Publications by authors named "Pekka Martikainen"

Background: Previous studies on socio-economic inequalities in mortality have documented a substantial contribution of alcohol-attributable mortality (AAM) to these inequalities. However, little is known about the extent to which AAM has contributed to time trends in socio-economic inequalities in mortality.

Objective: To study long-term trends in educational inequalities in AAM and assessed their impact on trends in educational inequalities in life expectancy in three European countries.

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This paper examines, using exogenous variation generated by a Finnish pension reform implemented in 2005, the interplay between health and financial incentives to postpone retirement. Based on detailed administrative data on individual health and retirement behavior, we focus on whether individual reactions to incentives vary according to health status and analyze whether individuals with ill health are also able to take advantage of the potential monetary benefits of delayed retirement created by the reform. We find that on average, individuals react to the financial incentives created by the reform as expected.

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Conjugal ties may contribute to a convergence of health behaviours between migrants and natives, but the association between intermarriage and health outcomes remains understudied. We investigated mortality patterns among Finnish migrants in Sweden according to the spouse's country of birth and compared these patterns with those observed in the native populations of both Sweden and Finland. Leveraging register data from Sweden and Finland, we identified all married Finnish migrants aged 40-64 and their spouses in Sweden in 1999 and corresponding reference groups in both countries.

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Depression and other mental health disorders are increasing while childlessness is increasing. However, this relationship has rarely been studied. We examine how depression, as measured by antidepressant use, is related to childlessness.

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Aims: The decline in old age mortality and subsequent increase in life expectancy among older women has stalled in some high-income countries. The contribution of causes of death to and sub-group variations in these trends are generally not well understood. We assess trends in mortality and cause-of-death decomposition of life expectancy by income over the past 30 years in Finland.

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Article Synopsis
  • - The study investigates how smoking-attributable mortality (SAM) affects socioeconomic mortality inequalities across England, Wales, Finland, and Italy from 1972 to 2017, focusing on trends related to education levels and sex.
  • - Results show that while inequalities in SAM decreased for males in England and Wales, and Finland, they increased for females—except in Italy, where trends were different, especially among men.
  • - The research indicates that changing trends in SAM based on education and gender significantly impact overall mortality inequalities, highlighting risks for Finnish and Italian women in future smoking-related health inequalities.
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Social relationships and genetic propensity are known to affect depression risk, but their joint effects are poorly understood. This study examined the association of a polygenic index for depression with time to antidepressant (AD) purchasing and the moderating role of partnership status. We analysed data from 30,192 Finnish individuals who participated in the FINRISK and Health 2000 and 2011 surveys and had register and medication data available.

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Fathers tend to achieve higher earnings than childless men, but there is limited evidence on the associations between fatherhood timing and men's later earnings. Using a longitudinal census-based sample of Finnish men, including a subsample of brothers, we investigated fatherhood timing and men's midlife earnings using both between- and within-family models. Earnings around age 50 were lower among adolescent and young fathers than for men who became fathers at ages 25-29 or later, but these associations became negligible after accounting for measured confounders and unobserved familial confounding.

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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.

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Objectives: Residential long-term care (LTC) use has declined in many countries over the past years. This study quantifies how changing rates of entry, exit, and mortality have contributed to trends in life expectancy in LTC (i.e.

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Aims: Social inequalities in mortality persist or even increase in high-income countries. Most evidence is based on a period approach to measuring mortality - that is, data from individuals born decades apart. A cohort approach, however, provides complementary insights using data from individuals who grow up and age under similar social and institutional arrangements.

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Purpose: Adolescents with psychiatric disorders are known to be more often not in education, employment, or training (NEET) in young adulthood than their peers. However, since most of the available evidence is based on cross-sectional measurement of NEET, there is less evidence on the processes underlying these differences in labor market disadvantage. We assessed these processes by examining transitions between NEET and non-NEET states across young adulthood and the differences in these transitions by adolescent psychiatric inpatient treatment.

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Grandparental support may protect mothers from depression, particularly mothers who separate and enter single parenthood. Using longitudinal Finnish register data on 116,917 separating and 371,703 non-separating mothers with young children, we examined differences in mothers' antidepressant purchases by grandparental characteristics related to provision of support. Grandparents' younger age (<70 years), employment, and lack of severe health problems predicted a lower probability of maternal depression.

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Background: Prior studies suggest that poor physical health, accompanied by functional disability, is associated with increased divorce risk. However, this association may depend on gender, the socioeconomic resources of the couple, as well as the social policy and social (in)equality context in which the illness is experienced. This study focuses on neurological conditions, which often have substantial functional consequences.

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Article Synopsis
  • Grey divorce and later remarriage show a growing trend in high-income countries, but there's limited research on their mental health effects, particularly regarding non-marital separation and re-partnering later in life.
  • A study using data from over 228,000 individuals in Finland revealed significant increases in antidepressant (AD) use leading up to and after events like divorce, non-marital separation, and bereavement, with women showing larger increases than men.
  • While re-partnering resulted in a small and temporary decrease in AD use, the overall mental health impact of union dissolution remains substantial and persistent, especially among women.
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The association between having older siblings and decreased risk for atopic symptoms is well-established. This has been interpreted as evidence for the microbiota hypothesis, i.e.

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Objectives: Excess winter mortality is a well-established phenomenon across the developed world. However, whether individual-level factors increase vulnerability to the effects of winter remains inadequately examined. Our aim was to assess long-term trends in excess winter mortality in Finland and estimate the modifying effect of sociodemographic and health characteristics on the risk of winter death.

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Background: Socioeconomic inequalities in mortality originate from different causes of death. Alcohol-related and smoking-related deaths are major drivers of mortality inequalities across Europe. In Finland, the turn from widening to narrowing mortality disparities by income in the early 2010s was largely attributable to these causes of death.

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Background: Higher mean body mass index (BMI) among lower socioeconomic position (SEP) groups is well established in Western societies, but the influence of genetic factors on these differences is not well characterized.

Methods: We analyzed these associations using Finnish health surveys conducted between 1992 and 2017 (N = 33 523; 53% women) with information on measured weight and height, polygenic risk scores of BMI (PGS-BMI) and linked data from administrative registers to measure educational attainment, occupation-based social class and personal income.

Results: In linear regressions, largest adjusted BMI differences were found between basic and tertiary educated men (1.

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Background And Aims: This paper assesses the impact of estimation methods for general and education-specific trends in alcohol-attributable mortality (AAM), and develops an alternative method that can be used when the data available for study is limited.

Methods: We calculated yearly adult (30+) age-standardised and age-specific AAM rates by sex for the general population and by educational level (low, middle, high) in Finland and Turin (Italy) from 1972 to 2017. Furthermore the slope index of inequality and relative inequality index were computed by country and sex.

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Prior research indicates that parental psychiatric disorders increase their offspring's risk of substance use problems. Though the association is likely bidirectional, the effects of an adult child's substance use on parental mental health remain understudied. We examined parents' psychotropic medication use trajectories by parental sex and educational attainment before and after a child's alcohol- or narcotics-attributable hospitalization.

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Background: Maternal mental illness appears to increase the risk of unintentional childhood injuries, which are a common cause of morbidity and mortality in early childhood. However, little is known about the variations in this association by type of injury and child's age, and studies on the effects of maternal somatic illness on children's injury risk are scarce.

Methods: We used Finnish total population register data from 2000 to 2017 to link 1 369 325 children to their biological mothers and followed them for maternal illness and childhood injuries until the children's sixth birthday.

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Background And Objectives: Cross-national research on cognitive aging inequality has largely concentrated on Western countries. It is unclear whether socioeconomic position (SEP) has similar effects on cognitive decline in emerging economies. We compared the association between life course SEP and cognitive function trajectories between China and England, the largest nation under state socialism and one of the oldest capitalist countries.

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