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After colectomy there are four options available. The least complicated and most common is to leave the end ileostomy and not go for any reconstructive surgery. Then there is the ileal pouch anal anastomosis (IPAA) in which the rectum is removed, but the anal canal and a small rectal “cuff” is preserved. The pouch is created from the distal ileum and anastomosed to the rectal cuff. In the ileorectal anastomosis (IRA) the rectum is spared, and the distal ileum is anastomosed to the top of the rectum. In the continent ileostomy (CI), also referred to as the Kock pouch, the fecal flow is let out through the abdominal wall, but a pouch and a nipple valve mechanism is created making the stoma continent which needs to be manually emptied. This thesis aims to investigate function, quality of life, satisfaction, complications, and aspects associated with the chance of having reconstructive surgery after colectomy for inflammatory bowel disease (IBD), i.e. ulcerative colitis (UC) or Crohn’s disease (CD). The first two papers focus on the continent ileostomy, the most uncommon of the options after colectomy. In Paper 1 all patients who have received a CI at our center were identified and medical charts were reviewed for complications and CI patency. Function and quality of life were evaluated with the 36-item short form survey (SF-36), short health scale (SHS) and a local CI specific questionnaire for function and satisfaction. In Paper II, the Swedish national patient register (NPR) was used to identify all patients with an IBD diagnosis who had received a CI and data on diagnosis, demographics, reoperations, and excisions were obtained from the register. Paper III describes an ongoing prospective non-randomized, multi-center, open-label, controlled trial between IRA and IPAA in UC patients subjected to colectomy. The primary endpoint is satisfaction but Quality of Life (QoL), sexual function, bowel function and complications are also evaluated. In Paper IV, we invest

Composite materials are known to have superior stiffness and strength properties per unit weight compared to metallic materials. These properties and the ability to tailor the mechanical properties of composites is the main motivation for choosing composite materials for structural components. Design of composite structures requires consideration of many material, design and manufacturing factors to generate designs with desired behaviour. A promising approach to handle this is to use structural optimization (SO) in the design process to obtain composite structures with optimal performance. However, optimality often comes at the cost of robustness unless consideration is taken to uncertainty in the input data to the optimization problem. It is for example well-known that composite materials can exhibit significant variation of mechanical properties and it is thus important that this is accounted for in the optimization. In this thesis, SO methods for design of composite structures are developed, including continuous and discrete parametrization methods, a method for reducing the impact of cure-induced distortion of composite parts in manufacturing; and methods for handling uncertainty to ensure robustness of optimized designs. The focus has been to extend the SO methodology to handle material uncertainty associated with the mechanical properties of composite materials. An uncertainty parametrization was developed for the stiffness properties of a composite material based on a worst-case, or deterministic, approach. Using this parametrization, an uncertainty quantification was performed to investigate the influence of material uncertainty on the performance of optimized composite structures, indicating that the effect can be significant. Combining a discrete parametrization method with the uncertainty quantification, a deterministic method for handling material uncertainty in SO of composite structures was then proposed. This method consists of a min-max optimizat, Kompositmaterial har väldigt goda styvhets- och hållfasthetsegenskaper samt låg vikt jämfört med exempelvis metaller. Dessa egenskaper tillsammans med möjligheten att skräddarsy de mekaniska egenskaperna hos kompositstrukturer har varit de främsta skälen till att välja kompositmaterial vid tillverkning av strukturella komponenter. Utveckling av kompositstrukturer styrs av ett stort antal faktorer kopplat till materialval, design och tillverkning som är viktiga att ta hänsyn till. Ett sätt att hantera detta är att använda strukturoptimering (SO) för att generera kompositstrukturer med önskade mekaniska egenskaper. Vid tillämpning av SO tas oftast ingen hänsyn till osäkerhet i indata till optimeringsproblemet, vilket medför att prestandan hos den optimerade strukturen kan vara känslig för variation i indata. Då kompositmaterial kan uppvisa en betydande variation i de mekaniska egenskaperna är det viktigt att denna osäkerhet tas med i formuleringen av optimeringsproblemet för att säkerställa robustheten hos strukturen. Denna avhandling behandlar utveckling av SO-metoder för design av komposit-strukturer. Tonvikten i arbetet har varit att utveckla metoder som tar hänsyn till materialosäkerhet i kompositmaterial, och därmed förbättra robustheten hos optimerade designer. Första steget i detta arbete är utvecklingen av en ny teknik för diskret designparametrisering, kallad Hyperbolic Function Parametrization (HFP), vilken möjliggör simultan optimering av topologi och materialval för kompositstrukturer. Tekniken använder filter baserade på hyperboliska funktioner för att generera diskreta designvariabler som behandlar kompositdesignen. Vidare utvecklas en teknik för osäkerhetsparametrisering som inkluderar variation av styvhetsegenskaperna hos kompositmaterial. Denna teknik baseras på en deterministisk, värsta-fallsformulering. Tekniken tillämpas för osäkerhets-kvantifiering genom att undersöka inverkan av materialosäkerhet på prestandan hos optimerade kompositstrukturer. D, Funding: The research papers included in the dissertation have been funded as follows: Papers I and II received funding from the Swedish Foundation for Strategic Research (SSF) through grant agreement PV08.000.02. Papers III and V-VI received funding from the Swedish Energy Agency (Energimyndigheten) through grant agreement P48175-1. Paper IV received funding from the Clean Sky 2 Joint Undertaking under the EUs Horizon 2020 program through grant agreement 716864. Paper VII received funding from the Swedish Agency for Innovation Systems (Vinnova) through grant agreements 2022-01200 and 2022-20565.

Composite materials are known to have superior stiffness and strength properties per unit weight compared to metallic materials. These properties and the ability to tailor the mechanical properties of composites is the main motivation for choosing composite materials for structural components. Design of composite structures requires consideration of many material, design and manufacturing factors to generate designs with desired behaviour. A promising approach to handle this is to use structural optimization (SO) in the design process to obtain composite structures with optimal performance. However, optimality often comes at the cost of robustness unless consideration is taken to uncertainty in the input data to the optimization problem. It is for example well-known that composite materials can exhibit significant variation of mechanical properties and it is thus important that this is accounted for in the optimization. In this thesis, SO methods for design of composite structures are developed, including continuous and discrete parametrization methods, a method for reducing the impact of cure-induced distortion of composite parts in manufacturing; and methods for handling uncertainty to ensure robustness of optimized designs. The focus has been to extend the SO methodology to handle material uncertainty associated with the mechanical properties of composite materials. An uncertainty parametrization was developed for the stiffness properties of a composite material based on a worst-case, or deterministic, approach. Using this parametrization, an uncertainty quantification was performed to investigate the influence of material uncertainty on the performance of optimized composite structures, indicating that the effect can be significant. Combining a discrete parametrization method with the uncertainty quantification, a deterministic method for handling material uncertainty in SO of composite structures was then proposed. This method consists of a min-max optimizat, Kompositmaterial har väldigt goda styvhets- och hållfasthetsegenskaper samt låg vikt jämfört med exempelvis metaller. Dessa egenskaper tillsammans med möjligheten att skräddarsy de mekaniska egenskaperna hos kompositstrukturer har varit de främsta skälen till att välja kompositmaterial vid tillverkning av strukturella komponenter. Utveckling av kompositstrukturer styrs av ett stort antal faktorer kopplat till materialval, design och tillverkning som är viktiga att ta hänsyn till. Ett sätt att hantera detta är att använda strukturoptimering (SO) för att generera kompositstrukturer med önskade mekaniska egenskaper. Vid tillämpning av SO tas oftast ingen hänsyn till osäkerhet i indata till optimeringsproblemet, vilket medför att prestandan hos den optimerade strukturen kan vara känslig för variation i indata. Då kompositmaterial kan uppvisa en betydande variation i de mekaniska egenskaperna är det viktigt att denna osäkerhet tas med i formuleringen av optimeringsproblemet för att säkerställa robustheten hos strukturen. Denna avhandling behandlar utveckling av SO-metoder för design av komposit-strukturer. Tonvikten i arbetet har varit att utveckla metoder som tar hänsyn till materialosäkerhet i kompositmaterial, och därmed förbättra robustheten hos optimerade designer. Första steget i detta arbete är utvecklingen av en ny teknik för diskret designparametrisering, kallad Hyperbolic Function Parametrization (HFP), vilken möjliggör simultan optimering av topologi och materialval för kompositstrukturer. Tekniken använder filter baserade på hyperboliska funktioner för att generera diskreta designvariabler som behandlar kompositdesignen. Vidare utvecklas en teknik för osäkerhetsparametrisering som inkluderar variation av styvhetsegenskaperna hos kompositmaterial. Denna teknik baseras på en deterministisk, värsta-fallsformulering. Tekniken tillämpas för osäkerhets-kvantifiering genom att undersöka inverkan av materialosäkerhet på prestandan hos optimerade kompositstrukturer. D, Funding: The research papers included in the dissertation have been funded as follows: Papers I and II received funding from the Swedish Foundation for Strategic Research (SSF) through grant agreement PV08.000.02. Papers III and V-VI received funding from the Swedish Energy Agency (Energimyndigheten) through grant agreement P48175-1. Paper IV received funding from the Clean Sky 2 Joint Undertaking under the EUs Horizon 2020 program through grant agreement 716864. Paper VII received funding from the Swedish Agency for Innovation Systems (Vinnova) through grant agreements 2022-01200 and 2022-20565.

After colectomy there are four options available. The least complicated and most common is to leave the end ileostomy and not go for any reconstructive surgery. Then there is the ileal pouch anal anastomosis (IPAA) in which the rectum is removed, but the anal canal and a small rectal “cuff” is preserved. The pouch is created from the distal ileum and anastomosed to the rectal cuff. In the ileorectal anastomosis (IRA) the rectum is spared, and the distal ileum is anastomosed to the top of the rectum. In the continent ileostomy (CI), also referred to as the Kock pouch, the fecal flow is let out through the abdominal wall, but a pouch and a nipple valve mechanism is created making the stoma continent which needs to be manually emptied. This thesis aims to investigate function, quality of life, satisfaction, complications, and aspects associated with the chance of having reconstructive surgery after colectomy for inflammatory bowel disease (IBD), i.e. ulcerative colitis (UC) or Crohn’s disease (CD). The first two papers focus on the continent ileostomy, the most uncommon of the options after colectomy. In Paper 1 all patients who have received a CI at our center were identified and medical charts were reviewed for complications and CI patency. Function and quality of life were evaluated with the 36-item short form survey (SF-36), short health scale (SHS) and a local CI specific questionnaire for function and satisfaction. In Paper II, the Swedish national patient register (NPR) was used to identify all patients with an IBD diagnosis who had received a CI and data on diagnosis, demographics, reoperations, and excisions were obtained from the register. Paper III describes an ongoing prospective non-randomized, multi-center, open-label, controlled trial between IRA and IPAA in UC patients subjected to colectomy. The primary endpoint is satisfaction but Quality of Life (QoL), sexual function, bowel function and complications are also evaluated. In Paper IV, we invest

After colectomy there are four options available. The least complicated and most common is to leave the end ileostomy and not go for any reconstructive surgery. Then there is the ileal pouch anal anastomosis (IPAA) in which the rectum is removed, but the anal canal and a small rectal “cuff” is preserved. The pouch is created from the distal ileum and anastomosed to the rectal cuff. In the ileorectal anastomosis (IRA) the rectum is spared, and the distal ileum is anastomosed to the top of the rectum. In the continent ileostomy (CI), also referred to as the Kock pouch, the fecal flow is let out through the abdominal wall, but a pouch and a nipple valve mechanism is created making the stoma continent which needs to be manually emptied. This thesis aims to investigate function, quality of life, satisfaction, complications, and aspects associated with the chance of having reconstructive surgery after colectomy for inflammatory bowel disease (IBD), i.e. ulcerative colitis (UC) or Crohn’s disease (CD). The first two papers focus on the continent ileostomy, the most uncommon of the options after colectomy. In Paper 1 all patients who have received a CI at our center were identified and medical charts were reviewed for complications and CI patency. Function and quality of life were evaluated with the 36-item short form survey (SF-36), short health scale (SHS) and a local CI specific questionnaire for function and satisfaction. In Paper II, the Swedish national patient register (NPR) was used to identify all patients with an IBD diagnosis who had received a CI and data on diagnosis, demographics, reoperations, and excisions were obtained from the register. Paper III describes an ongoing prospective non-randomized, multi-center, open-label, controlled trial between IRA and IPAA in UC patients subjected to colectomy. The primary endpoint is satisfaction but Quality of Life (QoL), sexual function, bowel function and complications are also evaluated. In Paper IV, we invest

Composite materials are known to have superior stiffness and strength properties per unit weight compared to metallic materials. These properties and the ability to tailor the mechanical properties of composites is the main motivation for choosing composite materials for structural components. Design of composite structures requires consideration of many material, design and manufacturing factors to generate designs with desired behaviour. A promising approach to handle this is to use structural optimization (SO) in the design process to obtain composite structures with optimal performance. However, optimality often comes at the cost of robustness unless consideration is taken to uncertainty in the input data to the optimization problem. It is for example well-known that composite materials can exhibit significant variation of mechanical properties and it is thus important that this is accounted for in the optimization. In this thesis, SO methods for design of composite structures are developed, including continuous and discrete parametrization methods, a method for reducing the impact of cure-induced distortion of composite parts in manufacturing; and methods for handling uncertainty to ensure robustness of optimized designs. The focus has been to extend the SO methodology to handle material uncertainty associated with the mechanical properties of composite materials. An uncertainty parametrization was developed for the stiffness properties of a composite material based on a worst-case, or deterministic, approach. Using this parametrization, an uncertainty quantification was performed to investigate the influence of material uncertainty on the performance of optimized composite structures, indicating that the effect can be significant. Combining a discrete parametrization method with the uncertainty quantification, a deterministic method for handling material uncertainty in SO of composite structures was then proposed. This method consists of a min-max optimizat, Kompositmaterial har väldigt goda styvhets- och hållfasthetsegenskaper samt låg vikt jämfört med exempelvis metaller. Dessa egenskaper tillsammans med möjligheten att skräddarsy de mekaniska egenskaperna hos kompositstrukturer har varit de främsta skälen till att välja kompositmaterial vid tillverkning av strukturella komponenter. Utveckling av kompositstrukturer styrs av ett stort antal faktorer kopplat till materialval, design och tillverkning som är viktiga att ta hänsyn till. Ett sätt att hantera detta är att använda strukturoptimering (SO) för att generera kompositstrukturer med önskade mekaniska egenskaper. Vid tillämpning av SO tas oftast ingen hänsyn till osäkerhet i indata till optimeringsproblemet, vilket medför att prestandan hos den optimerade strukturen kan vara känslig för variation i indata. Då kompositmaterial kan uppvisa en betydande variation i de mekaniska egenskaperna är det viktigt att denna osäkerhet tas med i formuleringen av optimeringsproblemet för att säkerställa robustheten hos strukturen. Denna avhandling behandlar utveckling av SO-metoder för design av komposit-strukturer. Tonvikten i arbetet har varit att utveckla metoder som tar hänsyn till materialosäkerhet i kompositmaterial, och därmed förbättra robustheten hos optimerade designer. Första steget i detta arbete är utvecklingen av en ny teknik för diskret designparametrisering, kallad Hyperbolic Function Parametrization (HFP), vilken möjliggör simultan optimering av topologi och materialval för kompositstrukturer. Tekniken använder filter baserade på hyperboliska funktioner för att generera diskreta designvariabler som behandlar kompositdesignen. Vidare utvecklas en teknik för osäkerhetsparametrisering som inkluderar variation av styvhetsegenskaperna hos kompositmaterial. Denna teknik baseras på en deterministisk, värsta-fallsformulering. Tekniken tillämpas för osäkerhets-kvantifiering genom att undersöka inverkan av materialosäkerhet på prestandan hos optimerade kompositstrukturer. D, Funding: The research papers included in the dissertation have been funded as follows: Papers I and II received funding from the Swedish Foundation for Strategic Research (SSF) through grant agreement PV08.000.02. Papers III and V-VI received funding from the Swedish Energy Agency (Energimyndigheten) through grant agreement P48175-1. Paper IV received funding from the Clean Sky 2 Joint Undertaking under the EUs Horizon 2020 program through grant agreement 716864. Paper VII received funding from the Swedish Agency for Innovation Systems (Vinnova) through grant agreements 2022-01200 and 2022-20565.

Composite materials are known to have superior stiffness and strength properties per unit weight compared to metallic materials. These properties and the ability to tailor the mechanical properties of composites is the main motivation for choosing composite materials for structural components. Design of composite structures requires consideration of many material, design and manufacturing factors to generate designs with desired behaviour. A promising approach to handle this is to use structural optimization (SO) in the design process to obtain composite structures with optimal performance. However, optimality often comes at the cost of robustness unless consideration is taken to uncertainty in the input data to the optimization problem. It is for example well-known that composite materials can exhibit significant variation of mechanical properties and it is thus important that this is accounted for in the optimization. In this thesis, SO methods for design of composite structures are developed, including continuous and discrete parametrization methods, a method for reducing the impact of cure-induced distortion of composite parts in manufacturing; and methods for handling uncertainty to ensure robustness of optimized designs. The focus has been to extend the SO methodology to handle material uncertainty associated with the mechanical properties of composite materials. An uncertainty parametrization was developed for the stiffness properties of a composite material based on a worst-case, or deterministic, approach. Using this parametrization, an uncertainty quantification was performed to investigate the influence of material uncertainty on the performance of optimized composite structures, indicating that the effect can be significant. Combining a discrete parametrization method with the uncertainty quantification, a deterministic method for handling material uncertainty in SO of composite structures was then proposed. This method consists of a min-max optimizat, Kompositmaterial har väldigt goda styvhets- och hållfasthetsegenskaper samt låg vikt jämfört med exempelvis metaller. Dessa egenskaper tillsammans med möjligheten att skräddarsy de mekaniska egenskaperna hos kompositstrukturer har varit de främsta skälen till att välja kompositmaterial vid tillverkning av strukturella komponenter. Utveckling av kompositstrukturer styrs av ett stort antal faktorer kopplat till materialval, design och tillverkning som är viktiga att ta hänsyn till. Ett sätt att hantera detta är att använda strukturoptimering (SO) för att generera kompositstrukturer med önskade mekaniska egenskaper. Vid tillämpning av SO tas oftast ingen hänsyn till osäkerhet i indata till optimeringsproblemet, vilket medför att prestandan hos den optimerade strukturen kan vara känslig för variation i indata. Då kompositmaterial kan uppvisa en betydande variation i de mekaniska egenskaperna är det viktigt att denna osäkerhet tas med i formuleringen av optimeringsproblemet för att säkerställa robustheten hos strukturen. Denna avhandling behandlar utveckling av SO-metoder för design av komposit-strukturer. Tonvikten i arbetet har varit att utveckla metoder som tar hänsyn till materialosäkerhet i kompositmaterial, och därmed förbättra robustheten hos optimerade designer. Första steget i detta arbete är utvecklingen av en ny teknik för diskret designparametrisering, kallad Hyperbolic Function Parametrization (HFP), vilken möjliggör simultan optimering av topologi och materialval för kompositstrukturer. Tekniken använder filter baserade på hyperboliska funktioner för att generera diskreta designvariabler som behandlar kompositdesignen. Vidare utvecklas en teknik för osäkerhetsparametrisering som inkluderar variation av styvhetsegenskaperna hos kompositmaterial. Denna teknik baseras på en deterministisk, värsta-fallsformulering. Tekniken tillämpas för osäkerhets-kvantifiering genom att undersöka inverkan av materialosäkerhet på prestandan hos optimerade kompositstrukturer. D, Funding: The research papers included in the dissertation have been funded as follows: Papers I and II received funding from the Swedish Foundation for Strategic Research (SSF) through grant agreement PV08.000.02. Papers III and V-VI received funding from the Swedish Energy Agency (Energimyndigheten) through grant agreement P48175-1. Paper IV received funding from the Clean Sky 2 Joint Undertaking under the EUs Horizon 2020 program through grant agreement 716864. Paper VII received funding from the Swedish Agency for Innovation Systems (Vinnova) through grant agreements 2022-01200 and 2022-20565.

After colectomy there are four options available. The least complicated and most common is to leave the end ileostomy and not go for any reconstructive surgery. Then there is the ileal pouch anal anastomosis (IPAA) in which the rectum is removed, but the anal canal and a small rectal “cuff” is preserved. The pouch is created from the distal ileum and anastomosed to the rectal cuff. In the ileorectal anastomosis (IRA) the rectum is spared, and the distal ileum is anastomosed to the top of the rectum. In the continent ileostomy (CI), also referred to as the Kock pouch, the fecal flow is let out through the abdominal wall, but a pouch and a nipple valve mechanism is created making the stoma continent which needs to be manually emptied. This thesis aims to investigate function, quality of life, satisfaction, complications, and aspects associated with the chance of having reconstructive surgery after colectomy for inflammatory bowel disease (IBD), i.e. ulcerative colitis (UC) or Crohn’s disease (CD). The first two papers focus on the continent ileostomy, the most uncommon of the options after colectomy. In Paper 1 all patients who have received a CI at our center were identified and medical charts were reviewed for complications and CI patency. Function and quality of life were evaluated with the 36-item short form survey (SF-36), short health scale (SHS) and a local CI specific questionnaire for function and satisfaction. In Paper II, the Swedish national patient register (NPR) was used to identify all patients with an IBD diagnosis who had received a CI and data on diagnosis, demographics, reoperations, and excisions were obtained from the register. Paper III describes an ongoing prospective non-randomized, multi-center, open-label, controlled trial between IRA and IPAA in UC patients subjected to colectomy. The primary endpoint is satisfaction but Quality of Life (QoL), sexual function, bowel function and complications are also evaluated. In Paper IV, we invest

The Swedish Commission on Health Inequality defined health inequality as systematic differences in health between groups in society with different social positions. All avoidable socioeconomic health inequalities are unfair, and as stated by WHO's Commission on the Social Determinants of Health, we have a moral obligation to try to reduce them. "Putting these inequities right is a matter of social justice. Reducing health inequities is, for the Commission on Social Determinants of Health, an ethical imperative." This ethical imperative is especially apparent regarding the health of children and adolescents. Children’s right to the highest attainable standard of health is also enshrined in Article 24 of the Convention on the Rights of the Child. To reach the goal of a reduction of health inequalities, research is necessary to describe the social gradients of health. Research is also needed to better understand why these gradients occur. A better understanding and knowledge about health inequalities can lead to policies that reduce these inequalities and ensure children’s right to health. This thesis investigates social inequality in child health using data from a Swedish population-based prospective birth cohort, the All Babies in Southeast Sweden (ABIS) cohort. Social inequality in obesity in the ABIS cohort is also compared with other birth cohorts participating in the Elucidating Pathways to Child Health Inequality (EPOCH) collaboration which includes cohorts from six high-income countries; Sweden, the Netherlands, Canada (one national and one cohort from Quebec), UK, Australia, and USA. In Paper 1 we show that health inequalities in overweight and obesity are detectable already at two years of age and that these inequalities increase during childhood. In adolescents, low socioeconomic status increases the risk of becoming overweight and the risk of components of the metabolic syndrome, including high blood pressure and dyslipidemia (low high-density cholesterol)., Hälsoojämlikhet definierades av den Svenska kommissionen för jämlik hälsa som "systematiska skillnader i hälsa mellan samhällsgrupper med olika social position." Debatten om de bakomliggande orsakerna till hälsoojämlikhet tog fart efter att rapporten "the Black Report" kom ut i Storbritannien på 1980-talet. I denna rapport konstaterades att ojämlikheten i hälsa hade ökat mellan socioekonomiska grupper trots införandet av fri sjukvård och andra samhällsförbättringar. Orsakerna till den ökande ojämlikheten har sedan dess debatterats och ett antal teorier har lagts fram för att förklara fenomenet. Fortfarande råder det dock oenighet kring hur de olika bakomliggande faktorerna leder fram till skillnaderna i hälsa. Internationella organisationer har samtidigt arbetat för att minska skillnaderna, bland annat WHO som 2008 bildades "the Commission on Social Determinants of Health". Denna kommission slog fast i sin rapport att vi alla har en moralisk plikt att minska skillnaderna i hälsa; "Att ställa dessa skillnader till rätta handlar om social rättvisa. Att minska hälsoojämlikhet är för kommissionen ett etiskt imperativ". Rätten till bästa möjliga hälsa slås också fast i Barnkonventionen, artikel 24. För att kunna minska hälsoojämlikheter behöver man studera inom vilka områden/sjukdomar skillnader uppstår och varför, med målet att utforma åtgärder för att minska skillnaderna. Denna avhandling syftar till att studera socioekonomiska skillnader i barns hälsa. Avhandlingen baseras på data från den svenska prospektiva födelsekohortstudien Alla Barn i Sydöstra Sverige (ABIS). Social ojämlikhet i övervikt och obesitas jämförs även med den sociala ojämlikheten i motsvarande data från födelsekohorter i fem andra höginkomstländer; Nederländerna, Kanada, Storbritannien, Australien och USA. Resultaten från Studie 1 visade att socioekonomiska skillnader i risken att utveckla obesitas kan upptäckas redan vid 2 års ålder och att denna skillnad i risk ökade under uppväxten. I tonåren fra

The Swedish Commission on Health Inequality defined health inequality as systematic differences in health between groups in society with different social positions. All avoidable socioeconomic health inequalities are unfair, and as stated by WHO's Commission on the Social Determinants of Health, we have a moral obligation to try to reduce them. "Putting these inequities right is a matter of social justice. Reducing health inequities is, for the Commission on Social Determinants of Health, an ethical imperative." This ethical imperative is especially apparent regarding the health of children and adolescents. Children’s right to the highest attainable standard of health is also enshrined in Article 24 of the Convention on the Rights of the Child. To reach the goal of a reduction of health inequalities, research is necessary to describe the social gradients of health. Research is also needed to better understand why these gradients occur. A better understanding and knowledge about health inequalities can lead to policies that reduce these inequalities and ensure children’s right to health. This thesis investigates social inequality in child health using data from a Swedish population-based prospective birth cohort, the All Babies in Southeast Sweden (ABIS) cohort. Social inequality in obesity in the ABIS cohort is also compared with other birth cohorts participating in the Elucidating Pathways to Child Health Inequality (EPOCH) collaboration which includes cohorts from six high-income countries; Sweden, the Netherlands, Canada (one national and one cohort from Quebec), UK, Australia, and USA. In Paper 1 we show that health inequalities in overweight and obesity are detectable already at two years of age and that these inequalities increase during childhood. In adolescents, low socioeconomic status increases the risk of becoming overweight and the risk of components of the metabolic syndrome, including high blood pressure and dyslipidemia (low high-density cholesterol)., Hälsoojämlikhet definierades av den Svenska kommissionen för jämlik hälsa som "systematiska skillnader i hälsa mellan samhällsgrupper med olika social position." Debatten om de bakomliggande orsakerna till hälsoojämlikhet tog fart efter att rapporten "the Black Report" kom ut i Storbritannien på 1980-talet. I denna rapport konstaterades att ojämlikheten i hälsa hade ökat mellan socioekonomiska grupper trots införandet av fri sjukvård och andra samhällsförbättringar. Orsakerna till den ökande ojämlikheten har sedan dess debatterats och ett antal teorier har lagts fram för att förklara fenomenet. Fortfarande råder det dock oenighet kring hur de olika bakomliggande faktorerna leder fram till skillnaderna i hälsa. Internationella organisationer har samtidigt arbetat för att minska skillnaderna, bland annat WHO som 2008 bildades "the Commission on Social Determinants of Health". Denna kommission slog fast i sin rapport att vi alla har en moralisk plikt att minska skillnaderna i hälsa; "Att ställa dessa skillnader till rätta handlar om social rättvisa. Att minska hälsoojämlikhet är för kommissionen ett etiskt imperativ". Rätten till bästa möjliga hälsa slås också fast i Barnkonventionen, artikel 24. För att kunna minska hälsoojämlikheter behöver man studera inom vilka områden/sjukdomar skillnader uppstår och varför, med målet att utforma åtgärder för att minska skillnaderna. Denna avhandling syftar till att studera socioekonomiska skillnader i barns hälsa. Avhandlingen baseras på data från den svenska prospektiva födelsekohortstudien Alla Barn i Sydöstra Sverige (ABIS). Social ojämlikhet i övervikt och obesitas jämförs även med den sociala ojämlikheten i motsvarande data från födelsekohorter i fem andra höginkomstländer; Nederländerna, Kanada, Storbritannien, Australien och USA. Resultaten från Studie 1 visade att socioekonomiska skillnader i risken att utveckla obesitas kan upptäckas redan vid 2 års ålder och att denna skillnad i risk ökade under uppväxten. I tonåren fra