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10-year trends of educational differences in long sickness absence due to mental disorders.

https://arctichealth.org/en/permalink/ahliterature285500
Source
J Occup Health. 2017 Jul 27;59(4):352-355
Publication Type
Article
Date
Jul-27-2017
Author
Hilla Sumanen
Olli Pietiläinen
Eero Lahelma
Ossi Rahkonen
Source
J Occup Health. 2017 Jul 27;59(4):352-355
Date
Jul-27-2017
Language
English
Publication Type
Article
Keywords
Absenteeism
Adolescent
Adult
Age Distribution
Cross-Sectional Studies
Education - classification - statistics & numerical data
Employment - psychology - statistics & numerical data
Female
Finland
Humans
Male
Mental Disorders - psychology
Middle Aged
Regression Analysis
Sex Distribution
Sick Leave - statistics & numerical data
Young Adult
Abstract
Mental disorders are a key cause of sickness absence (SA) and challenge prolonging working careers. Thus, evidence on the development of SA trends is needed. In this study, educational differences in long SAs due to mental disorders were examined in two age groups among employees of the City of Helsinki from 2004 to 2013.
All permanently and temporarily employed staff aged 18-34 and 35-49 were included in the analyses (n=~27800 per year). SA spells of =14 days due to mental disorders were examined annually. Education was classified to higher and lower levels. Joinpoint regression was used to identify major turning points in SA trends.
Joinpoint regression models showed that lower educated groups had more long SAs spells due to mental disorders than those groups with higher education. SA trends decreased during the study period in all studied age and educational groups. Lower educated age groups had similar SA trends. Younger employees with higher education had the fewest SAs.
A clear educational gradient was found in long SAs due to mental disorders during the study period. SA trends decreased from 2004 to 2013.
Notes
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Cites: Eur J Public Health. 2010 Jun;20(3):276-8019843600
Cites: J Occup Environ Med. 2017 Jan;59(1):114-11928045805
PubMed ID
28496028 View in PubMed
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Analysing changes of health inequalities in the Nordic welfare states.

https://arctichealth.org/en/permalink/ahliterature52241
Source
Soc Sci Med. 2002 Aug;55(4):609-25
Publication Type
Article
Date
Aug-2002
Author
Eero Lahelma
Katariina Kivelä
Eva Roos
Terhi Tuominen
Espen Dahl
Finn Diderichsen
Jon Ivar Elstad
Inge Lissau
Olle Lundberg
Ossi Rahkonen
Niels Kristian Rasmussen
Monica Aberg Yngwe
Author Affiliation
Department Public Health, University of Helsinki, Finland. eero.lahelma@helsinki.fi
Source
Soc Sci Med. 2002 Aug;55(4):609-25
Date
Aug-2002
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Comparative Study
Cross-Cultural Comparison
Denmark - epidemiology
Educational Status
Employment - statistics & numerical data
Female
Finland - epidemiology
Health Status Indicators
Health Surveys
Humans
Logistic Models
Male
Middle Aged
Morbidity
Norway - epidemiology
Research Support, Non-U.S. Gov't
Socioeconomic Factors
Sweden - epidemiology
Time
Abstract
This study examined changes over time in relative health inequalities among men and women in four Nordic countries, Denmark, Finland, Norway and Sweden. A serious economic recession burst out in the early 1990s particularly in Finland and Sweden. We ask whether this adverse social structural'development influenced health inequalities by employment status and educational attainment, i.e. whether the trends in health inequalities were similar or dissimilar between the Nordic countries. The data derived from comparable interview surveys carried out in 1986/87 and 1994/95 in the four countries. Limiting long-standing illness and perceived health were analysed by age, gender, employment status and educational attainment. First, age-adjusted overall prevalence percentages were calculated. Second, changes in the magnitude of relative health inequalities were studied using logistic regression analysis. Within each country the prevalence of ill-health remained at a similar level, with Finns having the poorest health. Analysing all countries together health inequalities by employment status and education showed no major changes. There were slightly different tendencies among men and women in inequalities by both health indicators, although these did not reach statistical significance. Among men there was a suggestion of narrowing health inequalities, whereas among women such a suggestion could not be discerned. Looking at particular countries some small changes in men's as well as women's health inequalities could be found. Over a period of deep economic recession and a large increase in unemployment, particularly in Finland and Sweden, health inequalities by employment status and education remained broadly unchanged in all Nordic countries. Thus, during this fairly short period health inequalities in these countries were not strongly influenced by changes in other structural inequalities, in particular labour market inequalities. Institutional arrangements in the Nordic welfare states, including social benefits and services, were cut during the recession but nevertheless broadly remained, and are likely to have buffered against the structural pressures towards widening health inequalities.
PubMed ID
12188467 View in PubMed
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Angina pectoris: relation of epidemiological survey to registry data.

https://arctichealth.org/en/permalink/ahliterature135757
Source
Eur J Cardiovasc Prev Rehabil. 2011 Aug;18(4):621-6
Publication Type
Article
Date
Aug-2011
Author
Tea Lallukka
Kristiina Manderbacka
Ilmo Keskimäki
Harry Hemingway
Ossi Rahkonen
Eero Lahelma
Reunanen Antti
Author Affiliation
Department of Public Health, University of Helsinki, Finland. tea.lallukka@helsinki.fi
Source
Eur J Cardiovasc Prev Rehabil. 2011 Aug;18(4):621-6
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Adult
Angina Pectoris - diagnosis - economics - epidemiology
Cardiovascular Agents - economics
Coronary Disease - diagnosis - economics - epidemiology
Drug Costs - statistics & numerical data
Female
Finland - epidemiology
Humans
Insurance, Health, Reimbursement - statistics & numerical data
Male
Middle Aged
Odds Ratio
Patient Admission - statistics & numerical data
Prevalence
Questionnaires
ROC Curve
Registries - statistics & numerical data
Regression Analysis
Reproducibility of Results
Self Report
Sex Distribution
Sex Factors
Time Factors
Abstract
Self-reported angina symptoms are collected in epidemiological surveys. We aimed at validating the angina symptoms assessed by the Rose Questionnaire against registry data on coronary heart disease. A further aim was to examine the sex paradox in angina implying that women report more symptoms, whereas men have more coronary events.
Angina symptoms of 6601 employees of the City of Helsinki were examined using the postal questionnaire survey data combined with coronary heart disease registries.
The self-reported angina was classified as no symptoms, atypical pain, exertional chest pain, and stable angina symptoms. Reimbursed medications and hospital admissions were available from registries 10 years before the survey. Binomial regression analysis was used.
Stable angina symptoms were associated with hospital admissions and reimbursed medications [prevalence ratio (PR), 6.75; 95% confidence interval (CI), 4.56-9.99]. In addition, exertional chest pain (PR, 5.31; 95% CI, 3.45-8.18) was associated with coronary events. All events were more prevalent among men than women (PR, 2.36; 95% CI, 1.72-3.25).
The Rose Questionnaire remains a valid tool to distinguish healthy people from those with coronary heart disease. However, a notable part of those reporting symptoms have no confirmation of coronary heart disease in the registries. The female excess of symptoms and male excess of events may reflect inequality or delay in access to treatment, problems in identification and diagnosis, or more complex issues related to self-reported angina symptoms.
PubMed ID
21450561 View in PubMed
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The association between body height and coronary heart disease among Finnish twins and singletons.

https://arctichealth.org/en/permalink/ahliterature185883
Source
Int J Epidemiol. 2003 Feb;32(1):78-82
Publication Type
Article
Date
Feb-2003
Author
Karri Silventoinen
Jaakko Kaprio
Markku Koskenvuo
Eero Lahelma
Author Affiliation
Division of Epidemiology, School of Public Health, University of Minnesota, USA. silventoinen@epi.umn.edu
Source
Int J Epidemiol. 2003 Feb;32(1):78-82
Date
Feb-2003
Language
English
Publication Type
Article
Keywords
Adult
Aged
Body Height - genetics
Cohort Studies
Coronary Disease - epidemiology - genetics
Diseases in Twins - epidemiology
Female
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Odds Ratio
Risk
Twins, Dizygotic
Twins, Monozygotic
Abstract
An inverse association between body height and the incidence of coronary heart disease (CHD) has been observed. However, the mechanisms behind this association are still largely unknown. We will examine the role of genetic and familial factors behind the association in a large twin data set.
The data were derived from the Finnish Twin cohort including 2438 singletons, 4073 monozygotic (MZ) twins, and 9202 dizygotic (DZ) twins aged 25-69 years at baseline in 1976. Incident CHD cases were derived from hospital discharge data and cause of death data between 1977 and 1995. Cox regression analysis and conditional logistic regression analysis were used.
In population-level analyses no differences in the general risk of CHD between zygosity groups were found. The association between body height and CHD was similar between sexes and zygosity groups. When men and women in all zygosity groups were studied together an increased risk of CHD was found only among the shortest quartile (hazard ratio [HR] = 1.34, 95% CI: 1.14-1.57). Among the twin pairs discordant for CHD a suggestive increased risk for the shorter twin was seen among DZ twins (odds ratio [OR] = 1.19, 95% CI: 0.95-1.48) when men and women were studied together.
An inverse association between body height and CHD was broadly similar between sexes and twin zygosity groups and was associated with short stature. Among discordant twin pairs we found a weak association among DZ twins but not MZ twins. This may suggest the role of genetic liability behind the association between body height and CHD.
PubMed ID
12690014 View in PubMed
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Associations among health-related behaviours: sociodemographic variation in Finland.

https://arctichealth.org/en/permalink/ahliterature187902
Source
Soz Praventivmed. 2002;47(4):225-32
Publication Type
Article
Date
2002
Author
Mikko Laaksonen
Eero Lahelma
Ritva Prättälä
Author Affiliation
Health Promotion Research Unit, Department of Epidemiology and Health Promotion, National Public Health Institute, Helsiniki. mikko.t.laaksonen@helsinki.fi
Source
Soz Praventivmed. 2002;47(4):225-32
Date
2002
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Alcohol Drinking
Data Interpretation, Statistical
Diet
Education
Exercise
Female
Finland
Health Behavior
Health Surveys
Humans
Life Style
Male
Marital status
Middle Aged
Odds Ratio
Questionnaires
Rural Population
Sex Factors
Smoking
Socioeconomic Factors
Urban Population
Abstract
The study examines sociodemographic variation in associations and co-occurrence of health behaviours that contribute to multifactorial chronic diseases.
Mantel-Haenszel odds ratios were used to examine pairwise associations among smoking, alcohol use, physical activity, and diet across categories of sociodemographic characteristics. Breslow-Day test for homogeneity was used to test for sociodemographic differences. In addition, co-occurrence of each two unhealthy behaviours was examined across sociodemographic groups using nationwide population survey data from 26,014 Finnish adults.
Most of the health behaviours examined were interrelated and sociodemographic differences in the associations were few. Differences were inconsistent for all sociodemographic characteristics. Variation was observed only in the strength of the associations, not in their direction. However, due to unequal distribution of the individual behaviours, co-occurrence of unhealthy behaviours varied strongly across sociodemographic groups.
Associations between health behaviours were relatively similar across sociodemographic groups. Since co-occurrence of unhealthy behaviours depends on the prevalence of individual unhealthy behaviours and the strength of their association, their co-occurrence in any particular sociodemographic group was primarily determined by the prevalence of individual unhealthy behaviours.
PubMed ID
12415926 View in PubMed
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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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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
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The associations of household wealth and income with self-rated health--a study on economic advantage in middle-aged Finnish men and women.

https://arctichealth.org/en/permalink/ahliterature142429
Source
Soc Sci Med. 2010 Sep;71(5):1018-26
Publication Type
Article
Date
Sep-2010
Author
Akseli Aittomäki
Pekka Martikainen
Mikko Laaksonen
Eero Lahelma
Ossi Rahkonen
Author Affiliation
Department of Public Health, University of Helsinki, P.O. Box 41, FIN-00014 Helsingin yliopisto, Helsinki, Finland. akseli.attomaki@helsinki.fi
Source
Soc Sci Med. 2010 Sep;71(5):1018-26
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Aged
Employment - statistics & numerical data
Family Characteristics
Female
Finland
Health Status Disparities
Humans
Income - statistics & numerical data
Male
Middle Aged
Questionnaires
Abstract
The economic resources available to an individual or a household have been hypothesised to affect health through the direct material effects of living conditions as well as through social comparison and experiences of deprivation. The focus so far has been mainly on current individual or household income, and there is a lack of studies on wealth, a potentially relevant part of household resources. We studied the associations of household wealth and household income with self-rated health, and addressed some theoretical issues related to economic advantage and health. The data were from questionnaire survey of Finnish men and women aged from 45 to 67 years, who were employed by the City of Helsinki from five to seven years before the collection of the data in 2007. We found household wealth to have a strong and consistent association with self-rated health, poor health decreasing with increasing wealth. The relationship was only partly attributable to the association of wealth with employment status, household income, work conditions and health-related behaviour. In contrast, the association of household income with self-rated health was greatly attenuated by taking into account employment status and wealth, and even further attenuated by work conditions. The results suggested a significant contribution of wealth differentials to differences in health status. The insufficiency of current income as the only measure of material welfare was demonstrated. Conditions associated with long-term accumulation of material welfare may be a significant aspect of the causal processes that lead to socioeconomic inequalities in ill health.
PubMed ID
20598791 View in PubMed
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Associations of multiple socio-economic circumstances with physical functioning among Finnish and British employees.

https://arctichealth.org/en/permalink/ahliterature153859
Source
Eur J Public Health. 2009 Jan;19(1):38-45
Publication Type
Article
Date
Jan-2009
Author
Elina Laaksonen
Pekka Martikainen
Jenny Head
Ossi Rahkonen
Michael G Marmot
Eero Lahelma
Author Affiliation
Department of Public Health, University of Helsinki, Finland. elina.laaksonen@helsinki.fi
Source
Eur J Public Health. 2009 Jan;19(1):38-45
Date
Jan-2009
Language
English
Publication Type
Article
Keywords
Cross-Sectional Studies
Disabled Persons
Employment
Female
Finland
Great Britain
Health Status Disparities
Humans
Male
Middle Aged
Social Class
Abstract
To further increase our understanding of socio-economic health inequalities, we need studies considering multiple socio-economic circumstances and comparing different cultural contexts. This study compared the associations of past and present socio-economic circumstances with physical functioning between employees from Finland and Britain.
Cross-sectional survey data from the Helsinki Health Study (n = 5866) and the Whitehall II Study (n = 3052) were used. Participants were white-collar public sector employees aged 45-60 years. Physical functioning was measured with the SF-36 physical component summary. The socio-economic indicators were parental and own education, childhood and current economic difficulties, occupational class, income, housing tenure.
Childhood and current economic difficulties were independently associated with physical functioning in both cohorts, although in London women childhood difficulties did not reach statistical significance. Own education was independently associated with physical functioning in Helsinki. Occupational class showed associations with physical functioning in both cohorts. These were mainly attenuated by education and income, but in London women there was a strong independent association. The association of income with physical functioning was attenuated by education (Helsinki) and occupational class (London). Parental education and housing tenure showed no consistent associations.
Past and present economic difficulties were independently associated with physical functioning. The conventional socio-economic indicators showed less consistent associations which were partly mediated through other indicators and modified by the national context. The associations that varied according to the indicators and between the cohorts highlight the importance of considering the multiplicity of socio-economic circumstances and comparing different cultural contexts in further studies.
Notes
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PubMed ID
19060329 View in PubMed
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Associations of work-family conflicts with food habits and physical activity.

https://arctichealth.org/en/permalink/ahliterature165248
Source
Public Health Nutr. 2007 Mar;10(3):222-9
Publication Type
Article
Date
Mar-2007
Author
Eva Roos
Sirpa Sarlio-Lähteenkorva
Tea Lallukka
Eero Lahelma
Author Affiliation
Department of Public Health, University of Helsinki, Finland. eva.roos@helsinki.fi
Source
Public Health Nutr. 2007 Mar;10(3):222-9
Date
Mar-2007
Language
English
Publication Type
Article
Keywords
Adult
Confidence Intervals
Conflict (Psychology)
Cross-Sectional Studies
Exercise - physiology - psychology
Family - psychology
Family Characteristics
Female
Finland
Food Habits - psychology
Health Behavior
Humans
Logistic Models
Male
Middle Aged
Odds Ratio
Questionnaires
Workload - psychology
Abstract
This study examines the relationship between family-work conflicts with food habits and physical activity, and whether the relationship is dependent on family structure and work-related factors.
Cross-sectional postal surveys were carried out in 2001 and 2002 among employees of the City of Helsinki, Finland, aged 40-60 years (n = 5346, response rate 66%; for women 70% and for men 60%). Dependent variables in logistic regression analyses were nationally recommended food habits and physical activity. Independent variables were work-family conflicts and family-work conflicts. Covariates included age, marital status, number of children, occupational class, working hours, time travelling to work, and physical and mental work load.
Women reporting strong work-family conflicts were more likely to follow recommended food habits (odds ratio (OR) and 95% confidence intervals 1.49 (1.19-1.86)), but this relationship weakened when adjusting for work-related factors (OR 1.20 (0.93-1.55)). Women and men with strong family-work conflicts were less likely to report recommended food habits after adjusting for family structure and work-related factors (women OR 0.75 (0.61-0.92), men OR 0.57 (0.34-0.96)). Women and men with strong work-family conflicts were less likely to follow the recommended amount of physical activity (women OR 0.76 (0.60-0.96), men OR 0.54 (0.34-0.87)). Additionally, women with strong family-work conflicts were less likely to follow the recommended amount of physical activity (OR 0.77 (0.63-0.94)). Adjusting for family and work-related factors did not affect these associations.
Conflicts between paid work and family life are likely to constitute barriers for a physically active lifestyle and possibly also for healthy food habits. Improving the balance between work and family may provide a route for promoting health-related behaviours.
PubMed ID
17288618 View in PubMed
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