Anette Edin-Liljegren

Risk factors for cardiovascular diseases among Swedish Sami – a controlled cohort study

Objective. To investigate the occurrence of clinical, psychosocial and behavioural risk factors for cardiovascular diseases (CVD) among reindeer herding (RS) and non-reindeer herding Sami (NRS). Study Design. A retrospective cohort study, comparing risk factors behind CVD between Sami and non-Sami, RS and NRS, and Sami men and women. Methods. A cohort of 611 Swedish Sami (276 men and 335 women) was constructed from national population registers. A twice as large control cohort of non-Sami was created, matched by age, gender and area of residence. Information on risk factors was obtained from a database containing clinical and psychosocial-behavioural data from a regional CVD preventive programme for the period 1990–2001. Results. The Sami and the non-Sami showed similar risk factor patterns. The main differences were related to working conditions and lifestyle factors of the RS. The RS men had lower blood pressure, were more physically active and had higher job demand and decision latitude. The RS women showed more negative scores on the indices of the job strain model. Conclusions. Previously reported differences in CVD mortality between Sami and non-Sami, and Sami men and women, can only partly be explained by different exposure to the psychosocial and behaviour risk factors investigated in this study.

Work-related musculoskeletal pain among reindeer herding Sami in Sweden - a pilot study on causes and prevention

Objective. To investigate the prevalence and to identify causes of musculoskeletal pain (MSP) among reindeer herding Sami, and to evaluate the impact on the MSP symptoms elicited by an intervention-prevention programme (IP programme). Study Design. A prospective cohort study in which alterations in MSP symptoms were documented over a two-year period. Methods. Data were collected from 51 reindeer herders (26 men, 25 women) before and after a two-year IP programme. Information on MSP characteristics (affected body regions, pain duration and pain intensity) and exposure to a number of physical and psychosocial risk factors were collected as part of comprehensive health examinations. Clinical examinations and interviews complemented self-reported data collected through questionnaires. Results. MSP symptoms were prevalent, both among women and men. High exposure to physical risk factors, to a large extent related to extensive use of snowmobiles and motorcycles, was the main cause of MSP among men, while psychosocial risk factors were suggested to be more important among women. About one-third of the reindeer herders reported fewer MSP symptoms as a result of the IP programme. Conclusions. This pilot study suggests that it is possible to reduce the number and the severity of the MSP symptoms among reindeer herders by implementing suitably tailored intervention-prevention measures.

Adherence to a traditional lifestyle affects food and nutrient intake among modern Swedish Sami

Abstract Objectives. To compare the nutrient and food intake of Sami still engaged in reindeer herding (traditionallifestyle or reindeer-herding Sami [RS]) and Sami not involved in reindeer herding (industrializedlifestyle or non-reindeer-herding Sami [NRS]) with other northern Swedish populations. Study design. Cross-sectional analysis of data from a prospective cardiovascular interventionprogram in northern Sweden. Methods. Data were used from a prospective cardiovascular intervention program in northernSweden. Sami recruited into this study were divided according to whether they were involved inreindeer herding (traditional lifestyle, RS) (66 females, 79 males) or not (NRS) (255 females, 195males), and compared to non-Sami from the same area taking part in the same study (controls)(499 females, 501 males). Subjects completed a Food Frequency Questionnaire (FFQ) and clinicalparameters were analysed. Results. RS had a higher overall intake of energy for both females (P<0.01) and males (P<0.05), but not total food intake compared to controls and NRS. The overall Sami diet was characterizedby a higher proportion of energy from protein and fat. RS had a lower energy adjusted intake ofvitamins A and E, and fibre, and a higher intake of sodium. RS and NRS both had a lower intakeof vegetables and a higher intake of meat, and for RS, fish. Nutrient and food-intake patterns weresimilar for males and females. Conclusions. Classification of Sami into RS and NRS indicates that a traditional lifestyle defined byoccupation is reflected in differences in food and nutrient intake.

Quality of life in relation to physical, psychosocial and socioeconomic conditions among reindeer-herding Sami

OBJECTIVES: To analyse different aspects of health-related quality of life factors among members of reindeer-herding families. STUDY DESIGN: Cross-sectional study based on data from a comprehensive survey. METHODS: The health-related quality of life (SF-36) factors were analysed on 99 (56 men, 43 women) adult members of reindeer-herding families. Comparisons were made between the reindeer-herding family members and a Swedish reference population. Associations between mental and physical component summary measures and a number of sociodemographic, biomedical, physical, psychosocial and socio-economic variables were analysed with multivariate regression statistics. RESULTS: Men scored higher than women on physical and social function and vitality. The average scores on the subscales for the reindeer-herding family members were similar to those of the Swedish reference population, except for reindeer-herding men who scored higher on physical function and lower on bodily pain. For women, the quality of life was related to age, sense of coherence, lifestyle and behavioural variables, as well as to issues such as diseases among close relatives, social networks and the economy of their business. For men, it was mainly related to musculoskeletal pain conditions, age, sense of coherence and physical and psychosocial working conditions. CONCLUSIONS: Men and women of the reindeer-herding families need partly different conditions to enjoy a high quality of life. From the results, it might be predicted that poor somatic and psychosocial health, increased intrusion from exploiters on the grazing land and declining profit in reindeer husbandry constitute important threats to a good quality of life among members of reindeer-herding families.

Changes in attitudes towards mental disorders and psychiatric treatment 1976–2014 in a Swedish population

Background: Mental illness has always been subject to stigma and discrimination. There are a number of studies on public attitudes towards people with mental illness. Long-term studies, however, examining changes over time are scarce. Aims: The aim of this study was to examine potential changes concerning attitudes between 1976 and 2014 in Vilhelmina, a community in northern Sweden. Methods: A postal questionnaire was sent out to a random sample of 500 adults aged 18–70 years. The same questionnaire has previously been used in 1976 and 2003. Results: The attitudes towards people with mental illness have not generally become more positive over the years. In 2014 almost a quarter of the population still think that “people with mental illness commit violentX acts more than others”. Even more people in 2014 than in 1976 agree to the statement that “mental illness harms the reputation more than a physical disease” (77.2% versus 52.8%). People with low educational level have more negative views than people with higher education. Younger respondents, < 20 years, had a more positive view than the older age groups. Almost 70% of the respondents would advise someone with psychological problems to seek a psychiatrist but only 23% of the respondents would follow their own advice. Psychotherapy has been and is still highly appreciated. As regards medication the perception is more critical, but there has been a significant change, however, to a more positive attitude towards medication since 1976. Conclusion: Attitudes towards mental illness and mentally ill people have not changed substantially over time.

Musculoskeletal symptoms and perceived work strain among reindeer herders in Sweden

BACKGROUND There is a shortage of knowledge on the extent of musculoskeletal symptoms in reindeer husbandry. AIMS To investigate the prevalence and relative risk for musculoskeletal symptoms and perceived psychosocial work strain among reindeer herders. METHODS The prevalence of self-reported musculoskeletal symptoms during the last week and last year, respectively, were obtained from male reindeer herders (n=74) of northern Sweden. Prevalence ratios (PRs) were calculated using two reference groups-women of reindeer-herding families (n=53) and men in blue-collar occupations (n=194). Comparisons were made of perceived job strain between the study and reference groups. Associations between job strain factors and the occurrence of musculoskeletal symptoms from different body regions were analysed with regression statistics. RESULTS The PRs for musculoskeletal symptoms from the hand/wrist (PR 3.48, 95% CI 1.86-6.50) and lower back (PR 1.44, 95% CI 1.06-1.95) were significantly higher among the reindeer herders in comparison with men working with other blue-collar occupations. The reindeer herders reported significantly higher work demands and decision latitude compared with both reference groups (P<0.05). Significant associations were observed between demands and prevalence of symptoms from the lower back (OR 1.42, 95% CI 1.01-2.01) and from at least one body region (OR 1.58, 95% CI 1.07-2.32). CONCLUSIONS The relative risk for musculoskeletal symptoms, particularly from the hands/wrists and lower back, was high among reindeer herders. It is suggested that musculoskeletal symptoms constitute a considerable health problem in modern reindeer husbandry, which calls for implementation of preventive measures addressing psychosocial, physical and socio-economic risk factors.

The confidence in health care and social services in northern Sweden--a comparison between reindeer-herding Sami and the non-Sami majority population.

Aims: To investigate the confidence in primary health care, psychiatry and social services among the reindeer-herding Sami and the non-Sami population of northern Sweden. Methods: A semi-randomized, cross-sectional study design comprising 325 reindeer-herding Sami (171 men, 154 women) and a control population of 1,437 non-Sami (684 men, 753 women). A questionnaire on the confidence in primary health care, psychiatry, social services, and work colleagues was distributed to members of reindeer-herding families through the Sami communities and to the control population through the post. The relative risk for poor confidence was analyzed by calculating odds ratios with 95% confidence intervals adjusted for age and level of education. Results: The confidence in primary health care and psychiatry was significantly lower among the reindeer-herding Sami compared with the control group. No differences were found between men and women in the reindeer-herding Sami population. In both the reindeer-herding Sami and the control population, younger people (≤48 years) reported significantly lower confidence in primary health care than older individuals (>48 years). Conclusions: A conceivable reason for the poor confidence in health care organizations reported by the reindeer-herding Sami is that they experience health care staff as poorly informed about reindeer husbandry and Sami culture, resulting in unsuitable or unrealistic treatment suggestions. The findings suggest that the poor confidence constitutes a significant obstacle of the reindeer-herding Sami to fully benefit from public health care services.

Reindeer-herding Sami experiences of seeking care in the mainstream society

(no abstract available) Citation: Int J Circumpolar Health 2016, 75: 33200 - http://dx.doi.org/10.3402/ijch.v75.33200Tularemia mapping in northernmost Sweden : seroprevalence and a case-control study of risk factors