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Is retirement beneficial for mental health?: antidepressant use before and after retirement.

https://arctichealth.org/en/permalink/ahliterature135187
Source
Epidemiology. 2011 Jul;22(4):553-9
Publication Type
Article
Date
Jul-2011
Author
Tuula Oksanen
Jussi Vahtera
Hugo Westerlund
Jaana Pentti
Noora Sjösten
Marianna Virtanen
Ichiro Kawachi
Mika Kivimäki
Author Affiliation
Finnish Institute of Occupational Health, Helsinki, Finland. tuula.oksanen@ttl.fi
Source
Epidemiology. 2011 Jul;22(4):553-9
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Aged
Antidepressive Agents - therapeutic use
Drug Utilization - statistics & numerical data
Female
Finland
Humans
Hypoglycemic agents - therapeutic use
Logistic Models
Longitudinal Studies
Male
Mental health
Middle Aged
Retirement - psychology
Abstract
Recent studies based on self-reported data suggest that retirement may have beneficial effects on mental health, but studies using objective endpoints remain scarce. This study examines longitudinally the changes in antidepressant medication use across the 9 years spanning the transition to retirement.
Participants were Finnish public-sector employees: 7138 retired at statutory retirement age (76% women; mean age, 61.2 years), 1238 retired early due to mental health issues (78% women; mean age, 52.0 years), and 2643 retired due to physical health issues (72% women; mean age, 55.4 years). Information on purchase of antidepressant medication 4 years before and 4 years after retirement year was based on comprehensive national pharmacy records in 1994-2005.
One year before retirement, the use of antidepressants was 4% among those who would retire at statutory age, 61% among those who would retire due to mental health issues, and 14% among those who would retire due to physical health issues. Retirement-related changes in antidepressant use depended on the reason for retirement. Among old-age retirees, antidepressant medication use decreased during the transition period (age- and calendar-year-adjusted prevalence ratio for antidepressant use 1 year after versus 1 year before retirement = 0.77 [95% confidence interval = 0.68 to 0.88]). Among those whose main reason for disability pension was mental health issues or physical health issues, there was an increasing trend in antidepressant use prior to retirement and, for mental health retirements, a decrease after retirement.
Trajectories of recorded purchases of antidepressant medication are consistent with the hypothesis that retirement is beneficial for mental health.
Notes
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Comment In: Epidemiology. 2011 Jul;22(4):560-221642778
PubMed ID
21502864 View in PubMed
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Association of physical activity with future mental health in older, mid-life and younger women.

https://arctichealth.org/en/permalink/ahliterature263892
Source
Eur J Public Health. 2014 Oct;24(5):813-8
Publication Type
Article
Date
Oct-2014
Author
Amanda Griffiths
Anne Kouvonen
Jaana Pentti
Tuula Oksanen
Marianna Virtanen
Paula Salo
Ari Väänänen
Mika Kivimäki
Jussi Vahtera
Source
Eur J Public Health. 2014 Oct;24(5):813-8
Date
Oct-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Cohort Studies
Exercise - psychology
Female
Finland - epidemiology
Humans
Life Style
Mental Disorders - epidemiology - psychology
Mental Health - statistics & numerical data
Middle Aged
Motor Activity
Prospective Studies
Questionnaires
Young Adult
Abstract
Mental ill-health, particularly depression and anxiety, is a leading and increasing cause of disability worldwide, especially for women.
We examined the prospective association between physical activity and symptoms of mental ill-health in younger, mid-life and older working women. Participants were 26 913 women from the ongoing cohort Finnish Public Sector Study with complete data at two phases, excluding those who screened positive for mental ill-health at baseline. Mental health was assessed using the 12-item General Health Questionnaire. Self-reported physical activity was expressed in metabolic equivalent task (MET) hours per week. Logistic regression models were used to analyse associations between physical activity levels and subsequent mental health.
There was an inverse dose-response relationship between physical activity and future symptoms of mental ill-health. This association is consistent with a protective effect of physical activity and remained after adjustments for socio-demographic, work-related and lifestyle factors, health and body mass index. Furthermore, those mid-life and older women who reported increased physical activity by more than 2 MET hours per week demonstrated a reduced risk of later mental ill-health in comparison with those who did not increase physical activity. This protective effect of increased physical activity did not hold for younger women.
This study adds to the evidence for the protective effect of physical activity for later mental health in women. It also suggests that increasing physical activity levels may be beneficial in terms of mental health among mid-life and older women. The alleviation of menopausal symptoms may partly explain age effects but further research is required.
Notes
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PubMed ID
24532567 View in PubMed
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Mental health functioning (SF-36) and intentions to retire early among ageing municipal employees: the Helsinki Health Study.

https://arctichealth.org/en/permalink/ahliterature169944
Source
Scand J Public Health. 2006;34(2):190-8
Publication Type
Article
Date
2006
Author
Karoliina Harkonmäki
Eero Lahelma
Pekka Martikainen
Ossi Rahkonen
Karri Silventoinen
Author Affiliation
Department of Public Health, University of Helsinki, Finland. karoliina.harkonmaki@helsinki.fi
Source
Scand J Public Health. 2006;34(2):190-8
Date
2006
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cross-Sectional Studies
Female
Finland - epidemiology
Health status
Humans
Male
Mental Disorders - epidemiology
Mental health
Middle Aged
Questionnaires
Retirement
Socioeconomic Factors
Abstract
To examine the associations of mental health functioning with intentions to retire early among ageing municipal employees.
Cross-sectional survey data (n = 7,765) from the Helsinki Health Study in 2000, 2001, and 2002 were used. Intentions to retire early were sought with a question: "Have you considered retiring before normal retirement age?" The dependent variable was divided into three categories: 1 = no intentions to retire early; 2 = weak intentions; 3 = strong intentions. Mental health functioning was measured by the Short Form 36 (SF-36) mental component summary (MCS). Other variables included age, sex, physical health functioning (SF-36), limiting longstanding illness, socioeconomic status, and spouse's employment status. Multinomial regression analysis was used to examine the association of mental health functioning with intentions to retire early.
Employees with the poorest mental health functioning were much more likely to report strong intentions to retire early (OR 6.09, 95% CI 4.97-7.47) than those with the best mental health functioning. Adjustments for physical health, socioeconomic status, and spouse's employment status did not substantially affect this association.
The findings highlight the importance of mental health for intentions to retire early. Strategies aimed at keeping people at work for longer should emphasize the importance of mental well-being and the prevention of poor mental health. More evidence is needed on why mental problems among ageing baby-boomer employees are giving rise to increasing social consequences, although the overall prevalence of mental problems has not increased.
PubMed ID
16581712 View in PubMed
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Changes in physical and mental health functioning during retirement transition: a register-linkage follow-up study.

https://arctichealth.org/en/permalink/ahliterature300387
Source
Eur J Public Health. 2018 10 01; 28(5):805-809
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
10-01-2018
Author
Minna Mänty
Anne Kouvonen
Tea Lallukka
Jouni Lahti
Eero Lahelma
Ossi Rahkonen
Author Affiliation
Department of Public Health, University of Helsinki, Helsinki, Finland.
Source
Eur J Public Health. 2018 10 01; 28(5):805-809
Date
10-01-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Employment - psychology
Female
Finland
Follow-Up Studies
Health status
Humans
Leisure Activities - psychology
Male
Middle Aged
Registries
Retirement - psychology - statistics & numerical data
Surveys and Questionnaires
Abstract
Changes in health functioning over different retirement transitions are poorly understood. This study aimed to examine associations between transition into statutory, disability and part-time retirement, and changes in health functioning.
Survey data were collected among ageing employees of the City of Helsinki, Finland, at three phases: (i) (2000-02), (ii) (2007) and (iii) (2012). Physical and mental health functioning were measured using the Short-Form 36 questionnaire at each phase. Retirees between phases 1 and 3 were identified from the national registers of the Finnish Centre for Pensions: full-time statutory retirement (n = 1464), part-time retirement (n = 404), and disability retirement (n = 462). Generalized estimating equations were used to examine the associations.
Disability retirees had poorer pre- and post-retirement health functioning compared to statutory and part-time retirees. Statutory and part-time retirement were associated with no or only small changes in physical health functioning during retirement transition (ß 0.1, 95% CI -0.3 to 0.5 and -1.0, -1.8 to -0.1, respectively), whereas a clear decline in functioning was observed among disability retirees (-4.3, -5.4 to -3.2). Mental health functioning improved during the retirement transition among statutory and part-time retirees (1.9, 1.4-2.4 and 2.0, 1.0-3.0, respectively), whereas no change was observed for disability retirees.
Transition to disability retirement led to a decrease in physical health functioning, and statutory retirement to a slight improvement in mental health functioning. Evidence on changes in physical and mental health functioning during retirement transition process may provide useful information for interventions to promote healthy ageing.
PubMed ID
29425301 View in PubMed
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Trajectories of mental health before and after old-age and disability retirement: a register-based study on purchases of psychotropic drugs.

https://arctichealth.org/en/permalink/ahliterature126218
Source
Scand J Work Environ Health. 2012 Sep;38(5):409-17
Publication Type
Article
Date
Sep-2012
Author
Mikko Laaksonen
Niina Metsä-Simola
Pekka Martikainen
Olli Pietiläinen
Ossi Rahkonen
Raija Gould
Timo Partonen
Eero Lahelma
Author Affiliation
Finnish Centre for Pensions, 00065 Eläketurvakeskus, Finland. mikko.laaksonen@etk.fi
Source
Scand J Work Environ Health. 2012 Sep;38(5):409-17
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Aged
Disabled Persons
Female
Finland
Humans
Male
Mental health
Psychotropic Drugs - therapeutic use
Registries
Abstract
Retirement from paid work is a major life event facing increasingly large numbers of people in the coming years. We examined trajectories of mental health five years before and five years after old-age and disability retirement using data on purchases of psychotropic drugs.
The study included all employees from the City of Helsinki, Finland, retiring between 2000-2008 due to old age (N=4456) or disability (N=2549). Purchases of psychotropic drugs were analyzed in 20 3-month intervals before and after retirement using graphical methods and growth curve models.
Old-age retirement was unrelated to purchases of psychotropic drugs. Among disability retirees, psychotropic medication tripled before retirement. The average increase was 0.95 [95% confidence interval (95% CI) 0.73-1.16] daily defined doses (DDD) 5-1.5 years before retirement; from 1.5 years until retirement it was 5.68 DDD (95% CI 5.33-6.03) for each 3-month interval. After disability retirement, purchases of antidepressants decreased on average by 0.40 DDD (95% CI 0.57-0.23) for each 3-month interval, those of hypnotics and sedatives increased by 0.30 DDD (95% CI 0.12-0.47), and no changes were seen for other psychotropic drugs. The changes before and after retirement were largest among those who retired due to mental disorders and those whose retirement had been granted as temporary.
While no overall decrease in psychotropic medication after retirement was observed, purchases of antidepressants decreased after disability retirement. Long-term trajectories suggest that disability retirement might be prevented if mental health problems were tackled more efficiently earlier in the pre-retirement period.
Notes
Comment In: Scand J Work Environ Health. 2012 Sep;38(5):391-222878398
PubMed ID
22411588 View in PubMed
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Physical and mental health functioning after all-cause and diagnosis-specific sickness absence: a register-linkage follow-up study among ageing employees.

https://arctichealth.org/en/permalink/ahliterature285084
Source
BMC Public Health. 2017 Jan 25;17(1):114
Publication Type
Article
Date
Jan-25-2017
Author
Minna Mänty
Tea Lallukka
Jouni Lahti
Olli Pietiläinen
Mikko Laaksonen
Eero Lahelma
Ossi Rahkonen
Source
BMC Public Health. 2017 Jan 25;17(1):114
Date
Jan-25-2017
Language
English
Publication Type
Article
Keywords
Adult
Disability Evaluation
Female
Finland
Follow-Up Studies
Humans
Male
Mental Disorders - physiopathology - psychology
Middle Aged
Musculoskeletal Diseases - physiopathology - psychology
Occupational Diseases - physiopathology - psychology
Prospective Studies
Registries
Respiratory Tract Diseases - physiopathology - psychology
Sick Leave - statistics & numerical data
Surveys and Questionnaires
Time Factors
Abstract
Sickness absence has been shown to be a risk marker for severe future health outcomes, such as disability retirement and premature death. However, it is poorly understood how all-cause and diagnosis-specific sickness absence is reflected in subsequent physical and mental health functioning over time. The aim of this study was to examine the association of all-cause and diagnosis-specific sickness absence with subsequent changes in physical and mental health functioning among ageing municipal employees.
Prospective survey and register data from the Finnish Helsinki Health Study and the Social Insurance Institution of Finland were used. Register based records for medically certified all-cause and diagnostic-specific sickness absence spells (>14 consecutive calendar days) in 2004-2007 were examined in relation to subsequent physical and mental health functioning measured by Short-Form 36 questionnaire in 2007 and 2012. In total, 3079 respondents who were continuously employed over the sickness absence follow-up were included in the analyses. Repeated-measures analysis was used to examine the associations.
During the 3-year follow-up, 30% of the participants had at least one spell of medically certified sickness absence. All-cause sickness absence was associated with lower subsequent physical and mental health functioning in a stepwise manner: the more absence days, the poorer the subsequent physical and mental health functioning. These differences remained but narrowed slightly during the follow-up. Furthermore, the adverse association for physical health functioning was strongest among those with sickness absence due to diseases of musculoskeletal or respiratory systems, and on mental functioning among those with sickness absence due to mental disorders.
Sickness absence showed a persistent adverse stepwise association with subsequent physical and mental health functioning. Evidence on health-related outcomes after long-term sickness absence may provide useful information for targeted interventions to promote health and workability.
Notes
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PubMed ID
28118837 View in PubMed
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Mental symptoms and cause-specific mortality among midlife employees.

https://arctichealth.org/en/permalink/ahliterature284147
Source
BMC Public Health. 2016 Nov 08;16(1):1142
Publication Type
Article
Date
Nov-08-2016
Author
Eero Lahelma
Olli Pietiläinen
Ossi Rahkonen
Jouni Lahti
Tea Lallukka
Source
BMC Public Health. 2016 Nov 08;16(1):1142
Date
Nov-08-2016
Language
English
Publication Type
Article
Keywords
Accidents
Adult
Cause of Death
Female
Finland - epidemiology
Health Behavior
Humans
Male
Mental Disorders - complications
Mental health
Middle Aged
Proportional Hazards Models
Social Class
Suicide
Surveys and Questionnaires
Violence
Workplace
Abstract
Mental symptoms are prevalent among populations, but their associations with premature mortality are inadequately understood. We examined whether mental symptoms contribute to cause-specific mortality among midlife employees, while considering key covariates.
Baseline mail survey data from 2000-02 included employees, aged 40-60, of the City of Helsinki, Finland (n?=?8960, 80 % women, response rate 67 %). Mental symptoms were measured by the General Health Questionnaire 12-item version (GHQ-12) and the Short Form 36 mental component summary (MCS). Covariates included sex, marital status, social support, health behaviours, occupational social class and limiting long-standing illness. Causes of death by the end of 2013 were obtained from Statistics Finland (n?=?242) and linked individually to survey data pending consent (n?=?6605). Hazard ratios (HR) and 95 % confidence intervals (95 % CI) were calculated using Cox regression analysis.
For all-cause mortality, only MCS showed a weak association before adjustments. For natural mortality, no associations were found. For unnatural mortality (n?=?21), there was a sex adjusted association with GHQ (HR?=?1.96, 95 % CI?=?1.45-2.64) and MCS (2.30, 95 % CI?=?1.72-3.08). Among unnatural causes of death suicidal mortality (n?=?11) was associated with both GHQ (2.20, 95 % CI?=?1.47-3.29) and MCS (2.68, 95 % CI?=?1.80-3.99). Of the covariates limiting long-standing illness modestly attenuated the associations.
Two established measures of mental symptoms, i.e. GHQ-12 and SF-36 MCS, were both associated with subsequent unnatural, i.e. accidental and violent, as well as suicidal mortality. No associations were found for natural mortality due to diseases. These findings need to be corroborated in further populations. Supporting mental health through workplace measures may help counteract subsequent suicidal and other unnatural mortality among midlife employees.
Notes
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PubMed ID
27825372 View in PubMed
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Associations of childhood circumstances with physical and mental functioning in adulthood.

https://arctichealth.org/en/permalink/ahliterature172653
Source
Soc Sci Med. 2006 Apr;62(8):1831-9
Publication Type
Article
Date
Apr-2006
Author
Tomi Mäkinen
Mikko Laaksonen
Eero Lahelma
Ossi Rahkonen
Author Affiliation
Department of Public Health, University of Helsinki, Helsinki, Finland. tomi.makinen@helsinki.fi
Source
Soc Sci Med. 2006 Apr;62(8):1831-9
Date
Apr-2006
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Child
Educational Status
Female
Finland
Humans
Life Change Events
Male
Mental health
Middle Aged
Questionnaires
Abstract
The aim of this study was to examine the associations of parental education and specific childhood circumstances with adult physical and mental functioning. Self-reported data were collected in 2000, 2001 and 2002 among middle-aged women (n=7,171) and men (n=1,799) employed by the City of Helsinki. Functioning was measured by the physical and mental component summaries of the Short-Form 36 Health Survey (SF-36). The lowest quartile of the scores on each component summary was considered to indicate limited functioning. Adult socio-economic circumstances were measured by their own education. Among women parental education was inversely associated with physical functioning. The association remained after adjusting for specific childhood circumstances but disappeared after adjustment for own education. In contrast, parental education was positively associated with mental functioning among women, and the association remained after adjusting for specific childhood circumstances and the own education. Among women childhood adversities such as own chronic disease, parental mental problems, economic difficulties and having been bullied in childhood were associated with both physical and mental functioning. Parental drinking problems were associated with adult mental functioning among women. Among men, chronic disease, economic difficulties and having been bullied in childhood were associated with physical functioning. Parental mental problems, economic difficulties and having being bullied in childhood were also associated with mental functioning among men. These results suggest that the effect of parental education on physical functioning is mediated through one's own education. The association between parental education and mental functioning and the effects of several specific childhood circumstances may suggest a latency effect. Some evidence of cumulative effects of childhood and adulthood circumstances were found among women in physical functioning. Specific childhood circumstances are therefore important determinants of adult functioning. These circumstances provide detailed information on the association of childhood circumstances with adult functioning over and above parental education.
PubMed ID
16194591 View in PubMed
Less detail

Cohort profile: the Helsinki Health Study.

https://arctichealth.org/en/permalink/ahliterature125620
Source
Int J Epidemiol. 2013 Jun;42(3):722-30
Publication Type
Article
Date
Jun-2013
Author
Eero Lahelma
Akseli Aittomäki
Mikko Laaksonen
Tea Lallukka
Pekka Martikainen
Kustaa Piha
Ossi Rahkonen
Peppiina Saastamoinen
Author Affiliation
Department of Public Health, Hjelt Institute, University of Helsinki, Finland. eero.lahelma@helsinki.fi
Source
Int J Epidemiol. 2013 Jun;42(3):722-30
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Female
Finland
Health Behavior
Health status
Health Status Indicators
Health Surveys
Humans
Life Style
Longitudinal Studies
Male
Mental health
Middle Aged
Questionnaires
Social Support
Socioeconomic Factors
Abstract
The Helsinki Health Study cohort was set up to enable longitudinal studies on the social and work related determinants of health and well-being, making use of self-reported as well as objective register data. The target population is the staff of the City of Helsinki, Finland. Baseline data for the cohort were derived from questionnaire surveys conducted in 2000, 2001 and 2002 among employees reaching 40, 45, 50, 55 or 60 years of age in each year. The number of responders at baseline was 8960 (80% women, response rate 67%). Additional age-based health examination data were available. A follow up survey was conducted in 2007 yielding 7332 responders (response rate 83%). Measures of health include health behaviours, self-rated health, common mental disorders, functioning, pain, sleep problems, angina symptoms and major diseases. Social determinants include socio-demographics, socio-economic circumstances, working conditions, social support, and work-family interface. Further register linkages include sickness absence, hospital discharge, prescribed drugs, and retirement updated at the end of 2010. The cohort allows comparisons with the Whitehall II study, London, UK, and the Japanese Civil Servants Study from western Japan. The cohort data are available for collaborative research at Hjelt Institute, Department of Public Health, University of Helsinki, Finland.
PubMed ID
22467288 View in PubMed
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The effects of childhood circumstances, adult socioeconomic status, and material circumstances on physical and mental functioning: a structural equation modelling approach.

https://arctichealth.org/en/permalink/ahliterature164371
Source
Ann Epidemiol. 2007 Jun;17(6):431-9
Publication Type
Article
Date
Jun-2007
Author
Mikko Laaksonen
Karri Silventoinen
Pekka Martikainen
Ossi Rahkonen
Janne Pitkäniemi
Eero Lahelma
Author Affiliation
Department of Public Health, University of Helsinki, Helsinki, Finland. mikko.t.laaksonen@helsinki.fi
Source
Ann Epidemiol. 2007 Jun;17(6):431-9
Date
Jun-2007
Language
English
Publication Type
Article
Keywords
Adult
Child
Female
Finland - epidemiology
Health status
Humans
Male
Mental health
Middle Aged
Models, Theoretical
Research Design
Socioeconomic Factors
Abstract
We sought to examine the importance of childhood circumstances, adult socioeconomic status, and material circumstances to physical and mental functioning among middle-aged women and men.
The data were collected among the employees of the City of Helsinki by mailed questionnaires from 2000 to 2002 (7148 women and 1799 men, response rate 67%). Three latent variables covering childhood circumstances, adult socioeconomic status, and material circumstances were constructed from 10 observed socioeconomic indicators. Direct and indirect effects of the latent variables on physical and mental functioning, measured by the SF-36 component summaries, were examined using structural equation modelling.
Childhood circumstances were not directly associated with either physical or mental functioning but had some effect through socioeconomic status. Low socioeconomic status was associated with poor physical functioning, but mental functioning was poorer among those in higher positions. Material circumstances were associated with physical and especially with mental functioning.
Low socioeconomic status and material circumstances are both important for physical functioning. However, mental functioning does not necessarily follow a similar socioeconomic pattern and the results are heavily influenced by how socioeconomic position is measured.
PubMed ID
17395480 View in PubMed
Less detail

Joint association of physical activity and body weight with subsequent physical and mental functioning: a follow-up study.

https://arctichealth.org/en/permalink/ahliterature115540
Source
BMC Public Health. 2013;13:197
Publication Type
Article
Date
2013
Author
Vivian Lindhom
Jouni Lahti
Ossi Rahkonen
Eero Lahelma
Tea Lallukka
Author Affiliation
Hjelt Institute, Department of Public Health, University of Helsinki, POB 41, 00014, Helsinki, Finland. vivian.lindholm@helsinki.fi
Source
BMC Public Health. 2013;13:197
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Body Weight - physiology
Female
Finland - epidemiology
Follow-Up Studies
Health status
Humans
Leisure Activities - psychology
Male
Mental Disorders - epidemiology - physiopathology
Mental Health - statistics & numerical data
Middle Aged
Motor Activity - physiology
Overweight - epidemiology - physiopathology
Risk factors
Sedentary lifestyle
Time Factors
Abstract
Physical inactivity and overweight are major threats to public health. However, it is not well understood to what extent physical activity might counteract the harmful effects of overweight on functioning. Thus, we examined the joint associations of leisure-time physical activity and body mass index (BMI) with subsequent physical and mental functioning over a follow-up of five to seven years.
The data were derived from the Helsinki Health Study, which is a cohort study among employees of the City of Helsinki, Finland. The baseline postal survey data were collected among 40-60-year-old employees in 2000-02 (n = 8960, response rate 67%), and the follow-up data in 2007 among all baseline survey respondents (n = 7332, response rate 83%). We divided the participants into six groups according to their amount of physical activity (inactive, moderately active and highly active) and their relative weight (normal weight and overweight). Highly active normal-weight participants were used as a reference group in all the analyses. Poor functioning was defined as the lowest quartile of the Short Form 36 (SF-36) health survey's physical and mental component summaries, with the follow-up cut-off point also applied at baseline. We used logistic regression analysis adjusted for age, gender, baseline functioning, smoking, alcohol use, marital status, socioeconomic position and working conditions.
At baseline 48% of the participants were overweight and 11% were inactive. After adjustments inactivity was associated with poor physical functioning at follow-up both among the normal-weight (OR 1.51, 95% CI 1.09-2.10) and overweight (OR 2.02, 95% CI 1.56-2.63) groups. Being overweight regardless of activity level was associated with poor physical functioning. Poor physical functioning was practically equally common among the highly active overweight group and the inactive normal-weight group. After adjustments, for mental functioning, only inactivity among the overweight was associated with poor mental functioning (OR 1.39, 95% CI 1.08-1.80).
Physical activity is likely to be beneficial for physical and mental functioning among both those with overweight and normal weight. However, maintaining normal weight is also important for good physical functioning. Therefore, efforts should be made to recommend people to engage in physical activity regardless of weight.
Notes
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PubMed ID
23497094 View in PubMed
Less detail

Determinants of health in early adulthood: what is the role of parental education, childhood adversities and own education?

https://arctichealth.org/en/permalink/ahliterature173037
Source
Eur J Public Health. 2006 Jun;16(3):306-15
Publication Type
Article
Date
Jun-2006
Author
Laura Kestilä
Seppo Koskinen
Tuija Martelin
Ossi Rahkonen
Tiina Pensola
Hillevi Aro
Arpo Aromaa
Author Affiliation
National Public Health Institute (KTL), Department of Health and Functional Capacity, Helsinki, Finland. laura.kestila@ktl.fi
Source
Eur J Public Health. 2006 Jun;16(3):306-15
Date
Jun-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Child
Education
Family
Female
Finland
Health status
Humans
Interviews as Topic
Life Change Events
Logistic Models
Male
Mental health
Outcome Assessment (Health Care)
Parents
Questionnaires
Socioeconomic Factors
Abstract
Of the many studies assessing the impact of childhood living conditions on health and health inequalities in adulthood, only few have combined information on current determinants of health with detailed individual level data on different aspects of childhood living conditions and adversities. This study aims (i) to assess the role of parental education, self-reported childhood adversities and family structure as determinants of different dimensions of health in early adulthood, and (ii) to identify the role of the respondent's own education as a modifier of the association between childhood living conditions and health.
The study is based on a representative sample (n = 3669; participation rate 83%) of young adults aged 18-39 years in 2000 in Finland. The main outcome measures were poor self-rated health (SRH), psychological distress (by GHQ12) and somatic morbidity.
Parental education, problems in childhood and the respondent's own education were independently related to SRH and psychological distress. The impact of childhood living conditions on health varied by gender and according to the measure of health. Childhood conditions were strongly associated with poor SRH and psychological distress, whereas the connection with somatic morbidity was weaker. The associations remained relatively unchanged after controlling for the respondent's own education.
Childhood living conditions and adversities are strongly associated with poor SRH and psychological distress in early adulthood. Early recognition of childhood adversities followed by relevant support measures may play an important role in preventing health problems in adulthood.
PubMed ID
16141301 View in PubMed
Less detail

The role of work group in individual sickness absence behavior.

https://arctichealth.org/en/permalink/ahliterature152872
Source
J Health Soc Behav. 2008 Dec;49(4):452-67
Publication Type
Article
Date
Dec-2008
Author
Ari Väänänen
Nuria Tordera
Mika Kivimäki
Anne Kouvonen
Jaana Pentti
Anne Linna
Jussi Vahtera
Author Affiliation
Finnish Institute of Occupational Health, Centre of Expertise for Work Organizations, Helsinki, Finland. Ari.Vaananen@ttl.fi
Source
J Health Soc Behav. 2008 Dec;49(4):452-67
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Absenteeism
Adult
Female
Finland
Health Behavior
Health status
Humans
Interpersonal Relations
Male
Mental health
Poisson Distribution
Prospective Studies
Psychometrics
Questionnaires
Work - psychology
Workplace - psychology
Abstract
The purpose of our two-year follow-up study was to examine the effect of the social components of the work group, such as group absence norms and cohesion, on sickness absence behavior among individuals with varying attitudes toward work attendance. The social components were measured using a questionnaire survey and data on sickness absence behavior were collected from the employers' records. The study population consisted of 19,306 Finnish municipal employees working in 1,847 groups (78% women). Multilevel Poisson regression modeling was applied. The direct effects of work group characteristics on sickness absence were mostly insignificant. In contrast, both of the social components of a work group had an indirect impact: The more tolerant the group absence norms (at both individual- and cross-level) and the lower the group cohesion (at the individual level), the more the absence behavior of an individual was influenced by his or her attitude toward work attendance. We conclude that work group moderates the extent to which individuals with a liberal attitude toward work attendance actually engage in sickness absence behavior.
PubMed ID
19181049 View in PubMed
Less detail

The double burden of and negative spillover between paid and domestic work: associations with health among men and women.

https://arctichealth.org/en/permalink/ahliterature175258
Source
Women Health. 2004;40(3):1-18
Publication Type
Article
Date
2004
Author
Ari Väänänen
May V Kevin
Leena Ala-Mursula
Jaana Pentti
Mika Kivimäki
Jussi Vahtera
Author Affiliation
Finnish Institute of Occupational Health, Department of Psychology, Topeliuksenkatu 41 A, FIN-00250 Helsinki, Finland. Ari.Vaananen@ttl.fi
Source
Women Health. 2004;40(3):1-18
Date
2004
Language
English
Publication Type
Article
Keywords
Adult
Confidence Intervals
Conflict (Psychology)
Cross-Sectional Studies
Female
Finland - epidemiology
Health status
Humans
Male
Mental health
Middle Aged
Odds Ratio
Questionnaires
Risk factors
Sex Distribution
Sick Leave - statistics & numerical data
Stress, Psychological - epidemiology - etiology
Time Factors
Work Schedule Tolerance - psychology
Abstract
The objective of the study was to determine whether the double burden of and negative spillover between domestic and full-time paid work are associated with an increase in health problems. Survey responses were linked with sickness absence records in a cross-sectional study of 6442 full-time municipal employees. Women and men experiencing severe work-family spillover had a 1.5-1.6 (95% confidence intervals 1.1 to 2.0) times higher rate of sickness absence than those with no such experience. The corresponding odds ratios for psychological distress and suboptimal self-assessed health varied between 3.6 and 6.5 (2.3 to 11.0). Among the women, severe family-work spillover increased the risk of psychological distress and suboptimal health [odds ratios 2.0 (1.4 to 2.9) and 1.6 (1.1 to 2.3), respectively], and accumulated sole responsibilities were associated with a 1.5 (1.1 to 2.1) times higher odds ratio for psychological distress. Long domestic work hours (>50/week) were associated with a 1.5 (1.1 to 2.0) times higher rate of sickness absence among the men, but there was no such increase among the women. We conclude that negative work-family spillover especially is associated with health problems among both women and men, and negative family-work spillover is related to a poorer health status among women.
PubMed ID
15829442 View in PubMed
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Educational differences in disability retirement among young employees in Helsinki, Finland.

https://arctichealth.org/en/permalink/ahliterature279190
Source
Eur J Public Health. 2016 Apr;26(2):318-22
Publication Type
Article
Date
Apr-2016
Author
Hilla Sumanen
Ossi Rahkonen
Olli Pietiläinen
Eero Lahelma
Eira Roos
Jouni Lahti
Source
Eur J Public Health. 2016 Apr;26(2):318-22
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Educational Status
Female
Finland - epidemiology
Health status
Humans
Male
Mental Health - statistics & numerical data
Pensions - statistics & numerical data
Regression Analysis
Risk factors
Sick Leave - statistics & numerical data
Socioeconomic Factors
Abstract
Disability retirement (DR) among young employees is an increasing problem affecting work life and public health, given the potential major loss of working time. Little is known about educational differences in the risk of DR among young employees, despite the need for such knowledge in targeting preventive measures. We examined the association between education and DR due to any cause and to mental and non-mental causes among young employees.
Personnel register data of the City of Helsinki from the years 2002-2013 for 25-to-34-year-old employees (n= 41225) were linked to register data from the Finnish Centre for Pensions on DR (n= 381), and from Statistics Finland on education. Education was categorised into four hierarchical groups. The mean follow-up time was 5.7 years. Cox regression analysis was used.
There were 381 DR events and of the events, over 70% were due to mental disorders and 72% were temporary. A consistent educational gradient was found. Those with a basic education were at the highest risk of DR due to any cause (HR 4.64, 95% CI 3.07, 7.02), and to mental (HR 4.79, 95% CI 2.89, 7.94) and non-mental causes (HR 4.32, 95% CI 2.10, 8.91).
DR due to any cause, and to mental and non-mental causes, followed a clear educational gradient. Early intervention, treatment and rehabilitation with a view to maintaining work ability are needed among young employees, especially those with low education. Adapting working conditions to their health and work ability may also help to avoid premature exit from work.
PubMed ID
26678276 View in PubMed
Less detail

Childhood adversity, adult socioeconomic status and risk of work disability: a prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature285311
Source
Occup Environ Med. 2017 Sep;74(9):659-666
Publication Type
Article
Date
Sep-2017
Author
Jaana I Halonen
Mika Kivimäki
Jussi Vahtera
Jaana Pentti
Marianna Virtanen
Jenni Ervasti
Tuula Oksanen
Tea Lallukka
Source
Occup Environ Med. 2017 Sep;74(9):659-666
Date
Sep-2017
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Disabled Persons - psychology
Employment
Family Relations - psychology
Female
Finland
Follow-Up Studies
Humans
Male
Mental Disorders - etiology
Mental health
Middle Aged
Musculoskeletal Diseases - etiology
Occupational Diseases - etiology
Pensions
Proportional Hazards Models
Retirement
Risk factors
Sick Leave
Social Class
Abstract
To examine the combined effects of childhood adversities and low adult socioeconomic status (SES) on the risk of future work disability.
Included were 34 384 employed Finnish Public Sector study participants who responded to questions about childhood adversities (none vs any adversity, eg, parental divorce or financial difficulties) in 2008, and whose adult SES in 2008 was available. We categorised exposure into four groups: neither (reference), childhood adversity only, low SES only or both. Participants were followed from 2009 until the first period of register-based work disability (sickness absence >9 days or disability pension) due to any cause, musculoskeletal or mental disorders; retirement; death or end of follow-up (December 2011). We ran Cox proportional hazard models adjusted for behavioural, health-related and work-related covariates, and calculated synergy indices for the combined effects.
When compared with those with neither exposure, HR for work disability from any cause was increased among participants with childhood adversity, with low SES, and those with both exposures. The highest hazard was observed in those with both exposures: HR 2.53, 95% CI 2.29?to 2.79 for musculoskeletal disability, 1.55, 95% CI 1.36?to 1.78 for disability due to mental disorders and 1.29, 95% CI 1.20?to 1.39 for disability due to other reasons. The synergy indices did not indicate synergistic effects.
These findings indicate that childhood psychosocial adversity and low adult SES are additive risk factors for work disability.
Notes
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PubMed ID
28784838 View in PubMed
Less detail

Leisure-time physical activity and disability retirement: a prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature120424
Source
J Phys Act Health. 2013 Jul;10(5):669-75
Publication Type
Article
Date
Jul-2013
Author
Jouni Lahti
Ossi Rahkonen
Eero Lahelma
Mikko Laaksonen
Author Affiliation
Dept of Public Health, University of Helsinki, Hjelt-institute, Helsinki, Finland.
Source
J Phys Act Health. 2013 Jul;10(5):669-75
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Adult
Disabled Persons - psychology - statistics & numerical data
Exercise - physiology - psychology
Female
Finland - epidemiology
Humans
Leisure Activities
Male
Mental Health - statistics & numerical data
Metabolic Equivalent
Middle Aged
Musculoskeletal Diseases - prevention & control - psychology
Prospective Studies
Retirement - psychology - statistics & numerical data
Sex Factors
Abstract
To examine whether leisure-time physical activity is associated with all-cause disability retirement as well as disability retirement due to musculoskeletal and mental causes.
The baseline data were collected by questionnaire surveys in 2000-2002 among 40- to 60-year-old employees of the City of Helsinki. Disability retirement data were derived from the registry of the Finnish Centre for Pensions (maximum follow-up time 6.8 years). The analysis included 4920 women and 1355 men. Physical activity was converted to metabolic equivalent (MET) index. We classified the participants into 4 groups according to physical activity recommendations and according to the participation in vigorous intensity activities. Cox regression analysis was used to calculate hazard ratios.
Physical activity decreased the risk of all-cause disability retirement among both genders, however, women engaging in recommended volume of moderate-intensity activity only did not have reduced risk. Those engaging in vigorous activity with sufficient total volume had clearly reduced risk of disability retirement. The association was similar when examining disability retirement due to musculoskeletal and mental causes.
For healthy middle-aged engaging in moderate-intensity physical activity additional vigorous exercise may be useful for maintaining musculoskeletal and mental health and thus lower the risk of subsequent disability retirement.
PubMed ID
23006587 View in PubMed
Less detail

The associations between psychosocial working conditions and changes in common mental disorders: a follow-up study.

https://arctichealth.org/en/permalink/ahliterature265965
Source
BMC Public Health. 2014;14:588
Publication Type
Article
Date
2014
Author
Hanna Laine
Peppiina Saastamoinen
Jouni Lahti
Ossi Rahkonen
Eero Lahelma
Source
BMC Public Health. 2014;14:588
Date
2014
Language
English
Publication Type
Article
Keywords
Adult
Aging
Female
Finland - epidemiology
Follow-Up Studies
Humans
Male
Mental Disorders - epidemiology - prevention & control
Middle Aged
Occupational Health Services
Questionnaires
Retirement
Socioeconomic Factors
Workplace - psychology
Abstract
Common mental disorders (CMD) are prevalent in working populations and have adverse consequences for employee well-being and work ability, even leading to early retirement. Several studies report associations between psychosocial working conditions and CMD. However, there is a lack of longitudinal research within a broad framework of psychosocial working conditions and improvement in CMD. The aim of this study was to examine the associations between several psychosocial working conditions and deteriorating and improving CMD among ageing employees over a five-to-six-year follow-up period.
The study is based on the Helsinki Health Study baseline survey in 2001-2002 and a follow-up in 2007 (N?=?4340, response rate 83%) conducted among 40-60-year-old female and male employees. The General Health Questionnaire (GHQ-12) was used to measure common mental disorders. Psychosocial working conditions were measured in terms of job strain, organisational justice, work-family interface, social support and workplace bullying. The covariates included sociodemographic and health factors.
Following adjustment for all the covariates, family-to-work (OR 1.41, 95% Cl 1.04-1.91) and work-to-family conflicts (OR 1.99, 95% Cl 1.42-2.78) and workplace bullying (OR 1.40, 95% Cl 1.09-1.79) were associated with deterioration, and family-to-work conflicts (OR 1.65, 95% Cl 1.66-2.34) and social support (OR 1.47, 95% Cl 1.07-2.00) with improvement in CMD.
Adverse psychosocial working conditions contribute to poor mental health among employees. Preventing workplace bullying, promoting social support and achieving a better balance between work and family may help employees to maintain their mental health.
Notes
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PubMed ID
24916716 View in PubMed
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Workplace bullying and common mental disorders: a follow-up study.

https://arctichealth.org/en/permalink/ahliterature137740
Source
J Epidemiol Community Health. 2012 Jun;66(6):e3
Publication Type
Article
Date
Jun-2012
Author
Eero Lahelma
Tea Lallukka
Mikko Laaksonen
Peppiina Saastamoinen
Ossi Rahkonen
Author Affiliation
Department of Public Health, University of Helsinki, Helsinki, Finland. eero.lahelma@helsinki.fi
Source
J Epidemiol Community Health. 2012 Jun;66(6):e3
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adult
Bullying
Female
Finland - epidemiology
Follow-Up Studies
Humans
Male
Mental Disorders - epidemiology - etiology
Middle Aged
Questionnaires
Workplace
Abstract
Workplace bullying has been associated with mental health, but longitudinal studies confirming the association are lacking. This study examined the associations of workplace bullying with subsequent common mental disorders 5-7 years later, taking account of baseline common mental disorders and several covariates.
Baseline questionnaire survey data were collected in 2000-2002 among municipal employees, aged 40-60 years (n=8960; 80% women; response rate 67%). Follow-up data were collected in 2007 (response rate 83%). The final data amounted to 6830 respondents. Workplace bullying was measured at baseline using an instructed question about being bullied currently, previously or never. Common mental disorders were measured at baseline and at follow-up using the 12-item version of the General Health Questionnaire. Those scoring 3-12 were classified as having common mental disorders. Covariates included bullying in childhood, occupational and employment position, work stress, obesity and limiting longstanding illness. Logistic regression analysis was used.
After adjusting for age, being currently bullied at baseline was associated with common mental disorders at follow-up among women (OR 2.34, CI 1.81 to 3.02) and men (OR 3.64, CI 2.13 to 6.24). The association for the previously bullied was weaker. Adjusting for baseline common mental disorders, the association attenuated but remained. Adjusting for further covariates did not substantially alter the studied association. CONCLUSION The study confirms that workplace bullying is likely to contribute to subsequent common mental disorders. Measures against bullying are needed at workplaces to prevent mental disorders.
PubMed ID
21252256 View in PubMed
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Multiple measures of socioeconomic circumstances and common mental disorders.

https://arctichealth.org/en/permalink/ahliterature169304
Source
Soc Sci Med. 2006 Sep;63(5):1383-99
Publication Type
Article
Date
Sep-2006
Author
Eero Lahelma
Mikko Laaksonen
Pekka Martikainen
Ossi Rahkonen
Sirpa Sarlio-Lähteenkorva
Author Affiliation
Department of Public Health, University of Helsinki, Finland. eero.lahelma@helsinki.fi
Source
Soc Sci Med. 2006 Sep;63(5):1383-99
Date
Sep-2006
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Cross-Sectional Studies
Female
Finland - epidemiology
Humans
Male
Mental Disorders - epidemiology
Middle Aged
Research Design - statistics & numerical data
Socioeconomic Factors
Abstract
While serious mental disorders typically show socioeconomic differences similar to physical illness-that is, that lower positions imply poorer health-differences for common mental disorders have been inconsistent. We aim to clarify the associations and pathways between measures of socioeconomic circumstances and common mental disorders by simultaneously analysing several past and present socioeconomic measures. The data were derived from middle-aged women and men employed by the City of Helsinki. Cross-sectional surveys were conducted in 2000-2002 among employees who, during each year, reached 40, 45, 50, 55 or 60 years of age. The pooled data include 8970 respondents (80% women; response rate 67%). Common mental disorders were measured by GHQ-12 and the SF-36 mental component summary. Seven socioeconomic measures were included: parental education, childhood economic difficulties, own education, occupational class, household income, home ownership, and current economic difficulties. Logistic regression analysis was used to examine associations between the socioeconomic circumstances and common mental disorders. Past and present economic difficulties were strongly associated with common mental disorders, whereas conventional past and present socioeconomic status measures showed weak or slightly reverse associations. Adjusting for age and gradually for each socioeconomic measure did not affect the main findings, which were very similar for women and men, as well as for both measures of common mental disorders. While the associations of conventional socioeconomic status measures with common mental disorders were weak and inconsistent, our results highlight the importance of past and present economic difficulties to these disorders.
PubMed ID
16690186 View in PubMed
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