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Social capital has become an attractive theoretical perspective for a range of phenomena. However there is no consensus about definitions and measures of the concept. The aim of this paper is to make a Swedish review with relevance for public health of how the concept is used among some well cited researchers in political science, sociology, economy and public health. The review describes the background and use of the concept within these four disciplines. Different forms and perspectives on social capital are reviewed, and the important question about sources and consequences of social capital is discussed. Some of the critics against the concept are also presented. Social capital is often measured by connecting variables from already existing databases to the concept. However there are also examples of instruments that are prepared especially for measuring social capital and some of these are showed in this review. Examples of both quantitative and qualitative studies are presented. The review calls attention to the wide application of social capital within public health. The concept is useful in understanding the connections between social factors and health outcome on three different levels, - state, community and individual level. Some researchers state that the concept is too broad to be able to add some new knowledge; while this review argues that a wide application also could be a benefit. The question about health determinants is complex and could not be understood only on one level. Social capital can add important new knowledge about health determinants on all three levels. However, there is a need for further theoretical development to make the research about social capital and health valid. The basis for community social capital has to be clarified. In addition, there is a need for more knowledge about the collective and the individual aspects of social capital. Analysis of social capital on different levels also demands awareness of the fact that social capital could have positive consequences on one level and concurrently, negative consequences on another level. ; Syftet med denna rapport är att bidra till en svensk kunskapsöversikt om hur begreppet socialt kapital definieras och används av några flitigt refererade forskare på området, med ett särskilt fokus på folkhälsa. Inledningsvis görs en genomgång av hur begreppet definieras, beskrivs och används inom statsvetenskap, sociologi, ekonomi och folkhälsa. Därefter redovisas olika former av och perspektiv på socialt kapital. Sedan görs ett försök att bena ut vilka källorna till, respektive effekterna av socialt kapital kan vara. En del av den kritik som finns mot begreppet redovisas och därefter presenteras en sammanfattande matris över hur begreppet används inom de fyra redovisade kunskapsområdena. Rapporten tar också upp frågan om hur socialt kapital mäts, där en rad exempel på undersökningar och mätinstrument för socialt kapital presenteras. Inom EU-finansierade projektet Urban Design.

Background Knowledge of what is uplifting and helpful during pandemics could inform the design of sustainable pandemic recommendations in the future. We have explored individuals' views on helpful and uplifting aspects of everyday life during the coronavirus disease 2019 (COVID-19) pandemic. Methods Participants answered a brief, daily survey via text messages during 14 consecutive days in July–August, 2020. The survey included the question: "During the past 24 hours, is there anything that has made you feel good or helped you in your life?" We used content analysis to compile responses from 693 participants, who provided 4,490 free-text answers, which resulted in 24 categories subsumed under 7 themes. Results Positive aspects during the COVID-19 pandemic primarily related to social interactions, in real life or digitally, with family, friends and others. Other important aspects concerning work, colleagues and maintaining everyday life routines. One theme concerning vacations, going on excursions and being in nature. Leisure and recreation activities, such as hobbies and physical exercise, also emerged as important, as did health-related factors. Bodily sensations, thoughts, feelings and activities that benefited well-being were mentioned frequently. Lastly, people commented on the government strategies for containing COVID-19, and whether to comply with restrictions. Conclusions To summarize, daily uplifts and helpful aspects of everyday life centered around social relationships. To comply with recommendations on physical distancing, people found creative ways to maintain social connections both digitally and face-to-face. Social interaction, maintenance of everyday life routines, hobbies and physical activity appeared to be important for well-being.

Context The demographic context for the EIWO project is continued population ageing and, especially, growth in the numbers of very elderly people, which applies to all four countries in this project: Germany, Poland, Sweden and the UK. However, the common ageing trend is unequally distributed. In particular there remain significant gaps in life expectancy (LE) and health life expectancy (HLE) both between countries and within them. For example LE differences based on socio-economic status, income, and education are present in all four countries. In terms of HLE, Swedish women have HLE at birth, that is, on average, 6 years longer than German women, 8 years longer than Polish women and 11 years longer than British women. ; This working paper has been reviewed within the EIWO project group.

Oxford COVID-19 Database (OxCOVID19 Database) is a comprehensive source of information related to the COVID-19 pandemic. This relational database contains time-series data on epidemiology, government responses, mobility, weather and more across time and space for all countries at the national level, and for more than 50 countries at the regional level. It is curated from a variety of (wherever available) official sources. Its purpose is to facilitate the analysis of the spread of SARS-CoV-2 virus and to assess the effects of non-pharmaceutical interventions to reduce the impact of the pandemic. Our database is a freely available, daily updated tool that provides unified and granular information across geographical regions. Design type Data integration objective Measurement(s) Coronavirus infectious disease, viral epidemiology Technology type(s) Digital curation Factor types(s) Sample characteristic(s) Homo sapiens.

Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached $8. 8 trillion (95% uncertainty interval [UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this, $13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and $1.4 billion was repurposed from existing health projects. $3.1 billion (22.4%) of the funds focused on country-level coordination and $2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34.3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. ; For complete list of authors see http://dx.doi.org/10.1016/S0140-6736(21)01258-7

Background: During the Covid-19 pandemic the Dutch government implemented its so-called 'intelligent lockdown' in which people were urged to leave their homes as little as possible and work from home. This life changing event may have caused changes in lifestyle behaviour, an important factor in the onset and course of diseases. The overarching aim of this study is to determine life-style related changes during the first wave of the COVID-19 pandemic among a representative sample of the adult population in the Netherlands. Methods: Life-style related changes were studied among a random representative sample of the adult population in the Netherlands using an online survey conducted from 22 to 27 May 2020. Differences in COVID-19-related lifestyle changes between Complementary and Alternative Medicine (CAM) users and non-CAM users were determined. The survey included a modified version of the I-CAM-Q and 26 questions on lifestyle related measures, anxiety, and need for support to maintain lifestyle changes. Results: 1004 respondents were included in the study, aged between 18 and 88 years (50.7% females). Changes to a healthier lifestyle were observed in 19.3% of the population, mainly due to a change in diet habits, physical activity and relaxation, of whom 56.2% reported to be motivated to maintain this behaviour change in a post-COVID-19 era. Fewer respondents (12.3%) changed into an unhealthier lifestyle. Multivariable logistic regression analyses revealed that changing into a healthier lifestyle was positively associated with the variables 'Worried/ Anxious getting COVID-19' (OR: 1.56, 95% C.I. 1.26-1.93), 'CAM use' (OR: 2.04, 95% C.I. 1.38-3.02) and 'stress in relation to financial situation' (OR: 1.89, 95% C.I. 1.30-2.74). 'Age' (OR 18-25: 1.00, OR 25-40: 0.55, 95% C.I. 0.31-0.96, OR 40-55:0.50 95% C.I. 0.28-0.87 OR 55+: 0.1095% C.I. 0.10-0.33), 'stress in relation to health' (OR: 2.52, 95% C.I. 1.64-3.86) and 'stress in relation to the balance work and home' (OR: 1.69, 95% C.I. 1.11-2.57) were found predicting the change into an unhealthier direction. Conclusion: These findings suggest that the coronavirus crisis resulted in a healthier lifestyle in one part and, to a lesser extent, in an unhealthier lifestyle in another part of the Dutch population. Further studies are warranted to see whether this behavioural change is maintained over time, and how different lifestyle factors can affect the susceptibility for and the course of COVID-19.T

Objective: During the COVID pandemic, government authorities worldwide have tried to limit the spread of the virus. Swedens distinctive feature was the use of voluntary public health recommendations. Few studies have evaluated the effectiveness of this strategy. Based on data collected in the spring of 2020, this study explored associations between compliance with recommendations and observed symptoms of contagion in others, using self-report data from university students. Results: Compliance with recommendations ranged between 69.7 and 95.7 percent. Observations of moderate symptoms of contagion in "Someone else I have had contact with" and "Another person"were markedly associated with reported self-quarantine, which is the most restrictive recommendation, complied with by 81.2% of participants. Uncertainty regarding the incidence and severity of contagion in cohabitants was markedly associated with the recommendation to avoid public transportation, a recommendation being followed by 69.7%. It is concluded that students largely followed the voluntary recommendations implemented in Sweden, suggesting that coercive measures were not necessary. Compliance with recommendations were associated with the symptoms students saw in others, and with the perceived risk of contagion in the students immediate vicinity. It is recommended that voluntary recommendations should stress personal relevance, and that close relatives are at risk. ; Funding Agencies|Malmo University - Swedish Research Council (Vetenskapsradet) [2019-01127]

During the COVID-19 crisis there have been many difficult decisions governments and other decision makers had to make. E.g. do we go for a total lock down or keep schools open? How many people and which people should be tested? Although there are many good models from e.g. epidemiologists on the spread of the virus under certain conditions, these models do not directly translate into the interventions that can be taken by government. Neither can these models contribute to understand the economic and/or social consequences of the interventions. However, effective and sustainable solutions need to take into account this combination of factors. In this paper, we propose an agent-based social simulation tool, ASSOCC, that supports decision makers understand possible consequences of policy interventions, but exploring the combined social, health and economic consequences of these interventions. ; Correction available: https://link.springer.com/article/10.1007%2Fs11023-021-09565-8 (WOS:000671651200001)

Introduction Although intimate partner violence (IPV) affects an estimated one out of three women globally, evidence on violence prevention is still scarce. No studies have measured long-term change in larger populations over a prolonged period. Methods The aim of this study was to measure changes in the prevalence of IPV in León, Nicaragua, between 1995 and 2016. The 2016 study interviewed 846 ever-partnered women aged 15 to 49 regarding experiences of physical, sexual and emotional IPV. These findings were analysed together with comparable data collected from 354 women in 1995. Multivariate logistic regression modelling was carried out on a pooled data set to identify differences between the two studies while controlling for potential confounding factors. Results Lifetime physical IPV decreased from 54.8 to 27.6 per cent (adjusted OR (AOR) 0.37; 95% CI 0.28 to 0.49) and 12-month prevalence of physical IPV decreased from 28.2 to 8.3 per cent (AOR 0.29; 95% CI 0.20 to 0.42), respectively. Similar decreases were found in lifetime and 12-month emotional IPV. No significant difference was found in the prevalence of lifetime sexual violence between the two time periods. Conclusions The results suggest that the reduction in IPV was not due to demographic shifts, such as increased education or age, but reflects a true decrease in the prevalence of IPV. The decrease is not likely to have occurred on its own, and may be attributable to multisectoral efforts by the Nicaraguan government, international donors and the Nicaraguan women's movement to increase women's knowledge of their rights, as well as access to justice and services for survivors during this time period.

BACKGROUND: Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. METHODS: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0-100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target-1 billion more people benefiting from UHC by 2023-we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. FINDINGS: Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2-47·5) in 1990 to 60·3 (58·7-61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9-3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010-2019 relative to 1990-2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6-421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0-3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5-1040·3]) residing in south Asia. INTERPRETATION: The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people-the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close-or how far-all populations are in benefiting from UHC. ; For complete list of authors see http://dx.doi.org/10.1016/S0140-6736(20)30750-9

BACKGROUND: Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe. METHODS: Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9 years) and adolescents (≥10 to 18 years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47,497 individuals (2-18 years) from 18 different European countries. RESULTS: Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7 years of age. CONCLUSIONS: Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe.

BACKGROUND: Educational inequalities in health and mortality in European countries have often been studied in the context of welfare regimes or political systems. We argue that the healthcare system is the national level feature most directly linkable to mortality amenable to healthcare. In this article, we ask to what extent the strength of educational differences in mortality amenable to healthcare vary among European countries and between European healthcare system types. METHODS: This study uses data on mortality amenable to healthcare for 21 European populations, covering ages 35-79 and spanning from 1998 to 2006. ISCED education categories are used to calculate relative (RII) and absolute inequalities (SII) between the highest and lowest educated. The healthcare system typology is based on the latest available classification. Meta-analysis and ANOVA tests are used to see if and how they can explain between-country differences in inequalities and whether any healthcare system types have higher inequalities. RESULTS: All countries and healthcare system types exhibited relative and absolute educational inequalities in mortality amenable to healthcare. The low-supply and low performance mixed healthcare system type had the highest inequality point estimate for the male (RII = 3.57; SII = 414) and female (RII = 3.18; SII = 209) population, while the regulation-oriented public healthcare systems had the overall lowest (male RII = 1.78; male SII = 123; female RII = 1.86; female SII = 78.5). Due to data limitations, results were not robust enough to make substantial claims about typology differences. CONCLUSIONS: This article aims at discussing possible mechanisms connecting healthcare systems, social position, and health. Results indicate that factors located within the healthcare system are relevant for health inequalities, as inequalities in mortality amenable to medical care are present in all healthcare systems. Future research should aim at examining the role of specific characteristics of healthcare systems in more detail.

This report describes the 2020 "From a Thesis to a Paper" Course hosted by the Department of Epidemiology and Global Health (EpiGH) at Umeå University, Sweden, and run across weeks 26-35 2020 (22nd June -28th August). The Course guides and advises early career researchers in scientific writing for targeted peer reviewed journals. Students develop papers based on their own research – typically a masters' thesis. They work in small groups reviewing one another's work and revising and re-drafting their manuscripts with support and input from the teacher. By the end of the Course students are expected to produce formatted draft documents suitable for submission to a peer reviewed journal of choice. Eligibility requires either one- or two-year masters' qualifications in public health (MPH), health care or health education. Students and alumni from EpiGH are the target group. Applications and enrolments are processed by Umeå University. Students residing outside the European Union (EU) or European Economic Area (EEA) are required to pay University tuition fees (12,367 Swedish Krona). The majority of students enrolled in EpiGH masters' courses are from low- and middle-income countries. In 2019 the Taylor & Francis Company (T&F) introduced a Scholarship Fund to pay tuition fees for up to ten non-EU/EEA students to enrol in the "From a Thesis to a Paper" Course each year. This report is in accordance with section 4.4 of the contract between T&F and Umeå University which affirms this financial support. See Appendix A.