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Lennartsson C. Need and support: determinants of intra‐familial financial transfers in SwedenInt J Soc Welfare 2011: 20: 66–74 © 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare.This study examined downward inter‐generational intra‐family financial transfers in Sweden made in the form of money transactions or gifts. The research questions focus on whether recipients of intra‐family financial transfers are children in 'need' of such support, and whether early family environment has any consequences for later financial transfers. Using data from a nationally representative survey, the results suggest that childhood disadvantages have long‐term consequences in connection with intra‐family financial transfers. Disadvantages and inequalities in childhood are likely to remain into adulthood, and children who experience adverse childhood conditions are less often recipients of later intra‐family financial support. Intra‐family transfers are also related to the 'needs' of the younger generation. Single parents and students from higher social class families are more often beneficiaries of financial support. In contrast, family support was no higher for unemployed children, for children lacking financial security in the form of a cash margin or for children reporting poor health.

This study explored changes in the associations between and coexistence of disadvantages in several dimensions of living conditions in the oldest old people in Sweden. We used nationally representative data from 1992 (n = 537), 2002 (n = 621) and 2011 (n = 931). Indicators of limited social resources, limited political resources, limited financial resources, psychological health problems, physical health problems and functional limitations were used. The probability of reporting coexisting disadvantages tended to increase and was particularly elevated in 2002. Physical health problems became more common, and functional limitations, limited financial resources and limited political resources became less common during the studied period. Associations between health-related disadvantages remained fairly stable, whereas associations including other kinds of disadvantages varied somewhat over the studied period. These changes suggest that in general, the composition of coexisting disadvantages is likely to have altered over time. Consequently, the challenges faced by disadvantaged groups in 2011 may have been different from those in 1992. Moreover, the healthcare and social care services directed to older people have undergone significant changes during the past decades. These changes to the system accentuate the vulnerability of people experiencing coexisting disadvantages.

Heap J, Lennartsson C, Thorslund M. Coexisting disadvantages across the adult age span: a comparison of older and younger age groups in the Swedish welfare stateTo experience coexisting disadvantages – the simultaneous lack of several different welfare resources – implies a hampered ability to manage one's living conditions. Here, we study coexisting disadvantages in the oldest population compared with younger age groups in Sweden, by drawing on two linked, nationally representative surveys (n = 5,392). The measurement of coexisting disadvantages included physical health, psychological health, frequency of social contact, cash margin and political resources. The highest odds of coexisting disadvantages were found after age 75 – age groups that are frequently excluded from studies of coexisting disadvantages. This pattern persisted when controlling for socio‐demographic and socio‐economic characteristics. The age pattern was partly driven by the high prevalence of physical health problems in the older population. However, even when excluding physical health problems, the odds of coexisting disadvantages were highest among people older than 85 – the fastest‐growing segment of the population in many Western countries.

Les études sur les évolutions de la santé cherchent à démontrer comment et pourquoi celle-ci change au fil du temps et à prévoir les besoins de santé à venir. L'un des moyens d'étudier ces évolutions est de comparer différentes cohortes de naissance sur plusieurs années. Cette étude porte sur un échantillon national représentatif de Suédois proches de la retraite, entre 50 et 64 ans. Quatre vagues d'enquêtes ont été menées, entre 1968 et 2000, et pour lesquelles des variables d'ordre sanitaire et para-sanitaire ont été utilisées. Les résultats liés à la santé sont variés, dépendant de l'indicateur. La mobilité et la santé dentaire ont connu des améliorations jusqu'à l'enquête de 1991, tandis que les problèmes d'audition, le diabète et le surpoids sont devenus plus répandus. Les résultats présentaient des différences liées à l'âge et au sexe. Le pourcentage de personnes concernées, diplômées ou employés de bureau, a augmenté avec le temps, tout comme le pourcentage de personnes allant chez le médecin et chez le dentiste. Le tabagisme a diminué chez les hommes, mais il a augmenté chez les femmes. Bien que les résultats suggèrent que les cohortes plus récentes qui approchent l'âge de la retraite sont en meilleure santé, ils montrent aussi que ces cohortes présentent plus de problèmes de santé chroniques nécessitant des soins médicaux et qu'elles feront plus appel aux aides à la personne. Les résultats sont présentés dans le cadre de la problématique de prolongation de la vie active et l'augmentation des coûts financiers pour la prise en charge des personnes âgées handicapées.

Despite the maturation of welfare states, family solidarity continues to be strong and a growing body of research has shown that substantial financial transfers are passed from older to younger generations within the family. At the same time, family solidarity in terms of instrumental and social support is found to be mutual. This study examines eventual reciprocity in time-for-money exchanges, by combining two large-scale Swedish representative longitudinal studies. It analyzes how earlier social contacts (time) are related to financial transfers (money) and to what extent social class and gender differentials are visible. The findings indicate that parents provide economic transfers if they have more frequent social contact with any of their children, and that these time investments pay off for children who were of higher social class origins. In contrast, no support for gender-specific patterns is found. In conclusion, family solidarity seems to have different bases in different social strata.

AbstractSweden is seen as a typical example of a social democratic welfare regime, with universal and generous welfare policies. However, in the last decades, there have been substantial reductions in the Swedish provision of care for older people. This study aimed to examine trends in sources of care‐receipt in older people (77+) living in their own home and with a perceived need for help with two specific tasks: house cleaning and/or food shopping. Trends in care‐receipt were examined in relation to gender, living alone, having children and socio‐economic position. Data from the 1992, 2002 and 2011 data collection waves of the national study, Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD), were used. Response rates varied between 86 and 95 per cent, and the sample represents the population well. Trends and differences between groups were explored in bivariate and logistic regression analyses. There was a reduction in formal care‐receipt regarding house cleaning and food shopping over the study period. It was more common for women than men to receive formal care, and more common for men than women to receive informal care. Reductions in formal care have affected older women more than older men. Still, living alone was the most influential factor in care‐receipt, associated with a greater likelihood of formal care‐receipt and a lower likelihood of informal care‐receipt. It can be concluded that public responsibility for care is becoming more narrowly defined in Sweden, and that more responsibility for care is placed on persons in need of care and their families.

Abstract
We aimed to identify short and long-term trajectories of self-rated health (SRH) and physical working capacity during the retirement transition, and investigate whether work-related factors and social class predict belonging to these trajectories. We used the representative, biennial Swedish Longitudinal Occupational Survey of Health (SLOSH) 2006–2018. We applied group-based trajectory modeling with B-spline smoothers to model trajectories of SRH (n = 2,183) and physical working capacity (n = 2,152) during the retirement transition. Multinomial logistic regression analyses were conducted to investigate trajectory belonging by work-related factors and social class. There was a small "honeymoon effect" in SRH for the total sample. We found four trajectories of SRH and five of physical working capacity. The large majority sustained excellent or good SRH and physical working capacity throughout the study period. Almost 6% had Fairly poor SRH and physical working capacity starting from years before retirement, which remained throughout the study period. High job demands, low job control, adverse physical working conditions, and being in manual occupation increased the likelihood of belonging to the trajectory groups Deteriorating or Fairly poor when compared with the Excellent trajectory group for both SRH and physical working capacity. Our findings suggest that for most people health status is already established some years' preretirement and maintained for years after retirement, except a short improvement in SRH in accordance with a honeymoon effect. In order to improve health and employability, interventions focusing on working environment should be aimed at younger and midlife employees as well as older workers.

AbstractIn response to the rising financial pressure on old-age pension systems in industrialised economies, many European countries plan to increase the eligibility age for retirement pensions. We used data from Sweden to examine whether (and if so, how) retirement after age 65 – the eligibility age for basic pension – compared to retiring earlier affects older adults' (between ages 70 and 85) cognitive functioning. Using a propensity score matching (PSM) approach, we addressed the selection bias potentially introduced by non-random selection into either early or late retirement. We also examined average and heterogeneous treatment effects (HTEs). HTEs were evaluated for different levels of cognitive stimulation from occupational activities before retirement and from leisure activities after retirement. We drew from a rich longitudinal data-set linking two nationally representative Swedish surveys with a register data-set and found that, on average, individuals who retire after age 65 do not have a higher level of cognitive functioning than those who retire earlier. Similarly, we did not observe HTEs from occupational activities. With respect to leisure activities, we found no systematic effects on cognitive functioning among those working beyond age 65. We conclude that, in general, retirement age does not seem to affect cognitive functioning in old age. Yet, the rising retirement age may put substantial pressure on individuals who suffer from poor health at the end of their occupational career, potentially exacerbating social- and health-related inequalities among older people.

Foreword by Lisa Berkman, Professor of Public Policy, Harvard University How welfare states influence population health and health inequalities has long been debated but less well tested by empirical research. This book presents new empirical evidence of the effects of Swedish welfare state structures and policies on the lives of Swedish citizens. The discussion, analysis and innovative theoretical approaches developed in the book have implications for health research and policy beyond Scandinavian borders. Drawing on a rich source of longitudinal data, the Swedish Level of Living Surveys (LNU), and other data, the authors shed light on a number of pertinent issues in health inequality research while at the same time showing how health inequalities have evolved in Sweden over several decades. Topics covered include how structural conditions relating to family, socio-economic conditions and the welfare state are important in producing health inequalities; how health inequalities change over the lifecourse and the impact of environment on health inequalities - at home, at school, in the workplace. Health inequalities and welfare resources will be invaluable to researchers, students and practitioners in sociology, social epidemiology, public health and social policy interested in the interplay between society and health