BACKGROUND: We investigated coping strategies and communication strategies as predictors of fertility problem stress 12 months after start of fertility treatment. METHODS: We used a prospective, longitudinal cohort design including 2250 people beginning fertility treatment with a 12-month follow-up. Data were based on self-administered questionnaires measuring communication with partner and with other people, coping strategies: active-avoidance coping, active-confronting coping, passive-avoidance coping, meaning-based coping, and fertility problem stress. The study population included those participants (n = 816, men and women) who had not achieved pregnancy by assisted reproduction or delivery at follow-up. RESULTS: Among both men and women, difficulties in partner communication predicted high fertility problem stress (odds ratio for women, 3.47, 95% confidence interval 2.09–5.76; odds ratio for men, 3.69, 95% confidence interval 2.09–6.43). Active-avoidance coping (e.g. avoiding being with pregnant women or children, turning to work to take their mind off things) was a significant predictor of high fertility problem stress. Among men, high use of active-confronting coping (e.g. letting feelings out, asking other people for advice, seeking social support) predicted low fertility problem stress in the marital domain (odds ratio 0.53, 95% confidence interval 0.28–1.00). Among women, medium or high use of meaning-based coping significantly predicted low fertility problem stress in the personal and marital domain. CONCLUSION: The study provides information about where to intervene with fertility patients in order to reduce their stress after medically unsuccessful treatment.

Most studies examining coping with infertility use the individual as the unit of analysis. Although valuable, these studies fail to show the impact that partner coping has on individual distress. Since infertility is a shared stressor, examining the impact of partner coping is particularly relevant. Data were based on a questionnaire in a consecutive sample of 1169 women and 1081 Danish men prior to beginning assisted reproduction treatment. Multilevel modeling using the Actor Partner Interdependence Model and follow-up analysis of variance were used to examine the couple as the unit of analysis. A partner’s use of active-avoidance coping was related to the increased personal, marital and social distress for men and women. A woman’s use of active-confronting coping was related to increased male marital distress. And a partner’s use of meaning-based coping was associated with decreased marital distress in men and increased social distress in women. Although understudied, partner coping patterns play a key role in a partner’s ability to cope with the infertility experience. Physicians and mental health providers can help couples to understand the coping strategies that lead to increased and decreased partner distress.

Objective: To analyse the association between area income inequality and mortality after adjustment for individual income and other established risk factors. Design: Analysis of pooled data from two cohort studies. The relation between income inequality in small areas of residence (parishes) and individual mortality was examined with Cox proportional hazard analyses. Setting: Two population studies conducted in Copenhagen, Denmark. Participants: 13 710 women and 12 018 men followed for a mean of 12.8 years. Main outcome measure: All cause mortality. Results: Age standardised mortality was highest in the parishes with the least equal income distribution. After adjustment for individual risk factors, parish income inequality was not associated with mortality, whereas individual household income was. Thus, individuals in the highest income quarter had lower mortality than those in the lowest quarter (adjusted hazard ratio for men 0.51 (95% confidence interval 0.45 to 0.59) and for women 0.60 (0.54 to 0.68)). Conclusion: Area income inequality is not in itself associated with all cause mortality in this Danish population. Adjustment for individual risk factors makes the apparent effect disappear. This may be the result of Denmark's welfare system, based on a Nordic model. What is already known on this topic Several ecological studies have shown that higher levels of income inequality in countries, states, or smaller areas are associated with higher all cause mortality A few prospective studies from the United States have examined this after controlling for individual risk factors What this study adds Inequality in the distribution of income in parishes in Copenhagen is as high as inequality reported from metropolitan areas in the United States Area based income inequality did not affect all cause mortality after adjustment for individual income and other risk factors Denmark's welfare system (based on a Nordic model) may even out the effect of area inequality

Objective: To present the Danish Occupational Social Class (DOSC) measurement as a measure of socioeconomic position (SEP) applicable in a late midlife population, and to analyze associations of this measure with three aging-related outcomes in midlife, adjusting for education. Method: Systematic coding procedures of the DOSC measurement were applied to 7,084 participants from the Copenhagen Aging and Midlife Biobank (CAMB) survey. We examined the association of this measure of SEP with chronic conditions, self-rated health, and mobility in logistic regression analyses, adjusting for school education in the final analysis. Results: The measure of SEP showed a strong social gradient along the social classes in terms of prevalence of chronic conditions, poor self-rated health, and mobility limitations. Adjusting for school education attenuated the association only to a minor degree. Discussion: The DOSC measure was associated with aging-related outcomes in a midlife Danish population, and is, thus, well suited for future epidemiological research on social inequalities in health and aging.

The Danish Metropolit project was established in 1965. The main initiator of the project was Kaare Svalastoga, the first professor of sociology at the Institute of Sociology, University of Copenhagen. In the late 1950s, Svalastoga attempted to promote a collaborative project between researchers from Denmark, Finland, Norway, and Sweden, the aim of which was to establish a prospective study covering early school age to early mid-life, which dealt with intergenerational mobility and differential life-chances in each of the four countries. Only boys were to be included since social mobility at that time was regarded to be most closely connected with the male breadwinner's occupation. In addition, deviant behaviour (one area of research interest) was assumed to be more prevalent in boys. The result of his effort was the establishment of a Danish and a Swedish cohort, the former called the Metropolit study. Details of the Swedish cohort are published in an accompanying cohort profile in this issue of the Journal.