Ilona Koupil

Ilona Koupil


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Arbetar vid Institutionen för folkhälsovetenskap
Telefon 08-16 39 52
Besöksadress Sveavägen 160, Sveaplan
Rum A 531
Postadress Institutionen för folkhälsovetenskap 106 91 Stockholm

Om mig

Professor i forskning om ojämlikhet i hälsa med folkhälsovetenskaplig/medicinsk inriktning (sedan 2002).

Gästprofessor i social epidemiologi med inriktning mot barn och ungdomar vid Institutionen för folkhälsovetenskap, Karolinska Institutet (2015-2019), anknuten till forskning, Karolinska Institutet (2020). 

Publikationer (urval):

Gao M, Allebeck P, Mishra GD, Koupil I. Developmental origins of endometriosis: a Swedish cohort study. J Epidemiol Community Health. 2019 Jan 19. pii: jech-2018-211811. doi: 10.1136/jech-2018-211811.

Gao M, Goodman A, Mishra G, Koupil I. Associations of birth characteristics with perimenopausal disorders: a prospective cohort study. J Dev Orig Health Dis. 2018 Oct 9:1-7. doi: 10.1017/S204017441800065X.

Holowko N, Jones M, Tooth L, Koupil I, Mishra GD. Socioeconomic Position and Reproduction: Findings from the Australian Longitudinal Study on Women's Health. Matern Child Health J. 2018 Dec;22(12):1713-1724. doi: 10.1007/s10995-018-2567-1.

Juárez SP, Goodman A, Koupil I. From cradle to grave: tracking socioeconomic inequalities in mortality in a cohort of 11 868 men and women born in Uppsala, Sweden, 1915-1929. J Epidemiol Community Health. 2016 Jun;70(6):569-75. doi: 10.1136/jech-2015-206547.

Chaparro MP, Koupil I. The impact of parental educational trajectories on their adult offspring's overweight/obesity status: a study of three generations of Swedish men and women. Soc Sci Med. 2014 Nov;120:199-207. doi: 10.1016/j.socscimed.2014.09.024.

Koupil I, Tooth L, Heshmati A, Mishra G. Social patterning of overeating, binge eating, compensatory behaviours and symptoms of bulimia nervosa in young adult women: results from the Australian Longitudinal Study on Women's Health. Public Health Nutr. 2016;19:3158-3168.

Goodman A, Heshmati A, Koupil I. Family history of education predicts eating disorders across multiple generations among 2 million Swedish males and females. PLoS One. 2014 Aug 27;9(8):e106475. doi: 10.1371/journal.pone.0106475.

Mishra GD, Chiesa F, Goodman A, De Stavola B, Koupil I. Socio-economic position over the life course and all-cause, and circulatory diseases mortality at age 50-87 years: results from a Swedish birth cohort. Eur J Epidemiol. 2013 Feb;28(2):139-47. doi: 10.1007/s10654-013-9777-z

Goodman A, Koupil I, Lawson DW. Low fertility increases descendant socioeconomic position but reduces long-term fitness in a modern post-industrial society. Proc Biol Sci. 2012 Nov 7;279(1746):4342-51.

De Stavola BL, Leon DA, Koupil I. Intergenerational correlations in size at birth and the contribution of environmental factors: The Uppsala Birth Cohort Multigenerational Study, Sweden, 1915-2002. Am J Epidemiol 2011;174:52-62.

Koupil I, Goodman A. Health Equity: A life course approach. Public Service Review: European Union 2011; 22:382-3.

Goodman A, Gisselmann M, Koupil I. Birth outcomes and early-life social characteristics predict unequal educational outcomes: consistency across Swedish cohorts born 1915-1929 and 1973-1980. Longitudinal and Life Course Studies 2010:1:317-338.

Manor O, Koupil I. Birth weight of infants and mortality in their parents and grandparents: the Uppsala Birth Cohort Study. Int J Epidemiol. 2010;39:1264-1276.

Goodman A, Koupil I. Social and biological determinants of reproductive success in Swedish males and females born 1915-1929.  Evolution And Human Behavior 2009;30:329-341.

Koupil I. The Uppsala studies on developmental origins of health and disease. J Internal Medicine 2007;261:426-436.


I urval från Stockholms universitets publikationsdatabas
  • 2018. Gita D. Mishra (et al.). Longitudinal and life course studies 9 (3), 351-375

    MatCH (Mothers and their Children's Health) is a nationwide Australian study to investigate the links between the history of health, wellbeing and living conditions of mothers and the health and development of their children. MatCH builds on the Australian Longitudinal Study on Women's Health (ALSWH), which began in 1996 and has surveyed more than 58,000 women in four nationally representative age cohorts. MatCH focuses on the three youngest offspring of the cohort of ALSWH participants randomly sampled from all women in Australia born in 1973-78 (N=5780 children of N=3039 mothers). These women, who had completed up to seven postal or online surveys since 1996, were invited in 2016-17 to complete surveys about the health and development of their three youngest children aged under 13. The mothers reported on their children's health conditions and symptoms, diet, anthropometric measures, childcare, screen time, physical activity, temperament, behaviour, language development, motor development and health service utilisation, as well as household and environmental factors. These data are being linked with each child's records from official sources including the Australian Early Development Census (collected at age five to six), the National Assessment Program-Literacy and Numeracy (collected at age eight, 10, 12 and 14) and other external datasets. MatCH will combine 20 years of maternal data with all the information on her children, taking into account the family setting. MatCH offers an unprecedented opportunity to advance our understanding of the relationship between maternal health and wellbeing and child health and development.

  • 2017. M. Pia Chaparro (et al.). Scandinavian Journal of Public Health 45 (5), 511-519

    Aim: The aim of this study was to investigate whether women's adult overweight and obesity risk was associated with their childhood family structure, measured as their mothers' marital status history, during the women's first 18 years of life. Methods: Using linked register data, we analyzed 30,584 primiparous women born in Sweden in 1975 who were between 19-35 years of age when their height and pre-pregnancy weight was recorded. The outcomes were women's overweight/ obesity (body mass index (BMI) >= 25 kg/m(2)) and obesity (BMI >= 30 kg/m(2)) and the predictor was mothers' marital status history, which was summarized using sequence analysis. We carried out nested logistic regression models adjusting for women's age and maternal sociodemographic characteristics. Results: Mothers' marital status history was summarized into six clusters: stable marriage, stable cohabitation, married then divorcing, cohabiting then separating, varied transitions, and not with father. In fully adjusted models and compared with women whose mothers belonged to the stable marriage cluster: (1) women whose mothers belonged to the other marital status clusters had higher odds of overweight/obesity (odds ratio (OR) ranging 1.15-1.19; p < 0.05); and (2) women whose mothers belonged to the stable cohabitation (OR = 1.31; 95% confidence interval (CI) = 1.14-1.52), cohabiting then separating (OR = 1.23; 95% CI = 1.01-1.49), varied transitions (OR = 1.24; 95% CI = 1.11-1.39), and not with father (OR = 1.24; 95% CI = 1.00-1.54) clusters had higher odds of obesity. Conclusions: Women whose mothers were not in stable marriage relationships had higher odds of being overweight or obese in adulthood. The finding that even women raised in the context of stable cohabitation had higher odds of being overweight or obese is intriguing as these relationships are socially accepted in Sweden.

  • 2016. Ilona Koupil (et al.). Public Health Nutrition 19 (17), 3158-3168

    Objective To study social patterning of overeating and symptoms of disordered eating in a general population.

    Design A representative, population-based cohort study.

    Setting The Australian Longitudinal Study on Women’s Health (ALSWH), Survey 1 in 1996 and Survey 2 in 2000.

    Subjects Women (n 12 599) aged 18–23 years completed a questionnaire survey at baseline, of whom 6866 could be studied prospectively.

    Results Seventeen per cent of women reported episodes of overeating, 16 % reported binge eating and 10 % reported compensatory behaviours. Almost 4 % of women reported symptoms consistent with bulimia nervosa. Low education, not living with family, perceived financial difficulty (OR=1·8 and 1·3 for women with severe and some financial difficulty, respectively, compared with none) and European language other than English spoken at home (OR=1·5 for European compared with Australian/English) were associated with higher prevalence of binge eating. Furthermore, longitudinal analyses indicated increased risk of persistent binge eating among women with a history of being overweight in childhood, those residing in metropolitan Australia, women with higher BMI, smokers and binge drinkers.

    Conclusions Overeating, binge eating and symptoms of bulimia nervosa are common among young Australian women and cluster with binge drinking. Perceived financial stress appears to increase the risk of binge eating and bulimia nervosa. It is unclear whether women of European origin and those with a history of childhood overweight carry higher risk of binge eating because of genetic or cultural reasons.

  • 2014. Anna Goodman, Amy Frances Heshmati, Ilona Koupil. PLoS ONE 9 (8), e106475

    Purpose To investigate which facets of parent and grandparent socio-economic position (SEP) are associated with eating disorders (ED), and how this varies by ED subtype and over time.

    Methods Total-population cohort study of 1,040,165 females and 1,098,188 males born 1973-1998 in Sweden, and followed for inpatient or outpatient ED diagnoses until 2010. Proportional hazards models estimated associations with parental education, income and social class, and with grandparental education and income.

    Results 15,747 females and 1051 males in our sample received an ED diagnosis, with rates increasing in both sexes over time. ED incidence in females was independently predicted by greater educational level among the father, mother and maternal grandparents, but parent social class and parental income showed little or no independent effect. The associations with education were equally strong for anorexia nervosa, bulimia nervosa and ED not-otherwise-specified, and had increased over time. Among males, an apparently similar pattern was seen with respect to anorexia nervosa, but non-anorexia ED showed no association with parental education and an inverse association with parental income.

    Conclusions Family history of education predicts ED in gender- and disorder-specific ways, and in females the effect is observed across multiple generations. Particularly given that these effects may have grown stronger in more recent cohorts, these findings highlight the need for further research to clarify the underlying mechanisms and identify promising targets for prevention. Speculatively, one such mechanism may involve greater internal and external demands for academic success in highly educated families.

  • 2013. Gita Devi Mishra (et al.). European Journal of Epidemiology 28 (2), 139-147

    Both child and adult socio-economic position (SEP) predict adult mortality, but little is known about the variation in the impact of SEP across the life course. The Uppsala Birth Cohort Study is a representative birth cohort born 1915–1929 in Uppsala, Sweden. For the 5,138 males and 5,069 females alive in 1980, SEP was available at birth; in adulthood (age 31–45); and in later life (age 51–65). Follow-up for mortality (all-cause, and circulatory disease) was from 1980 to 2002. To test which life course model best described the association between SEP and mortality, we compared the fit of a series of nested Cox proportional hazards regression models (representing either the critical, accumulation or sensitive period models) with a fully saturated model. For all-cause mortality in both genders, the sensitive period model best described the influence of SEP across the life course with a heightened effect in later adult life (males: Hazard Ratio (95 % CI) for advantaged SEP: 0.89 (0.81–0.97) at birth, 0.90 (0.81–0.98) in adulthood, 0.74 (0.67–0.82) in later life; females: 0.87 (0.78–0.98), 0.95 (0.86–1.06), 0.73 (0.64–0.83)). The effect of SEP on circulatory diseases mortality in males was cumulative (HR: 0.84 (0.80–0.87) per unit time in advantaged SEP). For circulatory disease mortality among females, a sensitive period model was selected due to SEP in later adult life (HR: 0.64 (0.52–0.80)). These findings suggest that reducing inequality throughout the life course might reduce all-cause and circulatory disease mortality.

  • 2012. Anna Goodman, Ilona Koupil, David W. Lawson. Proceedings of the Royal Society of London. Biological Sciences 279 (1746), 4342-4351

    Adaptive accounts of modern low human fertility argue that small family size maximizes the inheritance of socioeconomic resources across generations and may consequently increase long-term fitness. This study explores the long-term impacts of fertility and socioeconomic position (SEP) on multiple dimensions of descendant success in a unique Swedish cohort of 14 000 individuals born during 1915-1929. We show that low fertility and high SEP predict increased descendant socioeconomic success across four generations. Furthermore, these effects are multiplicative, with the greatest benefits of low fertility observed when SEP is high. Low fertility and high SEP do not, however, predict increased descendant reproductive success. Our results are therefore consistent with the idea that modern fertility limitation represents a strategic response to the local costs of rearing socioeconomically competitive offspring, but contradict adaptive models suggesting that it maximizes long-term fitness. This indicates a conflict in modern societies between behaviours promoting socioeconomic versus biological success. This study also makes a methodological contribution, demonstrating that the number of offspring strongly predicts long-term fitness and thereby validating use of fertility data to estimate current selective pressures in modern populations. Finally, our findings highlight that differences in fertility and SEP can have important long-term effects on the persistence of social inequalities across generations.

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Senast uppdaterad: 23 april 2020

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