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  • 1.
    Abbasi, Seyed Hesameddin
    et al.
    Mid Sweden University, Sundsvall, Sweden; Tehran University of Medical Sciences, Tehran, Iran; Iranian Petroleum Health Research Institute, Tehran, Iran .
    De Leon, Antonio Ponce
    Karolinska Institutet, Stockholm, Sweden; Universidade do Estado de Rio de Janeiro, Brazil.
    Kassaian, Seyed Ebrahim
    Tehran University of Medical Sciences, Tehran, Iran.
    Karimi, Abbasali
    Tehran University of Medical Sciences, Tehran, Iran.
    Sundin, Örjan
    Department of Psychology, Mid-Sweden University, Östersund, Sweden.
    Jalali, Arash
    Tehran University of Medical Sciences, Tehran, Iran.
    Soares, Joaquim
    Mid Sweden University, Sundsvall, Sweden; Karolinska Institutet, Stockholm, Sweden.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Mid Sweden University, Sundsvall, Sweden; Karolinska Institutet, Stockholm, Sweden.
    Socioeconomic status and in‑hospital mortality of acute coronary syndrome: can education and occupation serve as preventive measures?2015In: International Journal of Preventive Medicine, ISSN 2008-7802, E-ISSN 2008-8213, Vol. 6, article id 36Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Socioeconomic status (SES) can greatly affect the clinical outcome of medical problems. We sought to assess the in-hospital mortality of patients with the acute coronary syndrome (ACS) according to their SES.

    METHODS: All patients admitted to Tehran Heart Center due to 1(st)-time ACS between March 2004 and August 2011 were assessed. The patients who were illiterate/lowly educated (≤5 years attained education) and were unemployed were considered low-SES patients and those who were employed and had high educational levels (>5 years attained education) were regarded as high-SES patients. Demographic, clinical, paraclinical, and in-hospital medical progress data were recorded. Death during the course of hospitalization was considered the end point, and the impact of SES on in-hospital mortality was evaluated.

    RESULTS: A total of 6246 hospitalized patients (3290 low SES and 2956 high SES) were included (mean age = 60.3 ± 12.1 years, male = 2772 [44.4%]). Among them, 79 (1.26%) patients died. Univariable analysis showed a significantly higher mortality rate in the low-SES group (1.9% vs. 0.6%; P < 0.001). After adjustment for possible cofounders, SES still showed a significant effect on the in-hospital mortality of the ACS patients in that the high-SES patients had a lower in-hospital mortality rate (odds ratio: 0.304, 95% confidence interval: 0.094-0.980; P = 0.046).

    CONCLUSIONS: This study found that patients with low SES were at a higher risk of in-hospital mortality due to the ACS. Furthermore, the results suggest the need for increased availability of jobs as well as improved levels of education as preventive measures to curb the unfolding deaths owing to coronary artery syndrome.

  • 2.
    Abbasi, Seyed Hesameddin
    et al.
    Department of Health Sciences, Section of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden; Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
    Sundin, Örjan
    Department of Psychology, Mid Sweden University, Östersund, Sweden.
    Jalali, Arash
    Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
    Soares, Joaquim
    Department of Health Sciences, Section of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Department of Health Sciences, Section of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Ethnic Differences in the Risk Factors and Severity of Coronary Artery Disease: a Patient-Based Study in Iran2018In: Journal of Racial and Ethnic Health Disparities, ISSN 2197-3792, Vol. 5, no 3, p. 623-631Article in journal (Refereed)
    Abstract [en]

    Background

    Diverse ethnic groups may differ regarding the risk factors and severity of coronary artery disease (CAD). This study sought to assess the association between ethnicity and CAD risk and severity in six major Iranian ethnic groups.

    Methods

    In this study, 20,165 documented coronary artery disease patients who underwent coronary angiography at a tertiary referral heart center were recruited. The demographic, laboratory, clinical, and risk factor data of all the patients were retrieved. The Gensini score (an indicator of CAD severity) was calculated for all, and the risk factors and severity of CAD were compared between the ethnical groups, using adjusted standardized residuals, Kruskal–Wallis test, and multivariable regression analysis.

    Results

    The mean age of the participants (14,131 [70.1%] men and 6034 [29.9%] women) was 60.7 ± 10.8 years. The Fars (8.7%) and Gilak (8.6%) ethnic groups had the highest prevalence of ≥4 simultaneous risk factors. The mean Gensini score was the highest for the Gilaks (77.1 ± 55.9) and the lowest among the Lors (67.5 ± 52.8). The multivariable regression analysis showed that the Gilaks had the worst severity (β 0.056, 95% CI 0.009 to 0.102; P = 0.018), followed by the Torks (β 0.032, 95% CI 0.005 to 0.059; P = 0.020). Meanwhile, the Lors showed the lowest severity (β −0.087, 95% CI −0.146 to −0.027; P = 0.004).

    Conclusions

    This study found that there was heterogeneity in CAD severity and a diverse distribution in its well-known traditional risk factors among major Iranian ethnic groups.

  • 3.
    Abbasi, Seyed
    et al.
    Tehran University of Medical Sciences, Iran; Mid-Sweden University; Harvard T.H. Chan School of Public Health, Boston, MA, USA.
    Sundin, Örjan
    Mid-Sweden University.
    Jalali, Arash
    Tehran University of Medical Sciences, Iran.
    Soares, Joaquim
    Mid-Sweden University.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science. Mid-Sweden University.
    Mortality from Acute Coronary Syndrome: Does Place of Residence Matter?2022In: Journal of Teheran University Heart Center, ISSN 1735-8620, Vol. 17, no 2, p. 56-61Article in journal (Refereed)
    Abstract [en]

    Background: Current evidence shows inequality in the outcomes of rural and urban patients treated at their place of residence. This study compared in-hospital mortality between rural and urban patients with acute coronary syndrome (ACS) to find whether there were differences in the outcome and received treatment.

    Methods: Between May 2007 and January 2018, patients admitted with ACS were included. The patients’ demographic, clinical, and laboratory data, as well as their in-hospital medical courses, were recorded. The association between place of residence (rural/urban) and in-hospital mortality due to ACS was evaluated using logistic regression adjusted for potential confounders.

    Results: Of 9088 recruited patients (mean age =61.30±12.25 y; 5557 men [61.1%]), 838 were rural residents. A positive family history of coronary artery disease (P=0.003), smoking (P=0.002), and hyperlipidemia (P=0.026), as well as a higher body mass index (P=0.013), was seen more frequently in the urban patients, while the rural patients had lower education levels (P<0.001) and higher unemployment rates (P=0.009). In-hospital mortality occurred in 135 patients (1.5%): 10 rural (1.2%) and 125 urban (1.5%) patients (P=0.465). The Firth regression model, used to adjust the effects of possible confounders, showed no significant difference concerning in-hospital mortality between the rural and urban patients (OR, 1.57; 95% CI, 0.376 to 7.450; P=0.585).

    Conclusion: This study found no significant differences in receiving proper treatment and in-hospital mortality between rural and urban patients with ACS.

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  • 4.
    Abbasi, SH
    et al.
    Mittuniversitetet, Institutionen för hälsovetenskap.
    De Leon, AP
    Division of Social Medicine, Department of Public Health Sciences, Karolinska Intitutet, Sweden.
    Kassaian, SE
    Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
    Karimi.,, AA
    Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
    Sundin, Ö
    Mittuniversitetet, Institutionen för samhällsvetenskap.
    Soares, J
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Mittuniversitetet, Institutionen för hälsovetenskap.
    Gender Differences in the Risk of Coronary Artery Disease in Iran2012In: Iranian Journal of Public Health, ISSN 0304-4556, Vol. 41, no 3, p. 36-47Article in journal (Refereed)
    Abstract [en]

    Background: Given gender differences in the risk of coronary artery disease (CAD), the present study sought to investigate these dissimilarities amongst patients who underwent angiography at a major, tertiary heart hospital in Iran. Methods: Between 2005 and 2010, 44,820 patients who underwent coronary angiography were enrolled in a registry. Pre-procedural data such as demographics, CAD risk factors, presenting symptoms, and laboratory tests, as well as postprocedural data were collected. The data were, subsequently, compared between the men and women. Results: Out of the 44,820 patients (16,378 women), who underwent coronary angiography, 37,358 patients (11,995 women) had CAD. Amongst the CAD patients, the females were not only significantly older, less educated, and more overweight than were the males but also had higher levels of triglyceride, cholesterol, low-density lipoprotein, highdensity lipoprotein, and fasting blood sugar (P< 0.001). Of all the risk factors, hypertension and diabetes mellitus showed the strongest association in our female CAD patients (OR=3.45, 95%CI: 3.28-3.61 and OR=2.37, 95%CI: 2.26- 2.48, respectively). Acute coronary syndrome was more prevalent in the men (76.1% vs. 68.6%, P< 0.001), and chronic stable angina was more frequent in the females (31.4% vs. 23.9%, P< 0.001). With respect to post-procedural recommendations, the frequency of recommendations for non-invasive modalities was higher in the females (20.1% vs. 18.6%, P< 0.001). Conclusion: Hypertension and diabetes mellitus had the strongest association with CAD in our female patients. In the extensive CAD patients, medical treatment was recommended to the women more often.

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  • 5.
    Ahmadi, Elena
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Lundqvist, Daniel
    Department of Behavioural Sciences and Learning, Division of Education and Sociology, Linköping University, Linköping, Sweden.
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    A qualitative study of factors that managers in small companies consider important for their wellbeing2023In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 18, no 1, article id 2286669Article in journal (Refereed)
    Abstract [en]

    Purpose

    Given the importance of small businesses for society, and the significance of managers’ wellbeing for employee health, leadership, and business performance, more knowledge is needed on the sources of managers’ wellbeing. This study explored factors within the small business context that were perceived by managers to hinder or enable their wellbeing.

    Methods

    Data were collected through qualitative semi-structured interviews with 20 managers from 12 small companies, and analysed with content analysis.

    Results

    The factors that these managers in small businesses experienced as enhancing or hindering their personal wellbeing covered five categories: demands and resources in the daily managerial work, achievement of results, social factors, organizational factors, and individual factors.

    Conclusions

    The specific context of managerial work in small companies encompasses unique factors. For instance, the small company managers’ wellbeing was affected by vulnerability due to the smallness of the business and the absence of available resources. Simultaneously, a small company context provided a strong social climate and close relationships with employees and customers that strengthened the managers’ wellbeing. The findings suggest that the availability of financial, personnel, and organizational resources varies between small companies of different size, which may have implications for small business managers’ work and wellbeing.

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  • 6.
    Ahmadi, Elena
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Lundqvist, Daniel
    Linköpings universitet.
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science. EPIUnit–Instituto de Saude Publica, Universidade do Porto, Porto, Portugal.
    Managers’ and employees’ experiences of how managers’ wellbeing impacts their leadership behaviours in Swedish small businesses2023In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 75, no 1, p. 97-112Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:There is a growing interest in managers’ wellbeing due to the observed associations between their wellbeing and leadership behaviours, and between leadership behaviours and employees’ wellbeing. However, it is still unclear how managers’ wellbeing influences their practiced leadership across different workplace contexts, which specific behaviours are affected, and how this varies across time.

    OBJECTIVE:The purpose of this study was therefore to explore managers’ and employees’ experiences and perceptions regarding the consequences of managers’ wellbeing for their leadership behaviours in small businesses.

    METHODS:Semi-structured interviews were conducted with 37 participants (19 managers and 18 employees) working at 12 Swedish small firms, and analysed using content analysis.

    RESULTS:The findings show that managers were more constructive when they felt well, and more passively destructive when unwell. Variations in managers’ wellbeing influenced their mood, energy level, and performance, as well as the company’s working climate. However, these destructive leadership variations did not have a substantial impact, because several protective factors were present.

    CONCLUSION:This study shows that the wellbeing of managers in small businesses has perceptible consequences for their leadership behaviours. The study also shows that sustained leadership behaviours may coexist with temporary variations of these behaviours on a constructive-destructive continuum depending on the leader’s wellbeing. Overall, the findings contribute to a more nuanced and dynamic understanding of how the interaction between managers’ wellbeing and their behaviours unfolds in the particular context of small companies.

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  • 7.
    Ahmadi, Elena
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Psychology, Sports Science and Occupational Health Sciences, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Lundqvist, Daniel
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Psychology, Sports Science and Occupational Health Sciences, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work, Criminology and Public Health Sciences, Public Health Science.
    Managers in the context of small business growth: a qualitative study of working conditions and wellbeingManuscript (preprint) (Other academic)
  • 8.
    Ahmadi, Elena
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science. University of Porto.
    Larsson, Johan
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. LKAB.
    Managers’ work and behaviour patterns in profitable growth SMEs2021In: Small Business Economics, ISSN 0921-898X, E-ISSN 1573-0913, Vol. 57, p. 849-863Article in journal (Refereed)
    Abstract [en]

    We investigated managers’ work and behaviour patterns in profitable growth small- and medium-sized Swedish companies, and considered how these patterns might be associated with good health outcomes. Specifically, we looked at hours worked by managers, proportion of time spent on working activities, and leadership behaviour orientation. We used a quantitative cross-sectional design and collected data via a standardized questionnaire that was answered by 133 top managers. The data were analyzed with descriptive statistics, linear regression, and compositional data analysis. Our results indicate that the managers worked long hours, which is a health risk both for them as individuals and for their organizations, but also that they engaged in work practices and leadership behaviours that were favourable for organizational health and for their employees. The managers spent a high proportion of their time in touring, which could be beneficial to organizational health, and exercised active leadership through behaviours that contribute to both employee health and company effectiveness. Comparing our results to other studies, we can observe that patterns of managers’ time use differ between small and large companies, confirming that the size of the firm is an important determinant of managerial work.

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  • 9.
    Ahmadi, Elena
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Larsson, Johan
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Managers’ working hours and time allocation in effective SMEs – an organizational health perspective2018In: FALF KONFERENS 2018 Arbetet – problem eller potential för en hållbar livsmiljö?   10-12 juni 2018 Gävle: Program och abstracts / [ed] Per Lindberg, Gävle: Gävle University Press , 2018, p. 118-Conference paper (Refereed)
    Abstract [en]

    Background

    There is an increased global interest in occupational health across small businesses as they represent a large share of employers in many societies. In the model of healthy work organisations, employee health is a prerequisite for higher productivity and profitability and management practices are considered as determinants of organisational health. A better understanding of how managers in effective companies use their time can offer a better understanding of how this can affect employees’ well-being and business effect-iveness. Managers’ long working hours and share of time spent on Management by Walking Around (MBWA) are considered important characteristics of managers’ work that might have consequences for employees’ and managers’ own health outcomes, as well as for organisational effectiveness. MBWA is a management technique common for successful companies in regard to their effectiveness; providing an opportunity for a spontaneous manager-subordinate interaction that might be important for employee health and wellbeing. Studies of managerial work have to some extent not clearly placed managers’ time use in the broad context of leadership, often missing to link it with leadership behaviour theories, health and effectiveness.

    Objective

    The objective of this study was to explore, on the one hand, the total amount of working hours that managers spent, and on the other, their patterns of time allocation to different activities in effective SMEs. Research questions were: 1) What patterns regarding managers’ working hours can be identified across socio-demographic variables, leader-ship experience factors and leadership profiles in effective SMEs? 2) What patterns regarding proportions of total working hours spent on MBWA can be identified across socio-demographic variables, leadership experience factors and leadership profiles in effective SMEs?

    Method

    The study used data collected within the project, “Successful Companies in Gästrikland”. Annually the project nominates 120 companies for the award based on companies’ financial indicators. The study employed a cross-sectional design and analysed responses to questionnaires collected within the project during years 2014-2018. The inclusion criteria were small and medium sized companies (more than four and less than 250 subordinates), high-level managers having subordinates. Data analysis were carried out using descriptive statistics and regression analysis.

    Results

    The results section is being processed and will be reported on the conference.

  • 10.
    Ahmadi, Elena
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Vilhelmson, Pär
    University of Gävle, Faculty of Education and Business Studies, Department of Business and Economic Studies, Business administration.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Larsson, Johan
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    FRAMFÖR (Framgångsrika företag i Gästrikland): ett longitudinellt projekt om ledarskap, arbetsmiljö och effektivitet – fördel för både forskning, utbildning och ett hållbart arbetsliv?2016In: Inkluderande och hållbart arbetsliv: Book of abstracts - FALF 2016, Östersund: Mittuniversitetet , 2016, p. 48-48Conference paper (Refereed)
    Abstract [sv]

    Projektbeskrivning: FRAMFÖR har under 15 år bedrivits i Gästrikland i samarbete mellan utbildning och forskning vid Högskolan i Gävle, företagsutvecklare vid kommuner, företag och näringslivsorganisationer. Varje år delas utmärkelsen FRAMFÖR ut till 50 företag. Ambitionen är att uppmuntra framgångsrika företagare och visa upp intressanta exempel på hur framgång kan skapas. Processen startar med att 120 företag (>4 anställda) nomineras utifrån finansiella kriterier (ex. omsättningstillväxt, vinstmarginal). Sedan genomför studenter vid Ekonomprogrammet intervjuer med cheferna för dessa företag. Intervjuerna sker utifrån ett standardiserat frågeformulär kring arbetsmiljö, ledarskap, organisering och effektivitet. Avslutningsvis väljer en jury ut de 50 mest framgångsrika företagen utifrån såväl finansiella kriterier som studenternas intervjuresultat. Projektets trippel helixuppbyggnad (Utbildning, Forskning och, Företag) skapar nyttor för olika intressenter.

    Utbildningsnyttor: Studenterna får möjlighet till interaktion med företagare i sin direkta närhet. Aktiviteterna underlättar att uppfylla utbildningsmål där flera mål kan uppfyllas med samma aktiviteter. Förståelse för näringslivets förutsättningar samt kunskaper om ett vetenskapligt angreppssätt ökar.

    Forskningsnyttor: Stärker pågående forskning om hälsofrämjande och effektivt ledarskap inom arbetshälsovetenskap samt företagsutveckling inom företagsekonomi. Det stora urvalet av företag ger en bra bild av företagen i regionen och en möjlighet att följa dem över tid. Ambitionen är att få mer kunskap om hållbara och effektiva företag. Fördjupade studier av utmärkelseföretag möjliggörs och ett doktorandprojekt med inriktning på ledarskapsbeteenden, organisationsfaktorer, tidsanvändning samt chefers/medarbetares arbetsmiljö/hälsa i utmärkelseföretag är uppstartat.

    Företagsnyttor: Företagare får möta studenter och förstå hur de tänker. Ställda frågor, t.ex. rörande arbetsmiljö och ledarskap, kan starta reflektionsprocesser som bidrar till fortsatt utveckling. FRAMFÖR-utmärkelsen delas ut vid en högtidlig tillställning där företagarna kan bygga nätverk. Flera företagare lyfter fram det positiva symbolvärdet av att få utmärkelsen.

    Projektets framtid: Målet är att fortsätta ytterligare 15 år och fortsätta utveckla nyttorna för samtliga intressenter. Ett prioriterat område är återkoppling till företag i någon form samt ökad samverkan mellan studenter och företagare.

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  • 11.
    Antai, Diddy
    et al.
    Karolinska Inst, Stockholm, Sweden..
    Ghilagaber, Gebrenegus
    Stockholm Univ, Stockholm, Sweden.
    Wedrén, Sara
    Karolinska Inst, Stockholm, Sweden.
    Macassa, Gloria
    Karolinska Inst, Stockholm, Sweden.
    Moradi, Tahereh
    Karolinska Inst, Stockholm, Sweden.
    Inequities in Under-Five Mortality in Nigeria: Differentials by Religious Affiliation of the Mother2009In: Journal of religion and health, ISSN 0022-4197, E-ISSN 1573-6571, Vol. 48, no 3, p. 290-304Article in journal (Refereed)
    Abstract [en]

    Observations in Nigeria have indicated polio vaccination refusal related to religion that ultimately affected child morbidity and mortality. This study assessed the role of religion in under-five (0-59 months) mortality using a cross-sectional, nationally representative sample of 7,620 women aged 15-49 years from the 2003 Nigeria Demographic and Health Survey and included 6,029 children. Results show that mother's affiliation to Traditional indigenous religion is significantly associated with increased under-five mortality. Multivariable modelling demonstrated that this association is explained by differential use of maternal and child health services, specifically attendance to prenatal care. To reduce child health inequity, these results need to be incorporated in the formulation of child health policies geared towards achieving a high degree of attendance to prenatal care, irrespective of religious affiliation.

  • 12.
    Awuba, Jude
    et al.
    Karolinska Inst, Stockholm, Sweden.
    Macassa, Gloria
    Karolinska Inst, Stockholm, Sweden.
    HIV/AIDS in Cameroon: Rising gender issues in policy-making matters2007In: African Journal of Health Sciences, ISSN 1022-9272, E-ISSN 2306-1987, Vol. 14, no 3-4, p. 118-128Article in journal (Refereed)
    Abstract [en]

    This literature review investigated gender differentials in HIV/AIDS in Cameroon and to which extent gender was taken into account in the country’s current policy on HIV/AIDS. The review found that in Cameroon women were at increased risk of being infected with HIV/AIDS compared to men and that apart from biological vulnerability, socio-cultural as well as economic factors accounted for those differences. In addition, the review found that at the policy level, the government has drawn up plans to reduce the high prevalence of HIV/AIDS among women. However, although the current policy acknowledged the need for tackling gender differentials in HIV/AIDS transmission; little has been done at the level of implementation. The current policy needs to be implemented in a more effective manner and a multisectorial approach should be explored in order to curb the current trend of the feminization of HIV/AIDS in Cameroon.

  • 13.
    Begum, Afroza
    et al.
    Mid-Sweden University, Sundsvall, Sweden.
    Rahman, A. F.
    Center for Injury Prevention and Research, Dhaka, Bangladesh; Department of Epidemiology, Bangladesh University of Health Sciences, Dhaka, Bangladesh.
    Rahman, A.
    Center for Injury Prevention and Research, Dhaka, Bangladesh.
    Soares, Joaquim
    Mid-Sweden University, Sundsvall, Sweden.
    Reza Khankeh, H.
    Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Department of Health Sciences, Section of Public Health Sciences, Mid-Sweden University, Sundsvall, Sweden; Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden.
    Prevalence of suicide ideation among adolescents and young adults in rural Bangladesh2017In: International Journal of Mental Health, ISSN 0020-7411, E-ISSN 1557-9328, Vol. 46, no 3, p. 177-187Article in journal (Refereed)
    Abstract [en]

    Suicide is a leading cause of death world-wide. However, adolescent suicidal behavior is a neglected public health issue, especially in low-income countries such as Bangladesh. The study was conducted to estimate the prevalence of suicidal ideation among adolescents in a rural community and to examine factors associated with suicidal ideation. A cross-sectional survey was carried out in 2013 among 2,476 adolescents aged 14–19 years, selected randomly from a rural community of Bangladesh. An adapted version of the WHO/SUPRE-MISS questionnaire was used to collect data in the Raiganj sub-district. A two stage screening was performed to identify the suicidal ideation cases. It was found that the life-time prevalence for suicidal ideation was 5 percent among adolescents. The majority of the adolescents with suicidal ideation were females 66 (52.8%), unmarried 103 (82.4%), and students 92 (73%). Suicidal ideation was statistically significantly associated with age, education, occupation, living with parents or others, and house ownership. Respondents who were aged 18–19 years, had secondary school certificate (SSC) and secondary school certificate (HSC) or higher education, were day laborers, had own house, and do not lived with parents had odds ratios of 2.31 (CI 1.46–3.65), 2.38 (CI 1.51–3.77), 4.15 (CI 2.41–7.14), 0.28 (CI 0.13–0.60), 0.14(CI 0.05–0.35), and 1.80 (CI 1.07–3.03), respectively. Among adolescents, the prevalence of life-time suicidal ideation was moderately high. Age, education, occupation, house ownership, and living with parents were statistically significantly associated with suicidal ideation. It is important to design and implement effective community based suicide prevention programs for adolescents in Bangladesh.

  • 14.
    Begun, Afroza
    et al.
    Department of Health Sciences, Mid-Sweden University, Sundsvall, Sweden.
    Viitasara, Eija
    Department of Health Sciences, Mid-Sweden University, Sundsvall, Sweden.
    Soares, Joaquim
    Department of Health Sciences, Mid-Sweden University, Sundsvall, Sweden.
    Rahman, AKM Fazlur
    Department of Epidemiology, Bangladesh University of Health Sciences, Dhaka, Bangladesh.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Department of Health Sciences, Mid-Sweden University, Sundsvall, Sweden.
    Parental socio-economic position and suicidal ideation among adolescents in rural Bangladesh2018In: Journal of Psychiatry and Behavioral Sciences, ISSN 2637-8027, Vol. 4, article id 1018Article in journal (Refereed)
    Abstract [en]

    Background: Suicide is a leading cause of death world-wide and becoming a public health concern among adolescents. However, adolescent suicidal behaviour is a neglected public health issue, especially in low-income countries such as Bangladesh. Of great importance is the understanding of which factors might be related to this growing public problem.

    Objective: To examine the relationship between parental socio-economic position and suicide ideation among adolescents in rural Bangladesh

    Methods: A cross-sectional survey was conducted in 2013 among 2,476 adolescents, aged 14-19 years, selected randomly from a rural community of Bangladesh. An adapted version of the WHO/SUPRE-MISS questionnaire was used to collect data in the Raiganj sub-district, which is a surveillance area of the Centre for Injury Prevention and Research, Bangladesh (CIPRB).

    Descriptive statistics and binary logistic regression analyses were used to analyze the data. Comparisons of proportions between groups were carried out using the χ2 test. Multivariate logistic regression analysis was used to examine the relationship between parental co-variants and suicidal thoughts among adolescents. The significance level was set atp <0.05. All analyses were performed using SPSS 20.

    Results: The majority of parents had education only up to primary school (mothers 58.7% and fathers 49.5%). Most of them were farmers (53.3% of fathers) and housewives (96.5% of mothers). Monthly income and expenditure of the adolescent’s parents were mainly upto 10,000 taka only. Suicidal ideation is more common among adolescents of low income group parents 104 (5.5%) and who were not living with their parents 18 (8.2%). Adolescent’s suicidal ideation was found to be significantly associated with education, marital status and house ownership of their parents. Not being able to live with their parents was also a significant factor. Parents who received education up to SSC had odds ratio of 2.10 (1.21,3.64) and 1.92 (1.15, 3.23) for mothers and fathers respectively. Parent’s income or expenditure was not associated with adolescent’s suicidal ideation. Adolescent’s suicidal ideation of single parents had higher odds (OR 3.00, CI 1.75-5.19) in comparison to adolescents who had both parents. Adolescents whose parents owned a house and who weren’t living withtheir parents had odds ratios of 0.14 (0.05,0.35), and 1.80 (1.07,3.03) respectively. After adjusting for other covariates parents’ marital status and house ownership significantly associated with the adolescent suicide ideation.

    Conclusion: Parental socio-economic position was asso-ciated with suicidal ideation. Adolescent with single parents were more likely to report suicidal ideation. Low parental education and socio-economic status, marital status, house ownership, not living with parents at home as well as adolescent loneliness were the important factors for suicidal ideation.

  • 15.
    Burström, Bo
    et al.
    Karolinska Institutet.
    Macassa, Gloria
    Karolinska Institutet.
    Öberg, Lisa
    Södertörns högskola.
    Bernhardt, Eva
    Stockholm universitet.
    Smedman, Lars
    Karolinska Institutet.
    Barnadödlighet, fattigdom och sanitära reformer2003In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 80, no 3, p. 209-215Article in journal (Refereed)
  • 16.
    Burström, Bo
    et al.
    Centre of Health Equity Studies, Stockholm University/Karolinska Institutet, Sweden.
    Macassa, Gloria
    Centre of Health Equity Studies, Stockholm University/Karolinska Institutet, Sweden.
    Öberg, Lisa
    Centre of Health Equity Studies, Stockholm University/Karolinska Institutet, Sweden.
    Bernhardt, Eva
    Centre of Health Equity Studies, Stockholm University/Karolinska Institutet, Sweden.
    Smedman, Lars
    Centre of Health Equity Studies, Stockholm University/Karolinska Institutet, Sweden.
    Equitable Child Health Interventions: The Impact of Improved Water and Sanitation on Inequalities in Child Mortality in Stockholm, 1878 to 19252005In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 95, no 2, p. 208-216Article in journal (Refereed)
    Abstract [en]

    Today, many of the 10 million childhood deaths each year are caused by diseases of poverty—diarrhea and pneumonia, for example, which were previously major causes of childhood death in many European countries. Specific analyses of the historical decline of child mortality may shed light on the potential equity impact of interventions to reduce child mortality.

    In our study of the impact of improved water and sanitation in Stockholm from 1878 to 1925, we examined the decline in overall and diarrhea mortality among children, both in general and by socioeconomic group. We report a decline in overall mortality and of diarrhea mortality and a leveling out of socioeconomic differences in child mortality due to diarrheal diseases, but not of overall mortality. The contribution of general and targeted policies is discussed.

     

  • 17.
    Chaquisse, Eusebio
    et al.
    EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal; Faculdade de Ciências de Saúde, University of Lúrio, Nampula, Mozambique; National Health Institute, Maputo, Mozambique.
    Fraga, Silvia
    EPIUnit, Instituto de Saúde Pública da Universidade do Porto; Faculdade de Medicina, Universidade do Porto, Portugal.
    Meireles, Paula
    EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal.
    Soares, Joaquim
    EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal; Department of Health Sciences, Section of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Nbofana, Francisco
    National Health Institute, Maputo, Mozambique.
    Barros, Henrique
    EPIUnit, Instituto de Saúde Pública da Universidade do Porto; Faculdade de Medicina, Universidade do Porto, Portugal.
    Sexual and physical intimate partner violence among women using antenatal care in Nampula, Mozambique2018In: Journal of Public Health in Africa, ISSN 2038-9922, E-ISSN 2038-9930, Vol. 9, no 1, article id 744Article in journal (Refereed)
    Abstract [en]

    The aim was to estimate the prevalence of sexual and physical intimate partner violence (IPV) and its associated factors, in a sample of pregnant women using antenatal care (ANC) in Nampula province - Mozambique. This cross-sectional study was carried out in six health units in Nampula, from February 2013 to January 2014. Overall, 869 participants answered the Conflict Tactics Scale 2. The lifetime and past year prevalence of sexual abuse was 49% and 46%, and of physical abuse was 46% and 44%, respectively. Lifetime and past year sexual abuse was significantly associated with living as a couple, alcohol drinking and having a past diagnosis of gonorrhea. Lifetime and past year physical abuse increased significantly with age and was associated with living as a couple, alcohol drinking and history with syphilis. The prevalence of lifetime and previous year violence among women using ANC was high and similar showing that most women were constantly exposed to IPV. ANC provides a window of opportunity for identifying and acting on violence against women.

  • 18.
    Chowdhury, Ehsanul
    et al.
    University of Gävle, Faculty of Education and Business Studies, Department of Business and Economic Studies, Business administration.
    Backlund Rambaree, Brita
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Criminology, Social Work.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    CSR Reporting of Stakeholders’ Health: Proposal for a New Perspective2021In: Sustainability, E-ISSN 2071-1050, Vol. 13, no 3, article id 1133Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of the paper is to identify and categorize disclosures from the Global Reporting Initiative Sustainability Reporting Standards (GRI Standards) that have direct or indirect influence on health of external or internal stakeholders.

    Methodology: GRI core and comprehensive disclosures (as part of universal standards and topic-specific standards related to economic, environmental and social topics) that can be used by businesses for CSR reporting were grouped as to have direct or indirect influence on external and internal stakeholders’ health.

    Findings: The study proposes a systematic way of conceiving GRI standards in terms of direct or indirect influence on the health and well-being of internal and external stakeholders.

    Originality/Value: This is the first study that provides a classification of core and comprehensive GRI disclosures that have direct or indirect influence on the health of external or internal stakeholders. This classification will allow businesses to easily report those CSR activities that might be of importance to stakeholders’ health promotion. 

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  • 19.
    Csöff, Rosina-Martha
    et al.
    Evangel Hsch Ludwigsburg, Ludwigsburg, Germany.
    Macassa, Gloria
    Karolinska Institutet, Stockholm, Sweden .
    Lindert, Jutta
    Evangel Hsch Ludwigsburg, Ludwigsburg, Germany.
    Körperliche Beschwerden bei älteren Migranten in Deutschland [Somatic Complaints among Elderly Migrants in Germany]2010In: Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, ISSN 1661-4747, E-ISSN 1664-2929, Vol. 58, no 3, p. 199-206Article in journal (Refereed)
    Abstract [en]

    Bodily complaints are widespread among the elderly; few surveys investigating bodily complaints among elder migrants exist in Germany and internationally. Our multi-centric cross section study examined bodily complaints among persons between 60 and 84 years dwelling in Stuttgart on the basis of the short version of the Giessen Complaint Questionnaire (GBB-24). In Germany 648 were explored with 13.4% (n = 87) born outside of Germany. Gender distribution was equal among migrants and non-migrants; socioeconomic status was lower among the migrants: 8.0% (n = 7) of the migrants and 2.5% (n = 14) of the non-migrants had at most four years of education; 12.6% (n = 11) of the migrants and 8.2% (n = 46) of the non-migrants held a net income of below 1000 (sic); 26.4% of the migrants and 38.1% (n = 214) of the non-migrants disposed over 2000 (sic) monthly. The incidence of somatic complaints was 65.5% (n = 57) among the migrants and 55.8% (n = 313) among the non-migrants. Women (61.8%) displayed more often somatic complaints than men (51.8%). Somatic complaints increased with age. Except of the group aged between 70-74 years no significant difference between migrants and non-migrants could be shown concerning the incidence of bodily complaints. Outlook: population based studies on bodily complaints among migrants are urgently needed.

  • 20.
    Cutts, F T
    et al.
    London School of Hygiene and Tropical Medicine Keppel St.
    Dos Santos, C
    Ministry of Health Mozambique.
    Novoa, A
    Eduardo Mondlane Faculty of Medicine Mozambique.
    David, P
    London School of Hygiene and Tropical Medicine Keppel St.
    Macassa, Gloria
    Eduardo Mondlane Faculty of Medicine Mozambique.
    Soares, A C
    Eduardo Mondlane Faculty of Medicine Mozambique.
    Child and Maternal Mortality during a Period of Conflict in Beira City, Mozambique1996In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 25, no 2, p. 349-356Article in journal (Refereed)
    Abstract [en]

    Background Child mortality rates have been declining in most developing countries. We studied child and maternal mortality and risk factors for child mortality in Beira city in July 1993, after a decade of conflict in Mozambique.       

    Methods A community-based cluster sample survey of 4609 women of childbearing age was conducted. Indirect techniques were used to estimate child mortality (‘children ever born’ method and Preceding Birth Techniques [PBT]), and maternal mortality sisterhood method). Deaths among the most recent born child, born since July 1990, were classified as cases (n = 106), and two controls, matched by age and cluster, were selected per case.                 

    Results Indirect estimates of the probability of dying from birth to age 5 (deaths before age 5 years, 5q0 per 1000) decreased from 246 in 1977/8 to 212 in 1988/9. The PBT estimate for 1990/91 was 154 (95% confidence interval(CI): 124–184), but recent deaths may have been underreported. Lack of beds in the household (odds ratio[OR] = 2.0, 95% CI: 1.1–3.8), absence of the father (OR = 2.4, 95% CI: 1.2–4.8), low paternal educational level (OR = 2.1, 95% CI: 0.8–5.4), young maternal age (OR = 2.0, 95% CI: 1.0–3.7), self-reported maternal illness (OR = 2.4, 95% CI: 1.2–4.9), and home delivery of the child (OR = 2.3, 95% CI: 1.2–4.5) were associated with increased mortality, but the sensitivity of risk factors was low. Estimated maternal mortality was 410/100 000 live births with a reference date of 1982.                 

    Conclusions Child mortality decreased slowly over the 1980s in Beira despite poor living conditions caused by the indirect effects of the war. Coverage of health services increased over this period. The appropriateness of a risk approach to maternal-child-health care needs further evaluation.

  • 21.
    Dadich, Ann
    et al.
    Western Sydney University, Parramatta, NSW, Australia.
    Buttigieg, Sandra
    University of Malta, Msida, Malta.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    West, Thomas
    University of Bristol, Bristol, United Kingdom.
    Editorial: Health service management and leadership: COVID-style2023In: Frontiers In Public Health, ISSN 2296-2565, Vol. 11, article id 1141055Article in journal (Other academic)
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  • 22.
    de Rijke, Chris
    et al.
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Computer and Geospatial Sciences, Geospatial Sciences.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Sandberg, Mats
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Building Engineering, Energy Systems and Sustainability Science, Energy Systems and Building Technology.
    Jiang, Bin
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Computer and Geospatial Sciences, Geospatial Sciences.
    Living Structure as an Empirical Measurement of City Morphology2020In: ISPRS International Journal of Geo-Information, ISSN 2220-9964, Vol. 9, no 11, article id 677Article in journal (Refereed)
    Abstract [en]

    Human actions and interactions are shaped in part by our direct environment. The studies of Christopher Alexander show that objects and structures can inhibit natural properties and characteristics; this is measured in living structure. He also found that we have better connection and feeling with more natural structures, as they more closely resemble ourselves. These theories are applied in this study to analyze and compare the urban morphology within different cities. The main aim of the study is to measure the living structure in cities. By identifying the living structure within cities, comparisons can be made between different types of cities, artificial and historical, and an estimation of what kind of effect this has on our wellbeing can be made. To do this, natural cities and natural streets are identified following a bottom-up data-driven methodology based on the underlying structures present in OpenStreetMap (OSM) road data. The naturally defined city edges (natural cities) based on intersection density and naturally occurring connected roads (natural streets) based on good continuity between road segments in the road data are extracted and then analyzed together. Thereafter, historical cities are compared with artificial cities to investigate the differences in living structure; it is found that historical cities generally consist of far more living structure than artificial cities. This research finds that the current usage of concrete, steel, and glass combined with very fast development speeds is detrimental to the living structure within cities. Newer city developments should be performed in symbiosis with older city structures as a whole, and the structure of the development should inhibit scaling as well as the buildings themselves.

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  • 23.
    Dgedge, Martinho
    et al.
    Universidade Eduardo Mondlane, Maputo, Mozambique..
    Novoa, Ana
    Universidade Eduardo Mondlane, Maputo, Mozambique.
    Macassa, Gloria
    Universidade Eduardo Mondlane, Maputo, Mozambique.
    Sacarlal, Jahit
    Universidade Eduardo Mondlane, Maputo, Mozambique.
    Black, James
    Epidemiologista, Direcc¸a˜ o Provincial de Sau´ de, Manica, Mozambique..
    Michaud, Catherine
    Harvard Center for Population and Development Studies, Cambridge MA, USA..
    Cliff, Julie
    Universidade Eduardo Mondlane, Maputo, Mozambique.
    The burden of disease in Maputo City, Mozambique: registered and autopsied deaths in 19942001In: Bulletin of the World Health Organization, ISSN 0042-9686, E-ISSN 1564-0604, Vol. 79, no 6, p. 546-552Article in journal (Refereed)
    Abstract [en]

    Objective: To classify the causes of death in Maputo City, Mozambique, using the methods of the Global Burden of Disease study, in order to provide information for health policy-makers and to obtain a baseline for future studies in Maputo City and provincial capitals.

    Methods:  Data were taken from the Maputo City death register and autopsy records for 1994.

    Findings: A total of 9011 deaths were recorded in the death register, representing a coverage of approximately 86%. Of these, 8114 deaths (92%) were classified by cause. Communicable, maternal, perinatal, and nutritional disorders accounted for 5319 deaths; noncommunicable diseases for 1834; and injuries for 961. The 10 leading causes of registered deaths were perinatal disorders (1643 deaths); malaria (928); diarrhoeal diseases (814); tuberculosis (456); lower respiratory infections (416); road-traffic accidents (371); anaemia (269); cerebrovascular diseases (269); homicide (188); and bacterial meningitis (178).

    Conclusions: Infectious diseases of all types, injuries, and cerebrovascular disease ranked as leading causes of death, according to both the autopsy records and the city death register. AIDS-related deaths were underreported. With HIV infection increasing rapidly, AIDS will add to the already high burden of infectious diseases and premature mortality in Maputo City. The results of the study indicate that cause of death is a useful outcome indicator for disease control programmes

  • 24.
    Eslami, Bahareh
    et al.
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Melchiorre, Maria Gabriella
    Centre for Socio- Economic Research on Ageing, Italian National Institute of Health and Science on Aging, INRCA, Ancona, Italy.
    Barros, Henrique
    Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal.
    Viitasara, Eija
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Lindert, Jutta
    Department of Public Health, University of Emden, Emden, Germany; Women ’ s Studies Research Center, Brandeis University, Waltham, MA, USA.
    Stankunas, Mindaugas
    Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania; Health Service Management Department, Centre for Health Innovation, School of Medicine, University of Griffith, Gold Coast, Queensland, Australia.
    Torres-Gonzalez, Francisco
    Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), University of Granada, Granada, Spain.
    Ioannidi-Kapolou, Elisabeth
    Department of Sociology, National School of Public Health, Athens, Greece.
    Soares, Joaquim J. F.
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Life-time abuse and mental health among older persons: a European study2017In: Journal of Aggression, Maltreatment & Trauma, ISSN 1092-6771, E-ISSN 1545-083X, Vol. 26, no 6, p. 590-607Article in journal (Refereed)
    Abstract [en]

    This study aimed to investigate the association of lifetime abuse and mental health among older persons, considering associated factors (e.g., demographics) through a cross-sectional design. We recruited 4,467 women and men ages 60–84 years from 7 European cities. Mental health was measured with the Hospital Anxiety and Depression Scale, and abuse (psychological, physical, sexual, financial, and physical injuries) based on the Revised Conflict Tactics Scale and the UK survey of abuse/neglect of older people. Multiple logistic regression analyses showed that country of residence, low educational level, and experienced financial strain increased the odds of probable cases of anxiety and depression. Female sex, white-collar profession, and financial support by social/other benefits/or partner income were associated with higher odds of anxiety, while older age and experience of lifetime injury were associated with increased odds of depressive symptoms. The findings of this study indicate that socioeconomic factors, as well as experienced lifetime severe physical abuse leading to injuries, are significant in perceived mental health of adults in later life.

  • 25.
    Eslami, Bahareh
    et al.
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Mittuniversitetet; Karolinska Institutet.
    Sundin, Örjan
    Mittuniversitetet, Avdelningen för psykologi.
    Khankeh, Hamid Reza
    Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
    Soares, Joaquim
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Style of Coping and its Determinants in Adults with Congenital Heart Disease in a Developing Country2014In: Congenital Heart Disease, ISSN 1747-079X, E-ISSN 1747-0803, Vol. 9, no 4, p. 349-360Article in journal (Refereed)
    Abstract [en]

    Objective The objective of this study is to compare coping strategies between adults with and without congenital heart disease and to scrutinize the associations between different available resources (e.g., social support) and adoption of certain coping strategies.

    DesignThe study has a cross-sectional case-control design.

    SettingThe study was conducted in two university-affilliated heart hospitals in Tehran, Iran.

    Patients The participants comprised 347 persons (18–64 years) with and 353 individuals without congenital heart disease, matched by gender and age.

    Outcome Measures Coping strategies, assessed with the Utrecht Coping List-short form, were compared between both groups. Block-wise multiple regression analyses were conducted to scrutinize the associations between different independent variables (e.g., demographic/socioeconomic statuses) and adoption of certain styles of coping (dependent variables) among all participants and separately for each group.

    Results The styles of coping in the patients were comparable with those of the control group. Multivariate analyses revealed that congenital heart disease per se was not associated with style of coping except for palliative reaction pattern. The active problem-solving coping style was associated with never married marital status, parenthood, unemployment, higher level of anxiety/somatic symptoms, lower level of depressive symptoms, and better social support. The avoidance behavior style was associated with having a low income, whereas the expression of emotion style was associated with higher anxiety symptoms, experience of financial strain, and income. None of the adopted coping strategies was related to the heart disease variables.

    Conclusions The adults with congenital heart disease coped as well as adults without congenital heart disease. Marital status, parenthood, annual income, financial strain, psychological adjustment, and perceived social support were important explanatory factors in adopting a certain style of coping among adults with congenital heart disease. However, longitudinal studies with repeated measures are warranted.

  • 26.
    Eslami, Bahareh
    et al.
    Mittuniversitetet, Avdelningen för hälsovetenskap och Tehran Heart Center, Tehran University of Medical Sciences.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Mittuniversitetet, Institutionen för hälsovetenskap och Karolinska institutet.
    Sundin, Örjan
    Mittuniversitetet, Avdelningen för psykologi.
    Khankeh, Hamid Reza
    Karolinska Institutet; University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
    Soares, Joaquim J.F.
    Mittuniversitetet, Avdelningen för hälsovetenskap och Karolinska Institutet.
    Quality of life and life satisfaction among adults with and without congenital heart disease in a developing country2015In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 22, no 2, p. 169-179Article in journal (Refereed)
    Abstract [en]

    Background Life-expectancy of adults with congenital heart disease (CHD) has improved world-wide, but there are limited data on these patients' experiences of quality of life (QoL), life satisfaction (LS), and their determinants (e.g. social support), particularly among patients from developing countries.

    Design Cross-sectional case-control.

    Methods A total of 347 CHD patients (18-64 years, 52.2% women) and 353 non-CHD participants, matched by sex/age, were recruited from two heart hospitals in Tehran, Iran. LS and QoL served as dependent variables, and demographic/socioeconomic status, mental-somatic symptoms, social support, and clinical factors (e.g. defect category) served as independent variables in multiple regression analyses once among all participants, and once only among CHD patients.

    Results The CHD patients had significantly lower scores in LS and all domains of QoL than the control group. However, having CHD was independently negatively associated only with overall QoL, physical health, and life and health satisfaction. Additionally, multivariate analyses among the CHD patients revealed that female sex, younger age, being employed, less emotional distress, and higher social support were significantly associated with higher perceived QoL in most domains, while LS was associated with female sex, being employed, less emotional distress, and better social support. Neither QoL nor LS was associated with cardiac defect severity.

    Conclusions The adults with CHD had poorer QoL and LS than their non-CHD peers in our developing country. Socio-demographics, emotional health, and social support were important 'determinants' of QoL and LS among the CHD patients. Longitudinal studies are warranted to establish causal links.

  • 27.
    Eslami, Bahareh
    et al.
    Department of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Sundin, Örjan
    Department of Psychology, Mid Sweden University, Östersund, Sweden.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Department of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Khankeh, Hamid Reza
    Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
    Soares, Joaquim JF
    Department of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Anxiety, depressive and somatic symptoms in adults with congenital heart disease2013In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 74, no 1, p. 49-56Article in journal (Refereed)
    Abstract [en]

    Objective

    Despite the improvement in life-expectancy of adults with congenital heart disease, they may experience unique medical and social challenges that could impact on their psychological functioning. The aims of this study were to address the experience of anxiety, depressive and somatic symptoms among adults with congenital heart disease in comparison with that of non-heart diseased persons considering the role of various factors (e.g. socio-economic).

    Methods

    In cross-sectional case–control study, the participants consisted of 347 patients with congenital heart disease (18–64 years, 52.2% female) and 353 matched (by sex/age) non-heart diseased persons. The participants completed a questionnaire. The data were analyzed with bivariate and multivariate methods.

    Results

    In bivariate analyses, scores in anxiety and somatic symptoms were higher among patients than the healthy controls (both at p ≤ 0.001), whereas the groups did not differ in depressive symptoms. Following multiple-linear-regression-analyses, only the association between congenital heart disease and somatic symptoms was confirmed. Among the patients, perceived financial strain was significantly related to anxiety, depressive and somatic symptoms; lower perceived social support to anxiety and depression; and low annual income to somatic symptoms. Additionally, somatic symptoms were associated with anxiety and depressive symptoms, and vice versa. And no medical variables were related to anxiety, depressive and somatic symptoms.

    Conclusions

    Congenital heart disease was only independently associated with somatic symptoms. Financial strain, social support and co-existence of emotional distress with somatic symptoms should be considered in developing appropriate interventions to improve the well-being of patients with congenital heart disease. However, longitudinal research is warranted to clarify causality.

  • 28.
    Eslami, Bahareh
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Viitasara, Eija
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Melchiorre, Maria Gabriella
    Centre for Socio-Economic Research on Ageing, Italian National Institute of Health and Science on Aging, I.N.R.C.A, Ancona, Italy.
    Lindert, Jutta
    Department of Public Health, University of Emden, Emden, Germany; Brandeis University, Waltham, USA .
    Stankunas, Mindaugas
    Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania; Health Service Management Department, Centre for Health Innovation, School of Medicine, University of Griffith, Gold Coast, QLD, Australia.
    Torres-Gonzalez, Francisco
    Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), University of Granada, Granada, Spain.
    Barros, Henrique
    Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal.
    Ioannidi-Kapolou, Elisabeth
    Department of Sociology, National School of Public Health, Athens, Greece.
    Soares, Joaquim J. F.
    Section of Public Health Science, Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    The prevalence of lifetime abuse among older adults in seven European countries2016In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 61, no 8, p. 891-901Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate the lifetime prevalence rate of abuse among older persons and to scrutinize the associated factors (e.g. demographics).

    METHODS: This cross-sectional population-based study had 4467 participants, aged 60-84, from seven European cities. Abuse (psychological, physical, sexual, financial and injuries) was measured based on The Revised Conflict Tactics Scale, and the UK survey of abuse/neglect of older people.

    RESULTS: Over 34 % of participants reported experiencing lifetime psychological, 11.5 % physical, 18.5 % financial and 5 % sexual abuse and 4.3 % reported injuries. Lifetime psychological abuse was associated with country, younger age, education and alcohol consumption; physical abuse with country, age, not living in partnership; injuries with country, female sex, age, education, not living in partnership; financial abuse with country, age, not living in partnership, education, benefiting social/partner income, drinking alcohol; and sexual abuse with country, female sex and financial strain.

    CONCLUSIONS: High lifetime prevalence rates confirm that elder abuse is a considerable public health problem warranting further longitudinal studies. Country of residence is an independent factor associated with all types of elder abuse which highlights the importance of national interventions alongside international collaborations.

  • 29.
    Eslami, Bahareh
    et al.
    Mid Sweden University, Sundsvall, Sweden.
    Örjan, Sundin
    Mid Sweden University, Sundsvall, Sweden.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Mid Sweden University, Sundsvall, Sweden.
    Khankeh, Hamid Reza
    Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
    Soares, Joaquim J. F.
    Mid Sweden University, Sundsvall, Sweden.
    Gender differences in health conditions and socio-economic status of adults with congenital heart disease in a developing country2013In: Cardiology in the Young, ISSN 1047-9511, E-ISSN 1467-1107, Vol. 23, no 2, p. 209-218Article in journal (Refereed)
    Abstract [en]

    Background Providing appropriate care for adults with congenital heart disease requires the evaluation of their current situation. There is limited research in Iran about these patients, particularly in relation to gender differences in the demographic/socio-economic and lifestyle factors, as well as disease parameters.

    Materials and methods The sample consisted of 347 congenital heart disease patients in the age group of 18–64 years, including 181 women, assessed by an analytical cross-sectional study. The patients were recruited from the two major heart hospitals in Tehran. Data were collected using questionnaires.

    Results The mean age of the patients was 33.24 years. Women were more often married and more often had offspring than men (p < 0.001). Educational level and annual income were similar between women and men. Unemployment was higher among women (p < 0.001), but financial strain was higher among men (p < 0.001). Smoking, alcohol, and water-pipe use was higher among men than among women (p < 0.001). Cardiac factors, for example number of cardiac defects, were similar among women and men, except that there were more hospitalisations owing to cardiac problems, for example arrhythmia, among men. Disease was diagnosed mostly at the hospital (57.4%). Most medical care was provided by cardiologists (65.1%). Only 50.1% of patients had knowledge about their type of cardiac defect.

    Conclusion Gender differences exist in the socio-economic and lifestyle characteristics of adults with congenital heart disease, in some cases related to the disease severity. Our findings also point to the need for interventions to increase patients’ knowledge about, and use of, healthier lifestyle behaviours, irrespective of gender. Furthermore, providing appropriate jobs, vocational training, and career counselling may help patients to be more productive.

  • 30.
    Fraga, Silvia
    et al.
    EPI Unit-Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.
    Soares, Joaquim
    Department of Public Health Science, Mid Sweden University, Sundsvall, Sweden.
    Melchiorre, Maria Gabriella
    Center for Socioeconomic Research on Aging, Ancona, Italy.
    Barros, Henrique
    EPI Unit-Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.
    Eslami, Bahareh
    Department of Public Health Science, Mid Sweden University, Sundsvall, Sweden.
    Ioannidi-Kapolou, Elisabeth
    Department of Sociology, National School of Public Health, Athens, Greece.
    Lindert, Jutta
    Department of Public Health, University of Emden, Emden, Germany; Women's Studies Research Center, Brandeis University, Waltham, MA, United States.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Stankunas, Mindaugas
    Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania; Department of Health Service Management, Centre for Health Innovation, School of Medicine, University of Griffith, Gold Coast, QLD, Australia.
    Torres-Gonzales, Francisco
    Network of Biomedical Research on Mental Health Centers, University of Granada, Granada, Spain.
    Viitasara, Eija
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Lifetime Abuse and Quality of Life among Older People2017In: Health & Social Work, ISSN 0360-7283, E-ISSN 1545-6854, Vol. 42, no 4, p. 215-222Article in journal (Refereed)
    Abstract [en]

    Few studies have evaluated the impact of lifetime abuse on quality of life (QoL) among older adults. By using a multinational study authors aimed to assess the subjective perception of QoL among people who have reported abuse during the course of their lifetime. The respondents (N = 4,467; 2,559 women) were between the ages of 60 and 84 years and living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain, and Sweden). Lifetime abuse was assessed by using a structured questionnaire that allowed to assess lifetime experiences of abuse. QoL was assessed with the World Health Organization Quality of Life-Old module. After adjustment for potential confounders, authors found that to have had any abusive experience decreased the score of sensory abilities. Psychological abuse was associated with lower autonomy and past, present, and future activities. Physical abuse with injuries significantly decreased social participation. Intimacy was also negatively associated with psychological abuse, physical abuse with injury, and sexual abuse. The results of this study provide evidence that older people exposed to abuse during their lifetime have a significant reduction in QoL, with several QoL domains being negatively affected.

  • 31.
    Hiswåls, Anne-Sofie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Mittuniversitetet, Avdelningen för hälsovetenskap.
    Ghilagaber, Gebrenegus
    Avdelningen för statistikvetenskap, Stockholms Universitet, Department of Statistics, University of Stockholm.
    Walander, Anders
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm Sweden.
    Wijk, Katarina
    Samhällsmedicin, Landstinget Gävleborg, Community Medicine, County Council of Gävleborg.
    Öberg, Peter
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    Soares, Joaquim
    Mittuniversitetet, Avdelningen för hälsovetenskap, Mid Sweden University, Department of Health Science.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Mittuniversitetet, Avdelningen för hälsovetenskap.
    Employment Status and Inequalities in Self-Reported Health2014In: Epidemiology, Biostatistics and Public Health, ISSN 2282-2305, E-ISSN 2282-0930, Vol. 11, no 4, p. 1-11Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to investigate the impact of employment status on self-reported health in gävleborg county.

    Methods: The study used data from the 2010 health in equal terms survey, a cross-sectional survey carried out in gävleborg county in sweden. a total of 4,245 individuals, aged 16–65 years were included in the analyses. descriptive and logistic regression analyses were used to assess the relationship between employment status and self-reported health

    Results: Individuals outside the labour market had odds of poor health of 2.64 (cl 2.28–3.05) compared to their employed counterparts. controlling for other covariates reduced the risk slightly to 2.10 (1.69-2.60), but remained statistically significant. In addition, other variables were associated with self-reported poor health.

    Conclusions: This study found a statistically significant association between being outside the labour market and poor self-reported health. The relation was explained partially by socio-economic and demographic variables. More studies, in particular longitudinal, are needed to further investigate the observed relationships. Policy-makers within the gävleborg county need to pay attention to the health status of those out of work, especially during times of combined economic and labour market fluctuations.

    Results of the study suggest the need to pay attention to the health status of those outside the labour market, especially during times of economic hardship.

  • 32.
    Hiswåls, Anne-Sofie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Mittuniversitetet, Avdelningen för hälsovetenskap.
    Ghilagaber, Gebrenegus
    Stockholms universitet, Statistiska institutionen.
    Wijk, Katarina
    Öberg, Peter
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    Soares, Joaquim
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Mittuniversitetet, Institutionen för hälsovetenskap; Karolinska Institutet.
    Employment status and suicidal ideation during economic recession2015In: Health Science Journal, ISSN 1791-809X, Vol. 9, no 1, article id 13Article in journal (Refereed)
    Abstract [en]

    Objective: Suicide is a public health problem and an important indicator of severe mental ill-health. Thus, identifying risk factors for suicidal ideation is a public health priority. The aim of this study was to examine the relationship between employment status and suicidal ideation in Gävleborg County. Method: The study used data from the 2010 Health in Equal Terms survey, a cross-sectional survey carried out in Gävleborg County in Sweden. A total of 4,245 individuals, aged 16–65 years were included in the analyses. Descriptive and logistic regression analyses were carried out to assess the relationship between employment status and suicidal ideation Results: Individuals outside the labour market had odds of suicidal ideation of 4.21 (CI 3.14-5.64) compared to their employed counterparts. Controlling for other covariates, reduced the risk from 4.21(CI 3.14-5.64) in model I, to 1.73 (CI 1.16- 2.57) in model IV, but remained statistically significant. In addition, other variables were associated with suicidal ideation. Conclusion: There was a statistically significant association between being out of work and suicidal ideation. The association was explained partly by demographic, socio-economic and self-reported psychological variables. Results of the study suggest the need for primary prevention strategies among those out of the labour market, especially during times of economic hardship.

  • 33.
    Hiswåls, Anne-Sofie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Mittuniversitetet, Avdelningen för hälsovetenskap.
    Ghilagaber, Gebrenegus
    Avdelningen för statistik, Stockholms universitet, Department of statistics, Stockholm University.
    Wijk, Katarina
    Samhällsmedicin, Landstinget Gävleborg, Community Medicine,Gävleborg County Council .
    Öberg, Peter
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    Soares, Joaquim
    Mittuniversitetet, Avdelningen för hälsovetenskap, Mid Sweden University, Department of Health Science .
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Mittuniversitetet, Avdelningen för hälsovetenskap, Mid Sweden University, Department of Health Science .
    Inequalities and Suicide Ideation during Recession Times2014In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 24, no Suppl. 2, p. 361-Article in journal (Other academic)
    Abstract [en]

    Background

    Suicide behaviour is a serious public health problem as it imposes economic and human costs to individuals, families and communities. Available evidence from some European countries indicates a significant rise in suicides related to economic recession. However, the debate continues regarding the role of unemployment in the reported suicide rates. In Sweden, very few studies have investigated the relationship between suicide behaviours and employment status in the context of the recent economic crisis although unemployment increased nationally and across different counties.

    The aim of this study was to examine the relationship between employment status and suicide ideation in Gävleborg, Sweden.

    Methods

    The study used data from a cross-sectional survey, Health in Equal terms, carried out in Gävleborg County in Sweden, 2010. A total of 4245 individuals, aged 16–65 years were included in the analysis. The relationship between employment status and suicide ideation was assessed using descriptive and logistic regression analyses.

    Results

    People who were not working had odds of suicide ideation of 4.21 (95% Cl 3.14–5.64) as compared to those employed. Controlling for other covariates reduced the risk to 1.73 (95% CI 1.16-2.57) but remained statistically significant. In addition variables like anxiety, self-reported stress and young age were also associated with suicide ideation. However among the covariates, people who reported anxiety had the highest odds of suicide ideation.

    Conclusions

    This study found a statistically significant association between being out of work and suicide ideation. The association was largely explained by self-reported stress, anxiety, socioeconomic and demographic variables.

    Policy-makers within the County need to pay attention to the health status of those out of work, especially during times of combined economic and labour market fluctuations.

    Key messages

    • Suicide ideation was more common among people out of labor force in Gävleborg County, Sweden.

    • Further studies are needed to investigate suicide ideation among unemployed persons during times of economic and labor market insecurity.

  • 34.
    Hiswåls, Anne-Sofie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Department of Health Sciences, Section of Public Health Sciences, Mid-Sweden University, Sweden.
    Marttila, Anneli
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Mälstam, Emelie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Department of Health Sciences, Section of Public Health Sciences, Mid-Sweden University, Sweden; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Epidemiology Unit-ISPUP, University of Porto Medical School, Portugal.
    Experiences of Unemployment  and Well-Being  After Job Loss During Economic Recession: Results of a Qualitative Study in East Central Sweden2017In: Journal of Public Health Research, ISSN 2279-9028, E-ISSN 2279-9036, Vol. 6, no 3, p. 135-141, article id 995Article in journal (Refereed)
    Abstract [en]

    Introduction: Several studies have revealed an association between unemployment and ill health, and shown that unemployment can affect people differently. This study aimed to provide an understanding of the experiences of unemployment and perceptions of wellbeing among persons who involuntary lost their work during the recent economic recession in Gävle Municipality. Methods: Sixteen unemployed men and women aged 28-62 were interviewed face-to-face. A purposeful sampling strategy was used in order to suit the research question and to increase the variation among informants. The interview texts were analysed using thematic analysis. Results: Six different themes emerged from the accounts: The respondents perceived work as the basis for belonging, and loss of work affected their social life and consumption patterns due to changes in their financial situation. They also expressed feelings of isolation, loss of self-esteem, and feelings of hopelessness, which affected their physical well-being. Longer duration of unemployment increased the respondents’ negative emotions. The respondents reported activities, structure, and affiliation in other contexts as part of their coping strategy against poor mental health. Conclusions: After job loss, the respondents experienced feelings of loss of dignity and belonging as a human being. They also felt worry, insecurity, and stress due to their changed financial situation, which in turn led to isolation and loss of self-esteem. Social support and having other activities gave the respondents structure and meaning.

  • 35.
    Hiswåls, Anne-Sofie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of health sciences, Mid-Sweden University, Sweden.
    Walander, Anders
    Department of health sciences, Mid-Sweden University, Sweden; Department of public health, Karolinska institute, Stockholm, Sweden.
    Soares, Joaquim F J
    Department of health sciences, Mid-Sweden University, Sweden.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of health sciences, Mid-Sweden University, Sweden; Department of public health, Karolinska institute, Stockholm, Sweden.
    Employment Status, Anxiety and Depression in a Municipal Context2017In: Research in Health Science, ISSN 2470-6213, Vol. 2, no 1, p. 12-23Article in journal (Refereed)
    Abstract [en]

    Objectives:This study aimed to investigate the prevalence of anxiety and depression by employment status among a sample of the working age population residing in Gävle Municipality in Sweden.

    Methods: A total of 241 persons completed a self-administered postal questionnaire in the baseline survey of the Gävle Household, Labour Market and Health Outcomes (GHOLDH) survey, which collected information on the employment status and psychological health (anxiety and depression) among persons aged 18-65 years. Descriptive and multivariate analyses were performed.

    Results: The prevalence and risk of anxiety and depression were high among people who were out of work. In the multiple regression analysis, compared to employed people, those who were not employed had a risk of anxiety of 7.76 (5.97-9.75) and 4.67 (3.60-5.74) for depression.

    Conclusion: The prevalence of anxiety and depression was higher among those who were out of labour marketas compared to those employed. Furthermore, people who were out of work had a higher risk of anxiety and depression. The odds were slightly higher for anxiety than for depression.

  • 36.
    Hiswåls, Anne-Sofie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Wulff Hamrin, Cornelia
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Vidman, Åsa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Criminology, Social Work.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Corporate social responsibility and external stakeholders’ health and wellbeing: A viewpoint2020In: Journal of Public Health Research, ISSN 2279-9028, E-ISSN 2279-9036, Vol. 9, no 1, p. 27-30Article in journal (Refereed)
    Abstract [en]

    In recent years there has been increased interest in the roleplayed by business corporate social responsibility (CSR) strategiesin promoting the health and wellbeing of internal and externalstakeholders. However, the sparse public health research to datehas mainly focused on the health and wellbeing of internal stakeholders.This viewpoint article aims to ignite discussion of howCSR strategies need to also target external stakeholders beyondthe workplace. Businesses have an opportunity to help address themost important societal challenges, especially the social determinantsof health which are the root causes of inequities in health.However, while advancing a new agenda for promoting externalstakeholders’ health, businesses need to take into account potentialchallenges that might arise from ethical conflicts when trying tobalance their CSR initiatives against their business operations.

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  • 37. Innocent, M
    et al.
    Ndonko, F
    Ngo’o, G
    Soares, Joaquim J. F.
    Mid Sweden University, Sundsvall, Sweden.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Mid Sweden University, Sundsvall, Sweden.
    Breaking the Silence: Understanding the practice of Breast ironing in Cameroon2012In: African Journal of Health Sciences, ISSN 1022-9272, E-ISSN 2306-1987, Vol. 23, no 4, p. 232-237Article in journal (Refereed)
  • 38.
    Johansson, Malin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Sports Science.
    Hiswåls, Anne-Sofie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Svennberg, Lena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Sports Science.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    What do we know about corporate social responsibility and stakeholders physical activity? A public health perspective2022In: Journal of Public Health Research, ISSN 2279-9028, E-ISSN 2279-9036, Vol. 11, no 2, p. 1-9Article in journal (Refereed)
    Abstract [en]

    In the past decade and in the context of sustainable development, business organizations have been expected to partner with governments and others to address societal problems, including those pertinent to population health. Accordingly, through their corporate social responsibility (CSR) strategies and policies, companies should collaborate in health promotion efforts to modify the effects of the health determinants (including those concerning behavior change) affecting internal and external stakeholders. Although CSR strategies and policies are linked to stakeholder health and wellbeing (e.g. employee satisfaction), little is known of how these strategies affect physical activity. Thus, this perspective paper aims to contribute to the discussion of the topic by investigating what scientific evidence exists regarding the relationship between CSR and physical activity. So far there are indications that some business are implementing CSR activities targeting internal (e.g. employees) and external (e.g. consumers) stakeholders, especially in developed countries. Furthermore, among external stakeholders, CSR activities with a physical activity component targeted children, youth, the disabled, the under-privileged, and the elderly. However, there is still very little empirical evidence available using appropriate quantitative and qualitative designs. Public health and health science researchers in general should strive to advance our understanding of how CSR affects population health behavior, paving the way to develop frameworks for resilient, ethical, and sustainable health promotion.

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  • 39.
    Lindert, Jutta
    et al.
    Protestant University of Applied Sciences Ludwigsburg, Ludwigsburg, Germany, and Department of Psychology and Sociology, University of Leipzig, Leipzig, Germany.
    de Luna, Juan
    Department of Medicine, University of Granada, Granada, Spain .
    Torres- Gonzales, Francisco
    University of Granada, Granada, Spain.
    Barros, Henrique
    Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal .
    Loannidi- Kopolou, Elisabeth
    Department of Sociology, National School of Public Health, Athens, Greece .
    Melchiorre, Maria Gabriella
    Italian National Institute of Health and Science on Aging, INRCA, Ancona, Italy .
    Stankunas, Mindaugas
    School of Public Health, Griffith University, Gold Coast, QLD, Australia, and Lithuanian University of Health Sciences, Kaunas, Lithuania .
    Macassa, Gloria
    Institution for Health Sciences, Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden .
    Soares, Joaquim F J
    Institution for Health Sciences, Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden, and Division of Social Medicine, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
    Abuse and neglect of older persons in seven cities in seven countries in Europe: a cross-sectional community study2013In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 58, no 1, p. 121-132Article in journal (Refereed)
    Abstract [en]

    Objectives: We aimed to investigate the prevalence rate of abuse (psychological, physical, sexual, financial, neglect) of older persons (AO) in seven cities from seven countries in Europe (Germany, Greece, Italy, Lithuania, Portugal, Spain, Sweden), and to assess factors potentially associated with AO.

    Methods: A cross-sectional study was conducted in 2009 (n = 4,467, aged 60–84).  potentially associated factors were grouped into domains (domain 1: age, gender, migration history; domain 2: education, occupation; domain 3: marital status, living situation; domain 4: habitation, income, financial strain). We calculated odds ratios (OR) with their respective 95 % confidence intervals (CI).

    Results: Psychological AO was the most common form of AO, ranging from 10.4 % (95 % CI 8.1–13.0) in Italy to 29.7 % (95 % CI 26.2–33.5) in Sweden. Second most common form was financial AO, ranging from 1.8 % (95 % CI 0.9–3.2) in Sweden to 7.8 % (95 % CI 5.8–10.1) in Portugal. Less common was physical AO, ranging from 1.0 % (95 % CI 0.4–2.1) in Italy to 4.0 % (95 % CI 2.6–5.8 %) in Sweden. Sexual AO was least common, ranging from 0.3 (95 % CI 0.0–1.1) in Italy and Spain to 1.5 % (95 % CI 0.7–2.8) in Greece. Being from Germany (AOR 3.25, 95 % CI 2.34–4.51), Sweden (OR 3.16, 95 % CI 2.28–4.39) or Lithuania (AOR 2.45, 95 % CI 1.75–3.43) was associated with increased prevalence rates of AO.

    Conclusion: Country of residence of older people is independent from the four assessed domains associated

  • 40. Lindert, Jutta
    et al.
    Soares, Joaquim JF
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Csöff, RM
    Barros, H
    Torres-Gonzalez, F
    Ioannidi-Kapolou, E
    Lamura, G
    de Dios Luna, J
    Macassa, G
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Melchiorre, MG
    Stankunas, M
    Gewalt und Gesundheit bei älteren Menschen in Europa2013Book (Other academic)
  • 41.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    A Matter of Faith: Unravelling the role of religion on child survival in sub-Saharan Africa2012In: African Journal of Health Sciences, ISSN 1022-9272, E-ISSN 2306-1987, Vol. 22, no 3, p. 238-247Article in journal (Refereed)
    Abstract [en]

    This study has reviewed the role of religion on child mortality in subSaharan Africa using searches of electronic Databases. The review found only one study, which investigated the relationship between religion and child mortality in subSaharan Africa using religion as the “main” independent variable. In addition the review identified several areas (definition of religion, measurement and types of studies), which should be further addressed towards a better understanding of the role of religion on child health outcomes, especially child mortality.

  • 42.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Can Geographic Information Systems Help us to Better Understand Inequalities in Health Outcomes in the Era of Sustainable Development?2018Report (Other academic)
    Abstract [en]

    The objective of this working paper is to describe how geographic information systems can help the understanding of inequalities in health outcomes, including health care, in the era of sustainable development. Geographic information systems can help to reduce both social and spatial disparities in health outcomes (including health care location-based disparities) globally (in developed, middle-income and low-income countries alike), thus contributing to sustainable population health for today’s and future generations.

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  • 43.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Can sustainable health behaviour contribute to ensure healthy lives and wellbeing for all at all ages (SDG 3)?: A viewpoint2021In: Journal of Public Health Research, ISSN 2279-9028, E-ISSN 2279-9036, Vol. 10, no 3, article id 2051Article in journal (Refereed)
    Abstract [en]

    Sustainable health behaviours and, specifically, eating a sustainable diet and engaging in regular physical activity are health-promoting behaviours that can simultaneously contribute to reduction of greenhouse gases which are known to contribute to climate change. Good health usually facilitates societal development, and development often promotes improved health. However, while good health may be a prerequisite for societal development, some behavioural determinants of health, such as attitudes towards the environment, and people's lifestyles and consumption patterns, can impede the sustainability of the development process in the longer term. This perspective paper argues that there is a need to rethink 21st century health promotion practices by pairing sustainability literacy with health promotion for changing dietary and physical activity behaviour patterns to improve population health and contribute to the achievement of Sustainable Development Goal 3 (to ensure healthy lives and promote wellbeing for all at all ages).

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  • 44.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Can the interconnection between public health and social work help address current and future population health challenges? A public health viewpoint2022In: Journal of Public Health Research, ISSN 2279-9028, E-ISSN 2279-9036, Vol. 11, no 2, p. 1-7Article in journal (Refereed)
    Abstract [en]

    The debate over the function and role of public health in all societies (high, middle, and low-income) still continues today. Public health needs to interact with the social and translational sciences to achieve the best possible scientific evidence and practice aimed at development of effective policies for individual and population health practices. As a field, public health is most suited for development of transdisciplinary education, research and practice—improving population health would entail embedding with a variety of other disciplines including social work. Public health and social work in many ways share the same beginnings as well as their role in advocacy for social and health equity. For this reason, the transdisciplinary profession of public health social work is well placed to develop and build the inter-professional and cross-sectoral collaboration that is needed to address the many health challenges of the 21st century, based on theories, knowledge and interventions from both public health and social work. Furthermore, the profession can help in attempting to close the health inequalities gap, address social isolation, family violence and homelessness, advance long and productive lives, create social responses to the changing environment, reduce economic inequality, harness technology for social good, and work toward the achievement of justice and equality of opportunity.

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  • 45.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Does Structural Violence by Institutions Enable Revictimization and Lead to Poorer Health Outcomes?—A Public Health Viewpoint2023In: Annals of Global Health, ISSN 2214-9996, Vol. 89, no 1, article id 58Article in journal (Refereed)
    Abstract [en]

    Although structural violence is known to interact with and reinforce direct violence in the form of interpersonal violence (e.g., intimate partner violence), little debate takes place in public health on how it can lead to revictimization, leading to even poorer health outcomes (including psychological ill health). This viewpoint aims to discuss this issue using examples from empirical studies to elucidate how structural violence (perpetrated through institutions) contributes to revictimization among people who are already suffering direct violence. Public health professionals (and researchers) need to make efforts to theorize and measure structural violence to aid efforts toward the study of how it intersects with interpersonal violence to influence health outcomes. This will ultimately contribute to better prevention and intervention efforts to curb interpersonal violence and improve population health and well-being. In addition, there is a need to include structural violence in the academic curriculum when training future generations of public health professionals. Increased education on structural violence will bring about an awareness of the grave consequences of the potential additional harm that institutions could inflict on the lives of people they should be protecting or care for.

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  • 46.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Integrated corporate social responsibility and human resources management for stakeholders health promotion2019In: South Eastern European Journal of Public Health, ISSN 2197-5248, Vol. 12Article in journal (Refereed)
    Abstract [en]

    In the past decade, there has been an argument for the inclusion of corporate social responsibility (CSR) in models and business strategies. However, the conversion of CSR strategy into actual managerial practices and outcome values remains an issue of ongoing debate as well an important challenge for business organizations. Furthermore, still is very little discussion on how business will influence stakeholder’s health promotion and surrounding environment as means to help address society’s most pressing challenges.

    This paper discusses the potential of public health literacy in advancing stakeholders’ health promotion beyond the workplace. The discussion argues that integrating corporate social responsibility (CSR) and human resources management (HRM) is an effective strategy to achieve social sustainability in organizations in which stakeholders’ health and well-being are important components.

    This short report describes an integrated CSR-HRM and describes how it can facilitate public health literacy. In the era of sustainable development, there is a need to discuss how business organizations can strategize to enhance internal and external stakeholders’ health and well-being.

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  • 47.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Neighbourhood Social Sustainability, Urban Renewal and Health Inequalities: A Public Health Viewpoint2022In: International Journal of Urban Planning and Smart Cities, ISSN 2644-1659, Vol. 3, no 1, article id 52Article in journal (Refereed)
    Abstract [en]

    Social sustainability has been less studied than its counterparts, economic and environmental sustainability. Furthermore, social sustainability has not been often discussed within the discipline of public health and let alone, there has been very little discussion about the potential impact of neighbourhood social sustainability on health related outcomes as well as health inequities. This perspective paper attempts to fill that gap by igniting a discussion on how neighbourhood social sustainability can affect health equity in the context of health promotion and sustainable development. Neighbourhood social sustainability through urban renewal can contribute to the reduction of inequalities in health only if the process takes into account the health and wellbeing of the most disadvantaged groups. In addition, it is important that public health researchers become part of the discussions on how neighbourhood social sustainability can contribute to population health equity.

  • 48.
    Macassa, Gloria
    Stockholms universitet, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Poverty and health in different contexts. Social inequalities in child mortality in Mozambique and 19th century Stockholm2004Doctoral thesis, monograph (Other academic)
  • 49.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Public Perceptions of Sustainable Physical Activity and Active Transportation: A Pilot Qualitative Study in Gävle and Maputo2023In: Sustainability, E-ISSN 2071-1050, Vol. 15, no 21, article id 15354Article in journal (Refereed)
    Abstract [en]

    Sustainable physical activity and active transportation are important for achieving sustainable societies as well as for achieving the sustainable development goal of health and wellbeing for all. The main objective of this pilot study was to investigate the general public’s perceptions of sustainable physical activity and active transportation in the cities of Gävle (Sweden) and Maputo (Mozambique). Twelve semi-structured asynchronous e-mail interviews were subjected to content analysis. Findings indicated that participants knew what physical activity is and that they related it to general health and wellbeing. However, the majority were not familiar with the meaning of “sustainable physical activity” or “active transportation.” Furthermore, they did not know about the relationship between sustainable development and physical activity. The few participants who knew about active transportation said that it could contribute to reducing greenhouse gases. They mentioned barriers to active transportation in their respective cities, however, ranging from laziness (in the case of Gävle) to cultural norms and associations such as linking the use of active transportation to lacking the means to buy a motor vehicle (in Maputo). There is a need to integrate sustainability literacy with the already existing health and public health literacies to provide this knowledge to the general population. To this end, rather than creating new educational programmes for the public, the existing materials can be adjusted to include aspects of sustainability and sustainable health behaviours and lifestyles.

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  • 50.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Responsible leadership styles and promotion of stakeholders health2019In: South Eastern European Journal of Public Health, ISSN 2197-5248, Vol. 11Article in journal (Refereed)
    Abstract [en]

    The aim of this short report is to stimulate a conversation on the potential role to be played by responsible leadership in promoting the health and well-being of stakeholders (employees and society at large).

    The report first describes responsible leadership styles and then briefly discusses the potential connection with health promotion within the lens of the wider determinants of health and intersectorial collaboration.

    Integrative responsible leadership and health promotion share a common vision: to alter the economic, environmental, and social contexts in which decisions relating to health and well-being are made, thus affecting health equity.

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