Public health in restructuring coastal communities : Generational trends in self-rated health following the decline in small-scale fishing. The HUNT study, Norway

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Trends in absolute and relative educational inequalities in health during times of labour market restructuring in coastal areas : The HUNT Study, Norway

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Hvem inviteres inn i den moderne byen? : en kvantitativ analyse av sosial bakgrunns betydning for bruk av byen

Over the last decades Norwegian (and western) cities have undergone a massive transformation, where the sparsely inhabited and traffic-based city has changed into a compact, sustainable and cultural area for living, working and walking. However, this transformation and upgrade of urban areas has led to an extensive gentrification of the city – where former working class areas have become attractive neighbourhoods for the educated and creative middle class. The modern city has therefore been criticized for excluding groups based on social background. This thesis addresses modern city planning and its potential social consequences through an investigation of the correlation between social background and the use of urban activities – mainly related to culture, recreation and movement. The data consists of data from three different surveys (Levekårsundersøkelsen 2007, Undersøkelse om folks forhold til kommunen 2008 and Ungdata 2010-2015). To discuss my findings, I apply geographical theorizations regarding “place”, presented by Relph, Rose and Cresswell, in addition to Bourdieu’s theory of class and power. My findings show that social background (mainly education) have a positive effect on the use of cultural activities, and a negative or no effect on the recreational activities. Based on this I argue that the cultural city may be more accessible and attractive for those with a higher cultural capital, and therefore easier to identify with for the middle class. I extend this discussion with a description of other tendencies in modern city planning (image building and innovative workplaces) to show that my findings probably relate to not only the cultural city, but also other priorities in the modern city. Based on my assumption that social background correlates with many of the modern urban tendencies, I argue that the city represents a coupling of personal dispositions and place – where an exclusion based on capital not only results in an exclusion from specific activities, but the city as a whole

Understanding coastal public health: Employment, behavioural and psychosocial factors associated with geographical inequalities. The HUNT study, Norway

Recent decades have shown an international trend of decline in small-scale fishing; a longstanding and vital industry for numerous coastal populations. The decline has resulted in a loss of livelihoods in many coastal communities, potentially afflicting public health. Still, knowledge about the health situation of these areas is limited. Former studies on coastal health have primarily defined coastal areas based solely on their proximity to the coast, therefore not targeting the traditional coastal communities with longstanding coastal involvement through small-scale fishing. In this paper, we aim to illuminate the health situation in these areas by introducing a more fine-grained classification of the coastal study population; considering both geographical proximity to the coast, population density and employment in fishing. Using data from the Norwegian population-based HUNT Study, we perform individual and simultaneous adjustments for employment, behavioural and psychosocial factors to assess the contributions of these factors to the association between geographical affiliation and self-rated general health. The rural coastal areas with a history of small-scale fishing show a poorer health situation compared to urban coastal, rural inland and rural fjord populations, and behavioural factors contribute the most to the observed health disparities. Our findings encourage greater focus on societal differences between coastal communities when studying coastal health

Public health in restructuring coastal communities: Generational trends in self-rated health following the decline in small-scale fishing. The HUNT study, Norway

Restructuring rural communities can be seen as natural population level experiments of great social epidemiological interest. Following the extensive decline in small-scale fishing in the later decades of the 20th century, many coastal communities have undergone considerable societal restructuring. In Norway, this has entailed a substantial reduction of the fishing workforce, concurrent with new employment opportunities in public sector and aquaculture. The former socialization into fishing from a young age is greatly reduced, with coastal youths now facing other life courses than preceding generations. As restructuring of societies is found to be intertwined with public health, coastal communities can provide valuable insights on public health during times of transitions. In this study, we use repeated cross-sectional population health data from rural Norwegian municipalities to assess the development of self-rated health over four decades in a coastal population who has undergone restructuring of local labour markets. We assess generational differences in health by comparing the prevalence of poor self-rated health at three ages reflecting three generations at each cross section: youths, adults and elderly. We compare results to adjacent geographical areas to assess geographical differences in self-rated health over time. We found a higher predicted prevalence of poor self-rated health in rural coastal adults and elderly compared to other geographical areas across all decades. However, trends revealed improving self-rated health in rural coastal adults and elderly, as well as narrowing health gaps between the rural coastal population and the remaining geographical areas in this Norwegian setting. Our results shed light on public health development in restructuring coastal communities

Trends in absolute and relative educational inequalities in health during times of labour market restructuring in coastal areas : The HUNT Study, Norway

Background Restructuring labour markets offers natural population-level experiments of great social epidemiological interest. Many coastal areas have endured substantial restructuring of their local labour markets following declines in small-scale fishing and transitions to new employment opportunities. It is unknown how educational inequalities in health have developed in formerly fishery-dependent communities during such restructuring. In this study, we compare trends in social inequalities in health in Norwegian coastal areas with adjacent geographical areas between 1984 and 2019. Methods We used cross-sectional population-based data from the Trøndelag Health Study (HUNT), collected four times: HUNT1 (1984–86), HUNT2 (1995–97), HUNT3 (2006–08) and HUNT4 (2017–19). Adults above 30 years of age were included. Using Poisson regression, we calculated absolute and relative educational inequalities in self-rated health, using slope (SII) and relative (RII) indices of inequality. Results Trends in absolute and relative inequalities in rural coastal health were generally more favourable than in adjacent geographical areas. We found a statistically significant trend of declining relative educational inequalities in self-rated health in the rural coastal population from HUNT1 to HUNT4. Absolute inequalities overall increased from HUNT1 to HUNT4, although a declining trend followed HUNT2. Nonetheless, the rural coastal population exhibited the highest prevalence of poor self-rated health across the four decades. Conclusions Although absolute educational inequalities in self-rated health widened in all geographical areas, the smallest increase was in rural coastal areas. Relative educational inequalities narrowed in this rural coastal population. Considering the concurrent processes of large-scale investments in the Norwegian public sector and welfare schemes, increased fishing fleet safety, and employment opportunities in aquaculture, our findings do not suggest that potential positive effects on public health of this restructuring have benefitted inhabitants with higher educational attainment more than inhabitants with lower educational attainment in this rural coastal population