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Gustafsdottir SS, Sigurdardottir AK, Mårtensson L, Arnadottir SA. Making Europe health literate: including older adults in sparsely populated Arctic areas. BMC Public Health 2022; 22:511. [PMID: 35296283 PMCID: PMC8924562 DOI: 10.1186/s12889-022-12935-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/07/2022] [Indexed: 11/29/2022] Open
Abstract
Background Older people have been identified as having lower health literacy (HL) than the general population average. Living in sparsely populated Arctic regions involves unique health challenges that may influence HL. The research aim was to explore the level of HL, its problematic dimensions, and its association with the selection of contextual factors among older adults living in sparsely populated areas in Northern Iceland. Method This was a cross-sectional study based on a stratified random sample from the national register of one urban town and two rural areas. The study included 175 participants (57.9% participation rate) who were community-dwelling (40% rural) and aged 65–92 years (M 74.2 ± SD 6.3), 43% of whom were women. Data were collected in 2017-2018 via face-to-face interviews, which included the standardised European Health Literacy Survey Questionnaire-short version (HLS-EU-Q16) with a score range from 0 to 16 (low-high HL). Results The level of HL ranged from 6–16 (M 13.25, SD ± 2.41) with 65% having sufficient HL (score 13–16), 31.3% problematic HL (score 9–12) and 3.7% inadequate HL (score 0–8). Most problematic dimension of HL was within the domains of disease prevention and health promotion related to information in the media. Univariate linear regression revealed that better HL was associated with more education (p=0.001), more resiliency (p=0.001), driving a car (p=0.006), good access to health care- (p=0.005) and medical service (p=0.027), younger age (p=0.005), adequate income (p=0.044) and less depression (p=0.006). Multivariable analysis showed that more education (p=0.014) and driving a car (p=0.017) were independent predictors of better HL. Conclusion Difficulties in HL concern information in the media. HL was strongly associated with education and driving a car however, not with urban-rural residency. Mobility and access should be considered for improving HL of older people.
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Affiliation(s)
- Sonja S Gustafsdottir
- School of Health Sciences, University of Akureyri, Solborg v/Nordurslod, 600, Akureyri, Iceland.
| | - Arun K Sigurdardottir
- School of Health Sciences, University of Akureyri, Solborg v/Nordurslod, 600, Akureyri, Iceland.,Akureyri Hospital, Akureyri, Iceland
| | - Lena Mårtensson
- Health and Rehabilitation at the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Solveig A Arnadottir
- Department of Physical Therapy, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
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Jóhannsdóttir TB, Ingadottir B, Svavarsdóttir MH. Rural patients' experience of education, surveillance, and self-care support after heart disease related hospitalisation: a qualitative study. Int J Circumpolar Health 2021; 80:2007667. [PMID: 34839809 PMCID: PMC8635654 DOI: 10.1080/22423982.2021.2007667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 11/18/2022] Open
Abstract
People living in rural Iceland have a higher rate of cardiovascular risk factors and healthcare utilisation compared to people in urban areas.The aim of this qualitative study was to explore the experiences of people with coronary heart disease, living in rural Iceland regarding patient education, surveillance, and self-care support. The participants (N = 14, age 52‒79 years, 8 male), were interviewed 6 to 12 months after hospital discharge following a cardiac event (in 2018‒2019). Systematic text-condensation was used for analysis. The findings were categorised into three main themes: Education and support describes inadequate patient education and support from health-care professionals after discharge from hospitaland how the internet was the main information source supplemented with spouse's and family support. Local healthcare services describe thelack of and importance of access to health-care professionals, stable services, and underutilisation of telemedicine and primary healthcare in the local area, and Self-care behaviour describes the lack of professional support with lifestyle changes and how the participants manage self-care as well as their attitudes towards the disease.The results indicate that access to continuous healthcare services and person-centred support focusing on prevention strategies are widely impaired in rural areas in Iceland.
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Affiliation(s)
| | - Brynja Ingadottir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland and Landspitali University Hospital, Reykjavik, Iceland
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Ferrari Junior GJ, Teixeira CS, Felden ÉPG. Socioenvironmental factors and behaviors associated with negative self-rated health in Brazil. CIENCIA & SAUDE COLETIVA 2021; 26:4309-4320. [PMID: 34586281 DOI: 10.1590/1413-81232021269.18172020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 08/02/2020] [Indexed: 11/21/2022] Open
Abstract
The purpose of this study is to determine the factors associated with negative self-rated health in Brazil. The sample consisted of 5,259 adults from five representative capitals of the five regions of Brazil. Data collection was achieved in the following municipalities: Palmas (North Region), João Pessoa (Northeast Region), Goiânia (Central-West Region), Vitória (Southeast Region) and Florianópolis (South Region). For the analysis of the data, Binary Logistic Regression for determine the factors associated with negative self-rated health was used. Negative self-rated health was identified in 31.43% of Brazilians. The factors that were significantly associated were bad air quality, does not have public spaces for leisure, older age group, insufficient salary to cover expenses, a rare practice of physical exercises, does not perform healthy eating, active commuting for study or employment and commuting time for above 30 minutes, dissatisfaction with health services and still, not working, not looking for a job and finally, reside in some Brazilian regions. The study presents the importance of socioenvironmental and behavioral factors for the self-rated health of Brazilian adults, as well as it shows high rates of negative self-rated health compared to other studies.
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Affiliation(s)
- Geraldo Jose Ferrari Junior
- Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina. R. Pascoal Simone 358, Coqueiros. 88080-350 Florianópolis SC Brasil.
| | | | - Érico Pereira Gomes Felden
- Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina. R. Pascoal Simone 358, Coqueiros. 88080-350 Florianópolis SC Brasil.
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Sigurdardottir AK, Kristófersson GK, Gústafsdóttir SS, Sigurdsson SB, Arnadottir SA, Steingrimsson JA, Gunnarsdóttir ED. Self-rated health and socio-economic status among older adults in Northern Iceland. Int J Circumpolar Health 2020; 78:1697476. [PMID: 31783724 PMCID: PMC6896473 DOI: 10.1080/22423982.2019.1697476] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Little is known about self-rated health (SRH) of older people living in more remote and Arctic areas. Iceland is a high-income country with one of the lowest rates of income inequality in the world, which may influence SRH. The research aim was to study factors affecting SRH, in such a population living in Northern Iceland. Stratified random sample according to the place of residency, age and gender was used and data collected via face-to-face interviews. Inclusion criteria included community-dwelling adults ≥65 years of age. Response rate was 57.9% (N = 175), average age 74.2 (sd 6.3) years, range 65–92 years and 57% were men. The average number of diagnosed diseases was 1.5 (sd 1.3) and prescribed medications 3.0 (sd 1.7). SRH ranged from 5 (excellent) to 1 (bad), with an average of 3.26 (sd 1.0) and no difference between the place of residency. Lower SRH was independently explained by depressed mood (OR = 0.88, 95% CI = 0.80–0.96), higher body mass index (OR = 0.93, 95% CI = 0.87–0.99), number of prescribed medications (OR = 0.88, 95% CI = 0.78–1.00) and perception of inadequate income (OR = 0.45, 95% CI = 0.21–0.98). The results highlight the importance of physical and mental health promotion for general health and for ageing in place and significance of economic factors as predictors of SRH.
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Affiliation(s)
- Arun K Sigurdardottir
- School of Health Sciences, University of Akureyri, Solborg v/Nordursloð, Akureyri, Iceland.,Department of Education and science, Akureyri Hospital Eyrarlandsvegi, Akureyri, Iceland
| | | | | | - Stefan B Sigurdsson
- School of Health Sciences, University of Akureyri, Solborg v/Nordursloð, Akureyri, Iceland
| | - Solveig A Arnadottir
- Department of Physical Therapy, School of Health Sciences, University of Iceland, Reykjavik, Iceland
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Gender differences in the effect of self-rated health (SRH) on all-cause mortality and specific causes of mortality among individuals aged 50 years and older. PLoS One 2019; 14:e0225732. [PMID: 31800615 PMCID: PMC6892490 DOI: 10.1371/journal.pone.0225732] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 11/11/2019] [Indexed: 11/19/2022] Open
Abstract
Although different gender associations between self-rated health (SRH) and mortality have been reported, the results of the respective studies have been inconsistent and little is known about the cause-specific relation of mortality with SRH by gender. Therefore, to evaluate the gender differences in all-cause or specific causes of mortality by SRH, this retrospective cohort study was conducted using the data of 19,770 Korean adults aged 50 years and over who underwent health screening at Seoul National University Hospital between March 1995 and December 2008. SRH was surveyed using a simple questionnaire, and the all-cause mortality and cause-specific mortality were followed up from baseline screening until December 31, 2016. Results showed that the relationship between SRH and all-cause mortality differed by gender, and the differences also varied depending on the cause of death. In men, the adjusted hazard ratio (aHR) of all-cause mortality was higher in the poor SRH group than the very good SRH groups even after adjustment for socio-demographic, clinical, and behavioral risk factors (aHR:1.97, 95% CI 1.51-2.56), and these results were similar to those for cancer, cardiovascular, and respiratory disease mortalities (aHR:1.52, 95% CI 0.93-2.50; aHR: 2.11, 95% CI 1.19-3.74; aHR:10.30, 95% CI 2.39-44.44, respectively). However, in women, the association between SRH and all-cause mortality was insignificant, and inverse relationships were found for cardiovascular and respiratory disease mortalities in the poor and very good SRH groups. Cancer mortality had a positive relation with SRH (aHR: 1.14, 95% CI 0.75-1.72; aHR: 2.58, 95% CI 1.03-6.48; aHR: 0.49, 95% CI 0.24-0.98; aHR: 0.15, 95% CI 0.04-0.57: all-cause, cancer, cardiovascular, and respiratory disease mortalities, respectively). Clinicians need to take these gender differences by SRH into account when evaluating the health status of over-middle aged adults.
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Vilhjalmsdottir A, De Clercq B, Gardarsdottir RB, Bernburg JG, Sigfusdottir ID. Decreasing income inequality and adolescent emotional distress: a population-based case study of Icelandic adolescents 2006-2016. Int J Public Health 2019; 64:253-263. [PMID: 30617501 DOI: 10.1007/s00038-018-1193-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 11/26/2018] [Accepted: 12/19/2018] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES In this study, we aim to test whether changes in community income inequality influence adolescent emotional distress. We take advantage of the unique combination of data and history available in Iceland. This affluent welfare society has experienced extreme shifts in income inequality, allowing us to test whether changes in community income inequality are related to changes in adolescent emotional distress. METHODS Combining adolescent survey data (n = 24,107) with tax registry data on 76 neighborhood communities, we used a multilevel approach to model the data as longitudinal in order to test whether changes in community income inequality are related to changes in symptoms of anxiety and depression among adolescents. RESULTS The results showed that, after adjusting for relevant individual and community covariates, decreases in community income inequality were associated with decreases in symptoms of anxiety among adolescents (b = - 0.367, p ≤ 0.001), but not with decreases in symptoms of depression. CONCLUSIONS While the results provide a partial support for the income inequality thesis, we call for replications from other cultures and studies exploring the mediating role of social psychological processes.
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Affiliation(s)
| | - Bart De Clercq
- Faculty of Medicine and Health Sciences, Department of Public Health, Academical Hospital, Ghent University, K3-4, De Pintelaan, 185, 9000, Ghent, Belgium
| | | | - Jon Gunnar Bernburg
- Faculty of Social Science, University of Iceland, Oddi, 101, Reykjavík, Iceland
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Asgeirsdottir TL, Birgisdottir KH, Ólafsdóttir T, Olafsson SP. A compensating income variation approach to valuing 34 health conditions in Iceland. ECONOMICS AND HUMAN BIOLOGY 2017; 27:167-183. [PMID: 28709119 DOI: 10.1016/j.ehb.2017.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 06/06/2017] [Accepted: 06/06/2017] [Indexed: 06/07/2023]
Abstract
Using data from an Icelandic health-and-lifestyle survey carried out in 2007, 2009, and 2012, we employ a compensating income variation (CIV) approach to estimate the monetary value sufficient to compensate individuals for the presence of various sub-optimal health conditions. This method is inexpensive and easy on subjects and has been applied to several desiderata that do not have revealed market prices. The CIV literature is, however, still limited in its application to health and thus information about its suitability is limited. With the aim of shedding light on the method́s appropriateness we thus provide a broad-view analysis including a spectrum of diseases and conditions that can be held up against more traditionally used methods. CIV for physical conditions vary greatly, but paralysis, fibromyalgia, chronic back pain, rheumatoid arthritis, urinary incontinence, severe headache and thyroid disease were among those consistently associated with substantial well-being reductions. Mental-health results using this method should be read with caution. The societal value of health interventions is multidimensional, including for example increased productivity in the population. However, one of the main positive aspects of increased health is undoubtedly the increased well-being of the treated subjects. Such quality-of-life effects should thus preferably be taken into account. For this reason, information on the value individuals place on recovery from various sub-optimal health conditions is useful when it comes to prioritizing scarce capital in the health sector. It is therefore vital to estimate the importance individuals place on various health states and hold them up against each other. Furthermore, this paper has scientific value as it sheds light on attributes of a potentially useful method in health evaluations.
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Affiliation(s)
| | | | - Thorhildur Ólafsdóttir
- Faculty of Economics, University of Iceland, Oddi v/Sturlugotu, 101 Reykjavik, Iceland; Faculty of Business Administration, University of Iceland, Gimli v/Sturlugotu, 101 Reykjavik, Iceland
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Gustafsdottir SS, Fenger K, Halldorsdottir S, Bjarnason T. Social justice, access and quality of healthcare in an age of austerity: users' perspective from rural Iceland. Int J Circumpolar Health 2017; 76:1347476. [PMID: 28762300 PMCID: PMC5549823 DOI: 10.1080/22423982.2017.1347476] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Iceland is sparsely populated but social justice and equity has been emphasised within healthcare. The aim of the study is to examine healthcare services in Fjallabyggð, in rural northern Iceland, from users’ perspective and evaluate social justice, access and quality of healthcare in an age of austerity. Mixed-method approach with transformative design was used. First, data were collected with questionnaires (response rate of 53% [N=732] in 2009 and 30% [N=415] in 2012), and analysed statistically, followed by 10 interviews with healthcare users (2009 and 2014). The results were integrated and interpreted within Bronfenbrenner’s Ecological Model. There was significantly less satisfaction with accessibility and variety of healthcare services in 2012 after services downsizing. Solid primary healthcare, good local elderly care, some freedom in healthcare choice and reliable emergency services were considered fundamental for life in a rural area. Equal access to healthcare is part of a fundamental human right. In times of economic downturn, people in rural areas, who are already vulnerable, may become even more vulnerable and disadvantaged, seriously threatening social justice and equity. With severe cutbacks in vitally important healthcare services people may eventually choose to self-migrate.
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Affiliation(s)
- Sonja S Gustafsdottir
- a Faculty of Occupational Therapy, School of Health Sciences , University of Akureyri , Akureyri , Iceland
| | - Kristjana Fenger
- a Faculty of Occupational Therapy, School of Health Sciences , University of Akureyri , Akureyri , Iceland
| | - Sigridur Halldorsdottir
- b Head of Faculty of Graduate Studies, School of Health Sciences , University of Akureyri , Akureyri , Iceland
| | - Thoroddur Bjarnason
- c Faculty of Social Sciences, School of Humanities and Social Sciences , University of Akureyri , Akureyri , Iceland
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Sigurdardottir AK, Sigurlásdóttir K, Ólafsson K, Svavarsdóttir MH. Perceived consequences, changeability and personal control of coronary heart disease are associated with health-related quality of life. J Clin Nurs 2017; 26:3636-3645. [DOI: 10.1111/jocn.13734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Arun K Sigurdardottir
- School of Health Sciences; University of Akureyri; Akureyri Iceland
- Akureyri Hospital; Akureyri Iceland
| | - Kolbrún Sigurlásdóttir
- School of Health Sciences; University of Akureyri; Akureyri Iceland
- Akureyri Hospital; Akureyri Iceland
| | - Kjartan Ólafsson
- School of Humanities and Social Sciences; University of Akureyri; Akureyri Iceland
| | - Margrét Hrönn Svavarsdóttir
- School of Health Sciences; University of Akureyri; Akureyri Iceland
- Department of Nursing; Faculty of Health, Care and Nursing; NTNU; Norwegian University of Science and Technology; Gjøvik Norway
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Haraldsdottir S, Gudmundsson S, Thorgeirsson G, Lund SH, Valdimarsdottir UA. Regional differences in mortality, hospital discharges and primary care contacts for cardiovascular disease. Scand J Public Health 2017; 45:260-268. [DOI: 10.1177/1403494816685341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Aims: Surveillance of geographical variations in cardiovascular health is important in order to achieve the objectives of reducing regional health disparities. We aimed to explore differences in cardiovascular disease (CVD) mortality and prevalence of CVD diagnoses made in primary and in-patient care, as well as risk factor distribution by geographic regions (urban/rural) in Iceland. Methods: From nationwide health registers, we obtained data on CVD mortalities ( N = 7113), primary healthcare CVD contacts ( N = 58,246) and hospital CVD discharges ( N = 14,039), as well as data on CVD risk factors from a national health survey ( N = 5909; response rate 60.3%). Age-standardised annual mortality, primary healthcare contact and hospital discharge rates due to CVD were calculated per 100,000 population inside (urban) and outside (rural) the Capital Area (CA). Logistic regression was used to explore regional differences in CVD risk factors. Results: We observed slightly higher total CVD mortality rates among women outside compared to inside the CA (Standardised Rate Ratio (SRR) 1.06 (95% confidence interval (CI) 1.05–1.07)), particularly due to atrial fibrillation (SRR 1.47 (95% CI 1.46–1.48)), heart failure (SRR 1.29 (95% CI 1.27–1.31)) and ischemic heart disease (SRR 1.11 (95% CI 1.10–1.12)), while reduced mortality risk for cerebrovascular disease (SRR 0.81 (95% CI 0.80–0.83)). The rates of hospital discharges and primary care contacts for these diseases, as well as prevalence of several modifiable risk factors, were generally higher outside the CA, particularly among women. Conclusions:The higher prevalence of modifiable risk factors and CVD in rural areas, especially among women, calls for refined treatment and health-promoting efforts in rural areas.
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Affiliation(s)
- Sigridur Haraldsdottir
- Centre of Public Health Sciences, School of Health Sciences, University of Iceland, Reykjavik, Iceland
- Division of Health Information and Research, Directorate of Health, Reykjavik, Iceland
| | - Sigurdur Gudmundsson
- Centre of Public Health Sciences, School of Health Sciences, University of Iceland, Reykjavik, Iceland
- Department of Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - Guđmundur Thorgeirsson
- Department of Medicine, Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Sigrun H. Lund
- Centre of Public Health Sciences, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Unnur A. Valdimarsdottir
- Centre of Public Health Sciences, School of Health Sciences, University of Iceland, Reykjavik, Iceland
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
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Ólafsdóttir T, Hrafnkelsson B, Thorgeirsson G, Ásgeirsdóttir TL. The tax-free year in Iceland: A natural experiment to explore the impact of a short-term increase in labor supply on the risk of heart attacks. JOURNAL OF HEALTH ECONOMICS 2016; 49:14-27. [PMID: 27372576 DOI: 10.1016/j.jhealeco.2016.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 06/03/2016] [Accepted: 06/16/2016] [Indexed: 06/06/2023]
Abstract
Evidence is mixed on whether society-wide economic conditions affect cardiovascular health and the reasons for the suggested relationship are largely untested. We explore whether a short-term increase in labor supply affects the probability of acute myocardial infarctions, using a natural experiment in Iceland. In 1987 personal income taxes were temporarily reduced to zero, resulting in an overall increase in labor supply. We merge and analyze individual-level, registry-based data on earnings and AMIs including all Icelandic men and women aged 45-74 during the period 1982-1992. The results support the prominent hypothesis of increased work as a mechanism explaining worsening heart health in upswings, for men aged 45-64 who were self-employed. We furthermore find a larger increase in probability of AMIs during the tax-free year in men aged 45-54 than men aged 55-64.
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Affiliation(s)
| | | | - Gudmundur Thorgeirsson
- Landspitali, National University Hospital, University of Iceland, Hringbraut, 101 Reykjavik, Iceland
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Hu YN, Chen PC, Hsu CC, Yu HK, Chien KL, Li CC, Hu GC. Age and Gender Differences in the Relationship Between Self-rated Health and Mortality Among Middle-aged and Elderly People in Taiwan—Results of a National Cohort Study. INT J GERONTOL 2016. [DOI: 10.1016/j.ijge.2014.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Haraldsdottir S, Gudmundsson S, Bjarnadottir RI, Lund SH, Valdimarsdottir UA. Maternal geographic residence, local health service supply and birth outcomes. Acta Obstet Gynecol Scand 2014; 94:156-64. [DOI: 10.1111/aogs.12534] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 10/13/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Sigridur Haraldsdottir
- Centre of Public Health Sciences; School of Health Sciences; University of Iceland; Reykjavik Iceland
- Division of Health Information and Research; Directorate of Health; Reykjavik Iceland
| | - Sigurdur Gudmundsson
- Centre of Public Health Sciences; School of Health Sciences; University of Iceland; Reykjavik Iceland
- Department of Medicine; Landspitali University Hospital; Reykjavík Iceland
| | - Ragnheidur I. Bjarnadottir
- Icelandic Birth Register; Department of Obstetrics and Gynecology; Landspitali University Hospital; Reykjavik Iceland
| | - Sigrun H. Lund
- Centre of Public Health Sciences; School of Health Sciences; University of Iceland; Reykjavik Iceland
| | - Unnur A. Valdimarsdottir
- Centre of Public Health Sciences; School of Health Sciences; University of Iceland; Reykjavik Iceland
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