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Objective: To study the awareness of the Heart Symbol in different age and educational groups, and changes in the awareness over a 9-year period. In addition, the reported use of products with the symbol was examined.Design: A series of annual cross-sectional postal surveys on Health Behaviour and Health among the Finnish Adult Population.Setting: A random sample (n 5000 per annum) from the Finnish population aged 15-64 years, drawn from the National Population Register, received a questionnaire.Subjects: Men and women (n 29 378) participating in the surveys in 2000-2009.Results: At the early 2000s, 48 % of men and 73 % of women reported to be familiar with the symbol. The corresponding rates were 66 % for men and 91 % for women in 2009. The reported use of products with the symbol increased from 29 % to 52 % in men and from 40 % to 72 % in women. In men, the awareness did not vary by age, whereas older women (45-64 years) were less likely to be aware of the symbol compared with younger women (25-34 years). Men and women with the highest education were best aware of the symbol and more likely to use the products in the early 2000s. The educational differences diminished or disappeared during the study period.Conclusions: The majority of Finnish adults are familiar with the Heart Symbol, and the reported use of such products increased in all age and educational groups, especially among the less educated. The symbol may work as an effective measure to diminish nutrition-related health inequalities. [ABSTRACT FROM AUTHOR]

Objectives: To determine socio-economic differences from 1994 to 2004 in the use of butter and milk in Pitkäranta in the Republic of Karelia, Russia and North Karelia, Finland.Methods: Health behaviour surveys in Pitkäranta (n = 3,599) and North Karelia (n = 3,652) in 1994, 1996, 1998, 2000 and 2004.Results: A clear overall decrease occurred in the use of butter in cooking in Pitkäranta from 1994 to 2004. In both areas, subjects with lower education used butter in cooking and drank fat-containing milk more often. Regarding butter on bread, the educational patterns in the two areas were opposite: in Pitkäranta, subjects with lower education used butter less often but in North Karelia, they used butter on bread more often. Practically, no changes in socio-economic differences from 1994 to 2004 were observed in either area.Conclusions: The socio-economic differences in the use of dairy fat were stable in both areas but larger in North Karelia than in Pitkäranta. Our results support earlier assumptions of a weaker role of education as a determinant of health in Russia than in the western societies. [ABSTRACT FROM AUTHOR]

BACKGROUND: Despite their clear association with health, smoking and alcohol consumption among elderly people have not been extensively researched. This study examined changes in smoking and alcohol consumption and their sociodemographic patterning among the Finnish population aged 65-79 years over the period 1985-2001. METHODS: Population-based monitoring surveys conducted biennially from 1985 to 2001 were pooled into three time periods. Trends in smoking and alcohol consumption and their sociodemographic variations among 5870 men and 5923 women were calculated. Logistic regression was used as the main method of analysis. RESULTS: Smoking declined slightly among men, and consumption of higher levels of alcohol rose in both genders from the mid-1980s to the early 2000s. Smoking among women remained at a very low level throughout the study period. Smoking and higher level of alcohol consumption were more prevalent among the younger elderly and among the men than among their counterparts. Higher alcohol use was more common among retired office workers than other former employees. Smoking was clearly more prevalent among unmarried than married people. CONCLUSIONS: Declining numbers of male smokers and remarkably few female smokers, together with positive changes already noted in diet and functional ability, suggest healthier senior years ahead. On the other hand, the rising trend of alcohol use poses a challenge to future public health. © 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved. [ABSTRACT FROM AUTHOR]

Objectives: No previous study has analysed age-, period-, and cohort-related long-term trends in toothbrushing frequency among adults using a nationally representative data set. Our aim was to study age, period, and cohort effects on toothbrushing among 15- to 64-year-olds in Finland from 1978 to 2014., Methods: Data were gathered by nationally representative random cross-sectional samples of 15- to 64-year-old Finns annually from 1978 to 2014, during which response rates decreased from 84% to 53%. The final pooled sample size was 119,665. An age-period-cohort model was used to separate the effects of age, period, and cohort on trends in men's and women's toothbrushing frequency., Results: From 1978 to 2014, the proportion of respondents who brushed at least twice a day or once a day increased from 42% to 66% and from 83% to 95%, respectively. The proportion of respondents who brushed at least twice a day increased from 27% to 53% among men and from 60% to 75% among women. Increases in at least once-a-day toothbrushing were smaller in both sexes, and in women the increase was minimal over the study years. The increase in toothbrushing frequency occurred particularly among those older than 40 years of age. In men, toothbrushing frequency increased steadily cohort by cohort (cohort effect) and within a single cohort as men in the cohort got older (longitudinal age trend). Instead, in women the cohort effect and longitudinal age trend in toothbrushing were smaller at both frequency thresholds., Conclusions: On the population level, favourable changes in toothbrushing habits occurred among adult Finns from 1978 to 2014, especially in men., Competing Interests: Conflicts of interest None disclosed., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: Nationally representative studies on socioeconomic differences in toothache prevalence are very limited, especially with a long follow-up period. Our aim was to examine the education-related differences in toothache prevalence among 25- to 64-year-olds in Finland during 1990-2014., Methods: We used data from the Health Behaviour and Health Among the Finnish Adult Population surveys. Data were gathered by random samples of 15- to 64-year-old Finns annually between 1990 and 2014. Response rates decreased during this period from 76% (n = 3812) to 53% (n = 2630). Our final pooled total sample size was 63 372 after exclusion of edentate participants and missing data. Relative educational level was used to measure socioeconomic position. In addition to basic tabulations, educational differences in toothache prevalence during the past month were investigated using the multiple additive regression tree for mediation analysis., Results: The proportion of respondents who reported having had toothache during the past month increased from 7% to 12% from 1990 to 2014. Educational differences in toothache prevalence were small for the whole study period, especially in women. Men with high relative education had a lower toothache prevalence than people with low relative education during 1990-1994 and 2010-2014. This stemmed from the direct effect of relative education and the indirect effects of toothbrushing frequency, number of missing teeth and perceived health. In both sexes, those with middle-level relative education had higher toothache prevalence than people with low relative education 1995-2009., Conclusions: During 1990-2014, toothache prevalence increased among 25- to 64-year-olds in Finland. Since the mid-1990s, differences in toothache prevalence by relative education remained very small in both sexes. More actions are needed to understand reasons behind the clearly increased toothache prevalence in Finland during the last decades., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Information on long-term trends in toothache prevalence is scarce. The aim of this study was to assess age-, period-, and cohort-related changes in toothache prevalence among 15- to 64-yr-old adults in Finland between 1990 and 2014 by using annual, representative postal surveys, albeit with decreasing response rates from 76% (n = 3,812) to 53% (n = 2,630). Age-period-cohort analysis of toothache prevalence during the past month was performed. Logistic regression analyses were conducted to account for other factors contributing to toothache. Toothache prevalence increased from 7% to 12% during the time period 1990 to 2014. Age-period-cohort analysis revealed that toothache prevalence increased from cohort to cohort, especially from the 1960 birth cohorts onwards (cohort effect). Adults under 30 yr of age had the highest toothache prevalence (~17%), while, in those over 30 yr of age, toothache prevalence decreased steadily according to age (to ~5% at age 64 yr, age effect). Toothache prevalence peaked at ~ 11% in the mid-2000s (period effect). Toothache was strongly associated with poorer perceived health and lower toothbrushing frequency and less strongly associated with higher educational level, a higher number of missing teeth, history of smoking, being single, separated, or divorced, and female gender. The increase in toothache prevalence occurred especially from 1990 to the mid-2000s, and mainly among younger age groups and more recent cohorts., (© 2019 Eur J Oral Sci.)

Health inequalities exist across countries and populations, but little is known about their long-term trends and even less about factors shaping the trends. We examined the magnitude of absolute and relative educational inequalities in self-rated health over 36 years among Finnish adults, considering individual covariates and macro-economic fluctuations. Our data were derived from representative annual cross-sectional surveys in 1979-2014 conducted among adult men and women. Participants aged 25-64 were included and nine periods used (n = 8870-14235). Our health outcome was less-than-good self-rated health (SRH) and our socioeconomic indicator was completed years of education as a continuous variable. Educational inequalities in self-rated health were analysed using the relative index of inequality (RII) and the slope index of inequality (SII). Nine time-variant sociodemographic and health-related covariates were included in the analyses. Linear trends suggested stable or slightly curvilinear overall trends in both absolute and relative health equalities over 36 years. Among men, absolute and relative inequalities narrowed immediately after economic recession in Finland in 1993-1994. Among women, inequalities narrowed during financial crisis in 2008-2009. Adjusting for most covariates reduced the magnitude of inequalities throughout the nine periods, but affected little the temporal patterning of health inequalities. Educational inequalities in self-rated health remained during 36 years in Finland. While among men and women health inequalities narrowed during and after recessions, they widened soon back to the pre-recession level. The perseverance of the trends calls for novel and powerful measures to tackle health inequalities., Competing Interests: None., (© 2019 The Authors.)

Objective: The aim of this study was to examine long-term trends in the receipt of medicines information (MI) among adult medicine users from 1999 to 2014., Design: Repeated cross-sectional postal survey from the years 1999, 2002, 2005 and 2008-2014., Setting: Each study year, a new nationally representative sample of 5000 Finns aged 15-64 years was drawn from the Population Register Centre of Finland., Participants: The range of annual respondents varied from 2545 to 3371 and response rates from 53% to 67%. Of the total responses (n=29 465), 64% were from medicine users (n=18 862, ranging by year from 58% to 68%)., Outcome Measures: Receipt of information on medicines in use within 12 months prior to the survey from a given list of consumer MI sources available in Finland., Results: Physicians, community pharmacists and package leaflets were the most common MI sources throughout the study period. Receipt of MI increased most from the Internet (from 1% in 1999 to 16% in 2014), while decreased most from physicians (62% to 47%) and package leaflets (44% to 34%), and remained stable from community pharmacists (46% to 45%) and nurses (14% to 14%). In 1999, of the medicine users 4% did not report receipt of MI from any of the sources listed in the survey, while this proportion had remarkably increased to 28% in 2014., Conclusions: Healthcare professionals and package leaflets had still a dominating importance in 2014 despite the growing number of MI sources over time, but still a minority of adult medicine users reported receiving MI via the Internet in 2014. Worrying is that the proportion of adult medicine users who did not receive MI from any of the sources became seven fold during the study period., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Reasons for socioeconomic inequalities in alcohol harm are not sufficiently understood. One explanation relates to differential exposure to alcohol by socioeconomic status (SES). The present study investigated socioeconomic inequalities in alcohol use in two countries with high alcohol consumption and alcohol harm., Methods: Data from nationally representative surveys in 2009-2010 in Chile and in 2008-2011 in Finland were used. Surveys comprised 3477 participants in Chile and 9994 in Finland aged 30-64 years. Outcome measures included abstinence, weekly consumption of pure alcohol, heavy volume drinking and heavy episodic drinking (HED). We employed a novel method in alcohol research, the concentration index, to measure socioeconomic inequalities., Results: Alcohol abstinence showed a strong association with lower SES in Chile and Finland. These were largely driven by inequalities among women in Chile and older subgroups in Finland. In both countries, women aged 45-64 of higher SES showed higher weekly consumption of pure alcohol and heavy volume drinking. Heavy volume drinking among Chilean women aged 45-64 showed the highest inequality, favouring higher SES. HED was equally distributed among SES groups in Chile; in Finland HED disproportionally affected lower SES groups., Conclusions: Lower SES was associated with higher abstinence rates in both countries and heavy episodic drinking in Finland. Heavy volume drinking was more prevalent in middle-aged women of high SES. The results identified groups for targeted interventions, including middle-aged higher SES women, who traditionally have not been specifically targeted. The concentration index could be a useful measure of inequalities in alcohol use., (Copyright © 2017 Elsevier B.V. All rights reserved.)

In recent years studies on cultural consumption have experienced a Bourdieusian renaissance. This is indicated by a growing body of research analysing distinctions in different areas of culture, and numerous studies on the homology thesis applying the concepts of distinction, field and capital. Concurrently, however, it has been argued that instead of distinctive tastes, distinction and class status are increasingly manifested by cultural omnivorousness. For a good part studies focussing on distinction in food have analysed eating out and stylization through restaurant preferences, rather than everyday food choices. In this article we investigate everyday food choices from the perspective of distinction and omnivorousness. Our analysis draws on cross-sectional quantitative data collected in 2012 among 15-64-year-old Finns (N = 2601). The article maps out the relationship between food choice frequencies, dispositions and social background with Multiple Correspondence Analysis (MCA). The results show that the consumption of fruit and vegetables, ready-meals and convenience foods were among the most divisive food choices. The first structuring dimension juxtaposed processed, fatty and sugared foods with unprocessed foods and fresh ingredients. This dimension was associated with healthiness and weight control as dispositions. On the second structuring dimension there were differences in the valuation of taste, pleasure and sociability, and a contrast between moderate and restrictive choices. Particularly the first dimension was associated with educational, occupational, and gender differences. Distinction within everyday food choices was manifested in the use of healthy and unprocessed foods and 'moderate hedonism' in contrast to more restrictive tastes., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: Prevalence estimates may be biased if the characteristics of respondents differ from those of non-respondents in surveys. In this study, we used a follow-up telephone interview of initial non-respondents to examine the differences--in terms of self-rated health and health behaviours--to initial postal respondents and to assess improvements in prevalence estimates., Methods: Following a postal questionnaire survey using a random sample (n = 5000) of the Finnish working-age population with a response rate of 57% (n = 2826), a follow-up telephone survey was performed based on 1261 non-respondents (response rate 56%, n = 708) in 2010. Prevalence of smoking, alcohol use, body mass index, physical activity, self-rated fitness, dietary habits and self-rated health were calculated for the survey population with and without a telephone interview. Logistic regression models were used to examine differences in health behaviours and health between the initial postal questionnaire respondents and follow-up telephone interview respondents., Results: The total response rate increased from 57% to 71% when the telephone respondents were included. The telephone survey indicated that both male and female telephone respondents were more often smokers, and female telephone respondents were more often heavy episodic drinkers and less often reported poor self-rated fitness than postal respondents. Nonetheless, the prevalence rates of outcome variables did not change significantly when telephone respondents were included., Conclusion: The response rate of surveys can be increased by using a telephone survey in follow-up contacts with non-respondents. As non-respondents differ from respondents, this contributes to an improvement--although small--in internal validity., (© The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

Background: Low-carbohydrate (LC) diets have gained substantial media coverage in many Western countries. Little is, however, known about the characteristics of their followers., Objective: The article analyses how those who report following an LC diet differ from the rest of the population in their background, food choices, weight reduction status, as well as food-related perceptions and motives. The data are a part of the Health Behaviour and Health among the Finnish Adult Population survey collected in spring 2012 (n=2,601), covering 15- to 64-year-old Finns., Results: Seven per cent of the respondents identified themselves as followers of the LC diet. Gender and education were not associated with following an LC diet. The youngest respondents were the least likely to follow such a diet. The LC diet group preferred butter but also vegetables more commonly than the other respondents and were less likely to use vegetable bread spreads. The followers of the LC diet and the other respondents agreed about the healthiness of whole grain, vegetable oils, vegetables, and fruits and berries, and of the harmfulness of white wheat. Compared to the other respondents, the LC diet group was less likely to regard eating vegetable/low-fat products as important, more likely to regard eating healthy carbohydrates, and the health and weight-managing aspects of foods, as important and placed less value on sociability and pleasures connected to food. The results showed varying food choices among the followers of the LC diet: some even reported that they were not avoiding carbohydrates, sugars, and white wheat in their diet., Conclusions: Planners of nutrition policies should follow-up on new diets as they emerge and explore the food choices and motives of their followers and how these diets affect the food choices of the whole population.

Background: The late-2000s financial crisis had a severe impact on the national economies on a global scale. In Europe, the Baltic countries were among those most affected with more than a 20% decrease in per capita gross domestic product in 2008-2009. In this study, we explored the effects of economic recession on self-rated health in Estonia and Lithuania using Finland, a neighbouring Nordic welfare state, as a point of reference., Methods: Nationally representative cross-sectional data for Estonia (n=10 966), Lithuania (n=7249) and Finland (n=11 602) for 2004-2010 were analysed for changes in age-standardised prevalence rates of less-than-good self-rated health and changes in health inequalities using logistic regression analysis., Results: The prevalence of less-than-good self-rated health increased slightly (albeit not statistically significantly) in all countries during 2008-2010. This was in sharp contrast to the statistically significant decline in the prevalence of less-than-good health in 2004-2008 in Estonia and Lithuania. Health disparities were larger in Estonia and Lithuania when compared to Finland, but decreased in 2008-2010 (in men only). In Finland, both the prevalence of less-than-good health and health disparities remained fairly stable throughout the period., Conclusions: Despite the rapid economic downturn, the short-term health effects in Estonia and Lithuania did not differ from those in Finland, although the recession years marked the end of the previous positive trend in self-rated health. The reduction in health disparities during the recession indicates that different socioeconomic groups were affected disproportionately; however, the reasons for this require further research., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Background: Gambling problems currently affect approximately 100,000 Finns. In order to prevent and reduce gambling-related harms it is crucial for the Finnish public health authorities to gain a stronger understanding of the association between gambling problems and related socio-demographic factors, other commonly co-occurring dependencies (e.g. alcohol and nicotine) and the type of games gambled. In this article the prevalence of problem gambling in Finland and the socio-demographic profiles of problem gamblers are studied., Method: An annual postal survey entitled Health Behaviour and Health among the Finnish Adult Population AVTK was sent to a random sample of Finnish adults (N=5000) aged between 15 and 64. The sample was derived from the Finnish Population Register. The survey was mailed to the participants in April 2010. Gender differences in socio-demographic variables and Problem Gambling Severity Index PGSI were assessed. A multinomial regression model was created in order to explore the association between socio-demographic factors and the severity of gambling., Results: A total of 2826 individuals (1243 males and 1583 females) replied to the survey. Of the respondents, 1.1% (2.1% of males, 0.3% of females) were identified as problem gamblers. Those who were of younger age, gender, had less than twelve years of education, consumed alcohol at risk level and smoked had higher odds of having low or moderate levels of gambling problems. Whereas, unemployment and smoking predicted significantly for problem gambling. Females gambled Lotto and slot machines less frequently than males and had more low level gambling problems. Males gambled more with a higher frequency and had a more severe level of gambling problems. Females were more attracted to scratch card gambling and daily Keno lotteries compared to males. In comparison, males gambled more on internet poker sites than females. Overall, a high frequency of gambling in Lotto, daily lotteries, slot machines, horse race betting and internet gambling was significantly associated with a more severe level of problem gambling., Conclusion: Gambling problems affect tens of thousands of individuals annually, therefore certain vulnerabilities should be noted. Comorbid dependencies, smoking in particular, ought to be screened for and recognised in the public health sector. Regulating the availability of slot machine gambling and enforcement of the age limit should be acknowledged. In establishing new gambling venues, prevalence rates in those particular areas should be actively monitored.

Objective: Nowadays, most patients with celiac disease are diagnosed in adulthood. However, undetected disease may already have been present in childhood and may have subsequently affected growth. Earlier data on the eventual adult height of patients with celiac disease have been scant and inconsistent. We aimed to assess the final height in a large cohort of symptom-detected and screen-detected patients with celiac disease diagnosed in adulthood., Patients and Methods: The height of 1084 patients with celiac disease diagnosed in adulthood was determined in five separate birth cohorts between the years 1920 and 1989. Further, the patients were evaluated in three different subgroups depending on whether they were diagnosed on the basis of gastrointestinal or extraintestinal symptoms or by serological screening. The population-based control group included 112 340 patients in equal birth cohorts., Results: In general, the mean adult height of patients with celiac disease was at the same level as in the population at large. In subgroup analysis, men with intestinal symptoms were shorter than the population controls in the birth cohort 1948-1961, and a similar trend was observed in the older cohorts. In women, the mean height was also reduced in the older birth cohorts, but predominantly among screen-detected patients. In the younger birth cohorts, height was reduced in neither sex compared with the population., Conclusion: In general, the mean adult height of patients with celiac disease is at the same level as that of the general population. In a subgroup analysis, reduced height was observed in some of the older, but not younger, birth cohorts.

Background: The increasing concentration of populations into large conurbations in recent decades has not been matched by international health assessments, which remain largely focused at the country level. We aimed to demonstrate the use of routine survey data to compare the health of large metropolitan centres across Europe and determine the extent to which differences are due to socio-economic factors., Methods: Multilevel modelling of health survey data on 126,853 individuals from 33 metropolitan areas in the UK, Republic of Ireland, Sweden, Norway, Finland, Spain, Belgium and Germany compared general health, longstanding illness, acute sickness, psychological distress and obesity with the average for all areas, accounting for education and social class., Results: We found some areas (Greater Glasgow; Greater Manchester, Cheshire and Merseyside; Northumberland, Tyne and Wear and South Yorkshire) had significantly higher levels of poor health. Other areas (West Flanders and Antwerp) had better than average health. Differences in individual socio-economic circumstances did not explain findings. With a few exceptions, acute sickness levels did not vary., Conclusion: Health tended to be worse in metropolitan areas in the north and west of the UK and the central belt and south east of Germany, and more favourable in Sweden and north west Belgium, even accounting for socio-economic composition of local populations. This study demonstrated that combining national health survey data covering different areas is viable but not without technical difficulties. Future comparisons between European regions should be made using standardized sampling, recruitment and data collection protocols, allowing proper monitoring of health inequalities.

Objectives: To examine nonparticipation in a survey by linking it with register information and identify potential nonresponse bias of inequalities in health status among aging people., Study Design and Setting: Cross-sectional questionnaire survey with clinical checkups carried out in 2002 among persons born in 1926-1930, 1936-1940, and 1946-1950 in Southern Finland. The sample was linked with register information from Statistics Finland and analyzed in terms of participation and health status as measured by medicine reimbursements., Results: Participation in the survey was more frequent among those who were older, female, married or cohabiting, higher educated and nonurban residents, and those with higher income and moderate health. Among nonrespondents, women were less healthy than men, whereas among respondents, the results were reversed. Among nonrespondents, better income was associated with unfavorable health. Poor health was generally more common among nonrespondents than respondents in several subgroups., Conclusion: Differences in response rates were found in sociodemographic factors, health, and socioeconomic position. Favorable health was generally more frequent among respondents than nonrespondents. In particular, health inequalities by gender and income differed between respondents and nonrespondents. Thus, nonresponse may lead to bias in analyses of health inequalities among aging people., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Aims: The present study examined time trends and associations in exposure to secondhand smoke (SHS) at work in Finland in 1985-2008 and compliance with national smoke-free workplace legislation that has been enforced since 1995., Methods: The study population comprised respondents of nationally representative annual postal surveys from 1985 to 2008. The differences in the prevalence of SHS-exposed respondents were measured with particular reference to workplace size and workplace smoking arrangements., Results: From 1985 to 2008 daily exposure to SHS at work decreased in all workplaces. The annual decrease was largest in 1994-95 when the smoke-free workplace legislation was enacted. The proportion of exposed employees in workplaces with designated smoking rooms was two-fold compared to employees in workplaces where no one smoked, and this ratio remained unchanged between 1995 and 2008. Employees in small workplaces were exposed most and exposure to SHS was lowest in the largest workplaces., Conclusions: Totally smoke-free workplaces give better protection against the exposure to SHS than workplaces with designated smoking areas. We urge a law reform that does not allow any designated smoking rooms indoors. In the prevention of SHS exposure, special attention should be directed to small workplaces.

Background: People with mental disorders often report unmet medicine information needs and may search for information on medicines from sources including the Internet, telephone services, books and other written materials., Objective: This study aimed to identify and describe the sources of medicines information used by people with and without mental disorders., Methods: A cross sectional postal survey was mailed to a nationally representative sample (n = 5,000) of Finns aged 15-64 years in spring 2005. Completed responses were received from 3,287 people (response rate 66%), of whom 2,348 reported using one or more sources of medicines information during the past 12 months. Of those who reported one or more sources of medicines information, 10% (n = 228) reported being diagnosed with or treated for a mental disorder. The main outcome measures were the sources of medicines information used by people who did and did not report being diagnosed with or treated for a mental disorder., Results: Among respondents with and without a mental disorder, physicians (83 vs. 59%), pharmacists (56 vs. 49%) and patient information leaflets (53 vs. 43%) were the most common sources of medicines information. After adjusting for age, gender, level of education, working status and number of chronic diseases, respondents with mental disorders were more likely to use patient information leaflets (OR 1.47, 95% CI 1.06-1.98) and the Internet (OR 1.64, 95% CI 1.02-2.64) as sources of medicines information than respondents without mental disorders., Conclusions: The results indicate that physicians and pharmacists are the most common sources of medicines information among people both with and without mental disorders. However, patient information leaflets and the Internet were more commonly used by people with mental disorders. There may be an opportunity for clinicians to better exploit these sources of medicines information when developing medicines information services for people with mental disorders.

Health and dietary monitoring has a long history in Finland. The aim of this review is to summarise the main sources of Finnish dietary information including food balance sheets, household budget survey data, questionnaires related to dietary behaviour and risk factors of main chronic diseases as well as dietary surveys. According to these sources, dietary behaviour and food choices have changed considerably during the last decades. For example, the total fat intake (E %) has decreased remarkably from nearly 40 % in the late 1960s to close to 30 % in 2007. Furthermore, the type of fat consumed has changed noticeably due to the increased popularity of oil used in cooking and the large variety of softer spreads available. There has also been a notable decrease in intake of salt, and a multiple increase in the consumption of fruits and vegetables since the 1970s. The future challenges of dietary monitoring include keeping the participation rates in dietary surveys at acceptable levels, controlling under/over-reporting of diet, developing a national monitoring system for children and adapting to international changes and requirements to harmonise dietary monitoring in Europe.

Background: Alcohol consumption has been regarded as an important contributor to the high premature mortality rates. The objective of this paper was to provide an overview and comparison of alcohol consumption and its socio-demographic determinants among adults in Estonia and Finland., Methods: The study was based on a 25-64-year-old subsample of nationally representative postal cross-sectional surveys conducted in Estonia (n = 10,340) and Finland (n = 19,672) during 1994-2006. Abstinence, frequency, and the amount of alcohol consumed were examined. Logistic regression models were used to test the socio-demographic differences in alcohol consumption at least once a week. The effect of socio-demographic factors on pure alcohol consumed per week was calculated using linear regression., Results: The proportion of abstainers was 1.5 times higher among women than men in both countries. Throughout the study period, the amount of alcohol consumed per week increased for both genders in Estonia and for women in Finland, but was stable for men in Finland. In the final study year, medium risk amount of alcohol consumed per week was nearly 1.5 times higher among men in Estonia than in Finland, but about half that among women in Estonia than in Finland. Compared to ethnic majority in Estonia, alcohol consumption at least once a week was lower among men, but amount of pure alcohol drunk per week was higher among women of ethnic minority. In Finland, alcohol consumption at least once a week was more prevalent among women of ethnic minority, but the amount of pure alcohol drunk per week was lower for both gender groups of ethnic minority. Compared to married/cohabiting respondents, alcohol consumption at least once a week was less pronounced among single respondents in Finland, divorced or separated women in both countries, and widowed respondents in Estonia. Greater amount of alcohol consumed per week was more prevalent among single and divorced or separated respondents in Finland, but only among divorced or separated men in Estonia. Frequency of alcohol consumption was lower among less educated than higher educated respondents in Finland, but not in Estonia. The amount of consumed alcohol per week was higher among less educated men in Estonia, but lower among women with basic education in Finland., Conclusions: Alcohol consumption has increased in Estonia and Finland. National alcohol policies should reflect findings of alcohol epidemiology in order to introduce measures that will reduce alcohol related harm in the population effectively.

Survey respondents and non-respondents differ in their demographic and socio-economic position. Many of the health behaviours are also known to be associated with socio-economic differences. We aimed to investigate how much of the excess mortality of survey non-respondents can be explained by the socio-economic differences between respondents and non-respondents. Questionnaire-based adult health behaviour surveys have been conducted in Finland annually since 1978. Data from the 1978 to 2002 surveys, including non-respondents, were linked with mortality data from the Finnish National Cause of Death statistics and with demographic and socio-economic register data (marital status, education and household income) obtained from Statistics Finland. The mortality follow-up lasted until 2006, in which period there were 12,762 deaths (7,994 in men and 4,768 in women) during the follow-up. Total and cause-specific mortality were higher among non-respondents in both men and women. Adjusting results for marital status, educational level and average household income decreased the excess total and cause-specific mortality of non-respondents in both men and women. Of the total excess mortality of non-respondents, 41% in men and 20% in women can be accounted for demographic and socio-economic factors. A part of the excess mortality among non-respondents can be accounted for their demographic and socio-economic characteristics. Based on these results we can assume that non-respondents tend to have more severe health problems, acute illnesses and unhealthy behaviours, such as smoking and excess alcohol use. These can be reasons for persons not taking part in population surveys.

Objective: To assess the impact of the 1976 Tobacco Control Act (TCA) on smoking initiation across socioeconomic groups., Methods: Nationwide data from independent annual cross-sectional postal surveys in 1978-2002 in Finland. Subjects were 25-64-year-old men and women born 1926-1975 (n=68 071). Socioeconomic status was derived individually from population census data. Logistic regression was applied to assess the impact of the 1976 TCA on the prevalence of ever daily smoking in birth cohorts and socioeconomic groups., Results: Clear socioeconomic differences in ever daily smoking among men and women were found. In all socioeconomic groups a declining cohort trend was observed among men whereas women showed an increasing trend in early cohorts and a declining one thereafter. A statistically significant decline in the proportion of ever daily smokers compatible with the impact of the TCA was found in all socioeconomic groups except farmers. Among women the decline was roughly similar in each socioeconomic group, while among men it varied and was most pronounced among white collar employees., Conclusions: The impact of the 1976 TCA was less pronounced among male lower socioeconomic groups. In spite of the even impact of the TCA on female smoking across socioeconomic groups, large socioeconomic disparities remain. Tobacco control policy measures specifically directed at lower socioeconomic groups are needed.

Background: Health behaviours are potential explanatory factors for socioeconomic differences in mortality. We examined the extent to which seven health behaviours covering dietary habits, smoking and physical activity, can account for relative differences in cardiovascular and all-cause mortality by educational level., Methods: Health behaviour data derived from nationwide Finnish health behaviour surveys from the years 1979 to 2001. These annually repeated cross-sectional surveys were linked to register-based information on educational level and subsequent mortality from the year of the survey until the end of 2001 (average follow-up time 11.9 years). The analyses included 29 065 men and 31 543 women of whom 4263 died. Cardiovascular disease (CVD), coronary heart disease (CHD), stroke and all-cause mortality was studied., Results: Educational level showed a graded association with all mortality outcomes. Health behaviours explained 54% of the relative difference between primary and higher educational level in CVD mortality among in men and 22% among in women. For all-cause mortality the corresponding figures were 45 and 38%. Smoking, vegetable use and physical activity were the most important health behaviours explaining educational level differences in all mortality outcomes, while the effects of type of fat used on bread, coffee drinking, relative weight and alcohol use were small., Conclusions: Smoking, low vegetable use and physical inactivity explained a substantial part of educational level differences in cardiovascular and all-cause mortality among men and women. Socioeconomic trends in these behaviours are of crucial importance in determining whether socioeconomic mortality differences will widen or narrow in the future.

Objectives: To identify differences in reported sources of medicine information between age groups and genders in one European country (Finland)., Methods: A questionnaire on health behaviour was sent by mail to a random sample of 5000 Finns aged 15-64 years in the spring of 2005. The respondents (n=3287) were asked to report the sources from which they had received information about their medicines (both prescription medicines and self-medication) used over the past year (12 months). Number of respondents who had used medicines during the past year and reported at least one source of medicine information was 2348., Results: Women used PILs, newspapers, magazines, books, Health Food Stores (p<0.001) and advertisements (p<0.01) more than men as their medicine information sources. The oldest (50-64-year-olds) men and women reported doctors as sources of medicine information more commonly (p<0.001) and the Internet less commonly (p<0.001) than respondents in other age groups. The 15-29-year-old women received more information from PILs, nurses, relatives and friends (p<0.001) and from radio and television (p<0.05) than women in other age groups. The 15-29-year-old men found more information from relatives, friends, radio and television (p<0.001) than men in other age groups., Conclusions: There are differences in the reported sources of medicine information between genders and age groups. Older persons seem mostly to use health professionals as their source, while younger persons seem to prefer the Internet or other sources which they can use by themselves. Women seem to be more active than men in searching for medicine information and, like younger persons, on their own initiative.

This paper explores the relationship between height-adjusted weight and economic conditions in Finland, using individual microdata for the period 1978-2002. If anything, the results reveal that an improvement in regional economic conditions measured by the employment rate produces a decrease in BMI, other things being equal. The Finnish evidence presented does not support the conclusions reported for the USA, according to which temporary economic slowdowns are good for health. In contrast, at least BMI seems to increase during slumps., (Copyright (c) 2006 John Wiley & Sons, Ltd.)

When estimating population level changes in health indicators, the declining response rate, especially if also the characteristics of non-respondents are changing may bias the outcome. There is evidence that survey response rates are declining in many countries. It is also known that respondents and non-respondents differ in their socio-economic and demographic status as well as in their health and health behaviours. There is no information about the changes in the differences between respondents and non-respondents over time. Our purpose was to investigate the changes over time in the differences between respondents and non-respondents in respect to their sex, age, marital status and educational level. The data from the Finnish Adult Health Behaviour Survey (1978-2002) was used. The response rate declined over the past 25 years for both men and women in all age groups. The decline was faster among men than women, and also faster in younger age groups than older age groups. There is a marked difference in the response rate between married and non-married persons but it did not change over time. Also the response rate between different educational levels differed for both men and women, and this difference increased over the years. The declining response rate and at the same time occurring change in the non-respondent characteristics will decrease the representativeness of the results, limit the comparability of the results with other surveys, increase the bias of the trend estimates and limit the comparability of the results between population groups.