Väestöliitto

Evolutionary theory predicts that returns on investments in family relations will vary by sex and life stage and that there can be a trade-off between mating and (grand)parenting. Family sociology has shown that whereas couple relations are central to happiness in older age, the effects of grandparenting are more mixed and context dependent. Here, we merge these two perspectives and study how partnership histories over the life course relate to happiness among Europeans aged 50+ and whether grandparental investment moderates these associations. Of particular interest is whether there are signs of trade-offs, cumulative benefits, or compensatory benefits between the type of couple relations and grandparenting in postreproductive age. We employed the Survey of Health, Ageing and Retirement in Europe with data from 26 European countries and Israel for the years 2004–2020. The analyses distinguish between respondents who are in their first, second, or third union through marriage or cohabitation; are divorced; are widowed; are living apart from a partner; or are single. We investigated how quality of life and life satisfaction are associated with these seven types of partnership histories and whether the associations are moderated by grandparental status and provision of grandchild care. Europeans with a partner, and especially those in their first union, were happier than those in other partnership groups, and grandparents were happier than individuals without grandchildren. Grandparental investment was associated with being happier in most partnership groups. The “grandparenting bonus” was greatest among unpartnered respondents, suggesting a compensatory effect. We found no signs of a cumulative effect, nor of costs to happiness from grandchild care. Our results illustrate how reproductive strategies over the life course shape happiness returns to grandparenting. Being a grandparent and, especially, providing care for grandchildren may compensate for the lower happiness associated with the loss or lack of a partner.

Objective To examine the contribution of preterm birth and size‐for‐gestational age in stillbirths using six ‘newborn types’. Design Population‐based multi‐country analyses. Setting Births collected through routine data systems in 13 countries. Sample 125 419 255 total births from 22⁺⁰ to 44⁺⁶ weeks’ gestation identified from 2000 to 2020. Methods We included 635 107 stillbirths from 22⁺⁰ weeks’ gestation from 13 countries. We classified all births, including stillbirths, into six ‘newborn types’ based on gestational age information (preterm, PT, <37⁺⁰ weeks versus term, T, ≥37⁺⁰ weeks) and size‐for‐gestational age defined as small (SGA, <10th centile), appropriate (AGA, 10th–90th centiles) or large (LGA, >90th centile) for gestational age, according to the international newborn size for gestational age and sex INTERGROWTH‐21st standards. Main outcome measures Distribution of stillbirths, stillbirth rates and rate ratios according to six newborn types. Results 635 107 (0.5%) of the 125 419 255 total births resulted in stillbirth after 22⁺⁰ weeks. Most stillbirths (74.3%) were preterm. Around 21.2% were SGA types (PT + SGA [16.2%], PT + AGA [48.3%], T + SGA [5.0%]) and 14.1% were LGA types (PT + LGA [9.9%], T + LGA [4.2%]). The median rate ratio (RR) for stillbirth was highest in PT + SGA babies (RR 81.1, interquartile range [IQR], 68.8–118.8) followed by PT + AGA (RR 25.0, IQR, 20.0–34.3), PT + LGA (RR 25.9, IQR, 13.8–28.7) and T + SGA (RR 5.6, IQR, 5.1–6.0) compared with T + AGA. Stillbirth rate ratios were similar for T + LGA versus T + AGA (RR 0.7, IQR, 0.7–1.1). At the population level, 25% of stillbirths were attributable to small‐for‐gestational‐age. Conclusions In these high‐quality data from high/middle income countries, almost three‐quarters of stillbirths were born preterm and a fifth small‐for‐gestational age, with the highest stillbirth rates associated with the coexistence of preterm and SGA. Further analyses are needed to better understand patterns of gestation‐specific risk in these populations, as well as patterns in lower‐income contexts, especially those with higher rates of intrapartum stillbirth and SGA.

Denunciation furthers social control by providing access to hard-to-reach sections of social networks. We reconceptualize “voluntary” and “coercive” regimes of denunciation in terms of coercive pressure: the credible threat of use of violence by authorities. This allows us to articulate a processual approach to denunciation as situational in nature, adapting to shifting circumstances, rather than as a propensity characteristic of a regime. We test this approach using data from the trial of Waldensians in Giaveno, Italy, in 1335, headed by the inquisitor Alberto de Castellario. A dynamic network actor model attests that coercive pressure increases the rate of denunciation, as initial resistance gave way to cooperation, and decreases the social distance between denouncer and denounced, shifting the denunciation target from fellow villagers to congregation fellows and kinship members. The motivation to denounce was mixed in nature, as deponents simultaneously disclosed and concealed, protecting close ones until they could no more. The analysis implies that coercive regimes may be more effective instruments of social control than voluntary regimes.

Sexual expression is fundamental to human existence and an important topic of enquiry in its own right. Understanding sexual behavior is also essential to establish effective sexual health prevention activities (e.g., education), services and policies, and to assess the progress of policies and action plans. Questions on sexual health are rarely included in general health surveys, and therefore dedicated population studies are required. Many countries lack both funding and sociopolitical support to conduct such surveys. A tradition of periodic population sexual health surveys exists in Europe but the methods used (e.g., in questionnaire construction, recruiting methods or interview format) vary from one survey to another. This is because the researchers within each country are confronted with conceptual, methodological, sociocultural and budgetary challenges, for which they find different solutions. These differences limit comparison across countries and pooling of estimates, but the variation in approaches provides a rich source of learning on population survey research. In this review, survey leads from 11 European countries discuss how their surveys evolved during the past four decades in response to sociohistorical and political context, and the challenges they encountered. The review discusses the solutions they identified and shows that it is possible to create well designed surveys which collect high quality data on a range of aspects of sexual health, despite the sensitivity of the topic. Herewith, we hope to support the research community in their perennial quest for political support and funding, and ongoing drive to advance methodology in future national sex surveys.

Only a very few studies to date have comprehensively assessed children’s knowledge of sexuality. In this study, we examined the level of sexual knowledge among children aged 3–6 years in Finland. We analysed children’s explanations of what they saw in drawings related to genital naming, conception and childbirth, safety skills, and adult sexual activity. Levels of knowledge were generally low. The largest number of correct answers were given for genital naming and safety skills. Knowledge increased with age. Children’s gender was not related to their total level of knowledge. There was a correlation between children’s ability to name their genitals and their knowledge of safety skills. The results suggest that only what is known about can be protected. Building on the findings of this study, age-appropriate sexuality education should be provided to all children.

Our knowledge of family relations and well-being in LGBTQ+ families is increasing, yet few studies so far have gathered quantitative data from both children and parents. The Finnish Rainbow Family study conducted surveys of 10–12-year-old children (N = 41), 13–18-year-old adolescents (N = 47), and of parents of 7–18-year-old children (N = 80 parents/103 responses) living in a LGBTQ+ family. Unlike many earlier surveys, we also asked about experiences of transgender adults in the family. Responses were compared with the nationwide School Health Promotion Study in Finland. Results suggest that the parental relationships and family functioning of underaged children in Finnish LGBTQ+ families are good and resemble those of other Finnish children. Children and parents describe their family life rather similarly. Rainbow families had slightly worse parental relations among 10–12-year-old children but overall better family functioning, and parents were very supporting and encouraging. The detected differences may relate to higher levels of both parental separation and parental education in Finnish rainbow families. Additionally, most adolescents with a transgender parent feel proud of their parent, although many have experienced difficulties talking about the transition with other people.

The mother's bond to her baby starts to develop during pregnancy, and it is related to the baby's attachment. We study how the mother's prenatal expectations of her unborn baby, the mother's adult relationships, and postnatal psycho‐social factors (stress, depression, and anxiety) are related to the risk of bonding disturbance. The study comprised 1398 mothers and their unborn babies assessed both during pregnancy and when the babies were 3 months old (47.7% girls). The mother's risk of bonding disturbance was investigated using Brockington's Postpartum Bonding Questionnaire. According to the results, 71 (5.1%) of all the mothers in the study had a risk of a bonding disturbance. In a final adjusted logistic regression model, the most important risk factors were the mother's inability to form positive expectations about relationships with the baby during the third trimester of pregnancy (AOR = 7.78, p ≤ .001), maternal postnatal stress (AOR = 4.95, p ≤ .001) and maternal postnatal depression (AOR = 3.46, p ≤ .01). The results challenge healthcare professionals to screen pregnant mothers to identify at‐risk groups for post‐partum bonding disturbances. Intervention programs to prevent the development of bonding disturbances, and thus their possible serious consequences for children's development, should be considered.

Cues facilitating kin detection among children have been suggested to have a profound impact on adult sibling relationships. Using a large and population-based data of younger and middle-aged Finns, we test how childhood co-residence duration and maternal perinatal association (MPA) correlate with contact frequency, emotional closeness and provision of help between adult siblings. Employing sibling fixed-effect regression models we show that duration of co-residence in childhood and MPA are indeed associated with better relationship quality in all three measures. Provided MPA, sibling relationship quality is high independently of co-residence length, but in the absence of MPA, increased co-residence duration is associated with better relationship quality. Co-residence duration is more strongly associated with provision of help between opposite-gender than same-gender sibling dyads. Full siblings report better relationship quality than half siblings do, although the co-residence duration mediates the effect of genetic relatedness in emotional closeness between full and maternal half siblings and in provision of help between full and paternal half siblings. Moreover, MPA serves as a mediator in the case of emotional closeness between full and maternal half siblings. Our results provide solid support for the importance of childhood kin detection cues for sibling relationship quality in adulthood, and how such cues interact with genetic relatedness and gender.

This chapter sets the scene and raises the questions. We define the nature of siblinghood and its variations. (The definition of a brother/sister used in this book is someone who is a first-degree sibling relation, through genetic relatedness, kinship (e.g. adoption)(or co-residence in childhood (someone who has been brought up as a brother or sister in the family as a child; we also distinguish between full, half and step siblings.) The dynamics of sibling attachment and competition have universal traits, yet they can also vary greatly by age, family constellation, cultural and ecological factors, and of course individual sibling characteristics. With increases in wealth, health and longevity and decreases in fertility in most of the world’s countries, today’s adults have lived with fewer siblings than previous generations, but will live with them for a longer time, and inherit more from previous generations. In a fast-changing world, with smaller families, more diverse family types, and in various regions of the world, to what extent do siblings support each other at different stages of the life cycle, adolescence, mid-life, old age? Today, what factors are associated with support given, or not given, at different ages? How do cultural practices and family obligations impact on sibling support? How does sibling support differ in different situations; surrogate siblings; migrant families, cross-racial adoption, a sibling with special needs? In a world with increased ageing, will siblings be called upon to offer more support to their brothers and sisters? Will they be willing to help?

A safe childhood respecting sexual rights forms the foundation of an individual’s sexual health. However, the understanding, support, and protection of early sexuality are seldom discussed. Children already express their sexuality verbally and behaviorally in daycare, often requiring a response from staff. These day-to-day situations may have an influence on children’s later sexuality. The World Health Organization Regional Office for Europe and BZgA (2010) published a framework for professionals on age-appropriate, holistic sexuality education. Using this framework, we evaluated children’s sexuality-related expressions in Finnish daycare. Our nationwide questionnaire among professionals in early childhood education and care (n = 507) focused on how 1–6-year-old children expressed their sexuality in their speech and behavior. All eight topics in the WHO framework emerged regularly. The two most prevalent topics were the body and emotions. Also, 71% of professionals had a child in their group who masturbated openly. Early sexual development manifested as curiosity about one’s own body, exploring its functions, traits, and attributes, while on an emotional level it manifested as abundant feelings of infatuation and tenderness, shown openly toward those—peers and adults alike—whom the child cares for. Childhood sexuality is broadly and diversely present in children’s verbal and behavioral expressions in daycare settings. Children need and have the right to receive explicit responses related to issues concerning their sexual development and to receive age-appropriate information, skills, and attitudes fostering healthy development.

Background: Ignorance, misconceptions and fear hinder the implementation of young children’s age-appropriate sexuality education (SE) globally. Methods to promote the SE of young children are needed. Aim: We aimed to evaluate why parents and professionals resist the concept of childhood SE and to test whether a child-centred term could reduce this resistance. Setting: We conducted nationwide studies in Finland plus focused studies in three groups. Methods: In open online situation analysis and needs assessment studies among early childhood education professionals (n = 507) and parents (n = 614) of 1–6-year-olds, negative, adulthood-associated connotations for the term ‘sexuality education’ were detected. We then evaluated whether a less sex-connected term than SE would be feasible to promote SE of young children. We combined ‘body’ and ‘emotion’, after our earlier study on children’s most common sexuality-related expressions, to form the new Finnish term Kehotunnekasvatus [body–emotion education] and tested it among professionals of sexual health (n = 17) and early education (n = 63) and primary health nurses (n = 29). Results: Acceptance of the new term was excellent in all three groups; the new term was reported as ‘more positive, more neutral, downplaying thoughts of sex’. Most respondents deemed it appropriate, necessary and usable in their work. Furthermore, the majority of those working daily with the parents of young children preferred the new term to ‘sexuality education’. Conclusion: After testing the functionality of a new Finnish term among Finnish professionals, the authors suggest considering replacing the term ‘sexuality education’ with a more child-centred and less sex-connected synonym when referring to SE for young children.

Based on kin selection theory, amounts of grandparental investment should reflect the probability to share common genes with offspring. Adoption may represent a special case, however, yet grandparental investment in adopted children has previously been both theoretically misconstrued and little investigated. Here, we study for the first time how grandparental childcare provision is distributed between biological, adopted, and step-offspring. Using Generations and Gender Surveys ( n = 15,168 adult child–grandmother and 12,193 adult child–grandfather dyads) and the Survey of Health, Ageing, and Retirement in Europe ( n = 17,233 grandmother–adult child and 13,000 grandfather–adult child dyads), we find that grandparents were less likely to provide care to stepchildren than to adopted and biological children, but no difference between adopted and biological children. These findings were present in both data sets and for both grandmothers and grandfathers, after several potentially confounding factors were taken into account. The stepchild disadvantage is in line with kin selection theory. The congruent amounts of care provided to adopted and biological children may reflect similar levels of adult–child attachment, selection effects, and greater need in adoptive families, as well as some degree of genetical relatedness in the case of kin adoption. The study provides new evidence of biased kin investments in contemporary societies and stresses the importance of psychological motivation and attachment in evolutionary studies of kin investment.

Objectives: Nationally representative studies on socioeconomic differences in toothache prevalence are very limited, especially with a long follow-up period. Our aim was to examine the education-related differences in toothache prevalence among 25- to 64-year-olds in Finland during 1990-2014. Methods: We used data from the Health Behaviour and Health Among the Finnish Adult Population surveys. Data were gathered by random samples of 15- to 64-year-old Finns annually between 1990 and 2014. Response rates decreased during this period from 76% (n = 3812) to 53% (n = 2630). Our final pooled total sample size was 63 372 after exclusion of edentate participants and missing data. Relative educational level was used to measure socioeconomic position. In addition to basic tabulations, educational differences in toothache prevalence during the past month were investigated using the multiple additive regression tree for mediation analysis. Results: The proportion of respondents who reported having had toothache during the past month increased from 7% to 12% from 1990 to 2014. Educational differences in toothache prevalence were small for the whole study period, especially in women. Men with high relative education had a lower toothache prevalence than people with low relative education during 1990-1994 and 2010-2014. This stemmed from the direct effect of relative education and the indirect effects of toothbrushing frequency, number of missing teeth and perceived health. In both sexes, those with middle-level relative education had higher toothache prevalence than people with low relative education 1995-2009. Conclusions: During 1990-2014, toothache prevalence increased among 25- to 64-year-olds in Finland. Since the mid-1990s, differences in toothache prevalence by relative education remained very small in both sexes. More actions are needed to understand reasons behind the clearly increased toothache prevalence in Finland during the last decades.

Less frequent cervical cancer screening in human papillomavirus (HPV) vaccinated birth cohorts could produce considerable savings without increasing cervical cancer incidence and loss of life‐years. We report here the baseline findings and interim results of safety and accuracy of infrequent screening among HPV16/18 vaccinated females. The entire 1992–1994 birth‐cohorts (30,139 females) were invited to a community‐randomized HPV16/18‐vaccination trial. A total of 9,482 female trial participants received HPV16/18‐vaccination in 2007–2009 at age of 13–15. At age 22, 4,273 (45%) of these females consented to attend a randomized trial on frequent (ages 22/25/28; Arm 1: 2,073 females) vs. infrequent screening (age 28; Arm 2: 2,200 females) in 2014–2017. Females (1,329), who had got HPV16/18 vaccination at age 18 comprised the safety Arm 3. Baseline prevalence and incidence of HPV16/18 and other high‐risk HPV types were: 0.5% (53/1,000 follow‐up years, 10⁴) and 25% (2,530/10⁴) in the frequently screened Arm 1; 0.2% (23/10⁴) and 24% (2,413/10⁴) in the infrequently screened Arm 2; and 3.1% (304/10⁴) and 23% (2,284/10⁴) in the safety Arm 3. Corresponding prevalence of HSIL/ASC‐H and of any abnormal cytological findings were: 0.3 and 4.2% (Arm 1), 0.4 and 5.3% (Arm 2) and 0.3 and 4.7% (Arm 3). Equally rare HSIL/CIN3 findings in the infrequently screened safety Arm A3 (0.4%) and in the frequently screened Arm 1 (0.4%) indicate no safety concerns on infrequent screening despite the up to 10 times higher HPV16/18 baseline prevalence and incidence in the former.

This manuscript discloses end-of-study safety data of a community-randomized controlled trial in Finland (NCT00534638), assessing the effectiveness of two vaccination strategies (gender-neutral versus females only) using the AS04-adjuvanted human papillomavirus (HPV)-16/18 (AS04-HPV-16/18) vaccine. The total vaccination cohort included 32,175 adolescents aged 12–15 y at vaccination of whom 14,837 received the AS04-HPV-16/18 vaccine and 17,338 received the hepatitis-B virus vaccine (control). Spontaneous reporting of serious adverse events (SAEs) combined with surveillance using nation-wide health registries showed an acceptable safety profile of the AS04-HPV-16/18 vaccine. During the study period (up to 6.5 y), the incidences (per 100,000 person-years) of reported SAEs considered as possibly related to vaccination were 39.1 (95% confidence interval [CI]: 25.3–57.7) and 39.8 (95%CI: 26.8–56.8) in the HPV and control groups, respectively. The most frequently reported new-onset autoimmune diseases (NOADs) were ulcerative colitis (incidence rates of 28.2 and 33.1 per 100,000 person-years in the HPV and control groups, respectively), insulin-dependent diabetes mellitus (21.9 and 37.1), Crohn’s disease (15.6 and 22.5), celiac disease (15.6 and 21.2), and juvenile idiopathic arthritis (14.1 and 15.9). Of 1,344 pregnancies reported (777 and 567 in the HPV and control groups, respectively), most resulted in elective termination (58.4% and 58.6%), birth of a live infant (32.7% and 32.3%), or in spontaneous abortion (8.0% and 7.9%). No major, registered congenital anomalies were identified. The incidence rates of NOADs and pregnancy outcomes were generally balanced between groups. No specific safety signals were identified in the population-based health registry surveillance.

Information on long‐term trends in toothache prevalence is scarce. The aim of this study was to assess age‐, period‐, and cohort‐related changes in toothache prevalence among 15‐ to 64‐yr‐old adults in Finland between 1990 and 2014 by using annual, representative postal surveys, albeit with decreasing response rates from 76% (n = 3,812) to 53% (n = 2,630). Age–period–cohort analysis of toothache prevalence during the past month was performed. Logistic regression analyses were conducted to account for other factors contributing to toothache. Toothache prevalence increased from 7% to 12% during the time period 1990 to 2014. Age–period–cohort analysis revealed that toothache prevalence increased from cohort to cohort, especially from the 1960 birth cohorts onwards (cohort effect). Adults under 30 yr of age had the highest toothache prevalence (~17%), while, in those over 30 yr of age, toothache prevalence decreased steadily according to age (to ~5% at age 64 yr, age effect). Toothache prevalence peaked at ~ 11% in the mid‐2000s (period effect). Toothache was strongly associated with poorer perceived health and lower toothbrushing frequency and less strongly associated with higher educational level, a higher number of missing teeth, history of smoking, being single, separated, or divorced, and female gender. The increase in toothache prevalence occurred especially from 1990 to the mid‐2000s, and mainly among younger age groups and more recent cohorts.