In a population sample of 1462 middle-aged women socioeconomic data were studied in relation to obesity, assessed by a body weight index. Education, annual income, and social class were negatively correlated with weight index (WI). Husband's social class was a stronger determinant of obesity in the woman than her own class. Age of husband and number of children were significantly correlated with WI. There was also a weak correlation between being single and WI. Sick leave was not correlated to WI. Pension was correlated to WI when adjusted for age, but not when allowance was also made for social class. Age, husband's social class, education, husband's income, and number of children were independent predictors of WI among the married women. In the single women, age and own income were independent predictors of WI but not number of children, education or own social class.
OBJECTIVE: Secular increases in obesity have been widely reported in middle-aged adults, but less is known about such trends among the elderly. The primary purpose of this paper is to document the most recent wave of the obesity epidemic in population-based samples of 70-y-old men and women from Göteborg. Additionally, we will investigate the influences of physical activity, smoking and education on these secular trends. POPULATIONS AND METHODS: Five population-based samples of 3702 70-y-olds (1669 men and 2033 women) in Göteborg, Sweden, born between 1901 and 1930, were examined in the Gerontological and Geriatric Population Studies (H70) between 1971 and 2000. Cohort differences in anthropometric measures were the main outcomes studied. Physical activity, smoking habits and education were assessed by comparable methods in all cohorts. Subsamples of the women in the latest two cohorts (birth years 1922 and 1930) were also part of the Prospective Population Study of Women in Göteborg. In these women, it was possible to examine body mass index (BMI) and waist-to-hip circumference ratio (WHR) longitudinally since 1968. RESULTS AND CONCLUSIONS: Significant upward trends were found for height, weight, BMI, waist circumference (WC), WHR, prevalence of overweight (BMI> or =25 kg/m(2)) and obesity (BMI> or =30 kg/m(2)) across cohorts in both sexes. In 2000, 20% of the 70-y-old men born in 1930 were obese, and the largest increment (almost doubling) had occurred between the early 1980s and the early 1990s. In 70-y-old women the prevalence of obesity was 24% in 2000, a 50% increase compared to the cohort born 8 y earlier. BMI increased over time in all physical activity, smoking and education groups, with the exception of never-smoking men. Although 70-y-old women in 2000 were heavier than cohorts examined 8 y previously, data from the women studied longitudinally revealed that these differences were already present in earlier adulthood. In conclusion, the elderly population is very much part of the obesity epidemic, although secular trends in BMI were detected slightly earlier in men than in women. The health implications of these secular trends should be focused on in future gerontological research.
Data from an ongoing prospective population study of women in Göteborg, Sweden, were used to assess agreement between self-reported birth weight and birth weight obtained from original delivery records of women aged 44-60 years. Of the eligible population with traced delivery records (n = 693), only 28% (n = 192) could report their own birth weight. Spearman correlation between self-reported birth weight and birth weight from original records was r = 0.76. However, a difference plot, with limits of agreement at -1,028 to 1,038 g (95% confidence limits: lower limit, -1,157 to -901 g, upper limit, 910 to 1,166 g) revealed poor agreement between methods. Of the self-reported birth weights, 53% were in error by 250 g or more, and 31% were positively or negatively discordant by 500 g or more. Application in an analysis of cardiovascular risk factors in adulthood found conflicting results between self-reported and recorded birth weights. Low reporting rate, poor reporting accuracy, and misleading findings in application led to the conclusion that self-reported birth weights from middle-aged women would not be a satisfactory replacement for birth weights from original records.
The dental status with respect to number of missing teeth and proximal periodontal bone height in relation to social factors were studied in a population sample of women 38-60 years of age. There was an overrepresentation of edentulous women among those who had grown up in a rural area, who had low education, and in those who belonged to a low socio-economic group (irrespective of whether the socio-economic group of the women themselves or of their husbands was studied), while no obvious differences were observed when the proximal periodontal bone height was studied in relation to social factors. The relationships between social factors and number of missing teeth seemed to be stronger than between social factors and any other variable included in the comprehensive population study, of which this examination of the dental status was one of a number of research projects.
We examined relations between socioeconomic status and cardiovascular disease, cancer, and diabetes mellitus in a 24-year prospective study of 1,462 Swedish women. Two socioeconomic indicators were used: the husband's occupational category for married women and a composite indicator combining women's educational level with household income for all women. The husband's occupational category was strongly associated with cardiovascular disease and cancer mortality in opposite directions, independent of age and other potential confounders. Women with husbands of lower occupational categories had an increased risk of cardiovascular disease mortality [relative risk (RR) = 1.60; 95% confidence interval (95% CI) = 1.09-2.33] while experiencing lower rates of all-site cancer mortality (RR = 0.69; 95% CI = 0.50-0.96). A similar relation was seen with the composite variable: women with low socioeconomic status had an increased risk of cardiovascular disease (RR = 1.37; 95% CI = 1.01-1.84) but a somewhat lower risk for cancer of all sites (RR = 0.86; 95% CI = 0.66-1.11). Finally, morbidity data (diabetes mellitus, stroke, and breast cancer) yielded results that were consistent with the mortality trends, and breast cancer appeared to account for a major part of the association between total cancer and high socioeconomic status. In summary, higher socioeconomic status was associated with decreased cardiovascular disease mortality and excess cancer mortality, in such a way that only a weak association was seen for all-cause mortality.
OBJECTIVE: To study whether formal education and occupational class are associated with incidence of rheumatoid arthritis overall and with the incidence of the two major subgroups of rheumatoid arthritis-seropositive (RF+) and seronegative (RF-) disease. METHODS: 930 cases and 1126 controls participated in a population based case-control study using incident cases of rheumatoid arthritis, carried out in Sweden during the period May 1996 to June 2001. The relative risk (RR) of developing rheumatoid arthritis with 95% confidence interval (CI) was calculated for different levels of formal education compared with university degree and for different occupational classes compared with higher non-manual employees. RESULTS: SUBJECTS: without a university degree had an increased risk of rheumatoid arthritis compared with those with a university degree (RR = 1.4 (95% CI, 1.2 to 1.8)). For manual employees, assistant and intermediate non-manual employees together, the risk of developing rheumatoid arthritis was about 20% more than for non-manual employees. These increased risks were more pronounced for RF+ than for RF- rheumatoid arthritis and were mainly confined to women. Smoking could not of its own explain the observed associations between risk of rheumatoid arthritis in different socioeconomic groups in Sweden. CONCLUSIONS: There was an association between high socioeconomic status and lower risk of rheumatoid arthritis in a population based investigation that was representative for the Swedish population. The study shows that as yet unexplained environmental or lifestyle factors, or both, influence the risk of rheumatoid arthritis, even in the relatively egalitarian Swedish society.
Two years after an extensive health examination at a Swedish industry, a follow-up study was carried out in 110 employees (94% of those initially examined). The control included a history of the subject's health, a physical examination, an electrocardiogram, urine and faeces examinations and 16 chemical analyses of whole blood or serum. Except for repeat examinations of those who had had initial values outside reference values, most of the chemical analyses meant nothing, leading to unnecessary expense and possible risk of either worried or complacent participants. The history and physical and laboratory examinations, aimed at finding factors which can be improved by changing the life style seem to be most beneficial. It is concluded that extensive health examinations, including a large number of laboratory examinations which are carried out at many industries as a health control, should be critically evaluated at these industries.
As observed in a cross-sectional population study of 1,302 women, aged 44-66 years and representative of middle-aged women living in a Swedish city, symptoms and complaints were found to be unevenly distributed in the female population. Factors such as foreign origin, low education, different kinds of isolation such as not working outside of the home, being divorced or widowed seemed to be factors which increased the risk of experiencing different symptoms and complaints. When meeting a patient with a complaint it is important to take all possible causes into consideration including socio-economic factors.
In the Swedish community of Strömstad, where the mortality from cardiovascular disease is high in the female population, all women aged 45-64 years were offered a health survey with the main purpose of screening for cardiovascular risk factors. Altogether 927 of 1084 women (86%) participated. Women with one or more risk factors were invited to attend a three-month course organized by the primary health care service to receive information about how they themselves could influence their risk factors by changing dietary and physical exercise patterns. At a follow-up survey three months later, the participants in the courses had significantly improved many of their risk factor values compared with the non-participants. The improvement was still mainly present a year later.
An intervention study of men living in the Community of Habo in southwestern Sweden has been carried out. All men aged 33-42 and living in the community were invited. Altogether 652 men participated. The study included a questionnaire, an interview made by a nurse, anthropometric measurements, blood pressure measurements, measurements of respiratory function and work performance capacity, and blood sampling for chemical analyses. The participation rate was high, 86.1%, after one mail invitation even considering the fact that two reminders were sent. Most of the non-participants had recently been in contact with the health care organisation, either because they were high-consumers of health care, or because they had attended a health examination at work. A health profile was worked out comprising 11 different potential risk factors for coronary heart disease. This health profile turned out to be a useful educational tool when discussing the results of the examination with the participants. Risk points were given according to certain predetermined criteria. The distribution of risk factors was similar in the different ages studied. Most of the participants had at least one risk factor as defined, but many of them had two or more risk factors.