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
It has been suggested that there are associations among insomnia symptoms and unhealthy behaviours. However, previous studies are sparse and mainly cross-sectional, and have not been focused on several key unhealthy behaviours. The aim of this study was to examine whether the associations are bidirectional, i.e. whether insomnia symptoms are associated with subsequent unhealthy behaviours, and whether unhealthy behaviours are associated with subsequent insomnia symptoms. The data were derived from the Helsinki Health Study prospective cohort study. The baseline data were collected in 2000-02 (n = 8960, response rate 67%) among 40-60-year-old employees of the City Helsinki, Finland. The follow-up data were collected in 2007 (n = 7332, response rate 83%). Logistic regression analysis was used to examine the associations among insomnia symptoms and unhealthy behaviours, including smoking, heavy and binge drinking, physical inactivity and unhealthy food habits. Frequent insomnia symptoms at baseline were associated with subsequent heavy drinking [odds ratio (OR): 1.34; 95% confidence interval (CI): 1.07-1.68] and physical inactivity (OR: 1.27; 95% CI: 1.08-1.48) after full adjustment for gender, age, corresponding unhealthy behaviour at baseline, marital status, occupational class, sleep duration and common mental disorders. Additionally, heavy drinking (OR: 1.48; 95% CI: 1.22-1.80) and binge drinking (OR: 1.26; 95% CI: 1.08-1.46) at baseline were associated with subsequent insomnia symptoms at follow-up after full adjustment. In conclusion, insomnia symptoms were associated with subsequent heavy drinking and physical inactivity, and heavy and binge drinking were also associated with subsequent insomnia symptoms.
The aim was to examine whether changes in alcohol drinking are associated with sickness absence.
Repeated postal questionnaires on alcohol drinking were conducted among employees of the City of Helsinki in 2000-2 and 2007 to assess changes in drinking habits between these two time points. Data on the number of self-certified and medically confirmed sickness absences were derived from the employer's register. Sickness absences were followed from 2007 until the end of 2010 among employees participating in both questionnaire surveys. The study includes 3252 female and 682 male employees 40-60 years old at baseline. Poisson regression was used in the data analysis and population attributable fractions (PAFs) were calculated.
Alcohol drinking was associated especially with self-certified sickness absence. Rate ratios (RRs) and 95% confidence intervals (CIs) for increasing weekly average drinking were 1.38, 1.18-1.62 among women and 1.58, 1.18-2.12 among men. Also stable problem drinking (for women 1.39, 1.26-1.54, for men 1.44, 1.10-1.87) and among women stable heavy drinking (1.53, 1.20-1.94) increased self-certified sickness absence. There were associations between alcohol drinking and medically confirmed sickness absence but these were mainly explained by health and health behaviours. Also, a decrease in weekly average drinking was associated with sickness absence among women whereas among men former problem drinking increased sickness absence. According to the PAF values, problem drinking had a stronger contribution to sickness absence than weekly average drinking.
Alcohol drinking is particularly associated with self-certified sickness absence. Reducing adverse drinking habits is likely to prevent sickness absence.
The aim this study was to examine the effect of changes in physical and psychosocial working conditions on physical health functioning among ageing municipal employees.
Follow-up survey data were collected from midlife employees of the City of Helsinki, Finland, at three time points: wave 1 (2000-2002), wave 2 (2007), and wave 3 (2012). Changes in physical and psychosocial working conditions were assessed between waves 1 and 2. Physical health functioning was measured by the physical component summary (PCS) of the Short-Form 36 questionnaire at each of the three waves. In total, 2784 respondents (83% women) who remained employed over the follow-up were available for the analyses. Linear mixed-effect models were used to assess the associations and adjust for key covariates (age, gender, obesity, chronic diseases, and health behaviors).
Repeated and increased exposure to adverse physical working conditions was associated with greater decline in physical health functioning over time. In contrast, decrease in exposures reduced the decline. Of the psychosocial working conditions, changes in job demands had no effects on physical health functioning. However, decreased job control was associated with greater decline and repeated high or increased job control reduced the decline in physical health functioning over time.
Adverse changes in physical working conditions and job control were associated with greater decline in physical health functioning over time, whereas favorable changes in these exposures reduced the decline. Preventing deterioration and promoting improvement of working conditions are likely to help maintain better physical health functioning among ageing employees.
Comment In: Scand J Work Environ Health. 2015 Nov;41(6):509-1026441312
Panel studies on changes of occupational class differences in health have given varying results. The aim of this study was to examine changes of occupational class differences in physical functioning and the factors that explain these changes.
A cohort of middle-aged employees of the City of Helsinki was followed up for an average of 6 years in two surveys from 2000-2002 and 2007. Hierarchical linear random effects models were fitted to analyse the changes of occupational class differences in SF-36 physical functioning, as well as the contribution of physical and psychosocial working conditions, material conditions, health behaviours and employment status to these changes.
Lower occupational classes had worse physical functioning at baseline: among women, the SF-36 scores ranged from 50.5 in the highest class to 47.1 in the lowest one, and among men from 52.2 to 48.9, with higher scores indicating better health. Occupational class differences widened during the follow-up due to stronger decline of physical functioning in the lower occupational classes than in the higher occupational classes. The largest difference in the decline of functioning between classes was 1.2 scores among women and 1.5 scores among men. Among women the widening of the class differences could be explained partly by health behaviours and employment status and among men by material conditions.
Occupational class differences in physical functioning widened due to a faster decline of physical functioning in the lower occupational classes. Health behaviours, employment status and material conditions explained the widening class differences in physical functioning.