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.

On the lifecycle of aerosol particles : Sources and dispersion over Scandinavia

Aerosol particles are likely important contributors to our future climate. Further, during recent years, effects on human health arising from emissions of particulate material have gained increasing attention. In order to quantify the effect of aerosols on both climate and human health we need to better quantify the interplay between sources and sinks of aerosol particle number and mass on large spatial scales. So far long-term, regional observations of aerosol properties have been scarce, but argued necessary in order to bring the knowledge of regional and global distribution of aerosols further. In this context, regional studies of aerosol properties and aerosol dynamics are truly important areas of investigation. This thesis is devoted to investigations of aerosol number size distribution observations performed through the course of one year encompassing observational data from five stations covering an area from southern parts of Sweden up to northern parts of Finland. This thesis tries to give a description of aerosol size distribution dynamics from both a quantitative and qualitative point of view. The thesis focuses on properties and changes in aerosol size distribution as a function of location, season, source area, transport pathways and links to various meteorological conditions. The investigations performed in this thesis show that although the basic behaviour of the aerosol number size distribution in terms of seasonal and diurnal characteristics is similar at all stations in the measurement network, the aerosol over the Nordic countries is characterised by a typically sharp gradient in aerosol number and mass. This gradient is argued to derive from geographical locations of the stations in relation to the dominant sources and transport pathways. It is clear that the source area significantly determine the aerosol size distribution properties, but it is obvious that transport condition in terms of frequency of precipitation and cloudiness in some cases even more strongly control the evolution of the number size distribution. Aerosol dynamic processes under clear sky transport are however likewise argued to be highly important. Southerly transport of marine air and northerly transport of air from continental sources is studied in detail under clear sky conditions by performing a pseudo-Lagrangian box model evaluation of the two type cases. Results from both modelling and observations suggest that nucleation events contribute to integral number increase during southerly transport of comparably clean marine air, while number depletion dominates the evolution of the size distribution during northerly transport. This difference is largely explained by different concentration of pre-existing aerosol surface associated with the two type cases. Mass is found to be accumulated in many of the individual transport cases studied. This mass increase was argued to be controlled by emission of organic compounds from the boreal forest. This puts the boreal forest in a central position for estimates of aerosol forcing on a regional scale.