Anne Hammarström

Anne Hammarström

Researcher
Telephone: +46852487460
Visiting address: Nobels väg 13, 17177 Stockholm
Postal address: C6 Institutet för miljömedicin, C6 Arbetsmedicin Selander, 171 77 Stockholm
Part of:

About me

  • I am a professor of public health since 2000. I have earlier been employed at Umeå and Uppsala Universities. I am MD, with specialist exams in general practice and social medicine.

    In 1981, I initiated the Northern Swedish Cohort which has been followed since then. The two year follow-up of the cohort constituted my thesis at Karolinska Institutet in 1986, A 39- year follow-up will be performed from autumn 2020.

    My research has a strong focus on social epidemiology, with special focus on social inequalities in health during life, theory development and health impact of labour market positions from a life-course perspective. I work with both quantitative and qualitative methods.


    Academic awards
    Expert of SOU 1996:133 Gender Equal Care

    2005-2006 Member of the Swedish governments Scientific Working Committee

    Member of the organization committee for the National Institute of Public Health

    Member of WHO commission On the Social Determinants of Health

    Medical Consultant for ten years at the National Institute of Public Health

    2006-2009 Member of board of the Swedish Secretariat for Gender Research

    2009 Award winner of Görel Bohlins’ prize for gender research

Research

  • My major research program at present is:

    Mental health in adolescence and the paths ahead. An ecological life course approach to mental health development into adulthood

    •Specific objectives and goals of the program

    The overall objective of the research program is to analyse the importance of mental health in adolescence for well-being and health status into adult age. The proposed program applies data from an outstanding 40-year prospective cohort study of school-leavers with uniquely high continuing participation rate. Our specific goals are:

    1. To develop an ecological life course framework of mental health by conceptual integration of Bronfenbrenner’s ecological theory of human development and life course epidemiology with individual level theories (agency within structures) and to apply this framework in our research.

    2. To analyse perinatal (birth weight, small for gestational age, complications) and parental socioeconomic factors as early predictors for mental health at age 16.

    3. To analyse the prospective importance of mental health in adolescence for the social situation (mainly education, labour market position, social relations) and health status in adult age.

    4. To study the impact of settings at specific ecological levels (or systems): microlevel settings (family, peers, school, work) and exolevel settings (parental labour market position, neighbourhood) on mental health at various ages as well as the interactions between settings at various ecological levels over the life course, taking changes at macrolevel (trade cycles, gender equality) into account.

    5. To study different life course models (accumulation, social chain of risks and sensitive period) as possible explanations for the development of mental health up to middle age.

    6. To identify mental health trajectories over the life course extended to midlife through a data collection at age 56 and to examine possible determinants of these trajectories at various ages.

    7.To elucidate individual experiences of mental health-promoting and deteriorating processes over the life course with special focus on how individuals perceive their capacity to control and/or overcome mental health difficulties at various ages in different social contexts.

    8. Recently identified knowledge gaps within the field of mental health points out the need to analyse new determinants due to inequalities in environmental exposure. Thanks to the migration of the program to KI we have now the possibilities to fill in this gap. Thus, we will analyse the importance for mental health of life-course exposure to additional dimensions such as noise and air pollution. Also, comparisons between self-reported measures of mental health with register data on prescriptions of drugs related to mental health will be made for the most important exposures.

    The program can make a major difference for future research and policy-making by providing knowledge about what influences the development of mental health during life.

    The Northern Swedish Cohort

    The Northern Swedish Cohort (NoSCo) - a prospective longitudinal cohort study - is the base of much of my research. The cohort consists of all pupils (n=1083) who in 1981 attended the last year of compulsory school (age 16) in all nine schools in a middle-sized municipality in Northern Sweden. At the 27-year follow-up 94.3% (n =1010, 522 men, 488 women) of those still alive of the original cohort continued to participate. All nine school nurses and 56 form teachers in 1981 as well as all form teachers (or the supervisors for those in youth programmes) in 1983 were also part of the study. None of them refused to participate.

    Until now, the cohort has been followed up five times with extensive questionnaires. The questionnaire (built on well-known and validated scales) covered the broad areas of somatic and mental health, externalising behaviours, other health behaviours, exhaustion, time of puberty, school/work environment (including the demand, control, support model), labour market history and position, education, material and psychosocial life conditions (such as financial strain, social support, life events, gender equality), spare time use etc.

    All early unemployed participants (n=28) have been followed with personal interviews since autumn 1981. On average, they have been interviewed five times per person with a main focus on experiences of health promoting and health deteriorating mechanisms related to labour market position and social relations across life.

    See attached file: Design of the Northern Swedish Cohort

    Available biomedical measurements

    Blood pressure was measured after rest with standard mercury sphygmomanometer at age 16, 21 and 43. Information on weight and height is available from all follow-ups. The most recent clinical survey at age 43 comprised a health examination (92% participation rate, n=928) with blood samples (drawn after one night’s fast), assessed for lipids (total cholesterol, HDL, LDL cholesterol, triglycerides, Apo lipoprotein A1 and B), glucose and high-sensitive C-reactive protein. The participants also completed a one-day saliva collection (four samples) assessed for salivary cortisol. Serum and plasma samples have been stored at the biobank at Umeå University Hospital, frozen at minus 80 degrees Celsius for future analyses.

Teaching

  • I have extensive experience in teaching from 1970 and onward in various disciplines such as social medicine, public health, epidemiology, gender theory and register research. I have formal studies in university-level teaching corresponding to 24 ECTs. My teaching experience is from different levels and both as course director and as teacher. In addition I have served as main supervisor for eleven PhD thesis , as co-supervisor for seven PhD students and as post-doc supervisor for nine post-docs. I have served as opponent on ten PhD thesis. I serve regularly as member of thesis examination committees and as reviewer of candidates proposed for academic positions. I have also extensive experience of serving as evaluator of research applications in national and international competition. I have participated in a three year mentor programme at Umeå University for research leaders (2004-2007).

    Also, I have organized three international research congresses.

Articles

All other publications

Grants

  • C an work-related exposures during life explain the increasing social gradient in cardiovascular disease?
    Forte
    1 January 2024 - 31 December 2026
    Research problem and specific questions Despite the overall decrease in cardiovascular (C V) mortality there is, especially among women, an increasing social gradient in Sweden. The explanation is not known. Our aim is to analyse to what extent this gradient can be explained by the increasingly unsecure labour market. The research questions are: How large a proportion of the effect of education on C V health is mediated through weak labour market attachment (LMA, unemployment and precarious employment)? What are the other possible work-related mechanisms? Data and method Four life-course cohorts, born 1965 and 1973, will be used. Two of them are based on extensive register data about all Swedish inhabitants. Two are based on repeated questionnaires and extensive register data on all school-leavers from grade 9, in a middle-sized town. One contains repeated clinical data for 40 years. Data on exposure to LMA are available from school to midlife. Incident C V diagnoses and metabolic risks will be measured around age 56 and 51. All cohorts will be controlled for reverse causation and other confounders. While the register cohorts are complete and provide power and national representativity, the school cohorts provide rich data of high validity for analysing mechanisms and clinical outcomes. A qualitative study about possible mechanisms will be performed among those with highest risk of weak LMA who have been followed during 40 years with interviews. Sociatal relevance and utilisation Elimination of avoidable health inequalities is a major goal in the Swedish public health policy. To reach the goal, knowledge is needed about the mechanisms behind. The increasingly insecure labour market is our focus, a priority also in policies around EU. Our results can be used in health promotion and by work environmental actors to support targeted interventions aiming at improved equality in health and sustainable work conditions during life. Plan for project realisation Register update will be made of one school cohort. Advanced mediation analyses of work conditions will be made for the educational gradient in C V health, using latest methods for selecting confounders. Several mediators can be included at the same time, so the effect of structural factors on health behaviour can be analysed. Follow-up interviews will be performed with the early unemployed group. The theoretical development aim at developing a working life-course theory. The budget cover salaries and register updates.
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2024 - 31 December 2026
    Research problem and specific questionsDespite the overall decrease in cardiovascular (CV) mortality there is, especially among women, an increasing social gradient in Sweden. The explanation is not known. Our aim is to analyse to what extent this gradient can be explained by the increasingly unsecure labour market. The research questions are: How large a proportion of the effect of education on CV health is mediated through weak labour market attachment (LMA, unemployment and precarious employment)? What are the other possible work-related mechanisms?Data and methodFour life-course cohorts, born 1965 and 1973, will be used. Two of them are based on extensive register data about all Swedish inhabitants. Two are based on repeated questionnaires and extensive register data on all school-leavers from grade 9, in a middle-sized town. One contains repeated clinical data for 40 years. Data on exposure to LMA are available from school to midlife. Incident CV diagnoses and metabolic risks will be measured around age 56 and 51. All cohorts will be controlled for reverse causation and other confounders.While the register cohorts are complete and provide power and national representativity, the school cohorts provide rich data of high validity for analysing mechanisms and clinical outcomes. A qualitative study about possible mechanisms will be performed among those with highest risk of weak LMA who have been followed during 40 years with interviews.Sociatal relevance and utilisationElimination of avoidable health inequalities is a major goal in the Swedish public health policy. To reach the goal, knowledge is needed about the mechanisms behind. The increasingly insecure labour market is our focus, a priority also in policies around EU. Our results can be used in health promotion and by work environmental actors to support targeted interventions aiming at improved equality in health and sustainable work conditions during life.Plan for project realisationRegister update will be made of one school cohort. Advanced mediation analyses of work conditions will be made for the educational gradient in CV health, using latest methods for selecting confounders.  Several mediators can be included at the same time, so the effect of structural factors on health behaviour can be analysed. Follow-up interviews will be performed with the early unemployed group. The theoretical development aim at developing a working life-course theory. The budget cover salaries and register updates.
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2022 - 31 December 2024
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2019 - 31 December 2021
  • Swedish Research Council for Health Working Life and Welfare
    1 November 2016 - 31 October 2019
  • Swedish Research Council for Environment Agricultural Sciences and Spatial Planning
    1 January 2012 - 31 December 2017
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2012 - 31 December 2014
  • Swedish Research Council
    1 January 2012 - 31 December 2015
  • Swedish Research Council
    1 January 2010 - 31 December 2012
  • Swedish Research Council
    1 January 2010 - 31 December 2012
  • Australian Research Council
    1 August 2008 - 31 December 2016
  • Australian Research Council
    1 January 2005 - 1 August 2008

News from KI

Events from KI