European Journal of Public Health

BackgroundWhile the COVID-19 outbreak in China now appears surpressed, Europe and the US have become the epicenters, both reporting many more deaths than China. Responding to the pandemic, Sweden has taken a different approach aiming to mitigate, not suppressing community transmission, by using physical distancing without lock-downs. Here we contrast consequences of different responses to COVID-19 within Sweden, the resulting demand for care, intensive care, the death tolls, and the associated d...

Several studies based on the Synthetic Control Method (SCM) link the many COVID-19 deaths in Sweden during the spring of 2020 to its decision not to lock down. These studies predominantly rely on a limited pre-intervention period and tend to focus on the very short run neglecting that Swedish health authorities emphasized that their public health strategy was designed for the long run. This paper handles these shortcomings expanding both the pre- and post-intervention period considerably using w...

ObjectivesDuring March 2020, the COVID-19 pandemic has rapidly spread globally, and non-pharmaceutical interventions are being used to reduce both the load on the healthcare system as well as overall mortality. DesignIndividual-based transmission modelling using Swedish demographic and Geographical Information System data and conservative COVID-19 epidemiological parameters. SettingSweden ParticipantsA model to simulate all 10.09 million Swedish residents. Interventions5 different non-pharma...

We compared the total excess mortality per week in relation to the reported Covid-19 related deaths in the Stockholm region (Sweden). Total excess mortality peaked under the weeks of high COVID-19-related mortality, but 25% of these deaths were not recognized as Covid-related. Most of these deaths occurred outside hospitals. Total all-cause mortality in excess to average all-cause mortality during the epidemic peak period may provide a comprehensive picture of the total burden of COVID19-related...

ObjectivesMortality from Covid-19 is monitored in detail both within as well as between countries with different strategies against the virus. However, death counts and relative risks based on crude numbers can be misleading. Instead, age specific death rates should be used for comparability. Given the difficulty of ascertainment of Covid-19 specific deaths, excess all-cause mortality is currently more appropriate for comparisons. By estimating age- and sex-specific death rates we aim to get mor...

We aimed to assess differences in the summer excess of mortality by COVID-19 history using data from the mortality and COVID-19 surveillances. We found 4% excess risk in 2022 summer, compared to 2015-2019. A mortality rate ratio of 1.59 (95%CI 1.39-1.82) for COVID-19 survivors compared to naive, was found. Both were higher in people aged [≥]75 years. During the July heat wave, the excess for COVID-19 survivors decreased and disappeared when excluding people living in nursing homes. Funding s...

BackgroundWe aimed to describe the distribution of excess mortality (EM) during the first weeks of the COVID-19 outbreak in the Stockholm Region, Sweden, according to individual age and sex, and the sociodemographic context MethodsWeekly all-cause mortality data were obtained from Statistics Sweden for the period 01/01/2015 to 17/05/2020. EM during the first 20 weeks of 2020 was estimated by comparing observed mortality rates with expected mortality rates during the five previous years (N=2,379...

BackgroundPrevious studies highlighted the relationships between socioeconomic inequalities and the populations risk to become disease or die during COVID-19 epidemic. In France, socioeconomic inequalities vary across metropolitan areas, but little is known if that could explain the spatial disparities observed in terms of incidence and testing rates. We assessed the impact of socioeconomic inequalities on testing and incidence rates of COVID-19 for each metropolitan area and wave. MethodsFor e...

ObjectivesDescribe the burden and prevalence of prognostic factors of severe COVID-19 disease at national and county level in Sweden. DesignCross sectional study SettingSweden Participants9,624,428 individuals living in Sweden on 31st December 2014 and alive on 1st January 2016 Main outcome measuresBurden and prevalence of prognostic factors for severe COVID-19 based on the guidelines from the World Health Organization and European Centre for Disease Prevention and Control, which are age 70 ...

Lay persons and policy makers have speculated on how the imposition of social distancing to reduce SARS CoV-2 (severe acute respiratory syndrome coronavirus 2) infection has affected non-COVID-19 (coronavirus disease of 2019) deaths. No rigorous estimation of the effect appears in the scholarly literature. We use time-series methods to compare non-COVID-19 deaths observed in Norway before and during the epidemic to those expected from non-COVID-19 deaths in Sweden as well as from the history of ...

ObjectivesTo balance the costs and effects comparing a strict lockdown versus a flexible social distancing strategy for societies affected by Coronavirus-19 Disease (COVID-19). DesignCost-effectiveness analysis. ParticipantsWe used societal data and COVID-19 mortality rates from the public domain. InterventionsThe intervention was a strict lockdown strategy that has been followed by Denmark. Reference strategy was flexible social distancing policy as was applied by Sweden. We derived mortalit...

BackgroundLongitudinal evidence on the association between temperature fluctuations and psychological wellbeing remains limited, particularly in ageing populations of Southeast Asia. This study examines how heat exposure affects multiple wellbeing outcomes among older adults in Thailand. MethodsWe linked longitudinal data from 16,002 observations in the Health, Aging, and Retirement in Thailand (HART) study (2015-2023) with province-level meteorological data. Using a multilevel mixed-effects mo...

ObjectivesNon-communicable diseases (NCDs) account for almost 90% of deaths in Europe, yet comparative estimates of the productivity costs associated with premature NCD mortality across diseases and countries remain limited. This study estimates and compares productivity losses attributable to cardiovascular disease (CVD) and cancer mortality among working-age populations across Europe. Population-based data were used to estimate productivity costs for CVD and cancer deaths across 30 European co...

The direct and indirect impact of the COVID-19 pandemic on population-level mortality is of concern to public health but challenging to quantify. We modelled excess mortality and the direct and indirect effects of the pandemic on mortality in Switzerland. We analyzed yearly population data and weekly all-cause deaths by age, sex, and canton 2010-2019 and all-cause and laboratory-confirmed COVID-19 deaths from February 2020 to April 2022 (study period). Bayesian models predicted the expected numb...

BackgroundHeatwaves are becoming more frequent, intense, and prolonged. High temperat-ures raise mortality and morbidity, particularly in older adults and those with pre-existing conditions. However, it remains unclear whether increases in deaths during hot periods are accompanied by sim-ilar changes in hospital admissions. Understanding the full health burden of heat requires assessing both outcomes under a unified exposure framework. MethodsWe analyzed national hospital data from Austria (200...

BackgroundInternational sharing of cohort data for research is important and challenging. The LifeCycle project aimed to harmonise data across birth cohorts and develop methods for efficient federated analyses of early life stressors on offspring outcomes. AimTo explore feasibility of federated analyses of associations between four different types of pregnancy exposures (maternal education, area deprivation, proximity to green space and gestational diabetes) with offspring BMI from infancy to 1...

BACKGROUND: Recent evidence suggests that window-view and window-ventilation may contribute to mental wellbeing. Compared to their younger counterparts, older adults spend more time at home and have less contact with natural environments due to social isolation and physical decline. However, the association of residential window-opening with depressive symptoms is understudied among older populations. METHODS: We used data from a community-based cohort study conducted in 23 provinces of China in...

BackgroundDespite universal health care, socioeconomic differences in health care utilization (HCU) persist in modern welfare states. The aim of this study is to assess income-based differences in utilization of primary- and specialized care in relation to mortality for the Swedish general population (>15 years old) between 2004 and 2017. Methods and FindingsUsing a repeated cross-sectional register-based study design, data on utilization of i) primary-ii) specialized outpatient- and iii) inpat...

BackgroundSeveral factors for delirium have already been examined. However, the effects of location and weather conditions have not been fully evaluated yet. The aim of this study is to determine the effects of these factors on delirium in older adult patients. MethodsWe evaluated the data of older adult patients with and without delirium in the acute state on hospitalization from January 2017 to December 2020 in Johmoh Hospital. We also subdivided the patients into those who came from their ow...

BackgroundLower socioeconomic position (SEP) is associated with adverse pregnancy and perinatal outcomes and with less favourable metabolic profile in nonpregnant adults. However, socioeconomic differences in pregnancy metabolic profile are unknown. We investigated association between a composite measure of SEP and pregnancy metabolic profile in White European (WE) and South Asian (SA) women. MethodsWe included 3,905 WE and 4,404 SA pregnant women from a population-based UK cohort. Latent class...