Ritva Prättälä - Academia.edu (original) (raw)
Papers by Ritva Prättälä
Background: The Finbalt Health Monitor project collects standardized information on health and he... more Background: The Finbalt Health Monitor project collects standardized information on health and health-related behavioural activity and related trends in Finland and those Baltic countries that have major public health problems with noncommunicable diseases related to lifestyle and behavioural factors. The aims of this study were to compare patterns of and trends in selected health behaviours and their socioeconomic associations in Estonia, Finland and Lithuania in the period 1994-1998. Methods: Standardized questionnaires were posted to nationally representative samples in 1994, 1996 and 1998. Response rates varied between 62% and 83%. The total number of respondents was 3808 in Estonia, 9608 in Finland and 5716 in Lithuania. Prevalence of smoking, consumption of strong alcoholic beverages, use of vegetable oil in food preparation and leisure-time physical exercise were analysed in this study. Results: No major changes in daily smoking, consumption of strong alcoholic beverages and leisure-time physical exercise emerged. However, the use of vegetable oil increased rapidly in Estonia and particularly in Lithuania (from 41% to 81%). In 1994 the prevalence of daily smoking was 53%, 28% and 44% among men and 24%, 18% and 6% among women in Estonia, Finland and Lithuania, respectively. In Lithuania the prevalence of smoking among women was notably low but increased (from 6% to 13%). The prevalence of strong alcoholic beverage consumption was similar in all countries. Leisure-time physical exercise was most common in Finland. The socioeconomic differences remained similar in all countries, unhealthy behaviours were typical among the less educated groups and men, especially in the age groups 34-49 years. Conclusions: The sociodemographic pattern of risk-related lifestyles appears to be rather similar and stable in Estonia, Finland and Lithuania. However, from the view point of possible public health implications the rapid changes in the prevalences of some behaviours are notable.
Social Science & Medicine, 1998
This study examines social structural and family status factors as determinants of food behaviour... more This study examines social structural and family status factors as determinants of food behaviour. The data were derived from the FINMONICA Risk Factor Survey, collected in Finland in spring 1992. A multidimensional framework of the determinants of food behaviour was used, including social structural position, family status and gender. The associations between the determinants of food behaviour were estimated by multivariate logistic regression models, adjusted for age and regional differences. Food behaviour was measured by an index including six food items which were chosen based on Finnish dietary guidelines. In general, women's food behaviour was more in accordance with the dietary guidelines than that of men. The pattern of association between educational level and food behaviour was similar for both genders, but slightly stronger for men than women. Employment status was associated only with women's food behaviour, but the tendency was the same for men. Marital status was associated with men's as well as women's food behaviour. The food behaviour of married men and women was more in line with the dietary guidelines than the food behaviour of those who had been previously married. Parental status, however, was only associated with women's food behaviour, that is, the food behaviour of women with young children was more closely in line with the dietary guidelines than that of the rest of the women.
Social Science & Medicine, 1994
The aim of the study was to describe four health related lifestyle characteristics--smoking, exer... more The aim of the study was to describe four health related lifestyle characteristics--smoking, exercise, alcohol and food consumption--among Finnish men in 1982-1990. How do unhealthy patterns of behaviour vary according to socio-demographic factors, and do they aggregate or accumulate? The data was compiled in connection with a larger programme entitled 'Monitoring Health Behaviour among the Finnish Adult Population' and conducted by the National Public Health Institute. In the programme a postal questionnaire has been sent annually to a random sample of Finns (N = 5000, resp. rate 70-85%). In this paper, food consumption patterns are described by the use of butter, high-fat milk, coffee sugar and vegetables. The other patterns of behaviour are each measured by one variable. The degree of accumulation is analyzed by comparing the observed and expected (assuming independent occurrence) proportions for simultaneous occurrence of 3-4 unhealthy behaviour patterns. The proportion of men displaying 3-4 unhealthy behaviour patterns has decreased, mostly because of dietary changes. The majority of the men belonged to the intermediate group of 1-2 unhealthy behaviour patterns, and their proportion remained practically unchanged throughout the study period. Unhealthy behaviour was more common in lower educational groups, especially among middle-aged (30-49) and divorced men with a low educational level. Despite the decreasing prevalence of unhealthy behaviour, the degree of accumulation did not change. Accumulation of unhealthy behaviour was much less pronounced among non-smokers than among smokers. This implies that smokers are consistent in their unhealthy behaviour. Smoking might be the gateway to an unhealthy lifestyle in general.
Social Psychiatry and Psychiatric Epidemiology, 2009
Background Socio-economic differences in depressive symptoms are well reported, but there are onl... more Background Socio-economic differences in depressive symptoms are well reported, but there are only few studies concerning changes in these differences over time. The aim of this study was to assess trends in socio-economic differences in self-reported depression over the time period 1979-2002 in Finland. Methods The data source was a representative repeated cross sectional survey ''Health Behaviour and Health among the Finnish Adult Population'' (AVTK) linked with socio-economic register data from Statistics Finland, for the period 1979-2002. The age group of 25-64 years was included in this study (N = 71,290; average annual response rate 75%). Outcome measure was a single question of self-reported depression. Socio-economic factors included education, employment status and household income. The main analyses were conducted by multiple logistic regression. Results The prevalence of self-reported depression fluctuated in both men and women but remained higher in women compared to men over the past 24 years. After adjusting for age, socio-economic differences in selfreported depression were clear in regard to education, employment status and household income over the time period 1979-2002. When all socio-economic factors were mutually adjusted for, the association with self-reported depression remained significant in the unemployed, the retired and in those in the lowest household income categories in both genders. The effect of education on self-reported depression was mediated by the other socio-economic factors. Based on a time trend analysis, the socio-economic differences in self-reported depression remained stable over the time period 1979-2002.
Social Indicators Research, 2008
Background Mental health problems are a major public health issue worldwide. The aim of this stud... more Background Mental health problems are a major public health issue worldwide. The aim of this study was to assess the relative importance of socio-demographic characteristics associated with different domains of psychological distress in Finland. Methods Data source was a nationwide survey “Health Behaviour and Health among the Finnish Adult Population” (AVTK), from years 2002 to 2003 (N = 5425; response rate 66%).
Scandinavian Journal of Public Health, 2006
To investigate time trends in the smoking prevalence and the sociodemographic and psychosocial ba... more To investigate time trends in the smoking prevalence and the sociodemographic and psychosocial background of smoking in the Baltic countries in comparison with Finland during 1994-2002. Differences in daily smoking according to age, education, urbanization, and psychological distress in the Baltic countries and Finland were studied using postal surveys in 1994, 1996, 1998, 2000, and 2002 among adults (20-64 years old) in Estonia (n = 6,271), Latvia (n = 6,106), Lithuania (n = 9,824), and Finland (n = 15,764). In 1994, 1996, 1998, 2000, and 2002 the prevalence of smoking in Estonia, Latvia, Lithuania, and Finland was 47%, 54%, 46%, and 29% among men, and 21%, 19%, 11%, and 19% among women, respectively. Smoking increased among Lithuanian women from 6% in 1994 to 13% in 2002, but decreased among Estonian men and women. Smoking was generally more common among younger individuals, the less educated, and people with distress in all four countries. The odds ratios for smoking for those with low education compared with those with high education were 2.18 (1.69-2.81), 3.32 (2.55-4.31), 2.20 (1.79-2.70) and 2.80 (2.40-3.27) in men, and 1.90 (1.42-2.52). 3.09 (2.28-4.18), 0.86 (0.59-1.26), and 3.00 (2.53-3.55) in women, in Estonia, Latvia, Lithuania, and Finland, respectively. There were indications of increasing educational differences in Latvian men. Smoking was less common among rural women in all countries except Estonia. Estonia, Latvia, and Finland show characteristics of the "mature" phase of a smoking epidemic, and smoking may not increase in these countries. In Lithuanian women smoking may increase. Smoking may be increasingly unequally distributed in the future in all the studied countries.
Public Health Nutrition, 2009
Objective: The relationship of socio-economic status and vegetable consumption is examined in nin... more Objective: The relationship of socio-economic status and vegetable consumption is examined in nine European countries. The aim is to analyse whether the pattern of socio-economic variation with regard to vegetable consumption is similar in all studied countries with high v. low vegetable availability and affordability, and whether education has an independent effect on vegetable consumption once the effects of other socio-economic factors have been taken into account. Design: The data for the study were obtained from national surveys conducted in Finland,
Public Health Nutrition, 2001
To present disparities in consumption of vegetables and fruits in Europe and to discuss how educa... more To present disparities in consumption of vegetables and fruits in Europe and to discuss how educational level, region and level of consumption influence the variation. A review of selected studies from 1985 to 1997. 33 studies (13 dietary surveys, nine household budget surveys and 11 health behaviour surveys) representing 15 European countries were selected based on criteria developed as part of the study. Association between educational level and consumption of vegetables and fruits was registered for each study and common conclusions were identified. In the majority of the studies, with the exception of a few in southern and eastern Europe, consumption of vegetables and fruits was more common among those with higher education. The results suggest that in regions where consumption of vegetables and fruits is more common, the lower social classes tend to consume more of these than the higher social classes. The differences in the patterns of disparities in vegetable and fruit consumption between regions, as well as within populations, need to be considered when efforts to improve nutrition and health are planned.
Public Health Nutrition, 2001
Objective: The aim of this research was to describe the variation in bread consumption within soc... more Objective: The aim of this research was to describe the variation in bread consumption within social classes and to link this consumption to health-related lifestyles in Finland from 1978 until 1998. Design: A cross-sectional survey on health-related behaviour and socio-demographic factors has been conducted annually since 1978. Setting: Mailed questionnaire. Subjects: A random sample of 5000 Finns aged 15±64 years has been drawn annually. The response rate has varied from 84% to 68%. Results: The consumption of rye bread decreased, but among the female population a slight increase appeared in the 1990s. The consumption of rye bread was associated with a low educational level and a rural place of residence. White bread was consumed less than was rye bread. White bread was consumed more frequently by the less educated in urban areas. Contrary to white bread, the consumption of rye bread was not associated with smoking, exercise or alcohol consumption. Conclusions: The traditional place of rye bread in the Finnish dietary pattern has remained rather constant. White bread consumption has been associated with an unhealthy lifestyle. As a result, those Finns who are concerned about their health avoid white bread but seem not to associate rye bread with a healthier lifestyle. In Finland, rye bread has a different image to the image of whole-grain or dark brown bread in many other western European countries.
Public Health Nutrition, 2007
Objective: To examine educational differences among people who consume foods containing fat in Fi... more Objective: To examine educational differences among people who consume foods containing fat in Finland and the Baltic countries. Design: Data were collected from cross-sectional postal Finbalt Health Monitor surveys that were carried out in 1998, 2000 and 2002. Setting: Estonia, Finland, Latvia and Lithuania. Subjects: For each survey, nationally representative random samples of adults aged 20 -64 years were drawn from population registers (Estonia, n ¼ 3656; Finland, n ¼ 9354, Latvia, n ¼ 6015; Lithuania, n ¼ 5944). Results: Differences were revealed between the countries in the consumption of foods that contain fat. Finnish people consumed butter on bread, high-fat milk, meat and meat products, and vegetable oil for cooking less frequently than people in the Baltic countries. Cheese was most popular in Finland. Educational differences in fat-related food habits were examined by applying logistic regression analysis. A positive association was found between level of education and consumption of vegetable oil used in food preparation. Drinking high-fat milk was associated with low education in all countries. People with higher education tended to consume cheese more often. Educational patterns in the consumption of butter on bread and in the consumption of meat and meat products differed between countries. Conclusions: The consumption of foods containing fat was related to educational levels in all four countries. The diet of better-educated people was closer to recommendations for the consumption of saturated and unsaturated fats than the diet of people with lower level of education. The educational gradient was more consistent in Finland than in the Baltic countries. These existing educational differences in sources of fat consumed should be taken into account in the development of national cardiovascular disease prevention programmes.
Public Health Nutrition, 2008
Objective: The aim of this study was to examine whether there are associations between working co... more Objective: The aim of this study was to examine whether there are associations between working conditions and the use of staff canteen or packed meals among Finnish employees. Setting: Data were obtained from cross-sectional surveys on working conditions, conducted triennially (1997, 2000, 2003) since 1997. Subjects: In each survey, the subjects were 25-64-year-old employed Finnish employees: 3096 men and 3273 women.
Public Health Nutrition, 2013
To examine (i) whether the consumption of fresh vegetables, fruit and berries is associated with ... more To examine (i) whether the consumption of fresh vegetables, fruit and berries is associated with plasma vitamin C concentration and (ii) educational differences in plasma vitamin C concentration in two neighbouring areas in Russia and Finland. Cross-sectional risk factor surveys in 1992, 1997 and 2002. Logistic regression analysis was applied to examine the associations of consumption of selected foods and education with plasma vitamin C concentration. District of Pitkäranta in the Republic of Karelia, Russia and North Karelia, Finland. Adults aged 25-64 years: 579 men and 612 women in Pitkäranta; 974 men and 642 women in North Karelia. The plasma vitamin C concentration was strikingly low in Pitkäranta, Russia across the study years. During the 10 years of monitoring, the mean plasma vitamin C concentration among men ranged from 2·5 to 8·0 μmol/l in Pitkäranta, Russia and from 27·1 to 53·9 μmol/l in North Karelia, Finland. In both areas, daily consumption of fruit was most strongly associated with plasma vitamin C, while the association of fresh vegetable consumption with plasma vitamin C was less consistent. Consumption of berries was less important in explaining plasma vitamin C. In Pitkäranta, the plasma vitamin C concentration was lower among respondents in the lowest education group. Differences in the consumption of fresh vegetables and fruit resulted in notable differences in vitamin C status between Pitkäranta and North Karelia in spring. In comparative settings, knowledge of local food culture and validation pilots are important before conducting large population surveys.
Public Health, 2006
Socioeconomic inequalities in health in the Baltic countries are possibly increasing due to conco... more Socioeconomic inequalities in health in the Baltic countries are possibly increasing due to concomitant pressures. This study compared time trends from 1994 to 2004 in the pattern and magnitude of educational inequalities in health in Estonia, Latvia, Lithuania and Finland. The data were gathered from cross-sectional postal surveys of the Finbalt project, conducted every second year since 1994 on adult populations (aged 20-64 years) in Estonia (n=9049), Latvia (n=7685), Lithuania (n=11,634) and Finland (n=18,821). Three self-reported health indicators were used: (i) less than good perceived health, (ii) diagnosed diseases, and (iii) symptoms. The existing educational inequalities in health in three Baltic countries and Finland remained generally stable over time from 1994 to 2004. Also, the overall prevalence of all three health indicators was generally stable, but in the Baltic countries improvement in perceived health was mainly found among the better-educated men and women. Diagnosed diseases increased in the Baltic countries, except Lithuania, where diseases decreased among the better-educated women. Symptoms increased among the better-educated Estonian and Finnish women. The period from 1994 to 2004 of relative stabilization since the worst conditions of the social transition has not been followed by notable changes in self-reported health, and this appears to be the situation across all educational groups in the Baltic countries. While health inequalities did not markedly change, substantial inequalities do remain, and there were indications of favourable developments mainly among the better-educated respondents. The factors contributing towards increasing health inequalities may only be visible in the future.
Preventive Medicine, 2007
Objective. The aim was to study the associations of physical activity and socioeconomic status wi... more Objective. The aim was to study the associations of physical activity and socioeconomic status with overweight from 1978 to 2002 and to explore whether the trend in overweight was different across educational groups or leisure time and commuting physical activity groups.
Food Service Technology, 2005
ABSTRACT The aim of this study was to examine the trend of workplace cafeteria use among Finnish ... more ABSTRACT The aim of this study was to examine the trend of workplace cafeteria use among Finnish adults between 1979 and 2001. Data from annually collected cross-sectional surveys on health behaviour, conducted since 1978, were used. Subjects were 24 292 employed men and 24 746 women aged 25–64. Frequency of workplace cafeteria use has been stable in Finland over the two decades under study. Women used the cafeterias more often than men. Differences by years of education and place of residence have remained relatively stable. People living in the capital area and having more years of education used the cafeterias more often. The Finnish habit of having a mid-day lunch at the cafeteria of one's respective workplace has resisted major changes in working and living conditions and social structures during the past two decades.
International Journal of Public Health, 2010
To determine socio-economic differences from 1994 to 2004 in the use of butter and milk in Pitkär... more To determine socio-economic differences from 1994 to 2004 in the use of butter and milk in Pitkäranta in the Republic of Karelia, Russia and North Karelia, Finland. Health behaviour surveys in Pitkäranta (n = 3,599) and North Karelia (n = 3,652) in 1994, 1996, 1998, 2000 and 2004. A clear overall decrease occurred in the use of butter in cooking in Pitkäranta from 1994 to 2004. In both areas, subjects with lower education used butter in cooking and drank fat-containing milk more often. Regarding butter on bread, the educational patterns in the two areas were opposite: in Pitkäranta, subjects with lower education used butter less often but in North Karelia, they used butter on bread more often. Practically, no changes in socio-economic differences from 1994 to 2004 were observed in either area. The socio-economic differences in the use of dairy fat were stable in both areas but larger in North Karelia than in Pitkäranta. Our results support earlier assumptions of a weaker role of education as a determinant of health in Russia than in the western societies.
Sozial- und Pr�ventivmedizin SPM, 2002
The study examines sociodemographic variation in associations and co-occurrence of health behavio... more The study examines sociodemographic variation in associations and co-occurrence of health behaviours that contribute to multifactorial chronic diseases. Mantel-Haenszel odds ratios were used to examine pairwise associations among smoking, alcohol use, physical activity, and diet across categories of sociodemographic characteristics. Breslow-Day test for homogeneity was used to test for sociodemographic differences. In addition, co-occurrence of each two unhealthy behaviours was examined across sociodemographic groups using nationwide population survey data from 26,014 Finnish adults. Most of the health behaviours examined were interrelated and sociodemographic differences in the associations were few. Differences were inconsistent for all sociodemographic characteristics. Variation was observed only in the strength of the associations, not in their direction. However, due to unequal distribution of the individual behaviours, co-occurrence of unhealthy behaviours varied strongly across sociodemographic groups. Associations between health behaviours were relatively similar across sociodemographic groups. Since co-occurrence of unhealthy behaviours depends on the prevalence of individual unhealthy behaviours and the strength of their association, their co-occurrence in any particular sociodemographic group was primarily determined by the prevalence of individual unhealthy behaviours.
Health Economics, 2007
This study explores the relationship between obesity and economic conditions in Finland, using in... more This study explores the relationship between obesity and economic conditions in Finland, using individual microdata from 1978 to 2002. The results reveal that an improvement in regional economic conditions measured by the employment-topopulation ratio produces a decrease in obesity over the period of investigation, other things being equal. This effect arises from the decline in the height-adjusted weight of people who are deeply overweight (BMI>35). In addition, the effect is strongest for the people in later middle age (aged 45-65). The incidence of obesity is unrelated to the regional growth rate. All in all, the Finnish evidence presented does not support the conclusions reported by Ruhm (2000Ruhm ( , 2003Ruhm ( , 2004 for the USA, according to which temporary economic slowdowns are good for health. In contrast, at least overweight increases during slumps.
The European Journal of Public Health, 2007
Background: Women's diets are healthier than men's. Finnish women eat more fruits and vegetables ... more Background: Women's diets are healthier than men's. Finnish women eat more fruits and vegetables but less meat than men. Gender differences may be larger in the Baltic countries, which represent Eastern European transition societies than in Finland, a society characterized by the Scandinavian welfare ideology and a high degree of gender equality. Methods: The data are based on questionnaires to random samples of adults in Finland, Estonia, Latvia and Lithuania. The data provide a way of addressing gender differences at the turn of the century in the economically and culturally different countries. The purpose is to explore whether the consumption of foods classified as masculine or feminine-meat, fruits and vegetables-follow a similar gender pattern in Finland and the Baltic countries. Results: Men ate meat more often while women ate fruits and vegetables. A high educational level was associated with frequent consumption of fruits and vegetables. Educational differences in the consumption of meat were few and inconsistent. The consumption of fruits and vegetables was more common in urban areas except in Finland. Gender differences were similar in all countries throughout age and educational groups and in rural and urban areas. Conclusion: The consistent association of gender and food and the similarity of gender patterning in population subgroups point to the stability of masculine versus feminine food habits. The similarity suggests that food habits contribute equally to the gender gap in health in the Baltic countries as they do in Finland.
Background: The Finbalt Health Monitor project collects standardized information on health and he... more Background: The Finbalt Health Monitor project collects standardized information on health and health-related behavioural activity and related trends in Finland and those Baltic countries that have major public health problems with noncommunicable diseases related to lifestyle and behavioural factors. The aims of this study were to compare patterns of and trends in selected health behaviours and their socioeconomic associations in Estonia, Finland and Lithuania in the period 1994-1998. Methods: Standardized questionnaires were posted to nationally representative samples in 1994, 1996 and 1998. Response rates varied between 62% and 83%. The total number of respondents was 3808 in Estonia, 9608 in Finland and 5716 in Lithuania. Prevalence of smoking, consumption of strong alcoholic beverages, use of vegetable oil in food preparation and leisure-time physical exercise were analysed in this study. Results: No major changes in daily smoking, consumption of strong alcoholic beverages and leisure-time physical exercise emerged. However, the use of vegetable oil increased rapidly in Estonia and particularly in Lithuania (from 41% to 81%). In 1994 the prevalence of daily smoking was 53%, 28% and 44% among men and 24%, 18% and 6% among women in Estonia, Finland and Lithuania, respectively. In Lithuania the prevalence of smoking among women was notably low but increased (from 6% to 13%). The prevalence of strong alcoholic beverage consumption was similar in all countries. Leisure-time physical exercise was most common in Finland. The socioeconomic differences remained similar in all countries, unhealthy behaviours were typical among the less educated groups and men, especially in the age groups 34-49 years. Conclusions: The sociodemographic pattern of risk-related lifestyles appears to be rather similar and stable in Estonia, Finland and Lithuania. However, from the view point of possible public health implications the rapid changes in the prevalences of some behaviours are notable.
Social Science & Medicine, 1998
This study examines social structural and family status factors as determinants of food behaviour... more This study examines social structural and family status factors as determinants of food behaviour. The data were derived from the FINMONICA Risk Factor Survey, collected in Finland in spring 1992. A multidimensional framework of the determinants of food behaviour was used, including social structural position, family status and gender. The associations between the determinants of food behaviour were estimated by multivariate logistic regression models, adjusted for age and regional differences. Food behaviour was measured by an index including six food items which were chosen based on Finnish dietary guidelines. In general, women's food behaviour was more in accordance with the dietary guidelines than that of men. The pattern of association between educational level and food behaviour was similar for both genders, but slightly stronger for men than women. Employment status was associated only with women's food behaviour, but the tendency was the same for men. Marital status was associated with men's as well as women's food behaviour. The food behaviour of married men and women was more in line with the dietary guidelines than the food behaviour of those who had been previously married. Parental status, however, was only associated with women's food behaviour, that is, the food behaviour of women with young children was more closely in line with the dietary guidelines than that of the rest of the women.
Social Science & Medicine, 1994
The aim of the study was to describe four health related lifestyle characteristics--smoking, exer... more The aim of the study was to describe four health related lifestyle characteristics--smoking, exercise, alcohol and food consumption--among Finnish men in 1982-1990. How do unhealthy patterns of behaviour vary according to socio-demographic factors, and do they aggregate or accumulate? The data was compiled in connection with a larger programme entitled 'Monitoring Health Behaviour among the Finnish Adult Population' and conducted by the National Public Health Institute. In the programme a postal questionnaire has been sent annually to a random sample of Finns (N = 5000, resp. rate 70-85%). In this paper, food consumption patterns are described by the use of butter, high-fat milk, coffee sugar and vegetables. The other patterns of behaviour are each measured by one variable. The degree of accumulation is analyzed by comparing the observed and expected (assuming independent occurrence) proportions for simultaneous occurrence of 3-4 unhealthy behaviour patterns. The proportion of men displaying 3-4 unhealthy behaviour patterns has decreased, mostly because of dietary changes. The majority of the men belonged to the intermediate group of 1-2 unhealthy behaviour patterns, and their proportion remained practically unchanged throughout the study period. Unhealthy behaviour was more common in lower educational groups, especially among middle-aged (30-49) and divorced men with a low educational level. Despite the decreasing prevalence of unhealthy behaviour, the degree of accumulation did not change. Accumulation of unhealthy behaviour was much less pronounced among non-smokers than among smokers. This implies that smokers are consistent in their unhealthy behaviour. Smoking might be the gateway to an unhealthy lifestyle in general.
Social Psychiatry and Psychiatric Epidemiology, 2009
Background Socio-economic differences in depressive symptoms are well reported, but there are onl... more Background Socio-economic differences in depressive symptoms are well reported, but there are only few studies concerning changes in these differences over time. The aim of this study was to assess trends in socio-economic differences in self-reported depression over the time period 1979-2002 in Finland. Methods The data source was a representative repeated cross sectional survey ''Health Behaviour and Health among the Finnish Adult Population'' (AVTK) linked with socio-economic register data from Statistics Finland, for the period 1979-2002. The age group of 25-64 years was included in this study (N = 71,290; average annual response rate 75%). Outcome measure was a single question of self-reported depression. Socio-economic factors included education, employment status and household income. The main analyses were conducted by multiple logistic regression. Results The prevalence of self-reported depression fluctuated in both men and women but remained higher in women compared to men over the past 24 years. After adjusting for age, socio-economic differences in selfreported depression were clear in regard to education, employment status and household income over the time period 1979-2002. When all socio-economic factors were mutually adjusted for, the association with self-reported depression remained significant in the unemployed, the retired and in those in the lowest household income categories in both genders. The effect of education on self-reported depression was mediated by the other socio-economic factors. Based on a time trend analysis, the socio-economic differences in self-reported depression remained stable over the time period 1979-2002.
Social Indicators Research, 2008
Background Mental health problems are a major public health issue worldwide. The aim of this stud... more Background Mental health problems are a major public health issue worldwide. The aim of this study was to assess the relative importance of socio-demographic characteristics associated with different domains of psychological distress in Finland. Methods Data source was a nationwide survey “Health Behaviour and Health among the Finnish Adult Population” (AVTK), from years 2002 to 2003 (N = 5425; response rate 66%).
Scandinavian Journal of Public Health, 2006
To investigate time trends in the smoking prevalence and the sociodemographic and psychosocial ba... more To investigate time trends in the smoking prevalence and the sociodemographic and psychosocial background of smoking in the Baltic countries in comparison with Finland during 1994-2002. Differences in daily smoking according to age, education, urbanization, and psychological distress in the Baltic countries and Finland were studied using postal surveys in 1994, 1996, 1998, 2000, and 2002 among adults (20-64 years old) in Estonia (n = 6,271), Latvia (n = 6,106), Lithuania (n = 9,824), and Finland (n = 15,764). In 1994, 1996, 1998, 2000, and 2002 the prevalence of smoking in Estonia, Latvia, Lithuania, and Finland was 47%, 54%, 46%, and 29% among men, and 21%, 19%, 11%, and 19% among women, respectively. Smoking increased among Lithuanian women from 6% in 1994 to 13% in 2002, but decreased among Estonian men and women. Smoking was generally more common among younger individuals, the less educated, and people with distress in all four countries. The odds ratios for smoking for those with low education compared with those with high education were 2.18 (1.69-2.81), 3.32 (2.55-4.31), 2.20 (1.79-2.70) and 2.80 (2.40-3.27) in men, and 1.90 (1.42-2.52). 3.09 (2.28-4.18), 0.86 (0.59-1.26), and 3.00 (2.53-3.55) in women, in Estonia, Latvia, Lithuania, and Finland, respectively. There were indications of increasing educational differences in Latvian men. Smoking was less common among rural women in all countries except Estonia. Estonia, Latvia, and Finland show characteristics of the "mature" phase of a smoking epidemic, and smoking may not increase in these countries. In Lithuanian women smoking may increase. Smoking may be increasingly unequally distributed in the future in all the studied countries.
Public Health Nutrition, 2009
Objective: The relationship of socio-economic status and vegetable consumption is examined in nin... more Objective: The relationship of socio-economic status and vegetable consumption is examined in nine European countries. The aim is to analyse whether the pattern of socio-economic variation with regard to vegetable consumption is similar in all studied countries with high v. low vegetable availability and affordability, and whether education has an independent effect on vegetable consumption once the effects of other socio-economic factors have been taken into account. Design: The data for the study were obtained from national surveys conducted in Finland,
Public Health Nutrition, 2001
To present disparities in consumption of vegetables and fruits in Europe and to discuss how educa... more To present disparities in consumption of vegetables and fruits in Europe and to discuss how educational level, region and level of consumption influence the variation. A review of selected studies from 1985 to 1997. 33 studies (13 dietary surveys, nine household budget surveys and 11 health behaviour surveys) representing 15 European countries were selected based on criteria developed as part of the study. Association between educational level and consumption of vegetables and fruits was registered for each study and common conclusions were identified. In the majority of the studies, with the exception of a few in southern and eastern Europe, consumption of vegetables and fruits was more common among those with higher education. The results suggest that in regions where consumption of vegetables and fruits is more common, the lower social classes tend to consume more of these than the higher social classes. The differences in the patterns of disparities in vegetable and fruit consumption between regions, as well as within populations, need to be considered when efforts to improve nutrition and health are planned.
Public Health Nutrition, 2001
Objective: The aim of this research was to describe the variation in bread consumption within soc... more Objective: The aim of this research was to describe the variation in bread consumption within social classes and to link this consumption to health-related lifestyles in Finland from 1978 until 1998. Design: A cross-sectional survey on health-related behaviour and socio-demographic factors has been conducted annually since 1978. Setting: Mailed questionnaire. Subjects: A random sample of 5000 Finns aged 15±64 years has been drawn annually. The response rate has varied from 84% to 68%. Results: The consumption of rye bread decreased, but among the female population a slight increase appeared in the 1990s. The consumption of rye bread was associated with a low educational level and a rural place of residence. White bread was consumed less than was rye bread. White bread was consumed more frequently by the less educated in urban areas. Contrary to white bread, the consumption of rye bread was not associated with smoking, exercise or alcohol consumption. Conclusions: The traditional place of rye bread in the Finnish dietary pattern has remained rather constant. White bread consumption has been associated with an unhealthy lifestyle. As a result, those Finns who are concerned about their health avoid white bread but seem not to associate rye bread with a healthier lifestyle. In Finland, rye bread has a different image to the image of whole-grain or dark brown bread in many other western European countries.
Public Health Nutrition, 2007
Objective: To examine educational differences among people who consume foods containing fat in Fi... more Objective: To examine educational differences among people who consume foods containing fat in Finland and the Baltic countries. Design: Data were collected from cross-sectional postal Finbalt Health Monitor surveys that were carried out in 1998, 2000 and 2002. Setting: Estonia, Finland, Latvia and Lithuania. Subjects: For each survey, nationally representative random samples of adults aged 20 -64 years were drawn from population registers (Estonia, n ¼ 3656; Finland, n ¼ 9354, Latvia, n ¼ 6015; Lithuania, n ¼ 5944). Results: Differences were revealed between the countries in the consumption of foods that contain fat. Finnish people consumed butter on bread, high-fat milk, meat and meat products, and vegetable oil for cooking less frequently than people in the Baltic countries. Cheese was most popular in Finland. Educational differences in fat-related food habits were examined by applying logistic regression analysis. A positive association was found between level of education and consumption of vegetable oil used in food preparation. Drinking high-fat milk was associated with low education in all countries. People with higher education tended to consume cheese more often. Educational patterns in the consumption of butter on bread and in the consumption of meat and meat products differed between countries. Conclusions: The consumption of foods containing fat was related to educational levels in all four countries. The diet of better-educated people was closer to recommendations for the consumption of saturated and unsaturated fats than the diet of people with lower level of education. The educational gradient was more consistent in Finland than in the Baltic countries. These existing educational differences in sources of fat consumed should be taken into account in the development of national cardiovascular disease prevention programmes.
Public Health Nutrition, 2008
Objective: The aim of this study was to examine whether there are associations between working co... more Objective: The aim of this study was to examine whether there are associations between working conditions and the use of staff canteen or packed meals among Finnish employees. Setting: Data were obtained from cross-sectional surveys on working conditions, conducted triennially (1997, 2000, 2003) since 1997. Subjects: In each survey, the subjects were 25-64-year-old employed Finnish employees: 3096 men and 3273 women.
Public Health Nutrition, 2013
To examine (i) whether the consumption of fresh vegetables, fruit and berries is associated with ... more To examine (i) whether the consumption of fresh vegetables, fruit and berries is associated with plasma vitamin C concentration and (ii) educational differences in plasma vitamin C concentration in two neighbouring areas in Russia and Finland. Cross-sectional risk factor surveys in 1992, 1997 and 2002. Logistic regression analysis was applied to examine the associations of consumption of selected foods and education with plasma vitamin C concentration. District of Pitkäranta in the Republic of Karelia, Russia and North Karelia, Finland. Adults aged 25-64 years: 579 men and 612 women in Pitkäranta; 974 men and 642 women in North Karelia. The plasma vitamin C concentration was strikingly low in Pitkäranta, Russia across the study years. During the 10 years of monitoring, the mean plasma vitamin C concentration among men ranged from 2·5 to 8·0 μmol/l in Pitkäranta, Russia and from 27·1 to 53·9 μmol/l in North Karelia, Finland. In both areas, daily consumption of fruit was most strongly associated with plasma vitamin C, while the association of fresh vegetable consumption with plasma vitamin C was less consistent. Consumption of berries was less important in explaining plasma vitamin C. In Pitkäranta, the plasma vitamin C concentration was lower among respondents in the lowest education group. Differences in the consumption of fresh vegetables and fruit resulted in notable differences in vitamin C status between Pitkäranta and North Karelia in spring. In comparative settings, knowledge of local food culture and validation pilots are important before conducting large population surveys.
Public Health, 2006
Socioeconomic inequalities in health in the Baltic countries are possibly increasing due to conco... more Socioeconomic inequalities in health in the Baltic countries are possibly increasing due to concomitant pressures. This study compared time trends from 1994 to 2004 in the pattern and magnitude of educational inequalities in health in Estonia, Latvia, Lithuania and Finland. The data were gathered from cross-sectional postal surveys of the Finbalt project, conducted every second year since 1994 on adult populations (aged 20-64 years) in Estonia (n=9049), Latvia (n=7685), Lithuania (n=11,634) and Finland (n=18,821). Three self-reported health indicators were used: (i) less than good perceived health, (ii) diagnosed diseases, and (iii) symptoms. The existing educational inequalities in health in three Baltic countries and Finland remained generally stable over time from 1994 to 2004. Also, the overall prevalence of all three health indicators was generally stable, but in the Baltic countries improvement in perceived health was mainly found among the better-educated men and women. Diagnosed diseases increased in the Baltic countries, except Lithuania, where diseases decreased among the better-educated women. Symptoms increased among the better-educated Estonian and Finnish women. The period from 1994 to 2004 of relative stabilization since the worst conditions of the social transition has not been followed by notable changes in self-reported health, and this appears to be the situation across all educational groups in the Baltic countries. While health inequalities did not markedly change, substantial inequalities do remain, and there were indications of favourable developments mainly among the better-educated respondents. The factors contributing towards increasing health inequalities may only be visible in the future.
Preventive Medicine, 2007
Objective. The aim was to study the associations of physical activity and socioeconomic status wi... more Objective. The aim was to study the associations of physical activity and socioeconomic status with overweight from 1978 to 2002 and to explore whether the trend in overweight was different across educational groups or leisure time and commuting physical activity groups.
Food Service Technology, 2005
ABSTRACT The aim of this study was to examine the trend of workplace cafeteria use among Finnish ... more ABSTRACT The aim of this study was to examine the trend of workplace cafeteria use among Finnish adults between 1979 and 2001. Data from annually collected cross-sectional surveys on health behaviour, conducted since 1978, were used. Subjects were 24 292 employed men and 24 746 women aged 25–64. Frequency of workplace cafeteria use has been stable in Finland over the two decades under study. Women used the cafeterias more often than men. Differences by years of education and place of residence have remained relatively stable. People living in the capital area and having more years of education used the cafeterias more often. The Finnish habit of having a mid-day lunch at the cafeteria of one's respective workplace has resisted major changes in working and living conditions and social structures during the past two decades.
International Journal of Public Health, 2010
To determine socio-economic differences from 1994 to 2004 in the use of butter and milk in Pitkär... more To determine socio-economic differences from 1994 to 2004 in the use of butter and milk in Pitkäranta in the Republic of Karelia, Russia and North Karelia, Finland. Health behaviour surveys in Pitkäranta (n = 3,599) and North Karelia (n = 3,652) in 1994, 1996, 1998, 2000 and 2004. A clear overall decrease occurred in the use of butter in cooking in Pitkäranta from 1994 to 2004. In both areas, subjects with lower education used butter in cooking and drank fat-containing milk more often. Regarding butter on bread, the educational patterns in the two areas were opposite: in Pitkäranta, subjects with lower education used butter less often but in North Karelia, they used butter on bread more often. Practically, no changes in socio-economic differences from 1994 to 2004 were observed in either area. The socio-economic differences in the use of dairy fat were stable in both areas but larger in North Karelia than in Pitkäranta. Our results support earlier assumptions of a weaker role of education as a determinant of health in Russia than in the western societies.
Sozial- und Pr�ventivmedizin SPM, 2002
The study examines sociodemographic variation in associations and co-occurrence of health behavio... more The study examines sociodemographic variation in associations and co-occurrence of health behaviours that contribute to multifactorial chronic diseases. Mantel-Haenszel odds ratios were used to examine pairwise associations among smoking, alcohol use, physical activity, and diet across categories of sociodemographic characteristics. Breslow-Day test for homogeneity was used to test for sociodemographic differences. In addition, co-occurrence of each two unhealthy behaviours was examined across sociodemographic groups using nationwide population survey data from 26,014 Finnish adults. Most of the health behaviours examined were interrelated and sociodemographic differences in the associations were few. Differences were inconsistent for all sociodemographic characteristics. Variation was observed only in the strength of the associations, not in their direction. However, due to unequal distribution of the individual behaviours, co-occurrence of unhealthy behaviours varied strongly across sociodemographic groups. Associations between health behaviours were relatively similar across sociodemographic groups. Since co-occurrence of unhealthy behaviours depends on the prevalence of individual unhealthy behaviours and the strength of their association, their co-occurrence in any particular sociodemographic group was primarily determined by the prevalence of individual unhealthy behaviours.
Health Economics, 2007
This study explores the relationship between obesity and economic conditions in Finland, using in... more This study explores the relationship between obesity and economic conditions in Finland, using individual microdata from 1978 to 2002. The results reveal that an improvement in regional economic conditions measured by the employment-topopulation ratio produces a decrease in obesity over the period of investigation, other things being equal. This effect arises from the decline in the height-adjusted weight of people who are deeply overweight (BMI>35). In addition, the effect is strongest for the people in later middle age (aged 45-65). The incidence of obesity is unrelated to the regional growth rate. All in all, the Finnish evidence presented does not support the conclusions reported by Ruhm (2000Ruhm ( , 2003Ruhm ( , 2004 for the USA, according to which temporary economic slowdowns are good for health. In contrast, at least overweight increases during slumps.
The European Journal of Public Health, 2007
Background: Women's diets are healthier than men's. Finnish women eat more fruits and vegetables ... more Background: Women's diets are healthier than men's. Finnish women eat more fruits and vegetables but less meat than men. Gender differences may be larger in the Baltic countries, which represent Eastern European transition societies than in Finland, a society characterized by the Scandinavian welfare ideology and a high degree of gender equality. Methods: The data are based on questionnaires to random samples of adults in Finland, Estonia, Latvia and Lithuania. The data provide a way of addressing gender differences at the turn of the century in the economically and culturally different countries. The purpose is to explore whether the consumption of foods classified as masculine or feminine-meat, fruits and vegetables-follow a similar gender pattern in Finland and the Baltic countries. Results: Men ate meat more often while women ate fruits and vegetables. A high educational level was associated with frequent consumption of fruits and vegetables. Educational differences in the consumption of meat were few and inconsistent. The consumption of fruits and vegetables was more common in urban areas except in Finland. Gender differences were similar in all countries throughout age and educational groups and in rural and urban areas. Conclusion: The consistent association of gender and food and the similarity of gender patterning in population subgroups point to the stability of masculine versus feminine food habits. The similarity suggests that food habits contribute equally to the gender gap in health in the Baltic countries as they do in Finland.