Mental Health and Access to Active Labor Market Programs

This paper examines the often-overlooked precondition for successful implementation of active labor market policy, namely equal access to labor market programs. Focusing on a cohort of social assistance recipients, we compare program participation between individuals who were eligible for vocational training and had reported psychological distress, to possible participants with other health or social challenges. The study covers a period of six years. The results indicate that social services prioritize training for those without mental health problems. This is true independently of observed differences between the two groups in terms of demographic and human capital characteristics, work motivation and self-efficacy. Hence, the study concludes that there seems to be a mental health access bias in program participation among disadvantaged groups. Policy makers and future research should address possible organizational barriers to equal program acces

Changes in life expectancy and lifespan variability by income quartiles in four Nordic countries : a study based on nationwide register data

Objectives Levels, trends or changes in socioeconomic mortality differentials are typically described in terms of means, for example, life expectancies, but studies have suggested that there also are systematic social disparities in the dispersion around those means, in other words there are inequalities in lifespan variation. This study investigates changes in income inequalities in mean and distributional measures of mortality in Denmark, Finland, Norway, and Sweden over two decades. Design Nationwide register-based study. Setting The Danish, Finnish, Norwegian and Swedish populations aged 30 years or over in 1997 and 2017. Main outcome measures Income-specific changes in life expectancy, lifespan variation and the contribution of 'early' and 'late' deaths to increasing life expectancy. Results Increases in life expectancy has taken place in all four countries, but there are systematic differences across income groups. In general, the largest gains in life expectancy were observed in Denmark, and the smallest increase among low-income women in Sweden and Norway. Overall, life expectancy increased and lifespan variation decreased with increasing income level. These differences grew larger over time. In all countries, a marked postponement of early deaths led to a compression of mortality in the top three income quartiles for both genders. This did not occur for the lowest income quartile. Conclusion Increasing life expectancy is typically accompanied by postponement of early deaths and reduction of lifespan inequality in the higher-income groups. However, Nordic welfare societies are challenged by the fact that postponing premature deaths among people in the lowest-income groups is not taking place.Peer reviewe

Women’s negative childbirth experiences and socioeconomic factors: results from the Babies Born Better survey

Objective To investigate the association between women's socioeconomic status and overall childbirth experience and to explore how women reporting an overall negative birth experience describe their experiences of intrapartum care. Methods We used both quantitative and qualitative data from the Babies Born Better (B3) survey version 2, including a total of 8,317 women. First, we performed regression analyses to explore the association between women’s socioeconomic status and labour and birth experience, and then a thematic analysis of three open-ended questions from women reporting a negative childbirth experience (n=917). Results In total 11.7% reported an overall negative labour and birth experience. The adjusted odds ratio (OR) of a negative childbirth experience was elevated for women with non-tertiary education, for unemployed, students and not married or cohabiting. Women with lower subjective living standard had an adjusted OR of 1.70 (95% CI 1.44-2.00) for a negative birth experience, compared with those with average subjective living standard. The qualitative analysis generated three themes: 1) Uncompassionate care: lack of sensitivity and empathy, 2) Impersonal care: feeling objectified, and 3) Critical situations: feeling unsafe and loss of control. Conclusion Important socioeconomic disparities in women’s childbirth experiences exist even in the Norwegian setting. Women reporting a negative childbirth experience described disrespect and mistreatment as well as experiences of insufficient attention and lack of awareness of individual and emotional needs during childbirth. The study shows that women with lower socioeconomic status are more exposed to these types of experiences during labour and birth

Gestational Age, Parent Education, and Education in Adulthood

BACKGROUND: Adults born preterm ( METHODS: This register-based cohort study included singletons born alive from 1987 up to 1992 in Denmark, Finland, Norway, and Sweden. In each study population, we investigated effect modification by parents' educational level (low, intermediate, high) on the association between gestational age at birth (25-44 completed weeks) and low educational attainment at 25 years (not having completed upper secondary education) using general estimation equations logistic regressions. RESULTS: A total of 4.3%, 4.0%, 4.8%, and 5.0% singletons were born preterm in the Danish (n = 331 448), Finnish (n = 220 095), Norwegian (n = 292 840), and Swedish (n = 513 975) populations, respectively. In all countries, both lower gestational age and lower parental educational level contributed additively to low educational attainment. For example, in Denmark, the relative risk of low educational attainment was 1.84 (95% confidence interval 1.44 to 2.26) in adults born at 28 to 31 weeks whose parents had high educational level and 5.25 (95% confidence interval 4.53 to 6.02) in adults born at 28 to 31 weeks whose parents had low educational level, compared with a reference group born at 39 to 41 weeks with high parental educational level. CONCLUSIONS: Although higher parental education level was associated with higher educational attainment for all gestational ages, parental education did not mitigate the educational disadvantages of shorter gestational age.Peer reviewe

Success and failure in narrowing the disability employment gap: comparing levels and trends across Europe 2002–2014

Background: International comparisons of the disability employment gap are an important driver of policy change. However, previous comparisons have used the European Union Statistics on Income and Living Conditions (EU-SILC), despite known comparability issues. We present new results from the higher-quality European Social Survey (ESS), compare these to EU-SILC and the EU Labour Force Survey (EU-LFS), and also examine trends in the disability employment gap in Europe over the financial crisis for the first time. Methods: For cross-sectional comparisons of 25 countries, we use micro-data for ESS and EU-SILC for 2012 and compare these to published EU-LFS 2011 estimates. For trend analyses, we use seven biannual waves of ESS (2002–2014) with a total sample size of 182,195, and annual waves of EU-SILC (2004–2014) with a total sample size of 2,412,791. Results: (i) Cross-sectional: countries that have smaller disability employment gaps in one survey tend to have smaller gaps in the other surveys. Nevertheless, there are some countries that perform badly on the lower-quality surveys but better in the higher-quality ESS. (ii) Trends: the disability employment gap appears to have declined in ESS by 4.9%, while no trend is observed in EU-SILC – but this has come alongside a rise in disability in ESS. Conclusions: There is a need for investment in disability measures that are more comparable over time/space. Nevertheless, it is clear to policymakers there are some countries that do consistently well across surveys and measures (Switzerland), and others that do badly (Hungary)

Har oljen bidratt til å svekke arbeidsmoralen i Norge?

Fra tid til annen fremmes påstander om at oljerikdommen svekker den norske arbeidsmoralen. Sverige framholdes ofte som et eksempel på at arbeidsnormen lettere holdes i hevd i land som ikke kan tillate seg å slumre i oljerus og ukritisk trygdeforbruk. Slike forestillinger finnes også artikulert innenfor velferdskritisk fagteori. I denne artikkelen undersøker vi hvorvidt utviklingen i arbeidsinvolvering har vært mer fordelaktig i Sverige enn i Norge, slik disse teoriene gir grunnlag for å forvente. Vi benytter data fra International Social Survey Program på tre måletidspunkter (1997, 2005 og 2015). Arbeidsinvolveringen har økt i Norge, og til dels gått ned i Sverige. Dette gjelder særlig kvinner, lavt utdannede og trygdede. I begge land finner vi imidlertid en moderat nedgang i arbeidsinvolveringen blant unge mellom 20 og 30 år. Mulige forklaringer på disse overraskende resultatene er Norges tilbakeholdenhet med bruk av oljepengene, håndheving av arbeidslinja, men mindre rigid enn i Sverige, bedre og tryggere arbeidsmiljø, kortere ukentlig arbeidstid og mer fleksible arbeidsordninger tilpasset familieliv. Innstramminger i en rekke trygdeytelser har i Sverige blitt fulgt av redusert ikke-pekuniær arbeidsinvolvering, særlig blant svakere stilte grupper. Mangelen på innstramminger i Norge ser ikke ut til å ha svekket «arbeidsmoralen», slik mange har fryktet

Har oljen bidratt til å svekke arbeidsmoralen i Norge?

Fra tid til annen fremmes påstander om at oljerikdommen svekker den norske arbeidsmoralen. Sverige framholdes ofte som et eksempel på at arbeidsnormen lettere holdes i hevd i land som ikke kan tillate seg å slumre i oljerus og ukritisk trygdeforbruk. Slike forestillinger finnes også artikulert innenfor velferdskritisk fagteori. I denne artikkelen undersøker vi hvorvidt utviklingen i arbeidsinvolvering har vært mer fordelaktig i Sverige enn i Norge, slik disse teoriene gir grunnlag for å forvente. Vi benytter data fra International Social Survey Program på tre måletidspunkter (1997, 2005 og 2015). Arbeidsinvolveringen har økt i Norge, og til dels gått ned i Sverige. Dette gjelder særlig kvinner, lavt utdannede og trygdede. I begge land finner vi imidlertid en moderat nedgang i arbeidsinvolveringen blant unge mellom 20 og 30 år. Mulige forklaringer på disse overraskende resultatene er Norges tilbakeholdenhet med bruk av oljepengene, håndheving av arbeidslinja, men mindre rigid enn i Sverige, bedre og tryggere arbeidsmiljø, kortere ukentlig arbeidstid og mer fleksible arbeidsordninger tilpasset familieliv. Innstramminger i en rekke trygdeytelser har i Sverige blitt fulgt av redusert ikke-pekuniær arbeidsinvolvering, særlig blant svakere stilte grupper. Mangelen på innstramminger i Norge ser ikke ut til å ha svekket «arbeidsmoralen», slik mange har fryktet

The Norwegian policy to reduce health inequalities: key challenges

The Norwegian strategy for reducing health inequalities from 2007 has been recognised as one of the most ambitious and encompassing in Europe. By proposing action on the social determinants of health, such as income structure, employment opportunities and affordable child-care, the strategy was able to approach the entire social gradient rather than just the socially disadvantaged. In this article, we present the main features of the health equity strategy, and discuss possible obstacles to a successful implementation and a prolonged commitment to reducing health inequalities in Norway. We raise three major concerns: 1) a stubborn fundamental inequality structure, 2) a lack of focus on the gradient in the implementation of cross-sectoral reforms and 3) a possible re-orientation of policy away from redistribution and universalism

Disentangling the dynamics of social assistance: A linked survey—Register data cohort study of long-term social assistance recipients in Norway

Social assistance is a means-tested benefit that is supposed to be a short-term, temporary economic support. Understanding why some individuals are in repeated or continuous need of social assistance is thus of obvious policy relevance, but the dynamics of social assistance receipt remain poorly understood. In 2005, a survey among long-term recipients of social assistance in Norway collected data on (a) childhood disadvantages, (b) health status, (c) health behaviors, (d) psychological resources, and (e) social ties, in addition to basic sociodemographic information. This rich survey data has been linked with tax register data from 2005–2013, enabling us to explore the detailed characteristics of long-term social assistance recipients who are unable to reach financial self-sufficiency. Results from linear probability models show that surprisingly few of the 28 explanatory variables are statistically associated with social assistance dynamics, with two important exceptions: People with drug problems and immigrants both have a much higher probability of social assistance receipt. Yet overall, it is challenging to ‘predict’ social assistance dynamics, indicating that randomness most likely plays a non-negligible role. The 28 explanatory variables do a far better job in predicting both labor market success (employment), labor market preparation (work assessment allowance), and labor market withdrawal (disability benefit utilization). Thus, there seems to be something distinctive about the processes leading to continued social assistance recipiency, where randomness could be a more influential force