Profiles

SOL JUAREZ

Sol Juarez

Forskare, Docent

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Arbetar vid Institutionen för folkhälsovetenskap
E-post sol.juarez@su.se
Besöksadress Sveavägen 160, Sveaplan
Rum 341
Postadress Institutionen för folkhälsovetenskap 106 91 Stockholm

Om mig

I am Associate Professor (Docent) in Public Health Sciences. I completed my B.A with honors in Sociology (2006) and my PhD in Sociology with European Mention (2011) at the Universidad Complutense of Madrid and the Spanish National Research Council (CSIC). I was a postdoctoral researcher at the Centre for Economic Demography (School of Economics and Management) and at the Unit of Social Epidemiology (Faculty of Medicine), at Lund University. Later on, I was affiliated with the Division of Occupational and Environmental Medicine (Lund University) and Stockholm University Demography Unit, Department of Sociology (Stockholm University). I have been visiting scholar at the Population Studies Center (University of Michigan, U.S.A), at the Max-Planck Institute for Demography Research (Germany), at the London School of Hygiene and Tropical Medicine (UK) and at the Institute for the Futures Studies (Sweden).

Undervisning

At the Department, I am course manager (“Population health and health equity”) and lecturer in different methodological and theoretical courses within the master’s program: “Population health: societal and individual perspectives”. Also, I am manager of the PhD course “An introduction to Public Health” and supervise students at the master’s and doctoral levels.

Forskning

Major Research areas

  • Health inequities
  • Social determinants of health
  • Migration and health
  • Maternal and child health
  • Life-course epidemiology
  • Health policiy evaluation

My main research line revolves around health inequities, with a special focus on the presence of the “healthy migrant paradox” in Europe. Also, I examine the determinants and long-standing consequences of outcomes derived from birthweight and gestational age. More recently, I investigate the effect of governmental policies on health.

Ongoing research projects:

Principal investigator of the VR-project: The unintended consequences of Swedish parental leave policy: A health equity perspective (#2018-01825). Duration: 2019-2022; Total: 5,604,000SEK

Coordinator of the FORTE-programme: Social determinants of health among individuals with foreign background: Societal and individual perspectives and project leader of a subproject on Social policies (PI: Mikael Rostila, FORTE # 2016-07128). Duration: 2017-2022; Total: 18,000,000 SEK

Since 2005, I have participated in more than 15 (co-applicant of 6) national and international research projects.

Others

Since 2017 I am a member of the scientific advisory board of the Centre on Global Migration at the University of Gothenburg.

Publikationer

I urval från Stockholms universitets publikationsdatabas
  • 2017. Sol P. Juárez (et al.). Paediatric and Perinatal Epidemiology 31 (6), 509-521

    Background

    To investigate the association between maternal country of birth and father's origin and unplanned and planned caesarean birth in Sweden.

    Methods

    Population-based register study including all singleton births in Sweden between 1999 and 2012 (n = 1 311 885). Multinomial regression was conducted to estimate odds ratios (OR) for unplanned and planned caesarean with 95% confidence intervals for migrant compared with Swedish-born women. Analyses were stratified by parity.

    Results

    Women from Ethiopia, India, South Korea, Chile, Thailand, Iran, and Finland had statistically significantly higher odds of experiencing unplanned (primiparous OR 1.10–2.19; multiparous OR 1.13–2.02) and planned caesarean (primiparous OR 1.18–2.25; multiparous OR 1.13–2.46). Only women from Syria, the former Yugoslavia and Germany had consistently lower risk than Swedish-born mothers (unplanned: primiparous OR 0.76–0.86; multiparous OR 0.74–0.86. Planned; primiparous OR 0.75–0.82; multiparous OR 0.60–0.94). Women from Iraq and Turkey had higher odds of an unplanned caesarean but lower odds of a planned one (among multiparous). In most cases, these results remained after adjustment for available social characteristics, maternal health factors, and pregnancy complications. Both parents being foreign-born increased the odds of unplanned and planned caesarean in primiparous and multiparous women.

    Conclusions

    Unplanned and planned caesarean birth varied by women's country of birth, with both higher and lower rates compared with Swedish-born women, and the father's origin was also of importance. These variations were not explained by a wide range of social, health, or pregnancy factors.

  • 2017. Martin Dribe, Sol Pía Juárez, Francesco Scalone. Population, Space and Place 23 (2)

    This paper studies contextual effects on fertility at the onset of fertility decline in Sweden. We argue that the community exerts an influence on fertility when individuals belonging to a certain community are more similar to one another (within-area) in their reproductive behaviour than individuals living in another community (between-area). Our hypotheses are that community had a strong influence in the past but that it decreased over time as more individualistic values grew in importance. We expect that the community exerted a greater impact in the low socioeconomic groups as the elite were less constrained by proximity and, therefore, more exposed to new ideas crossing community borders. Using micro-census data from 1880, 1890, and 1900, we use multilevel analysis to estimate measures of intra-class correlation within areas. We measure net fertility by the number of own children under five living in the household to currently married women with their spouses present. Parish is used as proxy for community. Our results indicate that despite average differences in fertility across parishes, the correlation between individuals belonging to the same community is less than 2.5%, that is, only a negligible share of the number of children observed is attributable to true community effects. Contrary to our expectation, we do not find any substantial change over time. However, as expected, community has a greater impact in the low socioeconomic groups. Our findings suggest that it is who you are rather than where you live which explains fertility behaviour during the initial stages of the transition.

  • 2017. Andrea Dunlavy (et al.). European Journal of Public Health 27 (Suppl. 3)

    Background

    Persons of foreign-origin have higher rates of unemployment compared to those of native-origin, yet few studies have assessed relationships between unemployment and mental health in persons of foreign-origin relative to the native-origin. This study aims to examine the extent to which generational status, region of origin, age at arrival, and duration of residence modify the relationship between employment status and suicide risk.

    Methods

    Population-based registers were used to conduct a longitudinal, open cohort study of native-origin and foreign-origin Swedish residents of working age (25-64 years) from 1993-2008. Hazard ratios and 95% confidence intervals for suicide mortality were estimated using gender-stratified Cox proportional hazards models.

    Results

    Elevated hazard ratios for suicide were observed among the majority of foreign-origin persons exposed to unemployment. Second generation Swedish men exposed to unemployment demonstrated significantly greater (p < 0.05) excess risk of suicide (HR = 3.63, 95% CI: 2.90-4.54) than that observed among native-origin Swedish men exposed to unemployment (HR = 1.67, 95% CI: 1.29-2.16). In unemployed foreign-born men, younger age at arrival and longer duration of residence were associated with increased risk of suicide, whereas unemployed foreign-born men who arrived as adults and had a shorter duration of residence did not demonstrate excess suicide risk.

    Conclusions

    Analyses indicated that the majority of the foreign-origin exposed to unemployment demonstrated excess risk of suicide that was of a similar magnitude to that observed among their native-origin counterparts. Yet there were notable differences in patterns of association by generational status, region of origin, age at arrival, and duration of residence. The high excess risk observed in unemployed second generation men suggests that ensuring employment among this group may be of particular public health importance.

  • 2017. Sol P. Juárez (et al.). Journal of Immigrant and Minority Health 19 (1), 205-214

    Ample evidence shows that, in many developed countries, immigrants have similar or better perinatal health outcomes than natives despite facing socioeconomic disadvantages in the host country (“healthy migrant paradox” –HMP). This scoping review aims to: (1) summarize the literature on perinatal health among immigrants and natives in Spain and (2) examine whether there is evidence of the HMP in a context of recent migration. A total of 25 articles published between 1998 and 2014 were reviewed. Overall, we found evidence of the HMP in low birthweight and to a lesser extent in preterm, though the patterns vary by origin, but not in macrosomia and post-term. The results are consistent across settings, levels of adjustment, and birth year. Policies should be oriented towards identifying the modifiable risk factors leading to a higher risk of macrosomia and post-term among immigrants.

  • 2017. Sol P. Juárez, Anders Hjern. Social Science and Medicine 175, 81-90

    In this study we assessed the effect duration of residence on the association between maternal origin and birthweight in Sweden. Considering sibling information, we also investigated how far the presence or lack of such an effect could be biased by the use of cross-sectional data, since there may be a selection among those mothers who decide to have a child soon after moving to the country (e.g. those with a more stable family situation). Using the Swedish Medical Birth Register for the period 1992-2012, we performed linear and multinomial regressions, multilevel linear regressions, and random effect meta-analysis. Offspring of foreign-born mothers were lighter on average (−120 g [-143,-60]) and had a higher risk of having low birthweight (RRR:1.70 [1.61,1.80]) compared to those with Swedish-born mothers. The variation of birthweight by duration of residence was small (less than 50 g) compared to the gradient found between countries grouped according to the human development index (HDI), where the difference between countries with low and very high HDI was of 105 g. Moreover, no clear pattern toward a convergence with the Swedish population was observed after nine years in the country, which was confirmed when we compared the between- and within-mother analyses by HDI categories. Overall, our results support the thesis that contextual early life conditions have an impact on adult health (reproductive health in this case) with consequences in the next generation that cannot be buffered by the situation experienced in the host country.

  • 2017. Helena Honkaniemi (et al.). Metoder och verktyg för sociala nyttoberäkningar i kollektivtrafiken, 9-53

    Med skärpt fokusering på hållbar utveckling blir såväl politiskt ansvariga som akademiker allt mer sysselsatta inte enbart med infrastrukturens inverkan på ekonomi och miljö utan även dess sociala inverkan. Denna breda litteraturstudie har undersökt den sociala hållbarhetens roll i kollektivtrafikens infrastruktur. Den har siktat på att urskilja de olika komponenter i social hållbarhet som ingår i denna kontext, kvalitativa respektive kvantitativa analytiska metoder och deras krav på data samt tillämpbarheten av dessa rön i den svenska kontexten. Översikten utfördes med hjälp av indexeringstjänsten Web of Science, en kombinerad snöbollsmetod samt interna rekommendationer och analyser med hjälp av ett teoretiskt ramverk för hållbarhet anpassat från United Nations Environment Programme. Rönen ådagalade många kvantitativa tillvägagångssätt, däribland kostnads-/nyttoanalys [cost-benefit analyses (CBA)], tillämpningar av geografiska informationssystem (GIS), och jämlikhetsanalyser m.fl. Variabler för kollektivtrafik såsom tillgänglighet och rörlighet behandlades oftast tillsammans med sociala bestämningsfaktorer, liksom sociala utfallsvariabler däribland socialt utanförskap och socialt kapital. Kvalitativa infallsvinklar används däremot mer sällan i den här kontexten trots deras betydelse för att hjälpa till att fånga in användares erfarenheter och att urskilja nya sociala variabler. Utifrån dessa resultat och den rådande preferensen för kvantitativa metoder i svenska analyser av kollektivtrafik rekommenderar författarna mera fokus på de sociala utfallen av kollektivtrafikens infrastruktur genom att använda en blandning av kvantitativa och kvalitativa infallsvinklar.

  • 2016. Sol Pía Juárez, Bárbara A. Revuelta-Eugercios. Journal of Immigrant and Minority Health 18 (1), 42-50

    Evidence shows that in some contexts immigrants have better health than natives in spite of coming from poorer socioeconomic contexts and of facing socioeconomic disadvantages in the host country. However, this is a country or origin- and outcome-specific phenomenon. This study compares different health outcomes derived from birthweight and gestational age among different migrant groups residing in Sweden. Cross-sectional study based on the Swedish Medical Birth Register for years 1987–1993. Multinomial regression models were performed to obtain crude and adjusted Odd Ratios and their 95 % Confidence Intervals. Overall, immigrants show a higher risk of LBW and preterm and a lower risk of macrosomia and post-term. Moreover, some groups performed worse than natives even in indicators at the two ends of the distribution. The healthy migrant paradox is also outcome-specific within different perinatal indicators and the selection explanation cannot fully account for this phenomenon.

  • 2016. Sol P. Juárez, Anna Goodman, Ilona Koupil. Journal of Epidemiology and Community Health 70 (6), 569-575

    Background: Ample evidence has shown that early-life social conditions are associated with mortality later in life. However, little attention has been given to the strength of these effects across specific age intervals from birth to old age. In this paper, we study the effect of the family's socioeconomic position and mother's marital status at birth on all-cause mortality at different age intervals in a Swedish cohort of 11 868 individuals followed across their lifespan.

    Methods: Using the Uppsala Birth Cohort Multigenerational Study, we fitted Cox regression models to estimate age-varying HRs of all-cause mortality according to mother's marital status and family's socioeconomic position.

    Results: Mother's marital status and family's socioeconomic position at birth were associated with higher mortality rates throughout life (HR 1.18 (95% CI 1.12 to 1.26) for unmarried mothers; 1.19 (95% CI 1.12 to 1.25) for low socioeconomic position). While the effect of family's socioeconomic position showed little variation across different age groups, the effect of marital status was stronger for infant mortality (HR 1.47 (95% CI 1.23 to 1.76); p=0.04 for heterogeneity). The results remained robust when early life and adult mediator variables were included.

    Conclusions: Family's socioeconomic position and mother's marital status involve different dimensions of social stratification with independent effects on mortality throughout life. Our findings support the importance of improving early-life conditions in order to enhance healthy ageing.

  • 2015. Shai Mulinari (et al.). PLoS ONE 10 (5)

    Background Many public health and epidemiological studies have found differences between populations (e.g. maternal countries of birth) in average values of a health indicator (e.g. mean offspring birthweight). However, the approach based solely on population-level averages compromises our understanding of variability in individuals' health around the averages. If this variability is high, the exclusive study of averages may give misleading information. This idea is relevant when investigating country of birth differences in health. Methods and Results To exemplify this concept, we use information from the Swedish Medical Birth Register (2002-2010) and apply multilevel regression analysis of birthweight, with babies (n = 811,329) at the first, mothers (n = 571,876) at the second, and maternal countries of birth (n = 109) at the third level. We disentangle offspring, maternal and maternal country of birth components of the total offspring heterogeneity in birthweight for babies born within the normal timespan (37-42 weeks). We found that of such birthweight variation about 50% was at the baby level, 47% at the maternal level and only 3% at the maternal countries of birth level. Conclusion In spite of seemingly large differences in average birthweight among maternal countries of birth (range 3290-3677g), knowledge of the maternal country of birth does not provide accurate information for ascertaining individual offspring birthweight because of the high inter-offspring heterogeneity around country averages. Our study exemplifies the need for a better understanding of individual health diversity for which group averages may provide insufficient and even misleading information. The analytical approach we outline is therefore relevant to investigations of country of birth (and ethnic) differences in health in general.

  • 2015. Sol Pía Juárez. Revista Española de Salud Pública 89 (1), 85-91

    Background: Relative measures of birthweight (small and large-for-gestational age, SGA-LGA) are increasingly preferred to absolute measures (low birthweight, macrosomia). In this study we assess whether the national vital statistics provided by the Spanish National Statistical Institute (INE) reliably estimate SGA and LGA. Also, we will assess whether missing data (selection) and misreported information (bias) are systematically associated with parental socioeconomic information. Methods: We linked the information on 6,339 births at the Hospital Clínico San Carlos of Madrid (2005-06) with the vital statistics records (successful for the 95% of the observation). Validity measures and concordance were estimated for low birthweight (LBW, <2500 gr), macrosomia (>4500 gr), SGA (<10th percentile) and LGA (>90 percentile). Logistic regressions were fitted. Results: The prevalence estimated with the hospital data were: LBW (6%), macrosomia (0.5%) SGA (1%) and LGA (15%) and, with the data from INE: 5% 0.5% 2% 12% respectively. Kappa statistics: LBW (83%), macrosomia (79%), PEG (24%) and LGA (82%). Missing and misreported data vary with parental nationality and their situation in the labor market (OR between 1.5 y 2.2). Conclusions: Vital statistics overestimate the prevalence of SGA and underestimate the prevalence of LGA. The concordance between the sources is very good for low birthweight, macrosomia and LGA, and moderately good for SGA. Both missing and misreported birthweight and gestational age are associated with parental socioeconomic characteristics.

  • Andrea Dunlavy, Sol Juarez, Mikael Rostila.

    Background: The association between exposure to unemployment and increased risk of mortality is well established. Yet migrants and their children often experience a number of stressors in the country of residence which could exacerbate the negative effects of job loss or unemployment. This study examined the extent to which region of origin and generational status modified associations between employment status and risk of all-cause mortality.

    Methods: Using population-based registers, an open cohort study of 2,178,321 individuals aged 25-64 was followed from 1993-2008. Hazard ratios for mortality were calculated using Cox regression. Employment status and socio-demographic covariates were included as time-varying variables in all models.

    Results: Relative to employed native-origin Swedes, excess risk of mortality was found among most groups of foreign-origin persons exposed to unemployment. The excess risk of mortality found among African women exposed to long-term unemployment (HR=3.26, 95% CI: 2.30-4.63),  Finnish men exposed to short-and long-term unemployment (HR=2.74, 95% CI: 2.32-3.24 and HR=2.39, 95% CI: 2.12-2.69), and  second generation Swedish men exposed to short-term unemployment (HR=2.34, 95% CI: 2.06-2.64) was significantly greater (p<0.05) than that found among their unemployed native-origin counterparts. Decreased risk of mortality was observed among the employed in nearly all foreign-origin groups.

    Conclusions: Our findings suggest that the mortality health advantage often observed among foreign-origin groups is most evident among the employed, while the magnitude of excess risk for mortality in the foreign-origin exposed to unemployment varies by generational status and region of origin.

Visa alla publikationer av Sol Juarez vid Stockholms universitet

Senast uppdaterad: 18 november 2018

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