Scandinavian Journal of Public Health最新文献

{"title":"Diagnoses among long-term care recipients in Norway: a nation-wide registry study on prevalence and data completeness.","authors":"Inger Johanne Bakken, Thomas Nordbø Heyeraas, Øystein Døhl, Siri Rostoft, Inger Ariansen, Lisa Victoria Burrell","doi":"10.1177/14034948251339873","DOIUrl":"10.1177/14034948251339873","url":null,"abstract":"<p><strong>Background and aims: </strong>The Norwegian Registry for Primary Health Care (NRPHC) is a mandatory register for all publicly funded primary healthcare services in Norway, including long-term care (LTC) services. The registry holds information on diagnoses for recipients of LTC services, but little is known regarding data quality and completeness.</p><p><strong>Methods: </strong>The study population consisted of all LTC recipients in Norway in 2023 (<i>N</i>=393,446). We investigated the proportion registered with any diagnosis in NRPHC LTC data. We compared diagnoses reported by LTC providers with diagnoses reported by general practitioners and by specialist health services. Additionally, we investigated the distribution of diagnoses by type of LTC provided. Diagnoses presumed common among recipients of LTC were investigated (diabetes, cardiovascular diseases, chronic obstructive lung diseases, cancer, mental disorders/substance use disorders, dementia, intellectual disability and hip fracture).</p><p><strong>Results: </strong>Diagnoses were reported by LTC providers for 51.4% of LTC recipients. Diagnoses were more often reported for users with more complex services (long-term institutional stay: 85.5%; assistive technology: 30.5%). Including data from general practitioners and specialist health services increased prevalence estimates compared with using NRPHC LTC data alone (dementia: 14.2% vs 8.2%; chronic obstructive lung diseases: 12.7% vs. 4.1%). Based on all available data, the prevalence of reported dementia among recipients of long-term institutional stay was 58.7%. The prevalence of reported substance use disorders among recipients of home-based services was 13.4%.</p><p><strong>Conclusions: </strong>\u0000 <b>Data on diagnoses reported by LTC providers to the NRPHC are insufficient and should be supplemented with data from other sources.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"543-549"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Payment problems and suicide: life under financial strain.","authors":"Carla L Hughes, Åsmund Hermansen","doi":"10.1177/14034948241312375","DOIUrl":"10.1177/14034948241312375","url":null,"abstract":"<p><strong>Aims: </strong>Suicide deaths are often linked to impulsivity during moments of crisis, such as financial difficulties, relationship breakdowns and poor health. For individuals experiencing financial problems, risk factors for suicide can commonly include circumstances surrounding payment problems, including unemployment, divorce, low education and low income mediated by debt.</p><p><strong>Methods: </strong>In this study, we investigate the impact of payment problems on suicide in Norway using a spline-based parametric survival analysis, with suicide as the outcome variable. With access to high quality Norwegian register data and unique information on payment problems, defined as deductions in wages or benefits, we investigated suicide amongst the entire adult Norwegian population over an 11-year period (2008-2018).</p><p><strong>Results: </strong>We found that the prevalence of payment problems among the Norwegian population between 2009 and 2018 was associated with a higher risk of suicide for both males and females. Despite the greater proportion of suicide occurring amongst males both globally and in Norway, we found that women experiencing financial hardship had a relatively higher suicide risk when adjusted for demographic variables than their male counterparts.</p><p><strong>Conclusions: </strong>\u0000 <b>These findings highlight the need for stronger protections for individuals struggling with financial difficulties and emphasise the importance of further research on the relationship between payment problems and suicide, with the aim of informing and enhancing national suicide prevention strategies.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"488-494"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographical variation in quality-adjusted life expectancy in the North Denmark Region.","authors":"Jakob Juul Christensen, Cathrine Elgaard Jensen, Sabine Michelsen Raunbak, Sabrina Storgaard Sørensen, Jan Sørensen","doi":"10.1177/14034948241298986","DOIUrl":"10.1177/14034948241298986","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the geographical variations in quality-adjusted life expectancy (QALE) in the North Denmark Region.</p><p><strong>Methods: </strong>QALE was used to measure health expectancy within each municipality of the North Denmark Region. Measures of health-related quality of life (HRQoL) were obtained from a representative sample of 19,598 responses to the EQ-5D-5L questionnaire in the 2021 regional health survey. Abridged periodic life tables were constructed using mortality data from Statistics Denmark stratified by age, sex, and municipality. The stepwise replacement algorithm developed by Andreev et al. was applied to decompose QALE into its mortality and HRQoL components and investigate the main drivers of the QALE variations between municipalities.</p><p><strong>Results: </strong>The regional average QALE at 16 years of age was 52.6 quality-adjusted life years (QALYs) (95% CI: 52.1-53.0) for men and 53.1 QALYs (95% CI: 52.7-53.5) for women. No statistically significant variations in QALE were found between municipalities. Comparing the highest and lowest scoring municipalities for males, Rebild had 54.5 QALY (95% CI: 51.7-57.2) while Hjørring had 51.9 QALY (95% CI: 49.9-54.1), showing a variation of 2.57 QALE driven by higher HRQoL scores and lower mortality rates. For females, Rebild had 54.3 QALY (95% CI: 52.1-56.5) and Vesthimmerland had 51.3 QALY (95% CI: 49.1-53.4), showing a variation of 3.03 QALE, mostly driven by increased HRQoL scores and to some extent lower mortality rates.</p><p><strong>Conclusions: </strong>\u0000 <b>Variations in QALE, although not statistically significant, existed between the municipalities in the North Denmark Region. Further research should explore the reasons for these variations to inspire future policy development.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"451-460"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do community-dwelling adults aged 70 and older have someone to rely on for help when needed? A Trøndelag Health Study (HUNT).","authors":"Bjørn Heine Strand, Ellen Melbye Langballe","doi":"10.1177/14034948251338678","DOIUrl":"10.1177/14034948251338678","url":null,"abstract":"<p><strong>Aims: </strong>Independent living among older adults is a global political goal aimed at reducing government spending on health and care services. This study investigates the prevalence of having someone to rely on for help when needed among community-dwelling adults aged 70 and older.</p><p><strong>Methods: </strong>The study sample comprised population-based data from 24,289 adults aged 70 or older participating in the Trøndelag Health Study (HUNT4). Standardized prevalence of having someone to rely on for help if needed in total, and from family, friends, or neighbors was estimated using Trøndelag county as the standard population. Prevalences were additionally stratified by gender, age, living situation, activities of daily living (ADL), and utilization of home-based services.</p><p><strong>Results: </strong>Standardized results showed that overall, 97.3% reported having someone to ask for help if needed, of whom 92.5% relied on family, 31.7% on friends, 23.1% on neighbors. The youngest men living alone had fewer to rely on compared to those living with others. Moreover, living alone was associated with relying less on family and more on friends and neighbors. Factors associated with relying on family members were female gender, younger age, cohabitation, no ADL problems, and no home-based services. Along with education, these factors also correlated with relying on friends for help.</p><p><strong>Conclusions: </strong>\u0000 <b>Nearly all those aged 70 and older in Norway have someone to ask for help, which is positive for aging in place policies. However, those living alone, especially men, are at a higher risk of not having anyone to rely on for help when needed.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"529-537"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual harassment among higher education students: a systematic review with meta-analysis.","authors":"Rodeline Telfils, Marie-Pierre Tavolacci","doi":"10.1177/14034948261450775","DOIUrl":"10.1177/14034948261450775","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual harassment is a major problem in higher education systems worldwide with major impacts on students. This study aims to describe and synthesise quantitative data on sexual harassment prevalence among higher education students.</p><p><strong>Methods: </strong>We searched seven databases. We included studies published in English and French from 2000 until 2023 if they measured sexual harassment prevalence on students attending higher education, and they were quantitative cross-sectional studies. Prevalence estimates disaggregated by gender identity and world region were meta-analysed using a random effects model and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance.</p><p><strong>Results: </strong>We identified 53 articles, from six different world regions. The meta-analysed prevalence of sexual harassment was 43.7% for women, 16.8% for men, 33.4% for transgender and gender diverse people and 38.2% for healthcare students. The Eastern Mediterranean region had the highest prevalence estimates for women's sexual harassment, and the Region of the Americas had the highest prevalence estimates for men's sexual harassment.</p><p><strong>Conclusions: </strong>\u0000 <b>Higher education institutions, especially in low and middle-income countries, should commit to the conduct of surveys to monitor the prevalence of sexual harassment, and policymakers should allocate specific funds and resources to support the implementation of sexual harassment prevention and intervention initiatives in higher education, prioritising the safety and wellbeing of students.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261450775"},"PeriodicalIF":1.7,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining accumulation and adaptation in psychosocial and material exposures and self-rated health: A fixed-effects approach within income groups using German panel data.","authors":"Anja Knöchelmann, Tobias Rähse, Matthias Richter","doi":"10.1177/14034948261450780","DOIUrl":"https://doi.org/10.1177/14034948261450780","url":null,"abstract":"<p><strong>Aims: </strong>This study investigates how continuous exposure to psychosocial and material factors influences self-rated health (SRH) trajectories in different income groups, uniquely contrasting two mechanisms from a life course perspective: accumulation, where disadvantages intensify with longer exposure, and adaptation, where individuals adjust to adverse conditions.</p><p><strong>Methods: </strong>Based on the German Socio-Economic Panel (1994-2017), we analyzed data from 31,961 women and 29,149 men (18-75 years; ⩾2 observations). Psychosocial and material factors (e.g. financial/occupational worries, housing/income dissatisfaction) were measured dichotomously and as continuous exposition. Income- and sex-stratified fixed-effects regressions examined within-individual associations between exposure duration and SRH, adjusting for social environment, occupational position, and life stages. Additional specifications included continuous age and time fixed-effects.</p><p><strong>Results: </strong>Longer continuous exposure to disadvantageous factors was associated with declining SRH, particularly for financial worries, housing status, and income dissatisfaction, consistent with the accumulation thesis. For example, after five years of financial worries, low-income men rated their SRH ~0.2 points lower on a five-point scale compared with shorter or no continuous exposure. Adjustment for continuous age and time fixed-effects mitigated some duration effects, especially in lower income groups, indicating partly overlap of the observed patterns with age- or time-related health dynamics. Patterns indicative of adaptation were modest, with little attenuation across continuous exposure for most factors.</p><p><strong>Conclusions: </strong>\u0000 <b>Results mainly support the accumulation thesis, while evidence for adaptation was limited. Future research should further examine income-specific trajectories, concurrent exposures, and age-related health dynamics, thereby reinforcing the importance of longitudinal life-course research on psychosocial and material factors.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261450780"},"PeriodicalIF":1.7,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived work ability of recipients of sickness allowance: a retrospective registry-linkage study from the Healthy Finland survey.","authors":"Tero S Kujanpää, Johanna M Repo, Aliisa A J Palanne, Virpi H Liukkonen, Tuija Jääskeläinen, Annamari Lundqvist, Jouni Lahti, Riitta M Luoto","doi":"10.1177/14034948261454741","DOIUrl":"https://doi.org/10.1177/14034948261454741","url":null,"abstract":"<p><strong>Aims: </strong>To explore perceived work ability after sickness absences of varying durations.</p><p><strong>Methods: </strong>Questionnaire data from the Healthy Finland survey in 2022-2023, which included self-rated work ability (SRWA), were linked with registry data of the Social Insurance Institution of Finland on sickness allowance for the period 2021-2022. The association between the number of disability days on sickness allowance over a period of 2 years and SRWA were analysed among sickness allowance recipients (<i>N</i> = 2398) by cross-tabulation and multinomial logistic regression taking potential confounding factors into account.</p><p><strong>Results: </strong>The number of days on sickness allowance (<i>p</i> < .001) was associated with subsequent perceived work inability: the probability of perceived work inability increased with more sickness allowance days. Among individuals who received sickness allowance for more than 300 days over 2 years, the relative risk ratio was 174.5 for perceived work inability and 13.6 for perceived partial work inability, compared with those who received sickness allowance for 1-30 days. Nonetheless, only 44% of those with over 300 sickness allowance days perceived themselves to be completely unable to work. Individuals who did not believe they could work until normal retirement age were more likely to perceive themselves as completely or partially unable to work.</p><p><strong>Conclusions: </strong>\u0000 <b>Perceived partial work inability is common after receiving sickness allowance, but only a minority of recipients perceive themselves to be completely unable to work even after a high number of sickness allowance days. Utilising the remaining work capacity is key to enabling a successful return to the labour market and supporting longer working careers.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261454741"},"PeriodicalIF":1.7,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life-course social and economic inequalities in non-communicable disease prevalence: the Tromsø Study (2015-2016).","authors":"Rebecca A Hetland, Tom Wilsgaard, Laila A Hopstock, Inger Ariansen, Jonas Johansson, Bjarne K Jacobsen, Jens C Thimm, Catharina E Arfwedson Wang, Sameline Grimsgaard","doi":"10.1177/14034948261453066","DOIUrl":"https://doi.org/10.1177/14034948261453066","url":null,"abstract":"<p><strong>Aim: </strong>To systematically examine associations between six inequality indicators from different life-course domains and the adult prevalence of six non-communicable diseases (NCDs) within a Nordic population-based study.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis using data from the seventh Tromsø Study survey (2015-2016) in Norway. All residents aged ⩾40 years were invited (65% participation). Age-adjusted, sex-stratified logistic regression models were used to assess associations between inequality indicators (parental and own educational level, childhood economic status, adverse childhood experiences (ACEs), income, and subjective occupational status) on continuous 0-1 cumulative proportion scales, and NCDs (major adverse cardiovascular events (MACE), cancer, chronic obstructive pulmonary disease (COPD), diabetes, musculoskeletal symptoms, and mental distress). Odds ratios (ORs), with 95% confidence intervals (CIs), were estimated, where OR >1 indicates higher odds of an NCD with greater disadvantage.</p><p><strong>Results: </strong>Among 21,069 participants, greater social and economic disadvantage was associated with higher odds of MACE, COPD, diabetes, musculoskeletal symptoms, and mental distress. For musculoskeletal symptoms, significant associations were observed across all inequality indicators in both sexes. The steepest gradients were observed in mental distress for ACEs in women (OR 7.81, 95% CI 6.20-9.86) and men (10.09, 7.34-13.88). In contrast, greater disadvantage was associated with lower odds of cancer for some indicators; sensitivity analyses indicated these findings reflected cancer types with known positive socioeconomic gradients.</p><p><strong>Conclusions: </strong>Life-course social and economic disadvantage was consistently associated with higher prevalence of MACE, COPD, diabetes, musculoskeletal symptoms, and mental distress, with the pattern and magnitude varying across inequality indicators and NCDs.</p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261453066"},"PeriodicalIF":1.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Norwegian Sports Membership Database: Coverage, biases and potential.","authors":"Fredrik Methi, Ingeborg Hess Elgersma, Jonas Minet Kinge, Arnstein Mykletun, Rannveig Kaldager Hart, Atle Fretheim, Karin Magnusson","doi":"10.1177/14034948261432559","DOIUrl":"https://doi.org/10.1177/14034948261432559","url":null,"abstract":"<p><strong>Aims: </strong>This study describes the Norwegian Sports Membership Database (NSMD), assesses its coverage, and develops definitions of active sports memberships.</p><p><strong>Methods: </strong>We validated the coverage of the NSMD, a database capturing individual-level sports memberships among people aged 10-70 years between 2015 and 2024. We compared yearly membership counts in the NSMD with figures from official reports from the Norwegian Olympic and Paralympic Committee and Confederation of Sports (NIF). We defined all memberships as lasting one day or longer, and active memberships as lasting at least one season or with a paid licence.</p><p><strong>Results: </strong>Between 2015 and 2024, the NSMD contained 3,148,213 memberships, of which 2,180,621 (60%) were considered active. In total, there were 1,606,048 unique individuals across 55 sports federations and 279 disciplines. Football accounted for 24% of all memberships, handball for 11% and gymnastics for 9%. Database coverage was low in 2015, accounting for 11%-16% of expected memberships, but it improved substantially over time, exceeding 85% of all memberships and 92% of active memberships in 2023 for those aged 13-19.</p><p><strong>Conclusions: </strong>\u0000 <b>The coverage of the NSMD is high in recent years, representing a level of completeness that allows meaningful population-level analyses from 2019, although with large variations between sports. Linking sports data with health and socio-demographic outcomes provides a potentially significant opportunity for population-based research on sports participation and health across the lifespan.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261432559"},"PeriodicalIF":2.1,"publicationDate":"2026-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upper secondary school diploma and mental health in emerging adulthood: examining the severity and co-occurrence of depression and anxiety symptoms.","authors":"Maria Granvik Saminathen, Sara Brolin Låftman, Viveca Östberg","doi":"10.1177/14034948261447060","DOIUrl":"https://doi.org/10.1177/14034948261447060","url":null,"abstract":"<p><strong>Background: </strong>A significant proportion of young people in Sweden do not graduate from upper secondary school with a complete diploma, which may be crucial for their mental health. A diploma influences both perceived and actual future prospects, including access to tertiary education and employment opportunities. Additionally, education fosters personal control and problem-solving skills relevant to stress management and self-esteem. Therefore, this study explores the association between obtaining an upper secondary diploma and the severity and co-occurrence of depression and anxiety symptoms among emerging adults in Sweden.</p><p><strong>Methods: </strong>Data from a population-based cohort of Swedish 21-year-olds (<i>n</i>=3255) were analysed. Depression and anxiety symptoms were measured using the Patient Health Questionnaire-4 (PHQ-4). Registry data provided information on upper secondary education, sex, immigrant background, and parental education. Multinomial logistic regression was used.</p><p><strong>Results: </strong>Participants without an upper secondary diploma were at a higher risk of experiencing the most severe outcomes; that is, severe symptoms (<i>vs</i>. normal/mild) and co-occurring depression and anxiety symptoms (<i>vs</i>. no symptoms) compared with those with an academic diploma. They also had a higher risk of depression only, but not anxiety only. Additionally, compared with participants with an academic diploma, those with a vocational upper secondary diploma exhibited an elevated risk of depression only.</p><p><strong>Conclusions: </strong><b>This study highlights the link between an upper secondary diploma and mental health in emerging adulthood. It also suggests that depression, anxiety, and their co-occurrence may have distinct determinants. The findings indicate that initiatives to support school completion and re-engagement could have significant public health benefits</b>.</p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"14034948261447060"},"PeriodicalIF":2.1,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}