns among women and med during pregnancy and eight months postpartum compared to pre-pregnancy.

    MethodsThe study involved 123 women and 112 men (partners of the women) from the municipality of Karlskrona, Sweden. We measured the self-reported amount of physical activity performed outdoors and indoors before pregnancy (calculated from one month before pregnancy), throughout the entire pregnancy, and eight months postpartum. 

    ResultsWe found similar trends among both women and men in decreasing frequency of physical activity during pregnancy and eight months postpartum as compared to pre-pregnancy, however, overall physical activity levels did not change.

    ConclusionsOur findings contribute new knowledge about changes in men's physical activity patterns from pre-pregnancy to pregnancy and postpartum and is an important contribution in research, as the area is very limited. As couples seem to change activity patterns similarly, it is important to promote family-based physical activity initiatives and encourage couples to be active together during pregnancy and postpartum. 

    Key messages Couples seem to change physical activity patterns similarly during pregnancy and postpartum. as compared to pre-pregnancy.It is important to promote family-based physical activity initiatives and encourage couples to be active together during pregnancy and postpartum.

  • 23.
    Sjögren, Katarina
    et al.
    School of Health Science, Blekinge Institute of Technology; Lund University.
    Hansson, Eva Ekvall
    Lund University.
    Stjernberg, Louise
    School of Health Science, Blekinge Institute of Technology.
    Outdoor recreational physical activity and parenthood in a gender perspective-a study from south eastern part of Sweden2010In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 20, no Suppl. 1, p. 182-182Article in journal (Other academic)
  • 24.
    Sollerhed, Ann-Christin
    et al.
    Kristianstad Univ, Kristianstad, Sweden.
    Olesen, Line Gronholt
    Univ Southern Denmark, Odense, Denmark.
    Soini, Anne
    Univ Jyvaskyla, Jyvaskyla, Finland.
    Saakslahti, Arja
    Univ Jyvaskyla, Jyvaskyla, Finland.
    Kristjansdottir, Gudrun
    Univ Iceland, Reyjkavik, Iceland.
    Vilhjalmsson, Runar
    Univ Iceland, Reyjkavik, Iceland.
    Fjortoft, Ingunn
    Univ South Eastern Norway, Notodden, Norway.
    Larsen, Robert
    Univ South Eastern Norway, Notodden, Norway.
    Ekberg, Jan-Eric
    Malmö University, Faculty of Education and Society (LS), Department of Sports Sciences (IDV).
    Froberg, Karsten
    Univ Southern Denmark, Odense, Denmark.
    P01-03 Movement and physical activity in early childhood education and care in the Nordic countries2022In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 32, no Supplement 2Article in journal (Other academic)
    Abstract [en]

    Background: The World Health Organization (WHO) acknowledges the importance of preschool children taking part in comprehensive physical activities supporting, among other things, their motor development, and competencies. A growing number of children attend early childhood education and care (ECEC), and expectations that this will support the development and learning of the youngest children are high. ECEC are governed by different policies embodied in both laws and curricula, and the framework of a curriculum plays a key role in ensuring the quality of ECEC services. The documents represent the content society wants the ECEC institutions to disseminate, and set out the values, objectives, and content of the work of pre-school teachers and serve as a point of reference for ECEC teachers and schools. The purpose of this study was to examine the values of movement and physical activity (MoPA) using government policy documents ECEC from Denmark, Finland, Iceland, Norway, and Sweden.

    Methods: This descriptive, comparative study was designed based on curriculum theory and used word count and content analyses to examine values of MoPA and to identify similarities and differences in the ECEC policies of Nordic countries.

    Results: Seven terms were identified as MoPA related; body, motor, move, physical activity, physical education, coordination, idrott/liikunta. These terms occurred in various content contexts: development, environment, expression, health and well-being, learning and play, albeit sparsely and were referred to as both a goal in itself and as a mean of achieving other goals (e.g., learning or development in another area). Formulations dedicated to MoPA as a goal were present in the Danish and Finnish curricula and, to some extent, also in the Norwegian, while the Icelandic and Swedish curricula mentioned MoPA only as a mean.

    Conclusion: Findings indicated that MoPA, which are important for children's development, health, and well-being, is a low-priority value, to varying degrees, in the ECEC policies enacted by the Nordic countries. Thus, the guidance provided to educators and stakeholders therein is inexplicit. The low priority of the MoPA domain in the ECEC policies might negatively affect the possibility for young children to be physically active in preschools.

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  • 25.
    Stjernberg, Louise
    et al.
    Blekinge Inst Res & Dev; Blekinge Inst Technol, Sch Hlth Sci.
    Holmkvist, K
    Blekinge Inst Res & Dev..
    Berglund, J
    Blekinge Inst Res & Dev; Blekinge Inst Technol, Sch Hlth Sci.
    A newly detected TBE focus in the south-eastern part of Sweden: a follow-up study of TBEV seroprevalence, 1991 and 2002.2007In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 17, no Suppl. 2, p. 38-39Article in journal (Other academic)
    Abstract [en]

    Background. In 2002, 2 cases of tick-borne encephalitis were diagnosed among inhabitants living in a tick endemic area on the island of Aspö in south-eastern Sweden. During the previous 25 years, only 2 additional cases had been diagnosed in that region of Sweden. To study presence and evolution of seroprevalence of antibodies to the tick-borne encephalitis virus we carried out a follow-up study, comparing inhabitants´ immunoglobulin G antibody levels against the virus in blood samples drawn in 1991 and 2002. Method. The island of Aspö is located in the south-eastern archipelago by the Baltic Sea in the county of Blekinge, Sweden. Due to the confirmed cases of tick-borne encephalitis, permanent and part-time residents were offered tick-borne encephalitis vaccination in the autumn of 2002. Blood samples were collected and analyzed by the two-step enzyme-linked immunosorbent assay to detect immunoglobulin G antibodies against tick-borne encephalitis virus. Also, questionnaires including questions about sex, age, earlier history of and previous vaccination against tick-borne encephalitis, residency on Aspö, history of observed tick-bites and earlier history of Lyme borreliosis and human granulocytic erhlichiosis, was filled in. All those individuals who had participated in a study on LB performed in 1991, and where available blood samples made it possible to compare tick-borne encephalitis immunoglobulin G seroprevalence, were included in the follow-up. Results. A significant increase in immunoglobulin G levels was seen during the follow-up with 24 (12.0%) of 200 blood samples being seropositive in 2002 versus 7 (3,5%) of 200 blood samples in 1991. However, only five participants converted from seronegative level during the 11 y follow-up and one of these participants had been vaccinated against tick-borne encephalitis during the observation period. In only four of all positive sera from 2002 and in no sera from 1991, were neutralizing antibodies against tick-borne encephalitis virus demonstrated. Compared with women, significantly more men were seropositive. In comparison with other age groups the greatest increase was seen in the age group 20 to 29 years. However, most seropostive levels were seen among those >50 years. Conclusion. Although we found seropositive blood samples in this area already in 1991, the existence of tick-borne encephalitis virus at that time is doubtful since no neutralizing antibodies against tick-borne encephalitis virus were demonstrated. During the 11 years follow-up an obvious increase of tick-borne encephalitis immunoglobulin G seropositive levels in humans was seen. Recommending preventing measures, including vaccination against tick-borne encephalitis is of importance for people regularly staying in this endemic area.

  • 26.
    Tubert-Jeannin, S.
    et al.
    Dental School, University Clermont Auvergne, Clermont-Ferrand, France.
    Field, J.
    Dental School, University of Sheffield, Sheffield, UK.
    Davies, Julia R
    Malmö University, Faculty of Odontology (OD).
    Manzanares, C.
    Dental School, University of Barcelona, Barcelona, Spain.
    Dixon, J.
    Dental School, University of Sheffield, Sheffield, UK.
    Vital, S.
    Dental School, University of Paris, Paris, France.
    Paganelli, C.
    Dental School, University of Brescia, Brescia, Italy.
    Quinn, B.
    Dental School, ADEE, Dublin, Ireland.
    Gerber, G.
    Dental School, University Semmelweis, Budapest, Hungary.
    Akota, I.
    Dental School, University of Riga, Riga, Latvia.
    O-Health-Edu: Advancing oral health : A vision for dental education2020In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 30, no s5, p. V764-V764, article id ckaa166.631Article in journal (Other academic)
    Abstract [en]

    The prevalence and burden of untreated oral diseases throughout the life course remains high worldwide, and inequalities in oral health and dental care are increasing. This is a major public health issue that is not being enough addressed by the health care systems. To better manage populations' oral health, oral health professionals must be trained to adapt to population needs and societal and technological changes. Furthermore, dental institutions must fulfill their social responsibility by prioritizing educational and research activities that promote advancing individual and community health. In Europe, great variability exists between dental programs within the same country or between countries. This variability is an issue as European graduates can practice around the European Union through mutual recognition of their qualifications. This might lead to inequities in the availability, accessibility, acceptability and quality of health services. The convergence of competencies and quality standards at the international level must thus be better clearly identified, defined and improved. The purpose of the O-Health-Edu, EU funded project, “Advancing Oral Health: A vision for Dental Education” is thus to assess the current situation concerning the oral health professionals' education (OHP) and to identify educational priorities so that future graduating OHPs have competencies aligned with emerging population needs. The project is supported within the KA203 - “Cooperation for Innovation and the Exchange of Good Practices - Strategic Partnerships for higher education” Erasmus program. It began in October 2019 for three years, with eight European university partners and the ADEE (Association for Dental Education in Europe). The firsts steps consist of a scoping review to identify the available information followed by a questionnaire survey to gather more comprehensive data so that to build an opened data source, and a glossary of dental education terms.

    Key messages 

    Few Information about the current situation of dental education in Europe.Graduates must be equipped with adequate competencies to face populations needs.

  • 27.
    Wallander, Lisa
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Social Work (SA).
    Tikkanen, Ronny
    Mannheimer, Louise
    Östergren, Per-Olof
    Plantin, Lars
    Malmö högskola, Faculty of Health and Society (HS), Department of Social Work (SA).
    The problem of non-response in population surveys on the topic of HIV and sexuality: a comparative study2015In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 25, no 1, p. 172-177Article in journal (Refereed)
    Abstract [en]

    Background: Throughout the Western world, response rates are falling in population surveys. The aim of the study was to explore for the presence of non-response bias in two Swedish research projects on HIV [‘HIV in Sweden’ (HIS11)] and sexuality [‘Sex and health’ (UngKAB09)]. Methods: The study used four data sets (two from each project), each of which had been generated using different methods. By comparing means and percentages on 15 items across the data sets, we explore the potential presence of non-response bias due to interest in the survey topic (topic salience), and discuss the suitability of two increasingly common methods for recruiting respondents: the pre-recruited probability web panel and the self-selected web survey. Results: While a higher proportion of the respondents in the HIS11 substudies had been tested for HIV and were inclined to perceive themselves as being at high risk of HIV infection, the respondents in the UngKAB09 substudies were on average more sexually active. Further, while there was little variation in the results between the HIS11 substudies (postal/web survey and prerecruited web panel), there were some fairly large differences in the results between the UngKAB09 substudies (web surveys, one of which was based on a self-selected sample). Conclusion: The study concludes that (i) there are signs of non-response bias that may be due to topic salience, (ii) while care must be taken when using self-selection sampling methods, the pre-recruited probability web panel might provide a cost- and time-effective alternative for recruiting respondents in future population surveys.

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  • 28.
    Wretlind, Katharina
    et al.
    Malmö University, Faculty of Odontology (OD).
    Magnusson, M.
    Angered Hosp, Publ Hlth Unit, SV Hosp Grp, Gotaland, Sweden; Univ Skovde, Sch Hlth & Educ, Skovde, Sweden.
    Hallmyr, M.
    Angered Hosp, Publ Hlth Unit, SV Hosp Grp, Gotaland, Sweden.
    Implementing HEM in the assessment of oral health promotion to families in underserved areas2019In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29Article in journal (Other academic)
  • 29.
    Zdravkovic, Slobodan
    et al.
    Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM). Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Carlzen, K.
    Unit of Establishment and Integration, The County Administrative Board Skåne, Malmö, Sweden.
    Agardh, A.
    Division of Social Medicine and Global Health, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
    Svensson, P.
    Division of Social Medicine and Global Health, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
    Westerling, R.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Professional development of civic and health communicators: a national platform in Sweden MILSA 3.02020In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 30, p. V35-V35, article id ckaa165.081Article in journal (Other academic)
    Abstract [en]

    BackgroundEstablishing oneself in a new country is especially challenging for forced migrants affecting both physical and mental health. The Swedish introduction system includes a mandatory civic orientation program conducted in the refugeés native language, covering different aspects of the Swedish society. MILSA has advocated for including health promotion as a key component in the introduction system, stating that culturally sensitive health communication is a human right for refugees. Through this work, health communication is now included in the program in many parts of Sweden. However, there are challenges due to a lack of professional recognition related to the absence of a recognized training. In order to create a national capacity for a quality based civic and health communication, MILSA has developed a national training program carried out in collaboration with five universities, actors on local, regional, and national levels as well as NGOs and experts in different areas. 

    MethodsA web-based program including six physical workshops is given nationally. The program consists of 22 modules targeting society and public health issues but also pedagogy, leadership and communication. Evaluation studies are included in the program targeting the education itself and as well as investigating effects on the refugees.

    ResultsThe program has been running for three years ending in autumn 2020 including four admission periods. The early evaluation showed very encouraging results where participants reported a deeper knowledge of civics and public health, resulting in being more secure and comfortable in their daily work, including improvements regarding skills in pedagogy, leadership and conflict management.

    ConclusionsThe need for an educational platform is recognized by many stakeholders in Sweden. The program has received a very positive evaluation. Due to this, MILSA has initiated a process of establishing a national commissioned program on permanent basis.

    Key messages The program has been highly regarded by the communicators, due to the gained knowledge in their everyday work.The importance of health communication and professional development and its value for the recipients of civic orientation is recognized by many stakeholders within but also outside the country.

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  • 30.
    Zdravkovic, Slobodan
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Grahn, M.
    Enheten för Statistik och Data, Avdelningen för analys och hållbarhet, Stadskontoret, Malmö stad, Malmö, Sweden.
    Rämgård, Margareta
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Annersten Gershater, Magdalena
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Are recently arrived migrants at higher risk of developing diabetes in Scania, Sweden?2020In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 30, no s5, article id ckaa166.1107Article in journal (Other academic)
    Abstract [en]

    Background: The world is facing increased migration as well as increased diabetes prevalence including earlier disease debut than ever before. Sedentary lifestyle and obesity constitute risk factors for development of diabetes type 2, the most common diabetes type among adults. It is thus important to increase the awareness of diabetes prevalence and of those being at risk for the disease. The aim was to focus on self-reported diabetes and weight in recently arrived migrants (RAM) in comparison with the rest of the population of Scania.

    Methods: A cross-sectional study was used to collect data through random sampling using a self-administrated questionnaire. 10 000 questionnaires in Arabic were sent to adult RAM in Scania born in Syria or Iraq and 10 000 questionnaires to a random sample of the Scania population as a control group. The overall response rate was 32.8 %, 3461 were male and 3105 were female and the overall mean age was 44.7 (range 22 -70).

    Results: 170 RAM and 147 controls reported diabetes, 741 RAM and 585 controls reported a body mass index (BMI) ≥ 30 kg/m2. A significantly higher prevalence of self-reported diabetes was observed among RAM (6.2% compared to 4.9%, p-value = 0.02). In comparison with age, significantly (p-value < 0.05) higher prevalence was present in RAM as compared to the control group in all age categories except the age category 65-80 where the difference was borderline significant (p-value = 0.056). With regard to BMI no significant difference was observed between the RAM and the control group having diabetes, but independently of diabetes the prevalence of BMI 25-30 kg/m2 and BMI ≥ 30 kg/m2 was significantly higher in RAM (p-value < 0.01).

    Conclusions: Self-reported diabetes is more prevalent in RAM as compared to a control group representing the rest of the population in Scania. Considerably large amount of the respondents in both groups are overweight or obese and are therefore to be considered at risk for developing diabetes type 2.

    Key messages 

    Self-reported diabetes in Scania is more prevalent in RAM from Iraq and Syria than in the rest of the population in Scania.Health care services need to address that a large number of the population in Scania is being overweight or obese, which is even more prominent in RAM from Iraq and Syria.

  • 31.
    Zdravkovic, Slobodan
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV). Malmö högskola, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Grahn, Mathias
    Public Health and Social Sustainability Unit Region Skåne, Malmö, Sweden.
    Björngren Cuadra, Carin
    School of Social Work, Lund University, Lund, Sweden.
    Self-reported health issues in recently arrived migrants to Sweden2016In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 26, no suppl 1, p. 220-220Article in journal (Other academic)
    Abstract [en]

    Background The awareness of health and health related needs in migrants (i.e. refugees) is crucial for effective public support systems. For this and other reasons a regional survey was established to address various health issues in recently arrived migrants to Scania. The questions that the present study is seeking answers for relates health, changes in health as well as self-reported possibility to affect health in general but also in relation to level of education. Methods Data collection occurred between February 13, 2015 and February 12, 2016. The inclusion criteria were recently arrived adult migrants speaking Arabic, Dari, Pashto or Somali participating in the public support system. Questions on selfreported health, self-reported changes in health since the move to Sweden, self-reported possibility to affect own health as well as education was examined among others in an extensive health survey. The survey was funded by the European refugee fund. Results 681 respondents took part in the survey where 94% were Arabic speaking. 69% were men and 51% were 18 to 34 years. 23% graded self-reported health as very well and 46% as well. Highly educated reported very well to a higher degree (30%) than the primary (17%) and the secondary level (12%) (pvalue< 0.01). Change in health was reported by 32% as negative and by 21% as positive. No significant difference was observed in relation to education. 70% reported the possibility of affecting own health as very important and the comparison with education was significant (p-value<0.01). Over 64%, independently of education, reported own contribution as very important. Conclusions The majority of recently arrived migrants’ reports good health and own contribution for health as very important. Negative change in health was reported by almost a third of the migrants. (a) Increase efforts to stop negative changes in health. (b) Enhance health information practice to increase the benefits of own contribution for health. Key messages: - Recently arrived migrants reports a similar level of good health as the inhabitants of Scania observed in the latest regional public health survey - A third of the respondents reports worsening health since the move to Sweden

  • 32.
    Zdravkovic, Slobodan
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV). Malmö högskola, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Grahn, Mathias
    Department of Public Health and Social Sustainability, Scania Regional Council, Malmö, Sweden.
    Valentin Kvist, Ann
    Strategic Unit, Department Rehabilitation to Work, Swedish Public Employment Service, Stockholm, Sweden.
    Östergren, PO
    Social Medicine and Global Health, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden.
    Björngren Cuadra, Carin
    School of Social Work, Lund University, Lund, Sweden.
    Recently arrived migrants’ health status in the region of Scania, Sweden2016In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 26, no Suppl 1, p. 492-492Article in journal (Other academic)
    Abstract [en]

    Background Knowledge of health and health related issues in recently arrived migrants (i.e. refugees) to Sweden is limited, although studies indicate that health status of migrants in general is worse than people born in Sweden and that it deteriorates over time. Regular public health surveys have difficulty reaching new migrants, partly due to language barriers. In order to address health and health related issues a study was initiated in Scania targeting recently arrived migrants. A grant for the study was received by the European refugee fund. Methods Data was collected within the framework of the public system for supporting migrants’ establishment to society and labour market, which ensures coverage. The inclusion criteria were all adult recently arrived migrants to Scania, 18 to 64 years taking part in the public support system between February 13, 2015 and February 12, 2016. Questionnaires in Arabic, Dari, Pashto and Somali were used for data collection. Health issues covered diabetes, asthma, war injuries, dental, mental, and selfreported health among others. Health related issues address health-literacy, smoking, drug use, physical activity, and health system use as well as education and social relations mentioning few. The further aims of the study are to identify evidence for introducing need-specific strategies and to enhance the possibility for evaluating the adequacy of present practices. Results The study reveals necessary knowledge about health and health related needs in this group of new residents of Scania. Results will be available after the summer 2016 also including methodological concerns. Conclusions The study adds knowledge on health and health related needs in recently arrived residents and serves as a complement to the regular public health survey in Scania. It also addresses a number of methodological questions. Key messages: - Unique health and health related knowledge will be revealed in recently arrived immigrants of Scania - The study will reveal evidence for need-specific health strategies and for evaluating the adequacy of present practices

  • 33.
    Zdravkovic, Slobodan
    et al.
    Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM). Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Jonsson, C.
    Digitalisering IT & MT, VO Data & Analys, Lund, Region Skane, Sweden..
    Annersten Gershater, Magdalena
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Ericsson, A.
    Novo Nordisk Scandinavia AB, Natl Market Access, Malmo, Sweden..
    Grahn, M.
    Unit Stat & Anal, Malmo, Sweden..
    Rämgård, Margareta
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Dozet, A.
    Dept Hlth Care Governance, Lund, Region Skane, Sweden..
    Health care costs for residents diagnosed with diabetes type 2 in Malmo, Sweden between 2011 and 20182021In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 31, no S3Article in journal (Other academic)
    Abstract [en]

    Background

    During the last decade, type 2 diabetes (T2D) prevalence has increased worldwide, especially among children and young adults. Diabetes is a chronic disease that if not diagnosed in time can lead to serious health complications and put pressure on the societal resources. The aim of this study was to evaluate the economic impact of the increased T2D prevalence in Malmö over time on the regional health care organization.

    Methods

    A longitudinal population-based study in Malmö, within the Cities Changing Diabetes project. Data was collected from the Patient Administrative System in Region Skåne, classifying T2D by the ICD E11 code. The health care cost (HCC) has been adjusted by the Consumer Price Index (CPI) to 2020 prices.

    Results

    The prevalence of T2D increased from 2,5% in 2011 to 4,3% in 2018. The increase in T2D prevalence was most noticeable for residents 18 - 64 years. The overall HCC for treating residents with T2D was approximately €47,2 million in 2011 and €90,7 million in 2018. The HCC in 2018 was higher for males than for females (€54,6 million vs €36,2 million). In 2018, the cost was €49,9 million for those 18 - 64 years and €40,5 million for those being 65 years or older. The overall HCC increased during the study period (3,3 times for those 18 - 64 years and 1,4 times for those being 65 years or older). For the age group 18 - 64 the HCC per resident was €5 000 in 2011 and €5 300 in 2018. The HCC per resident for all age groups, has not changed markedly, from €6 200 in 2011 to €6 100 in 2018 as well as the number of health care visits (23 in 2011 and 29 in 2018).

    Conclusions

    The HCC for T2D has increased markedly since 2011. This increase is most noticeable for people under 65 years. The overall HCC for these patients and its change over time puts an increased strain on the health care provider Region Skåne, mainly due to increased prevalence.

    Key messages 

    • The overall HCC during 2011 – 2018 has increased 2 times for residents with T2D and 1.5 times for residents without T2D. This increase is likely to continue if the current trend remains.
    • The main driving force behind the increase in HCC over time is the increase in T2D prevalence and not in HCC per resident.
  • 34.
    Zdravkovic, Slobodan
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Mangrio, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Håkansson, Peter
    Malmö University, Faculty of Culture and Society (KS), Department of Urban Studies (US).
    Westerling, Ragnar
    Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden; Cty Adm Board Skåne, K Carlzen Unit Estab & Integrat, Malmo, Sweden.
    A support platform for migration and health (MILSA 2.0), Sweden2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 472-472Article in journal (Other academic)
    Abstract [en]

    Background: Solid health is a prerequisite for successful inclusion and participation in support systems for recently arrived migrants’ (RAM) i.e. refugees. The society support system may vary depending on the age of RAM but is equally important for an effective start of the establishing process. Understanding health needs of RAM in different phases of establishing is essential as such knowledge is central for the supporting system. Methods: MILSA 2.0 consists of five studies targeting various health aspects. The focus is depicted into an early phase of establishment as well as following the period after the mandatory process. The platform addresses health issues of families with children as well as various health aspects of Arabic speaking adult RAM soon after arrival to Sweden. Also, it focuses on RAM adolescents in relation to risk behavior, social capital and confidence as well as on health issues in adult RAM after the formal establishment process. The platform also illuminates an extended support system of civic and health communication both in time as well as lecturing environment primarily targeting social capital, coherence and self-efficacy. Results: MILSA 2.0 addresses different phases of an establishing process in Sweden. Several health and health related factors are addressed such as self-rated health, social capital, trust, physical activity, sexual and reproductive health and living conditions. The extended civic and health communication addresses increased program hours as well as new program environments such as libraries, museums, and workplaces. Conclusions: These five studies reveals health related knowledge in different aspects of the establishing process as well as it develops several questionnaires and reveals methodological aspects. The platform focuses on both adolescent and adult RAM during and after the mandatory public support system including both the recipients of the support as well as the supporting actors. Key messages: - MILSA 2.0 develops questionnaires and determines health related concerns both during and after the mandatory establishing process. - MILSA 2.0 evaluates the effect of a policy change regarding standard procedures of civic and health communication.

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