Better perceived health among the Swedish-speaking minority as compared with the Finnish-speaking majority in Finland: a cross-sectional study with an intergenerational perspective

BACKGROUND

Previous research has shown that the Swedish speaking minority in Finland has slightly but significantly better health compared with the Finnish speaking majority. However, a clear explanation for this is lacking.

AIM

The aim of the study was to explore differences of perceived health comparing three groups: Swedish speakers with reported dominance of Swedish also in the preceding generation; contemporary Finnish speakers with reported dominance of Finnish in the preceding generation and a group with a reported mixed-language structure of Finnish and Swedish between generations.

INDIVIDUALS AND METHODS

Health and Social Support is an on-going population-based survey initiated in 1998 (N = 64,797), aimed at working-age adults. The present study is based on the 2012 follow-up survey, which included a question on the dominating language (Swedish or Finnish) of the respondents and their parents. The outcome was perceived health, which in this study was dichotomized to very good/good and intermediate/poor/very poor. The statistical analysis was carried with logistic regression, using SAS software. Age, gender and occupational training were included as covariates in the multivariable analysis.

RESULTS

This study found that the Swedish-speaking group in Finland report better perceived health compared with the Finnish-speaking group (odds ratio 1.28, 95% confidence interval 1.04-1.57, p < 0.001). The health of the mixed language-speaking group fell between the other two groups.

CONCLUSIONS

The results gave some support to a culturally mediated mechanism for the health advantage of Swedish speakers. Cultural features of Swedish-speaking groups in Finland may also support health promotion of the Finnish-speaking majority.

Socioeconomic status and lifestyle patterns in the most common cancer types-community-based research

INTRODUCTION

As the global burden of chronic cancer increases, its correlation to lifestyle, socioeconomic status (SES) and health equity becomes more important. The aim of the present study was to provide a snapshot of the socioeconomic and lifestyle patterns for different cancer types in patients at a Nordic tertiary cancer clinic.

MATERIALS AND METHODS

In a descriptive observational study, questionnaires addressed highest-attained educational level, occupational level, economy, relationship status, exposures, and lifestyle habits. The questionnaire was distributed to all cancer patients attending the cancer clinic. Treating physicians added further information about the cancer disease, including primary origin, pathology report, TNM-classification and stage.

RESULTS

Patients with lung cancer had the lowest SES, and patients with gastrointestinal (GI) cancer, other cancer types and prostate cancer had the second, third and fourth lowest SES, respectively. However, breast cancer patients had the highest SES. Lifestyle and exposure patterns differed among the major cancer types. Lung cancer patients reported the highest proportion of unfavourable lifestyle and exposure patterns, and patients with GI cancer, prostate cancer and other cancer types had the second, third and fourth highest proportion of unfavourable lifestyle and exposure patterns, respectively. The most favourable exposure and lifestyle patterns were observed in breast cancer patients.

CONCLUSIONS

The present study indicated significant socioeconomic and lifestyle differences among cancer types at a Nordic cancer centre, with differences in lifestyle being more prominent than socioeconomic differences.

Life Expectancy of the Ethnically Mixed: Register-Based Evidence from Native Finns

As the ethnic composition around the world is becoming more diverse, the need to produce vital statistics for ethnically mixed populations is continuously increasing. Our aim is to provide the first life expectancy estimates for individuals with uniform Finnish, uniform Swedish, and mixed Finnish-Swedish backgrounds, based on individuals in the native population of Finland who can be linked to both their parents. Life expectancy at birth in the period 2005–2015 was calculated from population and mortality numbers at the one-year level based on each person’s sex, year of birth, and the unique ethnolinguistic affiliation of the index person and each parent. Swedish-registered individuals with Swedish-registered parents had the longest life expectancy at birth, or 85.68 years (95% CI: 85.60–85.77) for females and 81.36 for males (95% CI: 81.30–81.42), as compared to 84.76 years (95% CI: 84.72–84.79) and 78.89 years (95% CI: 78.86–78.92) for Finnish-registered females and males with Finnish-registered parents. Persons with mixed backgrounds were found in between those with uniform Finnish and uniform Swedish backgrounds. An individual’s own ethnolinguistic affiliation is nevertheless more important for longevity than parental affiliation. Similar register-based analyses for other countries with mixed populations would be useful.

Linguistic mortality gradients in Quebec and the role of migrant composition

OBJECTIVE

Anglophones and Allophones in Quebec (Canada) have lower mortality than Francophones, despite being linguistic minorities. This study assesses whether (1) language is a risk factor for mortality after accounting for migrant composition and (2) interprovincial migrants differ in mortality with respect to Quebec-born individuals.

METHODS

We analyzed death records between 2004 and 2008 from Quebec (all-cause and main causes) and population data from the 2006 census to estimate age-adjusted mortality rates according to language and migrant status. Risk ratios by language and migrant status, adjusted for age, sex, and socioeconomic status, were estimated using Poisson generalized estimating equations.

RESULTS

Francophone Quebec-borns had the highest mortality. Among Quebec-borns, Anglophones [RR= 0.85, 95% CI (0.79-0.91)] and Allophones [RR = 0.16, 95 %CI (0.12-0.22)] had lower mortality relative to Francophones. Interprovincial migrants had lower mortality (Anglophones [RR = 0.58, 95% CI (0.53-0.63)], Francophones [RR = 0.55, 95% CI (0.50-0.60)]) relative to Francophone Quebec-borns (Allophones were excluded due to small sample size). Among immigrants, mortality was lower for Francophones [RR = 0.62, 95% CI (0.57-0.67] and Allophones [RR = 0.35, 95% CI (0.31-0.38], but not Anglophones [RR = 0.92, 95% CI (0.84-1.01)], relative to Francophone Quebec-borns.

CONCLUSION

In Quebec, linguistic disparities in mortality remained after accounting for migrant status, and both Francophone and Anglophone interprovincial migrants in Quebec had lower mortality than Quebec-born Francophones. Public health initiatives to reduce linguistic disparities in health should account for migrant status.

Predictors for occupational injuries and diseases among commercial fishers in Finland 1996-2015

Fishing is a hazardous occupation worldwide. Commercial fishers in Finland are an aging and diminishing population with a high injury rate. Insurance claims data for self-employed Finnish commercial fishers during the years 1996 through 2015 (n = 1951) were analysed to assess predictors for occupational injuries and diseases. Out of the available variables, fishery location, career length, and participation in the voluntary occupational health service programme were not significant predictors. Male gender (OR 2.02; 95% CI 1.37-2.99), Finnish mother tongue vs. Swedish (OR 1.98, 95% CI 1.53-2.55), and higher income levels from fishing (four income categories, OR range: 1.71-3.53) were associated with higher odds for a compensated occupational injury or disease claim among commercial fishers in the final multivariate model. The identified risk groups could be targeted for interventions, and the content of the occupational health service programme should be developed to gain protective effect.

Sense of mastery differences between working-age Swedish- and Finnish-speaking Finns: a population-based study

AIM

To examine the probability of a high sense of mastery in a population-representative sample of working-age people and to study the differences in mastery between Finnish-speaking and Swedish-speaking Finns in particular.

METHODS

The data originates from the Western Finland Mental Health Surveys (2008-2014). Associations between sense of mastery and language groups were analyzed with logistic regressions.

RESULTS

Swedish-speaking Finns have a higher sense of mastery and the association is mediated by social support. Moreover, a difference in a high sense of mastery is found between Swedish- and Finnish-speaking married women that are outside the labor market.

CONCLUSIONS

Our findings imply that Finnish-speaking women that are outside the labor market, e.g. on maternity leave or taking care of the household, should be recognized in health and social care services as a group that can benefit from additional support.

Language and unintentional injury mortality in Quebec, Canada

Language-based differences in unintentional injury are poorly understood, despite the importance of language as a determinant of health. This study assessed inequalities in unintentional injury mortality between Francophones and Anglophones of Quebec, Canada. We calculated age-standardised rates of death by period, region, residential deprivation and cause of injury, and estimated rate ratios for Francophones relative to Anglophones. Francophones had higher unintentional injury mortality rates than Anglophones. Inequalities decreased over time for men, but rates remained 50% higher for Francophones at the end of the study period. Rates were stable for women, but were 30% higher for Francophones compared with Anglophones. Inequalities were larger at age 15-44 years, in urban areas, and for MVCs. Better understanding of risk factors for MVCs may benefit injury prevention in Quebec. Language-based differences in injury mortality warrant attention in other multilingual populations, especially across different demographic, temporal, regional and cause-of-injury groups.

Risk of schizophrenia and minority status: a comparison of the Swedish-speaking minority and the Finnish-speaking majority in Finland

Approximately five percent of the Finnish population are Swedish-speaking and have higher socioeconomic position and longer life expectancy than the Finnish-speaking majority. Previous studies have not investigated whether Swedish-speaking Finns have lower risk of schizophrenia spectrum disorders (SSD) than Finnish-speaking Finns. We investigated this in a representative sample of 47 445 Finns born in 1972-1984. Hazard ratios of SSD between language groups were assessed with conditional proportional hazards regression. Sex, parental ages at birth, paternal employment around conception, parental psychosis and place and residence in the capital area were used as other explanatory variables. The prevalence of SSD was 0.7% in the Swedish-speaking minority and 1.5% in the Finnish-speaking majority. In the adjusted regression model, belonging to the Swedish-speaking minority was associated with lower risk of SSD (hazard ratio (HR) 0.41, 95% confidence interval (CI) 0.24-0.69). In a subset analysis by gender, the protective effect was evident among Swedish-speaking males (HR 0.32, 95% CI 0.15-0.68) but marginal in females (HR 0.75, 95% CI 0.41-1.37). Parental psychosis and place of birth in the capital area were associated with higher risk of SSD, whereas paternal employment at the time of conception was associated with lower risk of SSD. Our results support the role of social factors in the etiology of schizophrenia. Belonging to a minority with high socioeconomic status and social capital may be protective against schizophrenia, especially for males.

Suicide mortality gap between Francophones and Anglophones of Quebec, Canada

PURPOSE

Few studies evaluate language-group differences in suicide mortality. This study assessed the suicide mortality gap between Francophones and Anglophones of Quebec, Canada according to age, sex, method, region and socioeconomic deprivation.

METHODS

Suicide decedents were extracted from the Quebec death file for 1989-2007 (N = 24,465). Age- and sex-specific suicide mortality rates were calculated for four periods (1989-1993, 1994-1998, 1999-2003, 2004-2007) for Francophones and Anglophones aged ≥10 years. Age-standardized rates of suicide by method, region, and level of social and material deprivation were calculated for each sex. Rate ratios and rate differences were estimated.

RESULTS

Suicide rates for Francophones were two to three times higher than rates for Anglophones, and differences were greatest for adults aged 25-64 years. Francophone males had more than two times the rate of suicide by hanging or firearms than Anglophone males. Francophone females had twice the rate of hanging, poisoning or firearm suicide as Anglophone females, although precision was low. Francophone-Anglophone suicide mortality gaps were higher in urban areas despite lower suicide rates, and varied little across levels of social and material deprivation.

CONCLUSIONS

There was a large suicide mortality gap between Francophones and Anglophones of Quebec; especially, among adults aged 25-64 years.

Life expectancy gap between the Francophone majority and Anglophone minority of a Canadian population

Language is an important determinant of health, but analyses of linguistic inequalities in mortality are scant, especially for Canadian linguistic groups with European roots. We evaluated the life expectancy gap between the Francophone majority and Anglophone minority of Québec, Canada, both over time and across major provincial areas. Arriaga's method was used to estimate the age and cause of death groups contributing to changes in the life expectancy gap at birth between 1989-1993 and 2002-2006, and to evaluate patterns across major provincial areas (metropolitan Montréal, other metropolitan centres, and small cities/rural areas). Life expectancy at birth was greater for Anglophones, but the gap decreased over time by 1.3 years (52% decline) in men and 0.9 years (47% decline) in women, due to relatively sharper reductions in Francophone mortality from several causes, except lung cancer which countered reductions in women. The life expectancy gap in 2002-2006 was widest in other metropolitan centres (men 5.1 years, women 3.2 years), narrowest in small cities/rural areas (men 0.8 years, women 0.7 years), and tobacco-related causes were the main contributors. Only young Anglophones <40 years in small cities/rural areas had mortality higher than Francophones, resulting in a narrower gap in these areas. Differentials in life expectancy favouring Anglophones decreased over time, but varied across areas of Québec. Tobacco-related causes accounted for the majority of the current life expectancy gap.

Language-group mortality differentials in Finland: the effects of local language composition

BACKGROUND

The higher mortality rate among the Finnish-speaking majority than among the Swedish-speaking minority in Finland is well established. The reasons for this phenomenon are only partially known. We aim to find out whether the social resources associated with the proportion of Swedish speakers in a locality result in lower mortality due to external and alcohol-related causes, and whether or not this also affects the Finnish-speaking residents.

METHODS

The register data are based on an 11% sample of Finns aged 30 years or more at the end of 1995--with an over-sample of deaths covering 80% of all deaths in the period 1996-2005.

RESULTS

Living in areas in which Swedish speakers are more prevalent has a favourable effect on mortality among Swedish-speaking females. Among the males the large difference in relative mortality between the language groups did not generally vary by area type.

CONCLUSION

We found indications that a higher concentration of Swedish speakers resulted in lower mortality in Swedish-speaking females and, to a lesser extent, in older males. The local environment is evidently an important factor and deserves attention in future research.