This new paper is part of the MERIT – Mother Income Inequality project co-authored with several Portuguese colleagues including prior PANSOC post-doc Margarida Pereira and Centre leader Svenn-Erik Mamelund: “Be Mothers as if we Were not Workers, Be Workers as if we Were not Mothers”: A Qualitative Study on Parenthood’s Impact on Careers and Well-Being – Ana Sofia Monteiro Maia, Margarida Miguel Costeira e Pereira, Svenn-Erik Mamelund, Joana Maria Correia Amaro, Sílvia Jesus da Silva Fraga, Teresa Isabel Costa Leão, 2025

Abstract: Parenthood challenges work–life balance, particularly where traditional gender norms persist. Despite policy advancements, disparities in income and career progression remain, with mothers disproportionately assuming childcare and household responsibilities. This study explored the impact of parenthood on professional and personal life through thirty semi-structured interviews with Portuguese mothers and fathers living in Portugal and seven other European countries. Thematic content analysis revealed a dual narrative shaped by gender norms and country contexts. Women perceived motherhood as a career barrier, with some reducing work hours or leaving the workforce to become primary caregivers. In contrast, men assumed the breadwinner role by increasing workloads. Parenthood also had gendered health implications: women, particularly in Portugal, experienced anxiety and guilt, whereas men described physical health effects. The findings underscore how parenthood perpetuates gender disparities, highlighting the need for equitable parental leave policies and workplace reforms that support caregiving responsibilities for both mothers and fathers.

A systematic review to understand the long-term mental health effects of influenza pandemics – Jessica L. Dimka, Benjamin M. Schneider, Svenn-Erik Mamelund, 2025

abstract

Aims:

Health effects of pandemics extend beyond morbidity and mortality from the disease itself and may include long-term mental health consequences. However, previous studies only consider narrowly defined populations at risk or examine pandemics caused by varied pathogens that may have inconsistent effects. We examine existing literature on these long-term mental health effects following one type of pandemic (influenza).

Methods:

We conducted a systematic review of the long-term mental health effects of the 1889, 1918, 1957, 1968, and 2009 influenza pandemics. To our knowledge, this is the first review of studies of broad populations and multiple measures of mental health morbidity.

Results:

The literature search returned 8190 articles. After deduplication and title/abstract and full-text screening, 12 articles were reviewed. Seven articles focused on the 1918 pandemic and five on the 2009 pandemic. Study regions were USA or North America (n=5), Europe (n=3), and Asia (n=4). Long-term outcomes studied were suicide (n=4), admission to hospital or psychiatric facility (n=2), stress/anxiety/post-traumatic stress disorder (n=4) and schizophrenia and other/related conditions (n=2). The suggested mechanisms were infection (n=6), effects of non-pharmaceutical interventions (NPIs) (n=3), or other exposure pathways (n=3). Seven studies had a moderate risk of bias and five studies a high risk of bias.

Conclusions:

Mental health effects have been an outcome of pandemics. Researchers should consider a variety of possible mechanisms, and that infection and restrictive NPIs may contribute to mental health morbidity. This study highlights the need for better understanding of the broader health, social, and demographic impacts of pandemics.

Global excess tuberculosis mortality during COVID-19: a country-level modeling study of policy and development correlates

Abstract:

The COVID-19 pandemic disrupted global tuberculosis (TB) control efforts, leading to a surge in TB-related excess mortality, particularly in low- and middle-income countries. Pandemic mitigation measures, such as lockdowns, reallocation of healthcare resources, and reduced access to diagnosis and treatment, contributed to delayed TB care and disease progression. Quantifying this collateral damage is crucial to bolstering health system resilience.

We estimated country-level excess TB mortality between 2020 and 2023 using annual TB mortality data reported by the World Health Organization (WHO). Our approach leverages the SubEpiPredict toolbox of the ensemble n-sub-epidemic modeling framework, calibrated to pre-pandemic trends (2010–2019) to forecast expected TB deaths in the absence of COVID-19 disruptions. We selected the best-fitting model based on AICc and compared projected and reported deaths to quantify excess mortality, incorporating both normal and Poisson error structures. We further examined associations between excess TB mortality and country-level indicators, including the COVID-19 Stringency Index, Global Health Security (GHS) Index, and Socio-demographic Index (SDI). It is also noteworthy that for each estimate of excess TB deaths, we provide an associated uncertainty.

Our global estimate of 755,876 excess TB deaths (95%CI: 591,099 to 965,015) aligns closely with the WHO estimate of approximately 700,000 excess deaths. Therefore, it can be estimated a global relative excess mortality of 12.8% (95%CI: 11.6% to 14.2%), compared to the WHO estimate of 14.6% (95% CI: 5.9% to 26.7%). We found substantial geographic heterogeneity, with the highest TB excess mortality rates observed in southern Africa, South Asia, and parts of South America. Countries with high GHS or SDI scores did not necessarily exhibit lower excess TB mortality, suggesting that pandemic-specific disruptions and competing priorities may have overridden structural advantages. Weak-to-moderate correlations were observed between excess mortality and pandemic stringency, peaking in 2021 and waning by 2022, possibly reflecting health system adaptation.

This study presents a systematic, model-based analysis of global excess TB mortality during the COVID-19 pandemic, emphasizing disparities in pandemic response impacts across countries. The findings highlight the need for integrated and resilient public health systems capable of maintaining essential services amid global crises. Our methodology can support real-time monitoring of collateral effects of pandemics on endemic diseases and guide strategic investments in TB surveillance and care continuity.

You can read the paper here: Global excess tuberculosis mortality during COVID-19: a country-level modeling study of policy and development correlates | BMC Public Health

This paper is part of the MERIT-project and collaborations with Portuguese colleagues : Balancing Work and Parenthood – A Comparative Analysis of Policies across European Countries | Journal of Child and Family Studies

Absract: Across Europe, changes in the labour market structure and fertility rates have been pressuring countries to adopt policies that support parenthood. Previous research has analysed parental leaves but has not compared other types of family support, such as access to childcare services or work arrangements. This study aimed to conduct a comparative analysis of the public policies implemented in 2022/2023 across 12 European countries through document analysis. Despite the international regulations, high heterogeneity was found. Some countries, such as Sweden and Norway, promoted well-compensated individual parental leaves, higher leave take-up rates among mothers and fathers, working time flexibility, and full-time childcare services. Conversely, others, such as Italy, Spain, and Portugal, showed limited public spending, fragmented public childcare services, short well-paid parental leaves, and an imbalance in leave take-up rates among mothers and fathers. This comparative analysis highlights and discusses the existing policy options according to countries’ economic, social, and demographic outcomes.

Our Centre leader Mamelund has co-authored a new paper in GeroScience.

You can access the paper here: Cognitive function, physical function, and mental health in older adults amid reduced primary and specialist healthcare service use during COVID-19: the HUNT study | GeroScience

Abstract:

COVID-19 containment measures reduced older adults’ healthcare access, with uncertain long-term effects on cognitive, physical, and mental health. To investigate whether reductions in primary and specialist healthcare service use during the pandemic were associated with changes in cognitive, physical, and mental health in community-dwelling older adults, with attention to sex differences. Data from the Norwegian Trøndelag Health Study collected before (HUNT4 70 + , 2017–2019) and after the pandemic (HUNT AiT, 2021–2023) included 5387 participants (53% women) aged 70 + . Propensity score matching, accounting for baseline confounders, was used to examine associations between reduced healthcare service use and cognitive, physical, and mental health changes from pre- to post-pandemic. Reduced contact with general practitioners was associated with greater cognitive decline among women (MoCa-change − 0.32 [95% CI − 0.62, − 0.32]). No differences were observed in physical or mental health. Reductions in other primary care services (e.g., in-home nursing, practical assistance) were associated with greater decline in cognitive function (MoCa-change − 0.94 [− 1.53, − 0.36]), particularly among men (MoCa-change − 2.12 [− 3.13, − 1.11]). Men also had a decline in physical function (SPPB-change − 1.06 [− 1.79, − 0.33]). No differences in mental health were observed. Reductions in specialist healthcare services were unrelated to health changes in the overall sample but linked to improved physical function in women (SPPB-change 0.32 [0.11, 0.53]). Although associations between reduced healthcare service use during the pandemic and cognitive, physical, and mental health were limited, findings highlight the importance of sustaining access to primary care for older adults during public health crises.

Together with two of our prior post-doc’s, Margarida Pereira and Jessica Dimka, our Centre leader S-E Mamelund has written a chapter in a new book: Pandemics and Urban Planning: Multidisciplinary Perspectives on Cities, Planning and Disease | SpringerLink. The book

• Discusses the potential of urban planning in anticipation and prevention of infectious disease epidemics and pandemics
• Offers multidisciplinary insights from historical case studies to present issues, and charting pathways into the future
• Encourages cross-sectoral discussions and integrative policies between urban planning and health fields

Our chapter (chap 10) is titled The New Syndemic of Obesity and COVID-19 in Urban Areas | SpringerLink

Abstract: Soon after the emergence of the COVID-19 pandemic, clinicians and scientists warned that individuals with obesity developed more severe cases of COVID-19, needed more intensive healthcare, and had higher chances of dying. Currently, nearly 40% of the world’s adult population is overweight and 15% has obesity. Obesity rates are higher in urban areas, which were the locations where the first large outbreaks of COVID-19 occurred. However, obesity is more than a risk factor for COVID-19 and addressing it as such underestimates the negative effect of the interaction between both diseases on social, health and gender equity. Obesity prevalence is higher in women, unemployed individuals, and those with lower socioeconomic status. The emergence of this new syndemic adds evidence on how poor health outcomes tend to cluster spatially and increase health inequities, particularly in urban areas. Hence, urban planning plays an important role in preventing social, health, and gender disparities. The ability to create healthier urban configurations for all is an important means to protect vulnerable populations and urban neighbourhoods during a pandemic. An equity lens is needed to address the major planning, namely land use, mobility, accessibility, and housing, as a strategy to tackle this new syndemic.

We are proud to announce that we have published a data paper in the Nature journal “Scientific Data” . Authors are A. O. Blinkova, U. Khakurel, H. G. Gaddy, S.-E. Mamelund & M. Bekker-Nielsen Dunbar. 

You can read the paper here: Construction and curation of a data set of historical mental health incidence in Norway | Scientific Data

Deprivation amplification theory suggests that the health effects of individual deprivation are amplified for people who live in areas with greater levels of deprivation. In a new paper in Vienna Yearbook of Population Research, first authored by former PANSOC post-doc, Maria Bekker-Nielsen Dunbar, we postulate that health (represented by norovirus incidence) is influenced and amplified by deprivation (a measure that includes socio-economic factors), and believe that this association has been neglected in surveillance models of infectious diseases. We construct a social epidemiological extension of a known surveillance model to evaluate the inclusion of deprivation in surveillance models using the German Index of Socio-economic Deprivation (GISD) in an endemic-epidemic model. We evaluate model types considered in the literature on the basis of Akaike’s information criterion. Our results suggest that a social epidemiological endemic-epidemic model with the GISD for enterically transmitted infections does not need to also include time-varying contact matrices as transmission weights.

You can read the paper here: Vienna Yearbook of Population Research 2025

Vi på PANSOC er skikkelig stolte av at Uddhav Kakhurel har publisert sitt master-arbeid i siste nummer av amerikanske Emerging Infectious Diseases. Arbeidet hans har Lisa Sattenspiel og Svenn-Erik Mamelund som medforfattere og er del av vårt CAS prosjekt 2022-23.

Du kan lese paperet her: Early Release – Role of Nonpharmaceutical Interventions during 1918–1920 Influenza Pandemic, Alaska, USA – Volume 31, Number 7—July 2025 – Emerging Infectious Diseases journal – CDC

This new paper is a collaboration with colleagues in Chile and Mexico. You can read it here:

Socioeconomic inequalities in Chile during the COVID-19 pandemic: A regional analysis of income poverty | PLOS One

he COVID-19 pandemic caused an unprecedented economic crisis, intensifying poverty levels in Latin America, particularly in Chile. This study examines the short- and long-term socioeconomic impacts of COVID-19 on income poverty in Chile, focusing on regional disparities, rurality, ethnicity, educational attainment, and immigration. Using data from the Chile National Socioeconomic Characterization Survey (CASEN) for 2017, 2020, and 2022, we analyzed poverty trends across the pre-pandemic, pandemic, and post-pandemic periods. We employed spatial clustering techniques with Local Moran’s I to detect poverty hotspots and applied logistic regression models to identify key sociodemographic factors associated with these hotspots. Our results reveal stark regional disparities, with disproportionately higher poverty rates among rural populations, Indigenous communities, and individuals with lower education levels or immigrant backgrounds. The proportion of individuals in poverty hotspots rose from 6.8% in 2017 to 8.6% in 2020, before slightly declining to 7.7% in 2022. Although emergency monetary subsidies helped reduce overall poverty from 10.8% in 2020 to 6.5% in 2022, these measures were insufficient to address deep-rooted structural inequalities. Our findings underscore the urgent need for targeted, long-term policies that go beyond temporary financial assistance and tackle systemic disparities linked to rurality, ethnicity, education, and immigration. Such measures are essential for achieving sustainable poverty reduction and fostering inclusive economic growth in Chile.