Socio-economic status and the rise of divorce in Sweden: The case of the 1880-1954 marriage cohorts in Västerbotten.

An established negative association between socio-economic status (SES) and divorce has applied to most Western nations since 1960. We expected a positive association between SES and divorce for low-divorce contexts historically because only individuals in higher social strata had the resources to overcome barriers to divorce. According to Goode's socio-economic growth theory, this relationship was reversed as industrialization and modernization began removing the economic and normative barriers. Making use of longitudinal data from parish registers, we investigated SES and other micro-level determinants of divorce among men and women in northern Sweden who married between 1880 and 1954. Results indicated a positive association between SES and divorce among those who married 1880-1919, with the middle class, not the elite, featuring the highest divorce risks. This association changed for couples who married in the 1920s, for whom divorce became more common and the working class faced similar divorce risks to the higher social strata.

The Impact of Hip Fracture on Geriatric Care and Mortality Among Older Swedes: Mapping Care Trajectories and Their Determinants.

In this study, we examined the impact of hip fractures on trajectories of home care, nursing home residence, and mortality among individuals aged 65 years or more and explored the impacts of living arrangements, cohabitation, frailty, and socioeconomic position on these trajectories. Based on a linkage of nationwide Swedish population registers, our study included 20,573 individuals with first hip fracture in 2014-2015. Care trajectories during the 2 years following the fracture were visualized and compared with those of 2 hip-fracture-free control groups drawn from the general population: age- and sex-matched controls and health-matched controls identified through propensity score matching. Multistate modeling was employed to identify sociodemographic and health-related factors associated with care trajectories among hip fracture patients. We found that hip fracture patients already had worse health than the general population before their fracture. However, when controlling for prefracture health, hip fractures still had a considerable impact on use of elder-care services and mortality. Comparisons with the health-matched controls suggest that hip fractures have an immediate, yet short-term, impact on care trajectories. Long-term care needs are largely attributable to poorer health profiles independent of the fracture itself. This emphasizes the importance of adequate comparison groups when examining the consequences of diseases which are often accompanied by other underlying health problems.

Determinants of home care utilization among the Swedish old: nationwide register-based study.

Since the 1990s, Sweden has implemented aging-in-place policies increasing the share of older adults dependent on home care instead of residing in care homes. At the same time previous research has highlighted that individuals receive home care at a higher age than before. Consequently, services are provided for a shorter time before death, increasing reliance on family and kin as caregivers. Previous studies addressing how homecare is distributed rely primarily on small surveys and are often limited to specific regions. This study aims to ascertain how home care services are distributed regarding individual-level factors such as health status, living arrangements, availability of family, education, and socioeconomic position. To provide estimates that can be generalized to Sweden as a whole, we use register data for the entire Swedish population aged 65 + in 2016. The study's main findings are that home care recipients and the amount of care received are among the oldest old with severe co morbidities. Receiving home care is slightly more common among women, but only in the highest age groups. Childlessness and socioeconomic factors play a small role in who receives home care or not. Instead, the primary home care recipients are those older adults living alone who lack direct support from family members residing in the same household. Supplementary Information: The online version contains supplementary material available at 10.1007/s10433-021-00669-9.

Supply or demand? Institutionalization of the mentally ill in the emerging Swedish welfare state, 1900-59.

Historical studies on the institutionalization of the mentally ill have primarily relied on data for institutionalized patients rather than the population at risk. Consequently, the underlying factors of institutionalization are unclear. Using Swedish longitudinal microdata from 1900-59 reporting mental disorders, we examine whether supply factors, such as distance to institutions and number of asylum beds, influenced the risk of institutionalization, in addition to demand factors such as access to family. Institutionalization risks were associated with the supply of beds and proximity to an asylum, but also dependent on families' unmet demand for care of relatives. As the supply of mental care met this family-driven demand in the 1930s, the relative risk of institutionalization increased among those lacking family networks.

Nationwide data on home care and care home residence: presentation of the Swedish Social Service Register, its content and coverage.

AIMS: All Swedish municipalities are legally obliged to provide publicly funded elder care to individuals in need. The Swedish Social Service Register collects data on such care. It is the only nationwide source of information on care home residency and use of home care but has rarely been used for research. This study aims to present the content and coverage of the Social Service Register and to provide guidance for researchers planning to use these data. METHODS: For each month between 2013 and 2020, we examined which of Sweden's 290 municipalities reported data to the Social Service Register. We calculated proportions of the population (restricted to ages 80-89 years to enable comparison) that were reported to the Social Service Register in each municipality and presented the types and amount of care recorded in the register. RESULTS: The proportion of municipalities reporting to the Social Service Register increased from 82% to 98% during the study period but several municipalities reported fragmentarily and inconsistently, particularly during earlier years. Among municipalities reporting to the Social Service Register, 9% of the population aged 80-89 years resided in care homes and 19% received home care, but the registered amount and types of care varied substantially between municipalities and over time. CONCLUSIONS: The Swedish Social Service Register provides valuable data for research on aging and elder care utilisation, but data should be selected and vetted carefully, especially for earlier years. The amount and types of care may not always be comparable between geographical regions and different time periods. In recent years, however, the coverage of the Social Service Register is good.

The Persistence of High Levels of Living Alone Among Adults with Disabilities in Sweden, 1993-2011.

This study investigates how the probability to live alone has developed among working age individuals with and without disabilities in Sweden during the period 1993-2011 when extensive political reforms to improve the integration of disabled individuals in society were implemented. The results show that individuals with disabilities are approximately twice as likely to be living alone when compared to individuals without disabilities. People with disabilities were also more likely to report low life satisfaction, and this was especially true among individuals with disabilities living alone. Men and women with disabilities also tend to experience longer periods of living as a one-person household than non-disabled people. Over time we find no indications of reduced differences in family outcomes between disabled and non-disabled individuals but rather evidence to the contrary. These differences are interpreted as being the result of the disadvantage disabled individual's experience in the partner market and that people with disabilities are less successful in forming partnerships that can lead to cohabitation and family formation. The results thus show how disabled individuals still face societal barriers that limit their possibilities to find and sustain relationships that result in stable cohabitation despite increased efforts to improve their inclusion in Swedish society.

The emergence of social gaps in mental health: A longitudinal population study in Sweden, 1900-1959.

During the recent decades, social inequalities in mental health have increased and are now one of the most persistent features of contemporary society. There is limited knowledge about when this pattern emerged or whether it has been a historically fixed feature. The objective of this study was to assess whether socioeconomic and gender gaps in mental health changed during the period 1900-1959 in Sweden. We used historical micro data which report all necessary information on individuals' demographic characteristics, occupational attainment and mental disorders (N = 2,450) in a Swedish population of 193,893. Changes over time was tested using multilevel Cox proportional hazard models. We tested how gender-specific risks of mental disorder changed and how gender-specific socioeconomic status was related to risks of mental disorder later in life. We found a reversal in gender gaps in mental health during the study period. Women had a lower risk than men in 1900 and higher risks in 1959. For men, we found a negative gradient in SES risks in 1900 and a positive gradient in 1959. For women, we found no clear SES gradient in the risk of mental disorder. These findings suggest that the contemporary patterns in socioeconomic and gender gaps in mental disorder emerged during the 1940s and 1950s and have since then persisted.

Seeding the gender revolution: Women's education and cohort fertility among the baby boom generations.

In Europe and the United States, women's educational attainment started to increase around the middle of the twentieth century. The expected implication was fertility decline and postponement, whereas in fact the opposite occurred. We analyse trends in the quantum of cohort fertility among the baby boom generations in 15 countries and how these relate to women's education. Over the 1901-45 cohorts, the proportion of parents with exactly two children rose steadily and homogeneity in family sizes increased. Progression to a third child and beyond declined in all the countries, continuing the ongoing trends of the fertility transition. In countries with a baby boom, and especially among women with post-primary education, this was compensated for by decreasing childlessness and increasing progression to a second child. These changes, linked to earlier stages of the fertility transition, laid the foundations for later fertility patterns associated with the gender revolution.

Agency in Fertility Decisions in Western Europe During the Demographic Transition: A Comparative Perspective.

We use a set of linked reproductive histories taken from Sweden, the Netherlands, and Spain for the period 1871-1960 to address key issues regarding how reproductive change was linked specifically to mortality and survivorship and more generally to individual agency. Using event-history analysis, this study investigates how the propensity to have additional children was influenced by the number of surviving offspring when reproductive decisions were made. The results suggest that couples were continuously regulating their fertility to achieve reproductive goals. Families experiencing child fatalities show significant increases in the hazard of additional births. In addition, the sex composition of the surviving sibset also appears to have influenced reproductive decisions in a significant but changing way. The findings offer strong proof of active decision-making during the demographic transition and provide an important contribution to the literature on the role of mortality for reproductive change.

Sex preference for children in German villages during the fertility transition.

In the past, parents' sex preferences for their children have proved difficult to verify. This study used John Knodel's German village genealogies of couples married between 1815 and 1899 to investigate sex preferences for children during the fertility transition. Event history analyses of couples' propensity to progress to a fifth parity was used to test whether the probability of having additional children was influenced by the sex composition of surviving children. It appears that son preference influenced reproductive behaviour: couples having only girls experienced significantly higher transition rates than those having only boys or a mixed sibset. However, couples who married after about 1870 began to exhibit fertility behaviour consistent with the choice to have at least one surviving boy and girl. This result represents a surprisingly early move towards the symmetrical sex preference typical of modern European populations.

Time-space trends in Swedish divorce behaviour, 1911-1974.

This study examines how the divorce rates in Sweden have varied over time and across different geographical areas during the period 1911-1974, and how these variations can be connected to the political, socio-economic and cultural development in Sweden. The analysis provides empirical support for the hypothesis that increased divorce rates have been the result of changes in the structural conditions that determine the degree of economic interdependence between spouses. There is a strong connection between the degree of urbanization and the divorce rate on a regional level for the entire research period. The statistical analysis of the regional data indicates that these patterns are connected to the more diversified economy that has developed in urban settings, in the form of a more qualified labour market and higher wages for females. These characteristics resulted in a faster and more pronounced reduction of economic interdependence between spouses, which made divorce more attainable in these areas as compared with rural settings.

Ready, willing, and able to divorce: an economic and cultural history of divorce in twentieth-century Sweden.

This study outlines a long history of divorce in Sweden, recognizing the importance of considering both economic and cultural factors in the analysis of marital dissolution. Following Ansley Coale, the authors examine how a framework of multiple theoretical constructs, in interaction, can be applied to the development toward mass divorce. Applying a long historical perspective, the authors argue that an analysis of gendered aspects of the interaction between culture and economics is crucial for the understanding of the rise of mass divorce. The empirical analysis finds support for a marked decrease in legal and cultural obstacles to divorce already during the first decades of the twentieth century. However, economic structures remained a severe obstacle that prohibited significant increases in divorce rate prior to World War II. It was only during the 1940s and 1960s, when cultural change was complemented by marked decreases in economic interdependence between spouses, that the divorce rate exhibited significant increases. The authors find that there are advantages to looking at the development of divorce as a history in which multiple empirical factors are examined in conjunction, recognizing that these factors played different roles during different time periods.