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.
The aim of the study was to identify heavy drinking trajectories from age 16 to 42 years and to examine their associations with health, social, employment and economic disadvantage in mid-adulthood.
Finnish cohort study's participants who were 16 years old in 1983 were followed up at age 22, 32 and 42 (n = 1334). Heavy drinking was assessed at every study phase and based on these measurements trajectories of heavy drinking were identified. The trajectory groups were then examined as predictors of disadvantage at age 42.
Five distinct heavy drinking trajectories were identified: moderate (35%), steady low (22%), decreasing (9%), increasing (11%) and steady high (23%). Frequencies of the trajectory groups differed by gender. Using the moderate trajectory as a reference category, women in the steady high trajectory had an increased risk of experiencing almost all disadvantages at age 42. In men, increasing and steady high groups had an increased risk for experiencing health and economic disadvantage.
Steady high female drinkers and steady high and increasing male drinkers had the highest risk for disadvantage in mid-adulthood. By identifying heavy drinking trajectories from adolescence to mid-adulthood we can better predict long-term consequences of heavy alcohol use and plan prevention and intervention programmes.
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.
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.
The aim of the study was to examine the association between social background and drunken driving.
A Finnish register on suspected drunken driving was combined with data on social background. There were 81,125 drivers arrested for drunken driving and 86,279 references from 1993 to 2007.
A low level of education, unemployment, living alone and divorce were strongly associated with drunken driving. In addition, for persons aged 15-24 years, low parental education and income, high own income and possession of a car correlated with higher odds of drunken driving. For working-aged men and women, low income was associated with a higher risk of drunken driving. For working-aged women, also possession of a car was a risk factor.
Social factors are associated with drunken driving. In general, people with a lower social position are more prone to drive after drinking. Social differences are visible already in youth, whereas working and own income of young persons signal different risk mechanisms for youth than for working-aged people. Measures for preventing drunken driving are needed within public health policies.
The present study was aimed to examine associations of current and ex-smoking status with obesity and diabetes among elderly people. Nationwide study of Finnish elderly people based on biennial surveys from 1985 to 1995, were used to study 7482 people aged 65-79 years. Smoking status included non-, ex-light, ex-heavy, current light, and current heavy smokers. Obesity was set as body mass index (BMI) > or = 30. Information of smoking, BMI, and diabetes was based on self-reports. Logistic regression was used as the main method of analyses. Compared to non-smokers (reference category), ex-heavy smokers had higher (odds ratio, 1.42; 95% confidence interval: 1.09, 1.85) and current light smokers (OR, 0.46; 95% CI: 0.31, 0.69) lower relative risk of obesity. Current light smokers had also lower and ex-heavy smokers higher rate of diabetes than non-smokers. Ex-heavy smokers had a higher risk of obesity (OR, 1.75; 95% CI: 1.30, 2.36) and diabetes (OR, 1.48; 95% CI: 1.10, 2.01) than ex-light smokers. Same pattern for current smokers was found. Heavy ex- and current elderly smokers are at risk of obesity and diabetes. Thus, heavy smokers should be emphasized in programs promoting smoking cessation.
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.
Cites: Int Arch Occup Environ Health. 2006 Mar;79(3):205-1216254726
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.
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.
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.
Cites: Int J Epidemiol. 1999 Oct;28(5):899-90410597989