The cities of Linköping and Norrköping – twins with big differences in public health

The concept ”Twincities” refers to the cities Norrköping and Linköping. These fairly equally sized cities are located within a distance of only 40 km. Linköping is often referred to as »the big small town« and Norrköping as »the small big city«. Despite the extrinsic resemblance between these two cities, there are profound differences. Their social and economic history, not least with regard to public health, are strikingly different. Norrköping could be labelled a ”blue-collar city”, while Linköping could be termed a ”white-collar city”. This design makes it possible to perform a wide array of research in public health and community medicine.

Like a classical experiment

The comparison between these two cities could be compared with a classical experiment, with an experiment group and a control group. Through this design it is possible to keep as many intervening factors as possible under control and uncover the relative importance of the social environment. As the number of different social factors varies between the cities, it is possible to unveil the relative importance of the social environment and its influence on people's health and disease risks. Important factors probably include social history, socioeconomic factors, lifestyle and behavioural factors, but also stress exposures.

TWINABIS

A subsample from the prospective ABIS-study, with around 2.500 children followed from birth and onwards by questionnaires and biological samples. These children are now teenagers and, in principle, all data regarding their health care visits as well as childhood ICDdiagnoses is collected. Half of these children live in Norrköping and half of them in Linköping. This is part of an international collaboration with INRICH and universities in Canada, Holland, the USA and the United Kingdom.

TWIBS

Gastrointestinal problems, particularly Irritable Bowel Syndrome (IBS), is a major public health disease. In this study, data from people with an IBS diagnosis is collected in primary care. These individuals are followed for symptoms, psychosocial factors and also stress measured by cortisol in hair and DNA from saliva. This is part of an international collaboration with Australia.

QWIN

A sample of around 800 middle-aged women from the Twincities are studied for psychosocial factors, lifestyle, cardiovascular symptoms and self-reported diseases and diagnosis from regional health registers. Comparisons will also be made with similar data from The Scottish Health Survey in collaboration with The University of Edinburgh.

TWINHISTCARDIO

Cardiovascular disease has been intensively studied in the populations of the Twincities. In this study, the historical rise of cardiovascular disease, in the Twincities is studied.

Our interdisciplinary research group includes an array of researchers from both social sciences, behavioural sciences, humanistic sciences, and medical and biomedical sciences. We are focusing on socially relevant issues related to people's health and welfare in order to expand our knowledge of the importance of the social environment for health. A basic question is how modern society, where people lead stressful lives affects health. Most major public health diseases such as cardiovascular diseases, mental disorders, cancers and gastrointestinal problems are related to the way we live our lives, and the question is whether this could differ in different social environments.

Are there certain features related to different social environments, such as behaviours, attitudes and values, that are firmly established and affect the population's health not only today but also in the future.

The general design of Twincities makes it possible to unveil the relative importance of the social environment for health.

The city of Norrköping was one of the first industrialized cities in Sweden. It was once called ”The Swedish Manchester”. In the late 1900s, the city went through several economical crises, resulting in factory closures. The city could be labelled a ”blue-collar city”. However, for the past ten years, one of the Linköping University campuses has been situated in the city, and it has become more prosperous. Today there are 135.000 inhabitants in the city.

The city of Linköping is an old, small medieval city, with bishop and regional administration, surrounded by farming landscapes. The city has seen rapid growth in the last 60 years due to high technology industries and the establishment of the university. The city could be labelled a ”white-collar city”. Today the city is home to 150.000 inhabitants

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