Jarmo Rusanen

Regional Differences in the Incidence of Insulin-dependent Diabetes Mellitus among Children in Finland from 1987 to 1991

The regional pattern of insulin-dependent diabetes mellitus (IDDM) incidence among children in Finland was analysed applying several methods attempting to describe the geographical variation in occurrence of IDDM. From 1987 to 1991 the number of newly diagnosed cases aged 14 years or less at diagnosis was 1728. The incidence, the incidence rate ratio and the Bayes relative risk (RR) for IDDM were calculated by municipality, by functional area (an urban centre with a subordinated surrounding area) and by area with a population of equal size at risk employing the Geographical Information Systems. The association of IDDM incidence with the degree of urbanization was assessed using the population density as a criterion for the degree of urbanization. The overall mean of the IDDM incidence was 35 per 100000 persons per year. Between municipalities the incidence varied from 4 to 245 per 100000 persons per year, whereas a clear regional pattern was seen among the functional areas and the incidence varied from 26 to 43 per 100000 persons per year. The RR for IDDM among the municipalities ranged from 0.82 to 1.34 and from 0.73 to 1.27 among the functional areas. The incidence determined in four zones with the same size of population was the highest in the middle part of the country. There was a strong inverse correlation between population density and the incidence of IDDM and this also applied to the relationship between child population density and incidence.

Rural definitions and short-term dynamics in rural areas of Finland in 1989 - 97

In this paper the authors first examine the concept of the rural area and the related typologies and then analyse changes in the internal structure of rural areas in Finland by using georeferenced data. Rural areas seem to have been defined on the basis of land use and population density for as long as they have been a topic of research, but no unambiguous rural – urban dividing line has ever emerged. Statistical areal typologies based on administrative divisions, as employed by the OECD and Eurostat, together with the national classifications prevailing in various countries, are the most commonly used tools for comparisons of spatial structures, but sociocultural analyses can also be used for defining rural areas. The empirical part of this work demonstrates that georeferenced data can be used for studying matters internal to rural areas without recourse to administrative boundaries. The example presented concerns the serious economic recession of the early 1990s, which is studied using the coordinate-based georeferenced census data collected annually by Statistics Finland from population registers. The results indicate that major changes in demographic and occupation structure and in the formation of incomes took place in the rural areas of Finland over a short space of time (1989–97) and that these affected different areas in different ways. Short-term developments of this kind cannot be observed on the basis of traditional census data produced at ten-year intervals.

Small-area variation in mortality in the city of Oulu, Finland, during the period 1978–1995

The aim of the present work was to explore small-area differences in mortality from all causes among males and females within the city of Oulu during the period 1978--1995 and to identify areas where mortality has been persistently high or low. Analyses carried out using Geographical Information System techniques with geo-referenced mortality data produced at a resolution of 1 x 1 km showed significant regional variations in mortality within the city. The differences were wide enough to suggest variations of several years in longevity, and were probably indicative of marked variations in the incidences of diseases. Observed mortality differences may reflect the influence of the rapidly changing urban structure and consequent health effects based on selection, lifestyles, work exposures and deprivation.

Finnish Socio-Economic Grid Data, GIS and the Hidden Geography of Unemployment

The use of georeferenced data in geographical research into unemployment reveals internal fluctuations and differences within localities. The observation unit in the present paper is a 1x1 km grid cell. The results obtained here indicate that the rate of unemployment in Finland during 1993-95 was highest in the most sparsely populated cells. The duration of unemployment in 1993 was longest in the centres and suburbs of major cities, and it was also very long in the most sparsely populated cells. In the largest ten cities, the areas with the highest unemployment rate mainly remained the same during 1989-96; more than 60% of the cells with the highest unemployment rates in 1989 also fell within the same quartile in 1996. Restricting the availability of grid-based information would have a contrasting impact on analysis. If data on cells containing five people or fewer had not been available, it would have meant a loss of 42.3% of the total inhabited cells and a 2.4% loss in population. Copyright Royal Dutch Geographical Society 2001.

Urbanization and Transportation in Finland, 1880–1970

Analysis based on historical geographical information systems (hgis) databases can be used to trace the relationship between railway infrastructure and population change in Finland from 1880 to 1970. The use of accessibility calculations, statistical analyses, and gis reveals that Finlands population was almost evenly distributed in 1880, when railway development began, but that immigration to cities was well underway by 1970, when motorization by road was rapidly becoming the primary form of transportation.

Fine-Scale Exposure to Allergenic Pollen in the Urban Environment: Evaluation of Land Use Regression Approach

Background: Despite the recent developments in physically and chemically based analysis of atmospheric particles, no models exist for resolving the spatial variability of pollen concentration at urban scale. Objectives: We developed a land use regression (LUR) approach for predicting spatial fine-scale allergenic pollen concentrations in the Helsinki metropolitan area, Finland, and evaluated the performance of the models against available empirical data. Methods: We used grass pollen data monitored at 16 sites in an urban area during the peak pollen season and geospatial environmental data. The main statistical method was generalized linear model (GLM). Results: GLM-based LURs explained 79% of the spatial variation in the grass pollen data based on all samples, and 47% of the variation when samples from two sites with very high concentrations were excluded. In model evaluation, prediction errors ranged from 6% to 26% of the observed range of grass pollen concentrations. Our findings support the use of geospatial data–based statistical models to predict the spatial variation of allergenic grass pollen concentrations at intra-urban scales. A remote sensing–based vegetation index was the strongest predictor of pollen concentrations for exposure assessments at local scales. Conclusions: The LUR approach provides new opportunities to estimate the relations between environmental determinants and allergenic pollen concentration in human-modified environments at fine spatial scales. This approach could potentially be applied to estimate retrospectively pollen concentrations to be used for long-term exposure assessments. Citation: Hjort J, Hugg TT, Antikainen H, Rusanen J, Sofiev M, Kukkonen J, Jaakkola MS, Jaakkola JJ. 2016. Fine-scale exposure to allergenic pollen in the urban environment: evaluation of land use regression approach. Environ Health Perspect 124:619–626; http://dx.doi.org/10.1289/ehp.1509761

A Grid Cell Viewpoint to Resorts: Case Studies in Northern Finland

Resorts are key elements in the tourism phenomenon, because they are considered places for tourism demand and supply. Basically, resorts are geographical units and, statistically, they are traditionally treated as administrative regions, that is as municipalities. However, resorts are often a part of a municipality, not independent administrative regions. When statistically examining the socio‐economic characteristics and changes of resorts smaller than municipalities, GIS (Geographical Information Systems) and georeferenced data seem to be a respectable option. The purpose of this investigation is to present a model, how to define resorts from their surrounding environment by utilizing so‐called grid cell data. The cases deal with the four large resorts – Levi, Ruka, Saariselkä and Ylläs – and their location municipalities (Kittilä, Kuusamo, Inari and Kolari) in Northern Finland. Population is used as an example variable to indicate the changes which occur on different geographical scales, that is municipality and resort levels. The study results show that at the municipality level, excluding Inari, the population development was negative in 1970–2003, but at the resort level the trend was vice versa. In addition, the population of the resorts seems to be concentrated in a smaller geographical area. Finally, the strengths, challenges and opportunities offered by GIS and georeferenced data are discussed in the context of resorts.

Invasive Group A Streptococcal Infections in Children: A Nationwide Survey in Finland.

Background: The incidence of invasive group A streptococcus (iGAS) infections varies in time and geographically for unknown reasons. We performed a nationwide survey to assess the population-based incidence rates and outcomes of children with iGAS infections. Methods: We collected data on patients from hospital discharge registries and the electronic databases of microbiological laboratories in Finland for the period 1996–2010. We then recorded the emm types or serotypes of the strains. The study physician visited all university clinics and collected the clinical data using the same data entry sheet. Results: We identified 151 children with iGAS infection. Varicella preceded iGAS infection in 20% of cases and fasciitis infection in 83% of cases. The annual incidence rate of iGAS infection was 0.93 per 100,000 in 1996–2000, 1.80 in 2001–2005 and 2.50 in 2006–2010. The proportion of emm 1.0 or T1M1 strains peaked in 1996–2000 and again in 2006–2010, to 44% and 37% of all typed isolates. The main clinical diagnoses of the patients were severe soft-tissue infection (46%), sepsis (28%), empyema (10%), osteoarticular infection (9%) and primary peritonitis (5%). Severe pain was the most typical symptom for soft-tissue infections. More than half of the patients underwent surgery and received clindamycin. The readmission rate was 7%, and the case fatality rate was 2%. Conclusions: The incidence rate of pediatric iGAS infections tripled during our study. The increase was not, however, the result of a change in the strain types causing iGAS. Varicella immunization would likely have prevented a significant number of the cases.

Health and well-being of movers in rural and urban areas – A grid-based analysis of northern Finland birth cohort 1966

We examined the association of health and well-being with moving using a detailed geographical scale. 7845 men and women born in northern Finland in 1966 were surveyed by postal questionnaire in 1997 and linked to 1 km(2) geographical grids based on each subjects home address in 1997-2000. Population density was used to classify each grid as rural (1-100 inhabitants/km²) or urban (>100 inhabitants/km²) type. Moving was treated as a three-class response variate (not moved; moved to different type of grid; moved to similar type of grid). Moving was regressed on five explanatory factors (life satisfaction, self-reported health, lifetime morbidity, activity-limiting illness and use of health services), adjusting for factors potentially associated with health and moving (gender, marital status, having children, housing tenure, education, employment status and previous move). The results were expressed as odds ratios (OR) and their 95% confidence intervals (CI). Moves from rural to urban grids were associated with dissatisfaction with current life (adjusted OR 2.01; 95% CI 1.26-3.22) and having somatic (OR 1.66; 1.07-2.59) or psychiatric (OR 2.37; 1.21-4.63) morbidities, the corresponding ORs for moves from rural to other rural grids being 1.71 (0.98-2.98), 1.63 (0.95-2.78) and 2.09 (0.93-4.70), respectively. Among urban dwellers, only the frequent use of health services (≥ 21 times/year) was associated with moving, the adjusted ORs being 1.65 (1.05-2.57) for moves from urban to rural grids and 1.30 (1.03-1.64) for urban to other urban grids. We conclude that dissatisfaction with life and history of diseases and injuries, especially psychiatric morbidity, may increase the propensity to move from rural to urbanised environments, while availability of health services may contribute to moves within urban areas and also to moves from urban areas to the countryside, where high-level health services enable a good quality of life for those attracted by the pastoral environment.

Body mass index and overweight in relation to residence distance and population density: experience from the Northern Finland birth cohort 1966

BackgroundThe effect of urban sprawl on body weight in Finland is not well known. To provide more information, we examined whether body mass index (BMI) and the prevalence of overweight are associated with an individual’s distance to the local community centre and population density in his/her resident area.MethodsThe sample consisted of 5363 men and women, members of the Northern Finland Birth Cohort 1966 (NFBC), who filled in a postal questionnaire and attended a medical checkup in 1997, at the age of 31 years. Body mass index (BMI; kg/m2) and the prevalence of overweight (BMI ≥ 25.0 kg/m2) were regressed on each subject’s road distance to the resident commune’s centre and on population density in the 1 km2 geographical grid in which he/she resided, using a generalized additive model. Adjustments were made for sex, marital status, occupational class, education, leisure-time and occupational physical activity, alcohol consumption and smoking.ResultsThe mean BMI among the subjects was 24.7 kg/m2, but it increased by increasing road distance (by 1.3 kg/m2 from 5–10 to 20–184 km) and by decreasing population density (by 1.7 kg/m2 from 1000–19,192 to 1–5 inhabitants/km2). The respective increases in overweight (overall prevalence 41%) were 13 per cent units for distance and 14 per cent units for population density. Adjusted regressions based on continuous explanatory variables showed an inverse L-shaped pattern with a mean BMI of 24.6 kg/m2 at distances shorter than 5 km and a rise of 2.6 kg/m2 at longer distances, and an increase of 2.5 kg/m2 from highest to lowest population density. The associations with road distance were stronger for women than men, while the sex difference in association with population density remained indeterminate.ConclusionsWe conclude that young adults in Northern Finland who live far away from local centres or in the most sparsely populated areas are fatter than those who live close to local centres or in densely populated areas. The likely explanations include variations in everyday physical activity in different residential environments, although causality of the associations remains to be confirmed.