Official Register Data Research Articles

IT really matters: Associations of computer hassles and technical support with medically certified sickness absence due to mental health complaints

Information and Communication Technology (ICT) at work can cause distress and frustration, commonly labeled ”technostress”. Nevertheless, few, if any, studies have examined the impact of ICT factors on sickness absence due to mental distress. We investigated effects of ”ICT-hassles” - disruption of work due to ICT-problems - on low or medium-level and high level sickness absence due to psychological diagnoses (LMSA-P/HSA-P). We also determined the mitigating influences of ICT-training and ICT-support. We surveyed 8620 workers in Norway, linking responses to official registry data of medically certified absence due to psychological complaints during 12 months following the survey. We used Bayesian multilevel multinomial logistic regression and analyzed ICT-variables at the individual level as well as averaged over employees within work-units. Moderated regressions determined whether effects of ICT-hassles varied with levels of support and training. Individual level ICT-hassles predicted HSA-P (OR 1.20, 95% CI 1.01,1.42) and work-unit level hassles LMSA-P (OR 1.47, 95% CI 1.11,1.94). ICT-support at both levels predicted lower risk of LMSA-P (individual: OR 0.84, 95% CI 0.74,0.97, work-unit: OR 0.63, 95% CI 0.50,0.80). Insufficient training appeared to have the most marked effects, with ORs ranging from 1.66 to 5.12. Effects were strongest at the work-unit level and persisted after adjustment for job demands and -control. No moderation of the effect of hassles by training and support was observed. In conclusion, ICT-hassles may promote absence whereas support and training prevent it. However, offering support after hassles have occurred may not be sufficient, suggesting that prevention is more effective than repair.

Delphi method applicability in drug foresight

BackgroundThe aim of the current study was to assess the accuracy of expert predictions, which were derived using a Delphi panel foresight study between 2009 and 2011, on a variety of drug-related topics in Finland in 2020.MethodsThe material used to evaluate the accuracy of the predictions consists of published reports on statistics, survey results, official register data, wastewater analyses and official documents. Whenever possible, we used multiple information sources to ascertain possible changes related to the predictions.ResultsBetween 2009 and 2011, the majority – but not all – of the experts accurately predicted an increase in drug use. Indeed, more people experimented with or used drugs, and more drug residues were found in wastewater monitoring. The experts also correctly predicted an increase in population-level approval of drug use, but this development has been rather slow. Contrary to predictions, there was no marked increase in the use of new synthetic drugs. However, the misuse of buprenorphine increased during the 2010s. In the drug market, unit prices were surprisingly stable over the ten-year period. There were no changes in legislation related to the legal status of drugs, as was foreseen by the experts. However, enforcement moved in the direction foreseen by the experts: more lenient measures have been taken against users. Drug care system reforms favored a combination of mental health and addiction care units between 2009 and 2011, and 2020, as foreseen by the experts.ConclusionsIt seems to have been easier for the experts to foresee the continuation of existing trends, e.g., increasing use of drugs or widening approval of drugs, than to predict possible changes in the popularity of distinct groups of drugs such as new psychoactive substances (NPS). Even armed with the prediction that drug imports and wholesale would increasingly fall into the domain of organized crime, this undesirable development could not be stopped. Expert disagreement can also be seen as a valuable indication of uncertainty regarding the future. Foresight related to drug-related issues can produce relatively accurate and realistic views of the future at least up to ten years ahead.

Fertility Decline in Iceland, 2013-2022: Trends and Structures

Iceland is one of the Western countries that have experienced an unexpected fertility decrease in the 2010s. In this study, the aggregate Icelandic fertility decline is dissected to explore which fertility components are the main drivers behind the decline since 2010 in order to better understand whether the development is associated with compositional changes or linked to changes such as increased propensities of childlessness and decreased propensities to have another child. As such, it contributes empirical evidence to ongoing theorisation within current fertility debates. Official administrative register data are analysed by means of event-history analysis. Findings are presented as parity-specific birth risks and in the form of Kaplan-Meier estimates of synthetic period-based cohorts of women and men progressing to parity one over calendar years. In terms of results, we find that the fertility decline was concentrated around first births, and the decline can principally be attributed to women under the age of thirty. Propensities to remain childless have increased slightly since 2013, while there were no declines in the intensities to have a second and a third child. Hence, the development in Iceland appears to be driven by clear postponement of parenthood but not altered childbearing behaviour in terms of propensities to have a second and a third child. Results do not necessary contradict theories under the umbrella of the gender-relations framework, but they highlight the importance of exploring other factors impacting the transition to parenthood, such as perceived global and welfare uncertainties. Socioeconomic differentials in first-birth fertility and factors affecting postponement and ultimate childlessness should be explored further, as well as short-term developments in higher-order birth intensities during adverse circumstances, such as the 2008 economic crisis and the Covid-19 pandemic, during which periods the third-birth intensities increased.

Physiotherapy and its service in Nepal: implementation and status reported from facility surveys and official registers

BackgroundPhysiotherapy is a growing profession in Nepal. Despite efforts to promote strengthening and development, there are still challenges in providing equitable access and availability to services, particularly in underserved areas. Updated information is needed to address challenges to provide proper planning for resource allocation.ObjectiveTo assess implementation of physiotherapy services and to explore plans, policies and the general status of physiotherapy in Nepal.MethodImplementation was assessed with a cross-sectional survey conducted in Province III containing closed-ended questions addressing physiotherapy services, human resources, charging and record-keeping systems, and accessibility. Stratified purposive sampling was used to select eligible facilities from the list of Department of Health Services. Official records were explored through visits to governing institutions and by reviews of registers and reports to obtain data and information on status, plans and policy.ResultsThe survey included 25 urban and 4 rural facilities, covering hospitals and rehabilitation centres; both public (37.9%) and non-public (62.1%). Most facilities (79.3%) employed physiotherapists with bachelor’s degrees. Average number of visits were 29.55 physiotherapy outpatients and 14.17 inpatients per day. Patient records were mainly paper based. Most (69%) used the hospital main card, while others (31%) had their own physiotherapy assessment card. Most referrals came from doctors. The most offered services were musculoskeletal, neurological, and paediatric physiotherapy. Daily basis charging was common. A single visit averaged 311 Nepalese rupees ≈ 2.33 US$. Convenience for persons with disabilities was reported as partial by 79% of outpatient departments. Official register data showed 313 master’s and 2003 bachelor’s graduates. Six colleges offered physiotherapy bachelor’s degree, whereof one also offered a master’s program. Government records revealed significant progress in physiotherapy in Nepal.ConclusionThe study highlights variations in physiotherapy services within a province owing to type, size and location, but also unwarranted variations. Despite the progress, implementation of physiotherapy services in the perspective of official records imply a need of systems for proper planning and monitoring. Physiotherapy provision in underserved areas warrants further attention.

Пути совершенствования эпидемиологического надзора за эндемичными биогельминтозами Дальнего Востока

One of the tasks of epidemiological surveillance of parasitic diseases is to maintain sanitary and epidemiological well-being for endemic biohelminthiasis in the territories included in the range of pathogens. The inclusion of a person in the circulation of pathogens depends on a complex of social factors, primarily on the nutritional characteristics of residents. Long-term studies show that the official registration data do not fully reflect the real picture of the population affected by pathogens of biohelminthiasis. Sanitary and parasitological examination of fish occupies one of the leading places in the system of preventive measures. The main task at the present stage is to provide a differentiated approach to the development and optimization of means and methods of disease prevention among the population of endemic territories, depending on the type of focus, the level of endemia and, accordingly, the degree of risk of infection of the population. Key words: clonorhiasis, nanofietosis, metagonimosis, epidemiological surveillance.

Is refugee experience in childhood a risk for poorer health in adulthood?-A Swedish national survey study.

Studies on experiences of migration in childhood and subsequent health in adulthood report conflicting results. While there is limited research on the long-term health outcomes of refugee children as they transition into adulthood, it is often observed that refugee children experience adverse health conditions upon their arrival in the host country. We examined whether adults with a childhood refugee experience were more likely to have poorer mental health, general health, and risk-behaviours compared to non-refugee migrants and Swedish-born peers We included a nationally representative sample of 18-64-year-olds who answered the Swedish National Public Health survey in 2018 or 2020. Using official register data, we categorized individuals as: 1) refugees in childhood (<age 18 years); 2) migrants in childhood; or 3) Swedish-born. Associations between childhood status (refugee, migrant, or Swedish-born) and all outcomes in adulthood were analyzed using logistic regression. The final model was adjusted for age, sexual- and gender-minority (SGM) identity, and stratified by sex. We also analysed the above and all outcomes stratified by age (18-25, 26-64), adjusted for sex and SGM-identity. We found that a childhood refugee experience was not associated with worse self-rated general or mental health, or more risk behaviours in adulthood, compared to non-refugee migrants or Swedish-born individuals. Additionally, adults with a childhood refugee experience had lower odds of at-risk alcohol use and substance use than Swedish-born peers. In general, a childhood refugee experience was not associated with worse self-rated health or risk behaviours in adulthood when considering age and sexual- and gender-minority status.

Poverty at a distance: Supply and demand side factors and the formation of civil society organizations in Iraq

AbstractThis paper contributes empirically to the international debate on the drivers for the formation of civil society organizations (CSOs) by testing three separate hypotheses: demand, supply and integration. To investigate this question, we analyse the CSO sector in Iraq, which transformed since 2003 from being implicitly banned to being a central pillar of poverty alleviation and social service provision with thousands of formally registered organizations. Using OLS regression analysis with district level and official register data, we examine the geographic distribution of CSOs in relation to poverty levels in Iraq. We find no significant confirmation for demand side drivers that social service providing CSOs form in high poverty districts. Instead, we find strong support for CSO formation in governorate administrative centres, which confirms supply‐side drivers of CSO development. However, we do find some support for a higher concentration of human rights‐based CSOs in high poverty areas. The findings raise important policy implications for the UN Sustainable Development Goal of no poverty in an Iraqi context and internationally, but also how to fund CSOs to meet the demands of the primary recipients.

Finnish Population Study Yields New Way to Identify Youth at Risk for Serious Mental Illness

Finnish Population Study Yields New Way to Identify Youth at Risk for Serious Mental Illness

With Time We Learn to Trust Others? Long-Standing Ethnic Diversity, Recent Immigration, and Out-Group Trust in Russia

This article examines the relationship between ethnic diversity and out-group trust in contemporary Russia, while distinguishing between long-standing ethnic diversity and recent immigration. In contrast to previous research that tested whether past regional experience with diversity is related to people's attitudes toward out-group members, we focus on long-standing ethnic diversity, defined as diversity resulting from the long-term coexistence of ethnic groups in a region, not recent immigration. We hypothesize that while the presence of out-groups may initially be threatening to the members of an ethnic group, long-standing diversity has positive consequences for intergroup relations. Using 2015 survey data combined with census and official registration data from Russian regions, we found that inhabitants of regions with higher levels of long-standing ethnic diversity tended to show higher out-group trust, while accounting for socio-economic characteristics of the regions and of individuals. In contrast, inhabitants of regions with higher recent immigration tended to have lower out-group trust, all else held constant. While these associations were weak, they speak in favor of a dynamic model of intergroup trust, which involves learning about others through mutual coexistence. We also acknowledge that the autochthonous status of ethnic minorities and existing institutional arrangements regarding different ethnic groups in Russia may additionally contribute to the development of trust.

The role of socioeconomic status and political attitudes in the spread of Covid-19 in Austria

Abstract This study investigates the role of socioeconomic status (SES) and political attitudes marked by populism and libertarianism in the spread of Covid-19 infections across Austria. A spatial regression approach is adopted based on official registry data on Covid-19 cases at the municipality level, granted by the Austrian National Public Health Institute. This allows the consideration of spatial dependencies between observations in close geographic proximity. Moreover, to uncover potential temporal (in)stabilities in the effects, the associations are examined over two pandemic phases, namely the second (06/20 to 02/21) and third wave (02/21 to 07/21) of infections. The analysis shows that low educational attainment and income led to higher infection rates during both periods under investigation. In contrast, unemployment was negatively related to the Covid-19 incidence. While the findings for income and education were more pronounced during the third wave of infections, unemployment had a more significant impact during the second wave. Contrary to what was expected, the findings report that populist attitudes were associated with lower case numbers during the second wave. This association reversed and became positive in the third wave but was no longer significant. A positive yet non-significant relationship was detected between libertarian attitudes and Covid-19 cases for both periods studied. The findings suggest that low-income and less-educated groups carry a higher Covid-19 disease burden in Austria. This provides vital information for policymakers to develop targeted public health strategies to protect vulnerable groups and achieve a more equitable distribution of health in society. Only limited evidence was provided regarding the impact of populist and libertarian sentiments on the spread of Covid-19. As polarisation has increased throughout the pandemic, further research on attitudes characterized by skepticism towards state intervention and science is needed. Key messages

Impact of socioeconomic position on childhood obesity in Finland based on register data from 2018

Abstract Background Obesity is a globally growing public health challenge among children. In developed countries, the risk of obesity is commonly higher among lower socioeconomic groups. Measuring socioeconomic position (SEP), especially income, is challenging in surveys as self-reported information may suffer from reporting, awareness, recall and non-response bias. Our aim is to utilize official register data on several SEP indicators and measured height and weight of children, to identify the strongest predictors of SEP of the parents on the risk of obesity among the whole 2-17-year-old child population in Finland. Methods Data for all children who had visited child health clinic or school health care in 2018 were extracted from the National Outpatient Register on Primary Health Care Services (n = 387623, coverage 40% in 2018). Obesity was defined according to the WHO criteria. SEP indicators were obtained from Statistics Finland for both parents living in the same household with a child. Boosted regression model was used to analyze the contribution of SEP to obesity using training dataset on 155479 non-related children. Results The area under the curve for the final model in training dataset was 0.736 and 0.718 in validation dataset. Mother's educational level (12.6% of the total explained variation) and household's disposable income (12.6%) were the SEP indicators that most strongly predicted childhood obesity, whereas the impact of educational level of the father was somewhat smaller (8.1%). The influence of the age of a child was even bigger (39.2%), the prevalence of obesity being highest at 11 and 9 years of age among boys and girls, respectively. Conclusions Our results based on official register data from Finland, a Nordic high-income country, endorse earlier findings on higher obesity risk among children with low socio-economic family background. Identification of the SEP related risk factors and support to families are essential in the prevention of childhood obesity. Key messages

Variations in vaccination uptake: COVID-19 vaccination rates in Swedish municipalities.

Facing the threat of the ongoing COVID-19 pandemic, vaccines are important for limiting the spread and consequences of the pandemic. In this study, we provide a descriptive overview of the within-country variations of vaccine rates by examining to what extent voter turnout, support for an anti-establishment political party (Sweden Democrats), presence of first-generation immigrants, and Evangelical religiosity are associated with the within-country variation in vaccine uptake rates. We use official register data for municipality-level vaccine rates and municipality-level regressions with regional fixed effects. Our analyses show that vaccine uptake, on average, is lower in municipalities where the anti-establishment political party Sweden Democrats has higher vote shares and where a larger share of the population is first-generation immigrants. We discuss that potential explanations for these associations between vote shares for an anti-establishment party and shares of first-generation immigrants could be lower levels of trust in institutions and language barriers.

The retirement (food)-consumption puzzle revisited - A panel data study from Denmark

The world population is ageing, and as lifestyle related illnesses and multi-morbidity increase with ageing, prevention with modifiable factors is becoming an increasingly important issue. In the current paper, we revisit the retirement (food) consumption puzzle in a welfare state context and examine how retirement affects food expenditure and energy intake as well as the dietary healthiness of elderly individuals with different marital and labor market status. We use a unique household panel data set covering the period from 2007–2017 with monthly food purchases from a sample of households above 55 years of age. We supplement the purchase data with official register data on income, health-contact days, unemployment, early voluntary and old age retirement at the individual level. The structure of the data set facilitates the identification of any associations between retirement and dietary behavior while controlling for important confounding factors such as the number of health-contact days as a proxy for health shocks and income as a proxy for wealth shocks. We compare the results with the results from estimations using instruments for the retirement decision. We do not find any evidence to support a retirement (food) consumption puzzle. Generally, the healthiness of diets increases at the point of retirement, and even more so for those who had the most unhealthy diets before retirement. Since the diets of individuals outside the labor market are less healthy both before and after retirement compared to other groups, the focus of dietary policy should be directed at this group.

All-cause excess mortality across 90 municipalities in Gujarat, India, during the COVID-19 pandemic (March 2020-April 2021).

Official COVID-19 mortality statistics are strongly influenced by local diagnostic capacity, strength of the healthcare and vital registration systems, and death certification criteria and capacity, often resulting in significant undercounting of COVID-19 attributable deaths. Excess mortality, which is defined as the increase in observed death counts compared to a baseline expectation, provides an alternate measure of the mortality shock-both direct and indirect-of the COVID-19 pandemic. Here, we use data from civil death registers from a convenience sample of 90 (of 162) municipalities across the state of Gujarat, India, to estimate the impact of the COVID-19 pandemic on all-cause mortality. Using a model fit to weekly data from January 2019 to February 2020, we estimated excess mortality over the course of the pandemic from March 2020 to April 2021. During this period, the official government data reported 10,098 deaths attributable to COVID-19 for the entire state of Gujarat. We estimated 21,300 [95% CI: 20, 700, 22, 000] excess deaths across these 90 municipalities in this period, representing a 44% [95% CI: 43%, 45%] increase over the expected baseline. The sharpest increase in deaths in our sample was observed in late April 2021, with an estimated 678% [95% CI: 649%, 707%] increase in mortality from expected counts. The 40 to 65 age group experienced the highest increase in mortality relative to the other age groups. We found substantial increases in mortality for males and females. Our excess mortality estimate for these 90 municipalities, representing approximately at least 8% of the population, based on the 2011 census, exceeds the official COVID-19 death count for the entire state of Gujarat, even before the delta wave of the pandemic in India peaked in May 2021. Prior studies have concluded that true pandemic-related mortality in India greatly exceeds official counts. This study, using data directly from the first point of official death registration data recording, provides incontrovertible evidence of the high excess mortality in Gujarat from March 2020 to April 2021.

Exploring the potential for sustainable accessibility across settlement types. A Swedish case

The potential for residents of smaller urban and rural areas to benefit from sustainable accessibility is an under-researched area. This paper explores accessibility to important every-day amenities within short travel times and how this differs across geography and mode of travel. The analysis draws on a combination of novel open-source data of the transport system and official Swedish register data of the total population of individuals and workplaces geocoded at a 100-meter resolution. The findings show considerable variation in accessibility to everyday amenities by travel mode for different settlement types. While the car provides good accessibility, short trips by bicycle are a very competitive alternative in urban and suburban areas. Access to every-day amenities by active travel modes is limited outside urban areas. Employing accessibility analysis by settlement type offers a powerful policy support tool for planners charged with developing measures to address sustainable accessibility for small urban and rural areas.

Cardiovascular Signal Entropy Predicts All-Cause Mortality: Evidence from The Irish Longitudinal Study on Ageing (TILDA).

In this study, the relationship between cardiovascular signal entropy and the risk of seven-year all-cause mortality was explored in a large sample of community-dwelling older adults from The Irish Longitudinal Study on Ageing (TILDA). The hypothesis under investigation was that physiological dysregulation might be quantifiable by the level of sample entropy (SampEn) in continuously noninvasively measured resting-state systolic (sBP) and diastolic (dBP) blood pressure (BP) data, and that this SampEn measure might be independently predictive of mortality. Participants’ date of death up to 2017 was identified from official death registration data and linked to their TILDA baseline survey and health assessment data (2010). BP was continuously monitored during supine rest at baseline, and SampEn values were calculated for one-minute and five-minute sections of this data. In total, 4543 participants were included (mean (SD) age: 61.9 (8.4) years; 54.1% female), of whom 214 died. Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) with 95% confidence intervals (CIs) for the associations between BP SampEn and all-cause mortality. Results revealed that higher SampEn in BP signals was significantly predictive of mortality risk, with an increase of one standard deviation in sBP SampEn and dBP SampEn corresponding to HRs of 1.19 and 1.17, respectively, in models comprehensively controlled for potential confounders. The quantification of SampEn in short length BP signals could provide a novel and clinically useful predictor of mortality risk in older adults.

Functional food for alleviation of nutritional amemia in China: an analysis on official registration data

Objective To analyze the status quo of functional food for improving nutritional anemia officially registered in China for providing evidences to relevant research and development of enterprises and governmental supervision. Methods From the website of China Food and Drug Administration (CFDA) and State Administration for Market Regulation (SAMR), we extracted the information on 228 functional food products (FFPs) for improving nutritional anemia officially registered in China from March 1996 through February 2010. Dosage form, function claim, composition of traditional Chinese medicine, content of iron-compound, and content measurement of functional/marker components of the FFPs were analyze with general descriptive analysis, visual data analysis, factor analysis and principal component analysis using Ucinet 6 and SPSS 22.0. Social network mapping was performed to display the utilization frequency of the 73 traditional Chinese medicine and its extracts and other bioactive compounds which were included in the ingredients of the three or more of the FFPs. Results Of the 228 FFPs in 7 dosage forms, 117 (51.3%) are oral liquids. The main raw materials were listed the ingredients of 197 (86.4%) of the FFPs. Angelica sinensis and its extract, Astragalus membranaceus and its extract, donkey-hide gelatin, Chinese-date and its extract, and iron and its compound are among the components locating in central region of the social network map constructed. Traditional Chinese medicine raw material and medicine food homology raw material were listed in the ingredients of 157 FFPs. Among 14 top traditional Chinese medicine raw material most frequently used in the FFPs, seven common factors (Angelica sinensis and Astragalus mongholicus, Poria cocos and Chinese yam, prepared rehmannia root and Codonopsis pilosula, Paeonia Lactiflora, mulberry, longan, Lycium chinensis and black-bone chicken) were identified, contributing a cumulative variance of 72.378. Among the 165 FFPs with iron-compound in the ingredients, 130 (78.8%) contain traditional Chinese medicine raw material. The top 5 iron-compounds utilized in the 165 FFPs are ferrous lactate (in 46 FFPs), ferrous gluconate (43), heme chloride (30), ferrous fumarate (9), and ehylenediaminetetraacetic acid ferric sodium (8), respectively. Of the 70 FFPs approved by the Ministry of Health of the People′s Republic of China, 42 (60.0%) indicated the contents of functional/marker components in the products′ registration information; all the 158 FFPs approved by CFDA and SAMR indicated the contents of functional/marker components in the products′ registration information, with the top 3 most frequently listed functional/marker components of iron (in the ingredients of 76% of the 158 FFPs), polysaccharide (29.5%), and total saponins (22%). Conclusion For the officially registered FFPs for improving nutritional anemia, the combination and types of utilized traditional Chinese medicine raw material is relatively identical and there is lack of known specific correlation between the utilized traditional Chinese medicine raw material and the implied effect of functional/marker components.

NAFLD-related gene polymorphisms and all-cause and cause-specific mortality in an Asian population: the Shanghai Changfeng Study.

The PNPLA3 and TM6SF2 gene variants have been found to cause NAFLD with a favourable cardiovascular risk profile. To investigate the effects of the NAFLD risk alleles on the all-cause and cause-specific mortality in 5581 Chinese adults. The genome-wide genotypes were detected using a genotyping array and serum lipoprotein profiles were examined using 1H NMR platform. Liver fat content (LFC) was measured using a quantitative ultrasound method. The vital status was determined using official registration data. Genome-wide association analysis showed that a series of variants in PNPLA3 were associated with LFC, including rs738409 C>G variant (P=8.6×10-7 ). Further analyses validated the associations of TM6SF2 rs58542926 C>T and MBOAT7 rs641738 C>T variants with NAFLD. During 29425.1 person-years of follow-up, the overall mortality was 816 per 100000 person-years, where 299 deaths were attributable to cardiovascular disease and 85 to liver disease. The PNPLA3 rs738409 C>G variant was independently associated with increased liver-specific mortality (P for trend=0.034) but reduced cardiovascular mortality (P for trend=0.047). A composite genetic-predisposition score of PNPLA3, TM6SF2, and MBOAT7 risk alleles presented similar opposite effects on liver-specific and cardiovascular mortality. Moreover, interactions of the NAFLD risk alleles with adiposity for liver-specific mortality were found (Pinteraction <0.05). The reduced serum VLDL1 concentration was responsible for the increased liver-specific mortality related to NAFLD risk alleles. The PNPLA3 rs738409 C>G variant and its combination with TM6SF2 rs58542926 C>T and MBOAT7 rs641738 C>T variants increase liver-specific mortality but reduce cardiovascular mortality in overweight/obese Chinese.

'Wish to die' is independently associated with cardiovascular mortality in later life. Data from TILDA.

There is an established bidirectional relationship between mental and heart health in later life but the link between wish to die (WTD) and cardiovascular mortality is less well-defined. This is a longitudinal study examining the association between WTD and mortality over 9-year follow-up in a large population-representative sample of older adults. Individual-level survey data was linked to official death registration data, divided into cardiovascular and noncardiovascular causes. WTD was defined as answering affirmatively when asked 'In the last month, have you felt that you would rather be dead?' Regression models were used to obtain hazard ratios for the association between WTD at Wave 1 and mortality. Kaplan-Meier plots were used to compare survival across groups. Just over 3% (275/8124) of participants reported WTD. Mortality data was available for 9% of participants (755/8124). WTD was significantly associated with all-cause mortality, with a hazard ratio of 1.41 (95% confidence interval [CI]: 1.00-1.99). Findings were attenuated and no longer significant after excluding participants with heart disease or depression/anxiety/other psychiatric illness. WTD was significantly associated with cardiovascular mortality (hazard ratio: 2.14 [95% CI: 1.21-3.78]), even after excluding participants with depression/anxiety/other illnesses but not heart disease. WTD was not associated with an increased risk of death due to non-cardiovascular causes. Older people who report a wish to die have double the risk of death from cardiovascular disease in the following 9 years, even when those with depression, anxiety or other mental health problems are excluded.

Poor family relationships in adolescence as a risk factor of in-patient somatic care across the life course: Findings from a 1953 cohort.

BackgroundPrior research has shown that poor family relations during upbringing have long-term detrimental effects on mental health. Few previous studies have, however, focused on somatic health outcomes and studies rarely cover the life span until retirement age. The aims of the current study were, firstly, to examine the association between poor family relationships in adolescence and in-patient somatic care across the life course whilst adjusting for confounders at baseline and concurrent psychiatric in-patient care; and secondly, to compare the risks of somatic and psychiatric in-patient care across the life course.MethodsProspective data from the Stockholm Birth Cohort study were used, with 2636 participants born in 1953 who were followed up until 2016. Information on family relationships was collected from the participants’ mothers in 1968. Annual information on in-patient somatic and psychiatric care was retrieved from official register data from 1969 to 2016.ResultsPoisson regressions showed that poor family relationships in adolescence were associated with an increased risk of in-patient somatic care in mid- and especially in late adulthood (ages 44–53 and 54–63 years), even when controlling for the co-occurrence of psychiatric illness and a range of childhood conditions. No statistically significant association was observed in early adulthood (ages 16–43 years), when controlling for confounders. These findings are in sharp contrast to the analyses of inpatient psychiatric care, according to which the association with poor family relations was strongest in early adulthood and thereafter attenuated across the life course.ConclusionPoor family relationships in adolescence are associated with an increased risk of severe consequences for somatic health lasting to late adulthood even when controlling for confounders including in-patient psychiatric care, emphasising the potentially important role of early interventions.