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Background Not having an established relationship is associated with an elevated risk of Chlamydia trachomatis (CT) infection, but this might reflect selection into and out of unions. Although union formation and union separation are common events in reproductive age, little is known about changes in CT risk before and after these transitions. Methods We linked Finnish Population Register data to the National Register of Infectious Diseases and used fixed-effects linear probability models that account for all time-invariant confounders to examine changes in women's 6-month CT risk 3 years before and 3 years after entry into first cohabitation (n  = 293 554), non-marital separation (n  = 201 647) or marital separation (n  = 92 232) during 2005–14. Results From 3 years to 1 year before first union formation, the 6-month risk of CT increased slightly, peaking at 1.27% immediately prior to union formation (95% confidence interval 1.22–1.31). It declined sharply following union formation, being only 0.40% (0.34–0.46) 6–12 months after union formation with little changes thereafter. Among women separating from non-marital unions, the risk increased from 0.50% (0.42–0.57) to 1.45% (1.40–1.49) around the time of separation and decreased following separation. The pattern of findings was relatively similar for marital separation, although the observed risks and changes were smaller in magnitude. Conclusions Our results based on longitudinal data and individual fixed-effects models indicate that the period immediately after separation may be causally associated with an elevated risk of CT. This suggests that recently separated women should be identified as a high-risk group for CT. [ABSTRACT FROM AUTHOR]

Background: Symptoms of depression and anxiety are elevated among parents of children with cancer. However, knowledge of parents' psychotropic medication use following child's cancer diagnosis is scarce. Methods: We use longitudinal Finnish register data on 3266 mothers and 2687 fathers whose child (aged 0–19) was diagnosed with cancer during 2000–2016. We record mothers' and fathers' psychotropic medication use (at least one annual purchase of anxiolytics, hypnotics, sedatives, or antidepressants) 5 years before and after the child's diagnosis and assess within‐individual changes in medication use by time since diagnosis, cancer type, child's age, presence of siblings, and parent's living arrangements and education using linear probability models with the individual fixed‐effects estimator. The fixed‐effects models compare each parent's annual probability of psychotropic medication use after diagnosis to their annual probability of medication use during the 5‐year period before the diagnosis. Results: Psychotropic medication use was more common among mothers than fathers already before the child's diagnosis, 11.2% versus 7.3%. Immediately after diagnosis, psychotropic medication use increased by 6.0 (95% CI 4.8–7.2) percentage points among mothers and by 3.2 (CI 2.1–4.2) percentage points among fathers. Among fathers, medication use returned to pre‐diagnosis level by the second year, except among those whose child was diagnosed with acute lymphoblastic leukemia or lymphoblastic lymphoma. Among mothers of children with a central nervous system cancer, medication use remained persistently elevated during the 5‐year follow‐up. For mothers with other under‐aged children or whose diagnosed child was younger than 10 years, the return to pre‐diagnosis level was also slow. Conclusions: Having a child with cancer clearly increases parents' psychotropic medication use. The increase is smaller and more short‐lived among fathers, but among mothers its duration depends on both cancer type and family characteristics. Our results suggest that an increased care burden poses particular strain to the long‐term mental well‐being of mothers. [ABSTRACT FROM AUTHOR]

Background: In many countries smoking rates have declined and obesity rates have increased, and social inequalities in each have varied over time. At the same time, mortality has declined in most high-income countries, but gaps by educational qualification persist—at least partially due to differential smoking and obesity distributions. This study uses a compass typology to simultaneously examine the magnitude and trends in educational inequalities across multiple countries in: a) smoking and obesity; b) smoking-related mortality and c) cause-specific mortality. Methods: Smoking prevalence, obesity prevalence and cause-specific mortality rates (35–79 year olds by sex) in nine European countries and New Zealand were sourced from between 1980 and 2010. We calculated relative and absolute inequalities in prevalence and mortality (relative and slope indices of inequality, respectively RII, SII) by highest educational qualification. Countries were then plotted on a compass typology which simultaneously examines trends in the population average rates or odds on the x-axis, RII on the Y-axis, and contour lines depicting SII. Findings: Smoking and obesity. Smoking prevalence in men decreased over time but relative inequalities increased. For women there were fewer declines in smoking prevalence and relative inequalities tended to increase. Obesity prevalence in men and women increased over time with a mixed picture of increasing absolute and sometimes relative inequalities. Absolute inequalities in obesity increased for men and women in Czech Republic, France, New Zealand, Norway, for women in Austria and Lithuania, and for men in Finland. Cause-specific mortality. Average rates of smoking-related mortality were generally stable or increasing for women, accompanied by increasing relative inequalities. For men, average rates were stable or decreasing, but relative inequalities increased over time. Cardiovascular disease, cancer, and external injury rates generally decreased over time, and relative inequalities increased. In Eastern European countries mortality started declining later compared to other countries, however it remained at higher levels; and absolute inequalities in mortality increased whereas they were more stable elsewhere. Conclusions: Tobacco control remains vital for addressing social inequalities in health by education, and focus on the least educated is required to address increasing relative inequalities. Increasing obesity in all countries and increasing absolute obesity inequalities in several countries is concerning for future potential health impacts. Obesity prevention may be increasingly important for addressing health inequalities in some settings. The compass typology was useful to compare trends in inequalities because it simultaneously tracks changes in rates/odds, and absolute and relative inequality measures. [ABSTRACT FROM AUTHOR]

Focuses on socioeconomic differences in weight gain and determinants and consequences of coronary risk factors among civil servants in London, England. Body mass index; Obesity.