Social differentials in health among lone mothers in different policy contexts : financial difficulties and employment status in relation to health

Lone mothers report worse health compared to couple mothers in most societies, regardless of which measure of health is chosen; whether it is mental or physical health. The poorer health of lone mothers has been linked to a lack of material resources. The aim of this thesis is to increase knowledge on how societal factors affect the health of lone mothers in different policy contexts, by specifically studying financial strain and employment status in relation to health. A key issue is also to consider the social differentials within the group lone mothers. In Study I we analysed whether economic strain is associated with excess risk of poor health among lone mothers in Sweden, by time period and income group. Data from the Swedish Survey of Living conditions (ULF) 1979-1998 were analysed using logistic regression analysis. Economic strain was associated with poor SRH and contributes to the excess risk of poor health among lone mothers. A polarisation of health was noticed among lone mothers over time, with improved health among the highest income groups, and a deterioration of health among the lowest income groups. Study II aimed to analyse whether social and policy changes in Sweden during the 1990s had adverse influence on the health of lone mothers. It was based on data from ULF (1983-2001) and routine statistics from health-data registers on severe morbidity and mortality (1985-2001), analysed by logistic regression and Poisson regression analysis respectively. The findings showed that despite an increase of poor health for lone mothers, and increased exposure to health risks such as lack of cash margin and economic strain, we did not find evidence of increased differentials in poor self-rated health, hospitalization or mortality over time between lone and couple mothers. Non-employed lone mothers had particularly poor health. In Study III, we analysed how non-employment and health is associated among lone and couple mothers in countries with different family policy models. Data from national surveys from Britain, Italy and Sweden (2000-2005) were analysed using logistic regression analysis and the synergy index. Non-employment only marginally contributed to the excess risk of poor health among lone mothers found in Britain and Sweden but there were indications of synergy effects between lone motherhood and non-employment, causing a higher risk of poor health than would be expected from a simple addition of these exposures, in Britain, Italy and Sweden. The aim of Study IV was to analyse the experiences and strategies of everyday life of Swedish lone mothers with financial strain in relation to maintaining health. The study was performed in Sweden 2010 and based on four focus group discussions with 15 participants. The thematic analysis was informed by critical discourse analysis, positioning theory and the concept of agency. The findings showed that lone mothers find themselves in a pressing context, where their financial situation and shortage of time to a high degree restrains their possibilities of maintaining health and to participate in society. Improving the economic conditions for lone mothers is important for their health, and for their social and financial participation in society. Improving the possibilities to combine employment and lone parenthood and ensuring sufficient economic conditions for lone mothers without employment is within the scope of social policy

Health inequalities between lone and couple mothers and policy under different welfare regimes – The example of Italy, Sweden and Britain

This study examines the welfare state arrangements and social policy, living conditions and health among lone and couple mothers in three contrasting policy environments: Italy, Sweden and Britain. These countries fall into distinctive family policy categories. Data were drawn from representative national household interview surveys. The findings highlight both similarities and differences. Lone mothers had significantly worse health than couple mothers in all three countries, were more likely to suffer material disadvantage and were much more likely to be smokers. They could be considered a disadvantaged group in particular need in all three countries, irrespective of the policy regime. It is the differences between countries, however, in the experiences of lone and couple mothers that indicate that the prevailing policy regime really does matter. There were telling differences in the prevalence of lone motherhood, their composition, rates of joblessness, poverty and health status of lone mothers in relation to couple mothers in each country. These may be traced back to the main policy regimes of each country, but also partly reflect culture and traditions. The study illustrates an emerging approach to investigating the health inequalities impact of complex social policy contexts. The experiences of lone mothers as a group may serve as a ‘litmus’ test of how each family policy system is operating and offer an early warning of adverse impacts when policies change

Does non-employment contribute to the health disadvantage among lone mothers in Britain, Italy and Sweden? Synergy effects and the meaning of family policy.

This study analyses self-rated health and non-employment and potential synergy effects among lone and couple mothers aged 25–59 in Britain, Sweden and Italy, representing different family policy categories using data from national surveys (2000–2005). Synergy effects on health were calculated by synergy index. Non-employment only marginally contributed to the excess risk of poor health among lone mothers but there were synergy effects between lone motherhood and non-employment in all three countries, producing a higher risk of poor health than would be expected from a simple addition of these exposures. Results are discussed in relation to the different family policy and living contexts

Konsekvenser för psykisk och fysisk hälsa för personer 70 år och äldre av smittskyddskyddsåtgärder mot covid-19

The risk of COVID-19 causing serious illness or death increases with age. Therefore, a general recommendation was introduced in March 2020 that people of 70 years of age and older should limit their physical contacts and avoid places where people gather. Analyses indicate that this recommendation has reduced the number of cases of serious illness and death due to COVID-19 among this age group. However, results also show that the recommendations have resulted in a decline in mental health among certain groups and may have an adverse effect on physical health. Analyses were based on international research, Swedish surveys, meetings with pensioners’ organisations and organisations representing the interests of foreign-born citizens, as well as data from 1177 Vårdguiden. Suggestions on preventive efforts, which now need to be intensified, are given.Risken för allvarlig sjukdom och död i covid-19 ökar med åldern. Därför infördes i mars 2020 ett allmänt råd om att personer som är 70 år och äldre bör begränsa sina sociala kontakter och undvika platser där många personer samlas. Artikeln beskriver konsekvenser av covid-19-pandemin och de relaterade smittskyddsåtgärderna för personer 70 år och äldre under våren och sommaren 2020. Samtidigt som rekommendationen bedöms ha räddat liv och var nödvändig i den rådande situationen, visar resultaten att rekommendationen har lett till sämre psykisk hälsa för vissa grupper och riskerar att påverka den fysiska hälsan. Detta framgår av internationell forskning, svenska undersökningar, möten med pensionärsorganisationer, intervjuer med organisationer som företräder utrikesfödda och data från 1177 Vårdguiden. Det förebyggande arbetet behöver nu intensifieras, och i artikeln presenteras förslag på förebyggande insatser

Combined chemotherapy and immunotherapy against experimental malignant brain tumors

Glioblastoma multiforme (GBM) is the most common and aggressive primary malignant brain tumor in adults. Despite standard treatment including surgery, radiotherapy and temozolomide (TMZ)-based chemotherapy, the prognosis for GBM patients is dismal, and there is a need for novel treatments. One possible therapeutic treatment modality presented here is immunotherapy, either alone or combined with intratumoral TMZ. In this doctoral thesis, I report enhanced cure of rats and mice with malignant brain tumors after peripheral immunizations using irradiated whole tumor cells transduced to produce different immunostimulatory cytokines such as interferon-gamma (IFNγ), interleukin-7 (IL-7) and granulocyte macrophage-colony stimulating factor (GM-CSF). In the N32 rat glioma model there is a synergistic therapeutic effect when combining immunization with IFNγ- and- IL7-producing tumor cells and this coincides with enhanced systemic proliferation of CD4+ and CD8+ T cells, and an increase in the plasma levels of IFNγ, thereby strengthening the anti-tumor immune response. In addition the synergistic therapeutic effect of immunization with irradiated GM-CSF-producing tumor cells and recombinant IFNγ in the GL261 mouse glioma model is mediated by both CD4+ and CD8+ T cells, and evokes a long-term memory response that protects against secondary tumors without any further treatment. Further I report that TMZ and cisplatin, two chemotherapeutic agents, could cure 41-45% of GL261 tumor-bearing mice when delivered intratumorally using micro-osmotic pumps. When immunization with irradiated GM-CSF-producing tumor cells is combined with intratumorally administered TMZ, the survival of tumor-bearing mice is synergistically enhanced, while systemic delivery of TMZ abrogates the effect of the immunotherapy. Cisplatin however, does not boost the effect of the immunotherapy. In conclusion, immunotherapy improves survival in experimental glioma models, and the therapeutic effect is enhanced by intratumoral, but not systemic TMZ treatment

Symbolic values of the natural wine : A phenomenological research about the postmodern consumer of natural wine

Uppsatsen har för avsikt att skapa förståelse i hur symboliska värden påverkar konsumtionen av naturvin. I den postmoderna konsumtionskulturen sker konsumtionen i syfte att bygga upp bilden av sig själv, snarare än att konsumera produkter av praktisk nytta. Studien omfattar ett teoretiskt ramverk bestående av symbolisk interaktionism, konsumtionskulturen och den postmoderna marknadsföringen. Genom en existentiell fenomenologisk metod har konsumenters upplevelser med naturvinet studerats och tolkas. Tolkning utfördes genom en kvalitativ innehållsanalys och mynnade ut i betydelsefulla symboler. Resultatet pekar på att symbolerna i naturvinet bidrar till ett gott liv, en gemenskap och en kamp om vinets existens. I studien framgår det att konsumtionens främsta anledning inte handlar om smakupplevelsen utan har en djupare mening än så.

From macro to micro: The health of Swedish lone mothers during changing economic and social circumstances

The deep recession in Sweden in the early 1990s led to high unemployment levels. In addition, policy changes and reductions in welfare benefits increased costs of living. These changes may have affected lone mothers to a greater extent than other groups. How have these changes in the social context and policy context impacted on the health of lone mothers in comparison with couple mothers in Sweden between 1983 and 2001? Survey data on 19,192 mothers over the period of 1983-2001 were used to study changes in individual economic and social circumstances and self-rated health (SRH) with multivariate logistic regression. In addition, all-cause mortality, cause-specific mortality and severe morbidity were studied using registers for the whole population. Three cohorts of mothers aged 20-54 years (starting 1985, 1990 and 1996) were formed. Age-adjusted risk ratios were calculated using Poisson regression. The employment rate among lone mothers declined from 1983 to 2001. At the same time, prevalence of self-reported financial problems and exposure to violence increased. Lone mothers reported worse SRH and had higher risks of hospitalisation and mortality than couple mothers in all time periods. Despite changes in social context and policy context causing an increase of health detrimental exposures, and deteriorated levels of SRH 1980-2001 for lone mothers, there was no evidence of increased differentials over time between lone and couple mothers in less than good SRH, hospitalisation or mortality. Three alternative explanations are discussed: the Swedish welfare state still acts as a buffer for ill health; latency makes the follow-up time too short; and finally, the lack of increased differentials is due to methodological reasons.Sweden Single parent Welfare state Women's health Mortality Morbidity Self-rated health Mothers

Child living arrangements following separation and mental health of parents in Sweden

Father involvement and joint physical custody in post-separation families are increasingly common. In Sweden, 35 percent of the children of separated parents live equally much with both parents. Since parenthood is gendered, the associations between child living arrangement and parental health may vary between women and men. This study analyzes the association between children's living arrangement and mental health of parents, and how this interacts with material and social circumstances. Drawing on The Swedish Survey of Living Conditions (ULF) 2008-2013, the association between child living arrangements and mental health (worry/anxiety) of parents in five family structures: two biological parents, reconstituted with joint or main/sole custody arrangements, single with joint physical custody, and single with main or sole custody, were analyzed. Data on 9,225 mothers and fathers with resident children aged 0-17 were analyzed by logistic regressions for average marginal effects adjusting for socio-demographic, socio-economic and social factors. Analyses of interaction effects were made using the synergy index. Substantial family type differences were found in mental health between two biological parent family and all other family types for mothers, and two biological parent family and single parents for fathers. For the single mothers, the higher risk for worry and anxiety was still found following controls for socioeconomic factors. For fathers, the only differences that remained following control for socioeconomic factors was that of single fathers with children in joint physical custody. Interaction effects were found for the combination of single motherhood and non-employment, indicating a higher risk of mental health problems for single mothers (both with joint and sole custody), than would be expected from a simple addition of these exposures, suggesting that this is a vulnerable group. The results indicate that joint custody is associated with higher risk for worry and anxiety for the parents, especially for mothers both re-partnered and single, but also for single fathers