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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: J Occup Environ Med. 2017 Jan;59(1):114-11928045805
PubMed ID
28496028 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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Body weight and health status: importance of socioeconomic position and working conditions.

https://arctichealth.org/en/permalink/ahliterature171118
Source
Obes Res. 2005 Dec;13(12):2169-77
Publication Type
Article
Date
Dec-2005
Author
Mikko Laaksonen
Sirpa Sarlio-Lähteenkorva
Päivi Leino-Arjas
Pekka Martikainen
Eero Lahelma
Author Affiliation
Department of Public Health, University of Helsinki, Finland. mikko.t.laaksonen@helsinki.fi
Source
Obes Res. 2005 Dec;13(12):2169-77
Date
Dec-2005
Language
English
Publication Type
Article
Keywords
Body mass index
Body Weight - physiology
Cross-Sectional Studies
Employment
Female
Finland
Health status
Humans
Male
Middle Aged
Occupations
Questionnaires
Regression Analysis
Social Class
Workplace
Abstract
To examine the association between relative body weight and health status and the potential modifying effects of socioeconomic position and working conditions on this association.
The data were derived from three identical cross-sectional surveys conducted in 2000, 2001, and 2002. Respondents to postal surveys were middle-aged employees of the City of Helsinki (7148 women and 1799 men, response rate 67%). BMI was based on self-reported weight and height. Health status was measured by the Short-Form 36 subscales and component summaries.
Body weight was inversely associated with physical health, but in mental health, differences between BMI categories were small and inconsistent. In women, physical health deteriorated monotonically with increasing BMI, whereas in men, poor physical health was found among the obese only. Socioeconomic position did not modify the association between BMI and health. In women, the association between body weight and physical health became stronger with decreasing job control and increasing physical work load, whereas in men, a similar modifying effect was found for high job demands.
Body weight was associated with physical health only. Lower levels of relative weight in women than in men may be associated with poor physical health. High body weight combined with adverse working conditions may impose a double burden on physical health.
PubMed ID
16421352 View in PubMed
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Different domains of health functioning as predictors of sickness absence--a prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature139391
Source
Scand J Work Environ Health. 2011 May;37(3):213-8
Publication Type
Article
Date
May-2011
Author
Mikko Laaksonen
Sanna-Mari Kääriä
Päivi Leino-Arjas
Eero Lahelma
Author Affiliation
Hjelt-Institute, Department of Public Health, PO Box 41, FIN-00014 University of Helsinki, Finland. mikko.t.laaksonen@helsinki.fi
Source
Scand J Work Environ Health. 2011 May;37(3):213-8
Date
May-2011
Language
English
Publication Type
Article
Keywords
Absenteeism
Adult
Female
Finland - epidemiology
Health status
Health Status Indicators
Humans
Male
Middle Aged
Pain - epidemiology
Prospective Studies
Questionnaires
ROC Curve
Regression Analysis
Risk assessment
Risk factors
Sick Leave - statistics & numerical data
Abstract
The aim of this study was to examine different domains of health functioning as predictors of sickness absence.
The Short Form 36 (SF-36) is one of the best known instruments measuring various domains of physical and mental health functioning. A questionnaire including the SF-36 was mailed to 40-60-year-old employees of the City of Helsinki in 2000-2002. For the subsequent three years, sickness absence episodes >2 weeks were derived from the employer's register. The predictive ability of the eight subscales and two component summaries of the SF-36 were compared using regression methods and receiver operating characteristic (ROC) curve analysis.
All eight SF-36 subscales and the two component summaries predicted the occurrence of sickness absence over the follow-up period. Among women, bodily pain was the strongest predictor, with 1 standard deviation increase in bodily pain increasing the occurrence of sickness absence by 77% [95% confidence interval (95% CI) 68-86%]. Role limitations due to emotional problems were the weakest predictor of sickness absence (29%, 95% CI 23-36%). Among men, the results were similar to those of women. In both genders, the area under the ROC curve was largest for bodily pain, general health, and physical functioning and lowest for mental health and role limitation due to emotional problems.
The subscales measuring physical domains of functioning were more strongly associated with sickness absence than the mental subscales. In particular, ability to perform daily activities, pain, and general health were important predictors of sickness absence >2 weeks.
PubMed ID
21069253 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
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Excess mortality after disability retirement due to mental disorders: variations by socio-demographic factors and causes of death.

https://arctichealth.org/en/permalink/ahliterature259172
Source
Soc Psychiatry Psychiatr Epidemiol. 2014 Apr;49(4):639-49
Publication Type
Article
Date
Apr-2014
Author
Taina Leinonen
Pekka Martikainen
Mikko Laaksonen
Eero Lahelma
Source
Soc Psychiatry Psychiatr Epidemiol. 2014 Apr;49(4):639-49
Date
Apr-2014
Language
English
Publication Type
Article
Keywords
Adult
Cause of Death
Depression - epidemiology
Disabled persons - statistics & numerical data
Female
Finland - epidemiology
Humans
Male
Mental Disorders - mortality - psychology
Middle Aged
Proportional Hazards Models
Regression Analysis
Retirement - psychology - statistics & numerical data
Risk factors
Suicide - statistics & numerical data
Abstract
Mental disorders are the key causes of disability retirement and are associated with a high risk of mortality. Social variations in excess mortality after disability retirement are nevertheless poorly understood. We examined socio-demographic differences in all-cause and cause-specific mortality after disability retirement due to depression and other mental disorders.
The data comprised a nationally representative sample of the Finnish population aged 25-64 in 1996 with no prior disability retirement due to mental disorders (N = 392,985). We used Cox regression analysis with disability retirement due to mental disorders as a time-varying covariate and mortality between 1997 and 2007 as the outcome variable.
We found excess mortality after disability retirement due to mental disorders as compared to those with no such retirement in all specific causes of death, in particular alcohol-related causes, suicide, and other unnatural causes. Excess suicide mortality was particularly large after depression-based disability retirement. Younger age groups, non-manual classes, and those living with a partner and children had largest excess mortality, especially from unnatural and alcohol-related causes. However, the absolute number of excess deaths was not always largest in these socio-demographic groups.
In young adulthood, disability retirement due to depression signifies severe health and other social disadvantages that lead to particularly large excess mortality, especially due to unnatural causes. The protective effects of a high socioeconomic position and family ties against unnatural and alcohol-related deaths are limited among those who have already developed depression or other mental disorders that have led to disability retirement.
PubMed ID
23925530 View in PubMed
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Occupational class differences in long sickness absence: a register-based study of 2.1 million Finnish women and men in 1996-2013.

https://arctichealth.org/en/permalink/ahliterature291594
Source
BMJ Open. 2017 Jul 20; 7(7):e014325
Publication Type
Journal Article
Date
Jul-20-2017
Author
Johanna Pekkala
Jenni Blomgren
Olli Pietiläinen
Eero Lahelma
Ossi Rahkonen
Author Affiliation
Department of Public Health, University of Helsinki, Helsinki, Finland.
Source
BMJ Open. 2017 Jul 20; 7(7):e014325
Date
Jul-20-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Cross-Sectional Studies
Female
Finland - epidemiology
Humans
Male
Middle Aged
Occupations - classification
Prevalence
Regression Analysis
Sampling Studies
Sex Distribution
Sick Leave - statistics & numerical data - trends
Abstract
Sickness absence is consistently higher in lower occupational classes, but attempts to analyse changes over time in socioeconomic differences are scarce. We examined trends in medically certified sickness absence by occupational class in Finland from 1996 to 2013 and assessed the magnitude and changes in absolute and relative occupational class differences.
Population-based, repeated cross-sectional study.
A 70% random sample of Finns aged between 25 and 63 years in the years 1996-2013.
The study focused on 25- to 63?year-old female (n between 572?246 and 690 925) and male (n between 525?698 and 644 425) upper and lower non-manual and manual workers. Disability and old age pensioners, students, the unemployed, entrepreneurs and farmers were excluded. The analyses covered 2?160?084 persons, that is, 77% of the random sample.For primary and secondary outcome measures, we examined yearly prevalence of over 10 working days long sickness absence by occupational class. The Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) were used to assess the magnitude and changes in occupational class differences.
Compared with mid-1990s, sickness absence prevalence was slightly lower in 2013 in all occupational classes except for female lower non-manual workers. Hierarchical occupational class differences in sickness absence were found. Absolute differences (SII) peaked in 2005 in both women (0.12, 95% CI 0.12 to 0.13) and men (0.15, 95%?CI 0.14 to 0.15) but reached the previous level in women by 2009 and decreased modestly in men until 2013. Relative differences narrowed over time (p
Notes
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PubMed ID
28729307 View in PubMed
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Pain and disability retirement: a prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature126913
Source
Pain. 2012 Mar;153(3):526-31
Publication Type
Article
Date
Mar-2012
Author
Peppiina Saastamoinen
Mikko Laaksonen
Sanna-Mari Kääriä
Tea Lallukka
Päivi Leino-Arjas
Ossi Rahkonen
Eero Lahelma
Author Affiliation
Department of Public Health, Hjelt Institute, Helsinki, Finland. peppiina.saastamoinen@helsinki.fi
Source
Pain. 2012 Mar;153(3):526-31
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Chronic Pain - epidemiology - psychology
Cohort Studies
Disabled Persons - psychology - statistics & numerical data
Female
Finland - epidemiology
Health Surveys
Humans
Male
Middle Aged
Occupational Health
Regression Analysis
Retirement - psychology - statistics & numerical data
Risk factors
Socioeconomic Factors
Workplace
Abstract
This study examined the association of pain with subsequent disability retirement due to all causes as well as musculoskeletal diseases, mental disorders, and a heterogeneous group of other diseases and to study whether pain has an effect of its own after taking into account long-standing illness, physician-diagnosed diseases, working conditions, and occupational class, which are the key factors affecting disability retirement. The data consisted of the Helsinki Health Study baseline survey linked to national pension register data (n=6258). Mean follow-up time was 8.1 years. The data included 594 disability retirement events. Pain (acute or chronic) was stratified by long-standing illness (yes/no). Cox regression analysis was performed. Chronic pain without and with co-occurring long-standing illness was strongly associated with all types of disability retirement outcomes, but the associations were particularly strong for disability retirement due to musculoskeletal diseases. The associations remained even when further adjusted for physician diagnosed chronic conditions and diseases, psychosocial and physical working conditions, and occupational class. Associations for acute pain were also found, but they were clearly weaker than those of chronic pain. Chronic pain contributes to disability retirement. Prevention and effective treatment of chronic pain may help prevent early retirement due to disability.
Notes
Comment In: Pain. 2012 Mar;153(3):507-822197639
PubMed ID
22340946 View in PubMed
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Relative weight and income at different levels of socioeconomic status.

https://arctichealth.org/en/permalink/ahliterature181284
Source
Am J Public Health. 2004 Mar;94(3):468-72
Publication Type
Article
Date
Mar-2004
Author
Sirpa Sarlio-Lähteenkorva
Karri Silventoinen
Eero Lahelma
Author Affiliation
Department of Public Health, University of Helsinki, Finland.
Source
Am J Public Health. 2004 Mar;94(3):468-72
Date
Mar-2004
Language
English
Publication Type
Article
Keywords
Adult
Body mass index
Body Weight
Female
Finland - epidemiology
Health status
Health Surveys
Humans
Male
Middle Aged
Occupations - classification - statistics & numerical data
Registries
Regression Analysis
Sex Factors
Social Class
Abstract
We examined the association of relative weight with individual income at different levels of socioeconomic status among gainfully employed Finnish women and men.
We used a population-based survey including 2068 women and 2314 men with linked income data from a taxation register. Regression analysis was used to calculate mean income levels within educational and occupational groups.
Compared with their normal-weight counterparts, obese women with higher education or in upper white-collar positions had significantly lower income; a smaller income disadvantage was seen in overweight women with secondary education and in manual workers. Excess body weight was not associated with income disadvantages in men.
Obesity is associated with a clear income disadvantage, particularly among women with higher socioeconomic status.
Notes
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PubMed ID
14998816 View in PubMed
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Trajectories of antidepressant medication before and after retirement: the contribution of socio-demographic factors.

https://arctichealth.org/en/permalink/ahliterature115436
Source
Eur J Epidemiol. 2013 May;28(5):417-26
Publication Type
Article
Date
May-2013
Author
Taina Leinonen
Eero Lahelma
Pekka Martikainen
Author Affiliation
Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland. taina.leinonen@helsinki.fi
Source
Eur J Epidemiol. 2013 May;28(5):417-26
Date
May-2013
Language
English
Publication Type
Article
Keywords
Age Factors
Antidepressive Agents - therapeutic use
Depression - drug therapy - epidemiology - psychology
Disability Evaluation
Disabled Persons
Female
Finland - epidemiology
Humans
Male
Mental health
Middle Aged
Morbidity
Prescriptions - statistics & numerical data
Regression Analysis
Retirement - psychology
Risk factors
Social Class
Social Environment
Socioeconomic Factors
Time Factors
Abstract
The association between retirement and mental health is assumed to depend on socio-demographic factors, but there is a lack of empirical evidence. We examined antidepressant medication before and after retirement by age, gender, living arrangements, and social class. The material comprised nationally representative register data from Finland. Linear regression analysis was used to calculate changes in antidepressant medication 7.5?years before and after disability (N?=?42,937) and old-age (N?=?19,877) retirement in 1997-2007 by socio-demographic factors. No changes in antidepressant medication (mean DDD/3-month period) were observed around old-age retirement regardless of the socio-demographic factors. After a slight initial increase in antidepressant medication there was a substantial rise 1.5-0?years before disability retirement, after which there was a marked decrease, particularly during the first 3?years. These effects were less pronounced in retirement due to somatic causes. Age was the strongest modifying factor in retirement due to both depression and somatic causes, with a stronger increase and limited decrease in antidepressant medication among the younger age groups. The post-retirement decrease was also somewhat stronger among men, and among those in higher social classes and those living with a spouse in depression-related retirement. In somatic causes, the pre-retirement increase was stronger among those in higher social classes. Prevention and rehabilitation of mental-health problems in association with work disability should focus particularly on young adults, among whom the strong increase in antidepressant medication before disability retirement, and the continued high levels of medication after the transition signify long periods of morbidity and premature retirement.
PubMed ID
23508328 View in PubMed
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11 records – page 1 of 2.