Income-related inequalities in diseases and health conditions over the business cycle

How business cycles affect income-related distribution of diseases and health disorders is largely unknown. We examine how the prevalence of thirty diseases and health conditions is distributed across the income spectrum using survey data collected in Iceland in 2007, 2009 and 2012. Thus, we are able to take advantage of the unusually sharp changes in economic conditions in Iceland during the Great Recession initiated in 2008 and the partial recovery that had already taken place by 2012 to analyze how income-related health inequality changed across time periods that can be described as a boom, crisis and recovery. The concentration curve and the concentration index are calculated for each disease, both overall and by gender. In all cases, we find a considerable income-related health inequality favoring higher income individuals, with a slight increase over the study period. Between 2007 and 2009, our results indicate increased inequality for women but decreased inequality for men. Between 2009 and 2012 on the contrary, men’s inequality increases but women’s decreases. The overarching result is thus that the economic hardship of the crisis temporarily increased female income-related health inequality, but decreased that of men.We are grateful for having received funding from The Icelandic Student Innovation Fund (application number 1536030091) and from The Icelandic Research Fund – Icelandic Center for Research (IRF grant number 130611–052) to support assistantship by Hildur Margrét Jóhannsdóttir.Peer Reviewe

Economic conditions, hypertension, and cardiovascular disease: analysis of the Icelandic economic collapse

Previous research has found a positive short-term relationship between the 2008 collapse and hypertension in Icelandic males. With Iceland's economy experiencing a phase of economic recovery, an opportunity to pursue a longer-term analysis of the collapse has emerged. Using data from a nationally representative sample, fixed-effect estimations and mediation analyses were performed to explore the relationship between the Icelandic economic collapse in 2008 and the longer-term impact on hypertension and cardiovascular health. A sensitivity analysis was carried out with pooled logit models estimated as well as an alternative dependent variable. Our attrition analysis revealed that results for cardiovascular diseases were affected by attrition, but not results from estimations on the relationship between the economic crisis and hypertension. When compared to the boom year 2007, our results point to an increased probability of Icelandic women having hypertension in the year 2012, when the Icelandic economy had recovered substantially from the economic collapse in 2008. This represents a deviation from pre-crisis trends, thus suggesting a true economic-recovery impact on hypertension.The project was funded by the Icelandic Research Fund (IRF grant number 130611-052) and The University of Iceland Eimskip Fund. The data collection was financed and carried out by the Directorate of Health Iceland (and formerly the Public Health Institute of Iceland). The authors would like to thank the Directorate for access to the data.Peer Reviewe

Beliefs of Icelandic elderly living in the greater Reykjavik area toward autonomy and paternalism in caregiving of the elderly

With the aging population and the increase in health care costs, issues of independence and autonomy will have a greater impact on formal and informal health care. Changes in occupational functioning that accompany increased age has raised the demandfor family assistance to the elderly. It is important for occupational therapists to understand the elderly\u27s perceptions toward autonomy and paternalism in caregiving of the elderly because it is assumed that attitudes and beliefs affect how people interact and care for the elderly. A convenience sample of 57 Icelandic elderly were surveyed regarding their attitudes toward autonomy and paternalism in caregiving of the elderly. Results indicated that Icelandic elderly held strong beliefs toward autonomy but were undecided toward paternalism. Significant differences were found between groups. Elderly living at home indicated stronger beliefs on both autonomy and paternalism compared to those living in senior housing complexes. Elderly women held stronger beliefs in autonomy in contrast to the males, who were more paternalistic, and married subjects held stronger beliefs than did single respondents

Organized leisure-time sport participation and academic achievement in preadolescents

Publisher's version (útgefin grein)Aims: The aims of this study were to study the correlation between lifestyle-related factors, such as organized leisure-time sport participation (OLSP), cardiorespiratory fitness, and adiposity, and academic achievement among preadolescents. Methods: A cross-sectional study involving 248 nine-year-old school children was carried out. OLSP was self-reported with parental assistance, categorized as ≤ 1× a week, 2–3× a week, and ≥ 4× times a week or more. Academic achievement was estimated with results from standardized test scores in Icelandic and math. Cardiorespiratory fitness was estimated using a maximal cycle ergometer test. The sum of four skinfolds was used to estimate adiposity. Results: Tests of between-subjects effect indicated that OLSP significantly correlated with achievement in math only (F(2,235) = 3.81, p = 0.024). Further analysis showed that the two less active groups had significantly lower scores in math compared to the most active group with OLSP ≥ 4× times a week or more (2–3× times a week, unstandardized coefficient (b) = –4.08, 95% confidence interval (CI) [–7.09, –1.07]; ≤ 1× a week, b = −3.84, 95% CI [–7.59, –0.08]), independent of sex, age, maturity level (age to/from peak height velocity), family structure, and parental education. Neither cardiorespiratory fitness nor adiposity significantly correlated with academic achievements. Conclusions: The study’s result indicates that frequent (four times per week or more often) sport participation is not harmful but may be beneficial to learning. However, further intervention-based study of this topic is needed to determine if this relationship is causal.The Icelandic Centre for Research (RANNIS) funded this, along with the Ministry of Education, Science and Culture, and The Icelandic Primary Health Care Research FundPeer Reviewe

Adolescent well-being amid the COVID-19 pandemic: Are girls struggling more than boys?

Background: Differential effects of the coronavirus SARS-CoV-2 (COVID-19) pandemic and associated public restrictions on adolescent girls and boys are emerging but have not been elucidated. This study examined gender differences across broad indicators of adolescent well-being during the COVID-19 pandemic in Iceland, and explored potential explanations for these differences. Methods: In total, 523 youth (56.5% girls) born in Iceland in 2004 completed measures on mental health problems (depressive symptoms, anger and suicide attempts) and measures designed for this study to assess broad indicators of adolescent well-being (e.g., day-to-day life, academic performance, family and peer relationships, and mental and physical health) and behavioral changes during the COVID-19 pandemic. Mental health problems during the pandemic were compared to expected scores based on nationwide ratings of same-aged peers in 2018. Results: Although both boys and girls appeared affected, girls reported a greater negative impact across all the broad indicators of well-being and behavioral change during COVID-19 than boys, and their depressive symptoms were above and beyond the expected nationwide scores (t(1514) = 4.80, p < .001, Cohen's d = 0.315). Higher depressive symptoms were associated with increased passive social media use and decreased connecting with family members via telephone or social media among girls, and decreased sleeping and increased online gaming alone among boys. Concern about others contracting COVID-19, changes in daily and school routines, and not seeing friends in person were among the primary contributors to poor mental health identified by youth, particularly girls. Conclusions: Adolescents were broadly negatively affected by the COVID-19 pandemic and accompanying restrictions; however, this negative impact was more pronounced in girls. The findings suggest that a steady routine and remaining socially connected may help youth cope with the uncertainty and social restrictions associated with a pandemic. Moreover, healthcare providers, teachers, and other professionals should pay close attention to depressive symptoms among girls during a pandemic

Depressive symptoms, mental wellbeing, and substance use among adolescents before and during the COVID-19 pandemic in Iceland: a longitudinal, population-based study

Background: Adolescence represents a crucial developmental period in shaping mental health trajectories. In this study, we investigated the effect of the COVID-19 pandemic on mental health and substance use during this sensitive developmental stage. Methods: In this longitudinal, population-based study, surveys were administered to a nationwide sample of 13-18-year-olds in Iceland in October or February in 2016 and 2018, and in October, 2020 (during the COVID-19 pandemic). The surveys assessed depressive symptoms with the Symptom Checklist-90, mental wellbeing with the Short Warwick Edinburgh Mental Wellbeing Scale, and the frequency of cigarette smoking, e-cigarette use, and alcohol intoxication. Demographic data were collected, which included language spoken at home although not ethnicity data. We used mixed effects models to study the effect of gender, age, and survey year on trends in mental health outcomes. Findings: 59 701 survey responses were included; response rates ranged from 63% to 86%. An increase in depressive symptoms (β 0·57, 95% CI 0·53 to 0·60) and worsened mental wellbeing (β -0·46, 95% CI -0·49 to -0·42) were observed across all age groups during the pandemic compared with same-aged peers before COVID-19. These outcomes were significantly worse in adolescent girls compared with boys (β 4·16, 95% CI 4·05 to 4·28, and β -1·13, 95% CI -1·23 to -1·03, respectively). Cigarette smoking (OR 2·61, 95% CI 2·59 to 2·66), e-cigarette use (OR 2·61, 95% CI 2·59 to 2·64), and alcohol intoxication (OR 2·59, 95% CI 2·56 to 2·64) declined among 15-18-year-olds during COVID-19, with no similar gender differences. Interpretation: Our results suggest that COVID-19 has significantly impaired adolescent mental health. However, the decrease observed in substance use during the pandemic might be an unintended benefit of isolation, and might serve as a protective factor against future substance use disorders and dependence. Population-level prevention efforts, especially for girls, are warranted

A multi-level developmental approach towards understanding adolescent mental health and behaviour: rationale, design and methods of the LIFECOURSE study in Iceland

Purpose: Identifying and understanding modifiable risk and protective factors that can inform early detection and intervention to prevent adolescent emotional problems and harmful behaviours is among the most pressing modern-day public health challenges. This paper describes the rationale, objectives, methods, and anticipated outcomes of the LIFECOURSE study, a multi-level, bio-psychosocial prospective study designed to advance our understanding of factors that shape adolescent mental health and behaviour. Methods: Conducted by the Icelandic Centre for Social Research and Analysis at Reykjavik University, LIFECOURSE is a longitudinal population-based developmental study of Icelandic adolescents born in 2004. The study utilizes a comprehensive multi-informant assessment of individual, societal and biological factors measured across the lifespan. Data assembly and collection were conducted from 2016-2020 and utilize both retrospective and prospective data sources: (a) retrospective registry data assembled from seven national databases, (b) prospectively collected social surveys and (c) biomarker samples. Results: Of the 3914 eligible adolescents, 60.8% (n = 2378) provided informed parental consent and student assent to participate in the study, with approximately half of the participants being female (n = 1175, 49.4%) and the majority being born in the capital area (n = 1455; 61.2%). The coverage of available data from the national databases and participation in the social surveys ranged from 81.7 to 100%. Conclusions: Major gaps remain in our knowledge of how individual, societal and biological factors across the lifespan-from early life to adolescence-interact and shape the risk for emotional problems and harmful behaviours during adolescence. The LIFECOURSE study was designed to address this knowledge gap