Socioeconomic differences in sickness absence are well established among middle-aged employees but poorly known among younger employees, in particular for shorter spells. We examined trends in occupational class differences in short sickness absence among young women.
The data were obtained from the registers of the City of Helsinki, Finland, and included female employees aged 18-34 years from 2002 to 2013. Self-certified (1-3 days) sickness absence spells were examined. Occupational class was classified into four hierarchical categories. Joinpoint regression models were used to identify major changes in sickness absence trends.
Short sickness absence increased until 2008, after which it decreased in all occupational classes except manual workers. Differences in sickness absence between occupational classes remained over time. Routine non-manuals had the highest amount of short sickness absence, while managers and professionals had the smallest amount. Manual workers had somewhat less short sickness absence than routine non-manuals and semi-professionals.
The socioeconomic differences in short sickness absence were clear among young women but not fully consistent as routine non-manuals tended to have more sickness absence than manual workers. Preventive measures are needed to narrow socioeconomic differences in young women's sickness absence especially among routine non-manuals.
A register investigation was carried out as of December 31, 1980, with the aim of giving a broad description of a child psychiatric clientele 30 years after admission to hospital. The material consists of 322 patients--189 boys (59%) and 133 girls (41%)--who were admitted during the period 1949-1951 to the only 2 child psychiatric departments at that time in Denmark. We succeeded in identifying 93% of the patients. The mean age at the time of analysis was 38.6 years (range 32-46). The material was compared with the age-related Danish population by marital status, vocational education, and socioeconomic class. A total of 115 patients (36%) had been admitted to an adult psychiatric department, and 50 patients only once. A total of 95 patients (30%) had committed criminal offences and 12 had only committed traffic offences. A total of 60 patients (19%) had obtained disability pensions. During the 30-year follow-up period, 19 patients (6%) had died. A statistically significant extra mortality was found only for women. Four patients had committed suicide. By logistic regression analysis, a statistically significant correlation was found between criminal record and admission to psychiatric department and the variables: divorce, no vocational education, and lowest socioeconomic class. About 54% had managed well, judging by the variables employed.
Department of Medicine, University of Manitoba Arthritis Center, RR149-800 Sherbrook Street, Winnipeg, Manitoba R3A 1M4, Canada. cpeschken@exchange.hsc.mb.ca
To describe disease expression and damage accrual in systemic lupus erythematosus (SLE), and determine the influence of ethnicity and socioeconomic factors on damage accrual in a large multiethnic Canadian cohort.
Adults with SLE were enrolled in a multicenter cohort. Data on sociodemographic factors, diagnostic criteria, disease activity, autoantibodies, treatment, and damage were collected using standardized tools, and results were compared across ethnic groups. We analyzed baseline data, testing for differences in sociodemographic and clinical factors, between the different ethnic groups, in univariate analyses; significant variables from univariate analyses were included in multivariate regression models examining for differences between ethnic groups, related to damage scores.
We studied 1416 patients, including 826 Caucasians, 249 Asians, 122 Afro-Caribbeans, and 73 Aboriginals. Although the overall number of American College of Rheumatology criteria in different ethnic groups was similar, there were differences in individual manifestations and autoantibody profiles. Asian and Afro-Caribbean patients had more frequent renal involvement and more exposure to immunosuppressives. Aboriginal patients had high frequencies of antiphospholipid antibodies and high rates of comorbidity, but disease manifestations similar to Caucasians. Asian patients had the youngest age at onset and the lowest damage scores. Aboriginals had the least education and lowest incomes. The final regression model (R2=0.27) for higher damage score included older age, longer disease duration, low income, prednisone treatment, higher disease activity, and cyclophosphamide treatment.
There are differences in lupus phenotypes between ethnic populations. Although ethnicity was not found to be a significant independent predictor of damage accrual, low income was.
Whether morbidity from the 1918-19 influenza pandemic discriminated by socioeconomic status has remained a subject of debate for 100 years. In lack of data to study this issue, the recent literature has hypothesized that morbidity was "socially neutral."
To study the associations between influenza-like illness (ILI) and socioeconomic status (SES), gender, and wave during the 1918-19 influenza pandemic.
Availability of incidence data on the 1918-19 pandemic is scarce, in particular for waves other than the "fall wave" October-December 1918. Here, an overlooked survey from Bergen, Norway (n = 10 633), is used to study differences in probabilities of ILI and ILI probability ratios by apartment size as a measure of SES and gender for 3 waves including the waves prior to and after the "fall wave."
Socioeconomic status was negatively associated with ILI in the first wave, but positively associated in the second wave. At all SES levels, men had the highest ILI in the summer, while women had the highest ILI in the fall. There were no SES or gender differences in ILI in the winter of 1919.
For the first time, it is documented a crossover in the role of socioeconomic status in 1918 pandemic morbidity. The poor came down with influenza first, while the rich with less exposure in the first wave had the highest morbidity in the second wave. The study suggests that the socioeconomically disadvantaged should be prioritized if vaccines are of limited availability in a future pandemic.
The number of days of absence because of sickness, recorded for all children in one city in Finland, cared for in municipal day care over a period of 2.5 years, was collected from the monthly figures kept by the city council office for accounting purposes. The average number of days of absence per child was 24 per year at child-care centers and 9 in family care (p
Unit for Social Epidemiology, Faculty of Medicine, Lund University, CRC, Jan Waldeströms gata, 35, S-205 02, Malmö, Sweden. sten.axelsson_fisk@med.lu.se.
While psychosocial theory claims that socioeconomic status (SES), acting through social comparisons, has an important influence on susceptibility to disease, materialistic theory says that socioeconomic position (SEP) and related access to material resources matter more. However, the relative role of SEP versus SES in chronic obstructive pulmonary disease (COPD) risk has still not been examined.
We investigated the association between SES/SEP and COPD risk among 667 094 older adults, aged 55 to 60, residing in Sweden between 2006 and 2011. Absolute income in five groups by population quintiles depicted SEP and relative income expressed as quintile groups within each absolute income group represented SES. We performed sex-stratified logistic regression models to estimate odds ratios and the area under the receiver operator curve (AUC) to compare the discriminatory accuracy of SES and SEP in relation to COPD.
Even though both absolute (SEP) and relative income (SES) were associated with COPD risk, only absolute income (SEP) presented a clear gradient, so the poorest had a three-fold higher COPD risk than the richest individuals. While the AUC for a model including only age was 0.54 and 0.55 when including relative income (SES), it increased to 0.65 when accounting for absolute income (SEP). SEP rather than SES demonstrated a consistent association with COPD.
Our study supports the materialistic theory. Access to material resources seems more relevant to COPD risk than the consequences of low relative income.
Notes
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