Women's subjective and objective health over time : the role of psychosocial conditions and physiological stress responses

Today, health problems are likely to have a complex and multifactorial etiology, whereby psychosocial factors interact with behaviour and bodily responses. Women generally report more health problems than men. The present thesis concerns the development of women’s health from a subjective and objective perspective, as related to psychosocial living conditions and physiological stress responses. Both cross-sectional and longitudinal studies were carried out on a representative sample of women. Data analysis was based on a holistic person-oriented approach as well as a variable approach. In Study I, the women’s self-reported symptoms and diseases as well as self-rated general health status were compared to physician-rated health problems and ratings of the general health of the women, based on medical examinations. The findings showed that physicians rated twice as many women as having poor health compared to the ratings of the women themselves. Moreover, the symptom ”a sense of powerlessness” had the highest predictive power for self-rated general health. Study II investigated individual and structural stability in symptom profiles between adolescence and middle-age as related to pubertal timing. There was individual stability in symptom reporting for nearly thirty years, although the effect of pubertal timing on symptom reporting did not extend into middle-age. Study III explored the longitudinal and current influence of socioeconomic and psychosocial factors on women’s self-reported health. Contemporary factors such as job strain, low income, financial worries, and double exposure in terms of high job strain and heavy domestic responsibilities increased the risk for poor self-reported health in middle-aged women. In Study IV, the association between self-reported symptoms and physiological stress responses was investigated. Results revealed that higher levels of medically unexplained symptoms were related to higher levels of cortisol, cholesterol, and heart rate. The empirical findings are discussed in relation to existing models of stress and health, such as the demand-control model, the allostatic load model, the biopsychosocial model, and the multiple role hypothesis. It was concluded that women’s health problems could be reduced if their overall life circumstances were improved. The practical implications of this might include a redesign of the labour market giving women more influence and control over their lives, both at and away from work.

Farewell to the Welfare : On the role of chronic stress in lifestyle migration

While studies concerned with migration and the welfare, or migration and stress, have been focusing on either notions of a welfare-magnet or issues related to PTSDs, representing an overt research focus on migration from poorer to richer nations, none have explored the possible role of chronic stress as an underlying trigger for wishing to escape the welfare society. This study explores just this, elaborating upon the lifestyle-concept. Using the latest financial crisis as a theoretical turning point, a comparative case study was performed with Swedish migrant entrepreneurs in Costa del Sol, as compared to previously performed studies from the area. Fourteen semi-structured interviews were carried out with different actors for the purpose of triangulation. Statistics were used for an elementary understanding, in a mixed method design. Analysis was performed on macro to micro scales, providing findings in line with previous research on lifestyle-migration. New findings however include a recognition of long-term exposure to stress as an underlying trigger for wishing to escape the welfare-society, as well as the perception of the holiday-destination as the antithesis to stress making it the preferred choice for relocation. The paper concludes that if stress push people away from Sweden, it can be considered global in scope.