Carina Mood

Parental Socioeconomic Status, Childhood Asthma and Medication Use – A Population-Based Study

Background Little is known about how parental socioeconomic status affects offspring asthma risk in the general population, or its relation to healthcare and medication use among diagnosed children. Methods This register-based cohort study included 211,520 children born between April 2006 and December 2008 followed until December 2010. Asthma diagnoses were retrieved from the National Patient Register, and dispensed asthma medications from the Prescribed Drug Register. Parental socioeconomic status (income and education) were retrieved from Statistics Sweden. The associations between parental socioeconomic status and outcomes were estimated by Cox proportional hazard regression. Results Compared to the highest parental income level, children exposed to all other levels had increased risk of asthma during their first year of life (e.g. hazard ratio, HR 1.19, 95% confidence interval, CI 1.09–1.31 for diagnosis and HR 1.17, 95% CI 1.08–1.26 for medications for the lowest quintile) and the risk was decreased after the first year, especially among children from the lowest parental income quintile (HR 0.84, 95% CI 0.77–0.92 for diagnosis, and HR 0.80, 95% CI 0.74–0.86 for medications). Further, compared to children with college-educated parents, those whose parents had lower education had increased risk of childhood asthma regardless of age. Children with the lowest parental education had increased risk of an inpatient (HR 2.07, 95% CI 1.61–2.65) and outpatient (HR 1.32, 95% CI 1.18–1.47) asthma diagnosis. Among diagnosed children, those from families with lower education used fewer controller medications than those whose parents were college graduates. Conclusions Our findings indicate an age-varying association between parental income and childhood asthma and consistent inverse association regardless of age between parental education and asthma incidence, dispensed controller medications and inpatient care which should be further investigated and remedied.

Choice by Contrast in Swedish Schools: How Peers' Achievement Affects Educational Choice

We ask whether a social contrast mechanism depresses the educational aspirations of students with high-achieving peers. We study two entire cohorts of students in the final grade of the Swedish comprehensive school with matched information on social origin and achievements (160,417 students, 829 schools). Controlling for school fixed effects and observed characteristics of students and families, we find that the propensity to make a high-aspiring choice of upper-secondary school program is lower for students with high-achieving schoolmates, given own achievement. While theoretically interesting, the effect is small compared to that of own achievement: Moving an average student from an average school to a school that lies one standard deviation lower in achievement increases the probability of a high-aspiring choice by three percentage points.

Life-style and self-rated global health in Sweden: a prospective analysis spanning three decades.

OBJECTIVE To study the relations between lifestyle factors (smoking, drinking, exercise, vegetable consumption, social relations) and global self-rated health in the adult Swedish population. METHOD The data come from the Swedish Level of Living Survey, a face-to-face panel study. The analysis follows the respondents with good health in 1991 (N=4035) and uses multivariate logistic regression to assess the relations between lifestyle factors in 1991 and health in 2000 and 2010. RESULTS Baseline (1991) exercise, social support, smoking and vegetable consumption are associated with health in 2000 and/or 2010. 2000: Weekly exercise in 1991 increases the probability of good health by 6 percentage points [95% CI: 1-10] compared to no exercise, and smoking 10 or more cigarettes a day decreases the probability of good health by 5 percentage points [95% CI 1-8]. Lacking social support decreases the probability of good health by 17 percentage points (95% CI: 9-25). 2010: Smoking 10 or more cigarettes a day decreases the probability of good health by 10 percentage points [95% CI 5-15], and eating vegetables every day increases the probability of good health by 4 percentage points [95% CI 0.2-7]. CONCLUSIONS Exercise, smoking, social support and vegetable consumption are related to self-rated health 2000 and/or 2010.

Social influence effects on social assistance recipiency

A potential self-reinforcing component in the dynamics of social assistance (SA) is analyzed in this paper. The core hypothesis is that the SA recipiency of others can assert a positive influence on an individuals propensity to apply for SA. The mechanisms through which such influence may operate are discussed and a set of hypotheses linking individual action and macro-level SA are proposed and tested by means of pooled cross-sections time-series analysis. Data on all individuals aged 20-25 in the Stockholm region who received SA in the years 1990-9 are used for the analyses. Results indicate that the level of SA in one year has a positive effect on the next years inflow of new SA recipients and a negative effect on the outflow, even when other relevant factors are controlled for. This lends support to the hypothesis of a self-reinforcing process.

Social Assistance dynamics in Sweden: Duration dependence and heterogeneity.

This article uses data on all persons who ever received Social Assistance (SA) in Sweden 1991-2007 (N=2,638,681 observations; 882,416 individuals) to study whether there is duration dependence in SA, i.e., whether the probability to remain in SA increases over the individual duration of SA recipiency. The risk of remaining in SA is higher at longer durations, but around half of this risk difference is caused by selection (those with favourable characteristics exit first, while those with higher likelihood of SA remain). This is captured by control variables and by conditioning on SA sequences as a method to control for unobserved heterogeneity. The probability to remain in SA increases with 2-5 percentage points per year during the first five calendar years, implying that duration dependence is substantively but not dramatically important: Nearly 8% stay in SA the fifth year after entry, but only 4% would do so in the absence of duration dependence.

Trends in Child Poverty in Sweden: Parental and Child Reports

We use several family-based indicators of household poverty as well as child-reported economic resources and problems to unravel child poverty trends in Sweden. Our results show that absolute (bread-line) household income poverty, as well as economic deprivation, increased with the recession 1991–96, then reduced and has remained largely unchanged since 2006. Relative income poverty has however increased since the mid-1990s. When we measure child poverty by young people’s own reports, we find few trends between 2000 and 2011. The material conditions appear to have improved and relative poverty has changed very little if at all, contrasting the development of household relative poverty. This contradictory pattern may be a consequence of poor parents distributing relatively more of the household income to their children in times of economic duress, but future studies should scrutinze potentially delayed negative consequences as poor children are lagging behind their non-poor peers. Our methodological conclusion is that although parental and child reports are partly substitutable, they are also complementary, and the simultaneous reporting of different measures is crucial to get a full understanding of trends in child poverty.

Neighborhood Social Influence and Welfare Receipt in Sweden: A Panel Data Analysis

This article places the choice to claim welfare benefits in a social context by studying how neighborhood welfare receipt affects welfare receipt among couples in Stockholm, Sweden. It is expected that the propensity to claim welfare should increase with welfare use in the neighborhood, primarily through stigma reduction and increasing availability of information. I use individual-level panel data (N = 1,595,843) for the Stockholm County population during the 1990s, data that contain a wide range of information and allow extensive controls for observed and unobserved confounding factors. The results from pooled and fixed-effects logistic regressions suggest that welfare receipt among people in the same neighborhood substantially increases the number of households entering the welfare system (inflow), but the effects on outflow are negligible.

The not-very-rich and the very poor: Poverty persistence and poverty concentration in Sweden

We question the common description of poverty in Western countries as largely brief and transient and show that the spell-based analyses from which this view stems diverts attention from the bulk of poverty, which is persistent rather than transient. Measures of poverty concentration are suggested. Using Swedish population data spanning 18 years (1990–2007, N (persons*years) = 102,754,809), we can avoid problems that plague poverty research using survey data and can give precise calculations of completed durations without relying on questionable assumptions. The majority of poverty years were experienced by people in long-term poverty: 69 percent of all poverty years over the 18-year period fell on people with 5 years or more in poverty. Half of all poverty years were borne by only 5 percent of the population, meaning that poverty was highly concentrated. This speaks in favour of the social policy efficiency in targeting a small group of long-term poor.