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Pförtner TK, Demirer I. [Working poverty and self-rated health during the COVID-19 pandemic: a comparative study over time using 1995-2021 Socioeconomic Panel data]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:869-881. [PMID: 37341742 PMCID: PMC10371887 DOI: 10.1007/s00103-023-03734-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 06/07/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND The working poor are considered a vulnerable group. This study examines whether health disparities between working-poor and non-working-poor workers have worsened in the wake of the COVID-19 pandemic by comparing them over time with earlier periods of economic crisis and social and labor market policy reform. METHODS The analyses are based on the Socioeconomic Panel (SOEP, 1995-2020) and the Special Survey on Socioeconomic Factors and Consequences of the Spread of Coronavirus in Germany (SOEP-CoV, 2020-2021). All employed persons aged 18-67 years were considered for the analyses to calculate the risks of poor subjective health due to working poverty using pooled logistic regression by sex. RESULTS Subjective health improved during the COVID-19 pandemic. Differences in health between the working poor and those who were not working poor remained relatively constant between 1995 and 2021. Individuals who were more likely to be in working poverty over time had the highest risk of inadequate health. The health disparities associated with the frequency of working poverty increased over time and peaked for both sexes in the pandemic. Significant sex differences were not identified. DISCUSSION This study illustrates the social embeddedness of working poverty as a determinant of poor health. In particular, those who were more likely to experience working poverty during their working lives are considered to be particularly vulnerable to inadequate health. Tendentially, the COVID-19 pandemic appears to reinforce this gradient in health.
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Affiliation(s)
- Timo-Kolja Pförtner
- Arbeitsbereich Forschungsmethoden, Humanwissenschaftliche Fakultät, Universität zu Köln, Köln, Deutschland.
- Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Medizinische und Humanwissenschaftliche Fakultät, Universität zu Köln, Köln, Deutschland.
| | - Ibrahim Demirer
- Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Medizinische und Humanwissenschaftliche Fakultät, Universität zu Köln, Köln, Deutschland
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Wulkotte E, Bozorgmehr K. Trends and Changes in Socio-Economic Inequality in Self-Rated Health among Migrants and Non-Migrants: Repeated Cross-Sectional Analysis of National Survey Data in Germany, 1995-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8304. [PMID: 35886157 PMCID: PMC9317826 DOI: 10.3390/ijerph19148304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 12/10/2022]
Abstract
Socio-economic inequalities in health may change over time, and monitoring such change is relevant to inform adequate policy responses. We aimed to quantify socio-economic inequalities in health among people with direct, indirect and without migration background in Germany and to assess temporal trends and changes between 1995 and 2017. Using nationally representative survey data from the Socio-Economic Panel (SOEP), we quantified absolute and relative socio-economic inequalities in self-reported general health by calculating the slope (SII) and relative index of inequality (RII) with 95% confidence intervals (CI) among each group and year (1995−2017) in a repeated cross-sectional design. Temporal trends were assessed using a GLM regression over the SII and RII, respectively. The total sample size comprised 492,489 observations, including 108,842 (22.23%) among people with migration background. About 31% of the population with and 15% of the population without migration background had a low socio-economic status. Socio-economic inequalities in health persisted in the group with migration background (1995 to 2017), while inequalities in the non-migrant population increased (SII: βTrend = 0.04, p < 0.01) and were on a higher level. The highest socio-economic inequalities in health were found among those with direct migration background (βSII, min = −0.23, p< 0.01; βSII, max = −0.33, p < 0.01). The results show that the magnitude and temporal dynamics of inequalities differ among populations with direct, indirect and without migration background. Monitoring systems can capture and investigate these inequalities if migrant populations are adequately integrated into the respective systems.
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Affiliation(s)
- Elisa Wulkotte
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, P.O. Box 10 01 31, 33501 Bielefeld, Germany;
| | - Kayvan Bozorgmehr
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, P.O. Box 10 01 31, 33501 Bielefeld, Germany;
- Section of Health Equity Studies & Migration, Department of General Practice & Health Services Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
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Esch T. The ABC Model of Happiness-Neurobiological Aspects of Motivation and Positive Mood, and Their Dynamic Changes through Practice, the Course of Life. BIOLOGY 2022; 11:biology11060843. [PMID: 35741364 PMCID: PMC9220308 DOI: 10.3390/biology11060843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 05/30/2022] [Indexed: 12/12/2022]
Abstract
Simple Summary This article proposes a new model for exploring happiness primarily from a neurobiological perspective. Such understanding includes the dynamics of positive mood states and how they change throughout life. Happiness is not a cognitive construct: it is an immediate emotional experience—a feeling that relies on neurophysiological activation in the brain’s reward system. With this in mind, three types of happiness are proposed: (A) wanting, approaching, and pleasure, (B) avoiding, departing, and relief, (C) non-wanting, staying, and satisfaction. Behind this is a sophisticated (neuro)biological dynamic, ranging from the search for autonomy and ecstasy, which is particularly characteristic of young people, to the way we cope with stress, as we find it pronounced in the middle-aged, to deep contentment, peace, and inner joy, as it is mainly attributed to older people. Paradoxically, it is in fact the elderly who appear to be the happiest and most content—this phenomenon is also known as the “satisfaction paradox”. Apparently, these dynamic changes in happiness can be amplified with practice. Happiness is biological in this context, but can still be “learned”. Contemplative practices can serve as an example here to demonstrate this trainability, and they may themselves influence the course of happiness. Abstract Background: Happiness is a feeling, an immediate experience, not a cognitive construct. It is based on activity in the brain’s neurobiological reward and motivation systems, which have been retained in evolution. This conceptual review provides an overview of the basic neurobiological principles behind happiness phenomena and proposes a framework for further classification. Results: Three neurobiologically distinct types of happiness exist: (A) wanting, (B) avoiding, and (C) non-wanting. Behind these types lies a dynamic gradation, ranging from the more youthful anticipation, pleasure and ecstasy (A), to stress processing, escape and relief (B) as we find them accentuated in the middle-aged, to deep satisfaction, quiescence and inner joy (C), which is particularly attributed to older people. As a result, the development of happiness and satisfaction over the course of life typically takes the form of a U-curve. Discussion: The outlined triad and dynamic of happiness leads to the paradoxical finding that the elderly seem to be the happiest—a phenomenon that is termed “satisfaction paradox”. This assumed change in happiness and contentment over the life span, which includes an increasing “emancipation” from the idea of good health as a mandatory prerequisite for happiness and contentment, can itself be changed—it is trainable. Conclusions: Programs for mindfulness, contemplation, or stress reduction, including positive psychology and mind–body/behavioral medicine training, seem to be capable of influencing the course happiness over time: Happiness can be shaped through practice.
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Affiliation(s)
- Tobias Esch
- Institute for Integrative Health Care and Health Promotion, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany
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Heller C, Sperlich S, Tetzlaff F, Geyer S, Epping J, Beller J, Tetzlaff J. Living longer, working longer: analysing time trends in working life expectancy in Germany from a health perspective between 2002 and 2018. Eur J Ageing 2022; 19:1263-1276. [PMID: 36692756 PMCID: PMC9729498 DOI: 10.1007/s10433-022-00707-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 01/26/2023] Open
Abstract
Population ageing poses growing challenges to social security systems, in particular to public pension funds. The study analyses how Working Life Expectancy (WLE) and Healthy Working Life Expectancy (HWLE) in terms of three health indicators developed in Germany. Based on the German Socio-Economic Panel (GSOEP) from 2002 to 2018 (n = 211,141), time trends in labour force rates, mental and physical Health-Related Quality of Life (HRQoL), self-rated health (SRH) and the respective combinations (health indicator*labour force) were analysed for all respondents aged 18-74. WLE and HWLE were calculated using the Sullivan method. WLE and HWLE in men and women at age 18 and 50 clearly increased over time. These increases in HWLE were found in terms of all three health indicators. This development was mainly driven by the clear increase of the labour force rates, since the shares of individuals with good and satisfactory SRH or average and good HRQoL remained largely stable over time. The results show that from a health perspective there have been potentials for increases in WLE during the past two decades and that increasingly more healthy life years are spent economically active. However, life years in the labour force but in poor health have increased, too. The absence of clear improvements in health emphasises the importance of current and future preventive measures to maintain health, especially among the middle-aged and older labour force.
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Affiliation(s)
- Chiara Heller
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany
| | | | - Fabian Tetzlaff
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany
| | - Siegfried Geyer
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany
| | - Jelena Epping
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany
| | - Johannes Beller
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany
| | - Juliane Tetzlaff
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany
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Rendtel U, Liebig S, Meister R, Wagner GG, Zinn S. Die Erforschung der Dynamik der Corona-Pandemie in Deutschland: Survey-Konzepte und eine exemplarische Umsetzung mit dem Sozio-oekonomischen Panel (SOEP). ASTA WIRTSCHAFTS- UND SOZIALSTATISTISCHES ARCHIV 2021. [PMCID: PMC8655718 DOI: 10.1007/s11943-021-00296-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Die Weltgesundheitsorganisation (WHO) hat im Frühjahr 2020 Richtlinien für Bevölkerungsstichproben veröffentlicht, die Basisdaten für gesundheitspolitische Entscheidungen im Pandemiefall liefern können. Diese Richtlinien umzusetzen ist keineswegs trivial. In diesem Beitrag schildern wir die Herausforderungen einer entsprechenden statistischen Erfassung der Corona Pandemie. Hierbei gehen wir im ersten Teil auf die Erfassung der Dunkelziffer bei der Meldung von Corona Infektionen, die Messung von Krankheitsverläufen im außerklinischen Bereich, die Messung von Risikomerkmalen sowie die Erfassung von zeitlichen und regionalen Veränderungen der Pandemie-Intensität ein. Wir diskutieren verschiedene Möglichkeiten, aber auch praktische Grenzen der Survey-Statistik, den vielfältigen Herausforderungen durch eine geeignete Anlage der Stichprobe und des Survey-Designs zu begegnen. Ein zentraler Punkt ist die schwierige Koppelung medizinischer Tests mit bevölkerungsrepräsentativen Umfragen, wobei bei einer personalisierten Rückmeldung der Testergebnisse das Statistik-Geheimnis eine besondere Herausforderung darstellt. Im zweiten Teil berichten wir wie eine der großen Wiederholungsbefragungen in Deutschland, das Sozio-oekonomische Panel (SOEP), für eine WHO-konforme Covid-19-Erhebung genutzt wird, die im Rahmen einer Kooperation des Robert-Koch-Instituts (RKI) mit dem SOEP als „RKI-SOEP Stichprobe“ im September 2020 gestartet wurde. Erste Ergebnisse zum Rücklauf dieser Studie, die ab Oktober 2021 mit einer zweiten Erhebungswelle bei denselben Personen fortgesetzt werden wird, werden vorgestellt. Es zeigt sich, dass knapp fünf Prozent der bereits in der Vergangenheit erfolgreich Befragten aufgrund der Anfrage zwei Tests zu machen die weitere Teilnahme an der SOEP-Studie verweigern. Berücksichtigt man alle in der Studie erhobenen Informationen (IgG-Antikörper-Tests, PCR-Tests und Fragebögen) ergibt eine erste Schätzung, dass sich bis November 2020 nur etwa zwei Prozent der in Privathaushalten lebenden Erwachsenen in Deutschland mit SARS-CoV‑2 infiziert hatten. Damit war die Zahl der Infektionen etwa doppelt so hoch wie die offiziell gemeldeten Infektionszahlen.
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Affiliation(s)
| | - Stefan Liebig
- Freie Universität Berlin, Berlin, Deutschland
- Sozio-oekonomisches Panel (SOEP), Berlin, Deutschland
| | | | - Gert G. Wagner
- Sozio-oekonomisches Panel (SOEP), Berlin, Deutschland
- Max PIanck Institut für Bildungsforschung, Berlin, Deutschland
| | - Sabine Zinn
- Sozio-oekonomisches Panel (SOEP), Berlin, Deutschland
- Humboldt Universität, Berlin, Deutschland
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Cost, Gain, and Health: Theoretical Clarification and Psychometric Validation of a Work Stress Model With Data From Two National Studies. J Occup Environ Med 2020; 61:898-904. [PMID: 31490898 DOI: 10.1097/jom.0000000000001696] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The aim of this study was to test nonsymmetric effects of cost/gain imbalance at work on depression, based on the effort-reward imbalance (ERI) model. METHODS Study participants were derived from two large national studies from Germany and Sweden. Associations between the ERI scales, including the effort-reward (E-R) ratio in 2016 and depression (in 2016 for German sample, and in 2018 for Swedish sample) were examined by multivariable logistic regression. RESULTS In both samples, high cost/low gain, but not low cost/high gain, is associated with depression, with a 3- to 5-fold elevated risk in the highest decile of the E-R ratio. CONCLUSIONS The short version of the ERI questionnaire is a psychometrically useful tool for epidemiological research. The finding demonstrating nonsymmetric effects of cost/gain imbalance contributes to a theoretical clarification of this stress-theoretical model.
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Radon K, Saathoff E, Pritsch M, Guggenbühl Noller JM, Kroidl I, Olbrich L, Thiel V, Diefenbach M, Riess F, Forster F, Theis F, Wieser A, Hoelscher M. Protocol of a population-based prospective COVID-19 cohort study Munich, Germany (KoCo19). BMC Public Health 2020; 20:1036. [PMID: 32605549 PMCID: PMC7324773 DOI: 10.1186/s12889-020-09164-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 06/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to the SARS-CoV-2 pandemic, public health interventions have been introduced globally in order to prevent the spread of the virus and avoid the overload of health care systems, especially for the most severely affected patients. Scientific studies to date have focused primarily on describing the clinical course of patients, identifying treatment options and developing vaccines. In Germany, as in many other regions, current tests for SARS-CoV2 are not conducted on a representative basis and in a longitudinal design. Furthermore, knowledge about the immune status of the population is lacking. Nonetheless, these data are needed to understand the dynamics of the pandemic and hence to appropriately design and evaluate interventions. For this purpose, we recently started a prospective population-based cohort in Munich, Germany, with the aim to develop a better understanding of the state and dynamics of the pandemic. METHODS In 100 out of 755 randomly selected constituencies, 3000 Munich households are identified via random route and offered enrollment into the study. All household members are asked to complete a baseline questionnaire and subjects ≥14 years of age are asked to provide a venous blood sample of ≤3 ml for the determination of SARS-CoV-2 IgG/IgA status. The residual plasma and the blood pellet are preserved for later genetic and molecular biological investigations. For twelve months, each household member is asked to keep a diary of daily symptoms, whereabouts and contacts via WebApp. If symptoms suggestive for COVID-19 are reported, family members, including children < 14 years, are offered a pharyngeal swab taken at the Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, for molecular testing for SARS-CoV-2. In case of severe symptoms, participants will be transferred to a Munich hospital. For one year, the study teams re-visits the households for blood sampling every six weeks. DISCUSSION With the planned study we will establish a reliable epidemiological tool to improve the understanding of the spread of SARS-CoV-2 and to better assess the effectiveness of public health measures as well as their socio-economic effects. This will support policy makers in managing the epidemic based on scientific evidence.
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Affiliation(s)
- Katja Radon
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-Universität (LMU) University Hospital Munich, Ziemssenstr. 1, 80336 Munich, Germany
- Center for International Health, LMU University Hospital, Munich, Germany
| | - Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Germany, Leopoldstrasse 5, 80802 Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Michael Pritsch
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Germany, Leopoldstrasse 5, 80802 Munich, Germany
| | | | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Germany, Leopoldstrasse 5, 80802 Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Laura Olbrich
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Germany, Leopoldstrasse 5, 80802 Munich, Germany
| | - Verena Thiel
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Germany, Leopoldstrasse 5, 80802 Munich, Germany
| | - Max Diefenbach
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Germany, Leopoldstrasse 5, 80802 Munich, Germany
| | - Friedrich Riess
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Germany, Leopoldstrasse 5, 80802 Munich, Germany
| | - Felix Forster
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-Universität (LMU) University Hospital Munich, Ziemssenstr. 1, 80336 Munich, Germany
| | - Fabian Theis
- Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
- Departments of Mathematics and Life Sciences, Technical University of Munich, Munich, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Germany, Leopoldstrasse 5, 80802 Munich, Germany
- Max von Pettenkofer Institute, Faculty of Medicine, LMU of Munich, Munich, Germany
| | - Michael Hoelscher
- Center for International Health, LMU University Hospital, Munich, Germany
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Germany, Leopoldstrasse 5, 80802 Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
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Virtanen M, Jokela M, Lallukka T, Magnusson Hanson L, Pentti J, Nyberg ST, Alfredsson L, Batty GD, Casini A, Clays E, DeBacquer D, Ervasti J, Fransson E, Halonen JI, Head J, Kittel F, Knutsson A, Leineweber C, Nordin M, Oksanen T, Pietiläinen O, Rahkonen O, Salo P, Singh-Manoux A, Stenholm S, Suominen SB, Theorell T, Vahtera J, Westerholm P, Westerlund H, Kivimäki M. Long working hours and change in body weight: analysis of individual-participant data from 19 cohort studies. Int J Obes (Lond) 2020; 44:1368-1375. [PMID: 31767974 PMCID: PMC7260128 DOI: 10.1038/s41366-019-0480-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 10/01/2019] [Accepted: 10/27/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To examine the relation between long working hours and change in body mass index (BMI). METHODS We performed random effects meta-analyses using individual-participant data from 19 cohort studies from Europe, US and Australia (n = 122,078), with a mean of 4.4-year follow-up. Working hours were measured at baseline and categorised as part time (<35 h/week), standard weekly hours (35-40 h, reference), 41-48 h, 49-54 h and ≥55 h/week (long working hours). There were four outcomes at follow-up: (1) overweight/obesity (BMI ≥ 25 kg/m2) or (2) overweight (BMI 25-29.9 kg/m2) among participants without overweight/obesity at baseline; (3) obesity (BMI ≥ 30 kg/m2) among participants with overweight at baseline, and (4) weight loss among participants with obesity at baseline. RESULTS Of the 61,143 participants without overweight/obesity at baseline, 20.2% had overweight/obesity at follow-up. Compared with standard weekly working hours, the age-, sex- and socioeconomic status-adjusted relative risk (RR) of overweight/obesity was 0.95 (95% CI 0.90-1.00) for part-time work, 1.07 (1.02-1.12) for 41-48 weekly working hours, 1.09 (1.03-1.16) for 49-54 h and 1.17 (1.08-1.27) for long working hours (P for trend <0.0001). The findings were similar after multivariable adjustment and in subgroup analyses. Long working hours were associated with an excess risk of shift from normal weight to overweight rather than from overweight to obesity. Long working hours were not associated with weight loss among participants with obesity. CONCLUSIONS This analysis of large individual-participant data suggests a small excess risk of overweight among the healthy-weight people who work long hours.
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Affiliation(s)
- Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.
- Stress Research Institute, Stockholm University, Stockholm, Sweden.
| | - Markus Jokela
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
| | | | - Jaana Pentti
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Solja T Nyberg
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - G David Batty
- Department of Epidemiology & Public Health, University College London, London, UK
- School of Biological & Population Health Sciences, Oregon State University, Corvallis, USA
| | - Annalisa Casini
- IPSY, Université catholique de Louvain (UCLouvain), Louvain-la-Neuve & School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Els Clays
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Dirk DeBacquer
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Eleonor Fransson
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Jaana I Halonen
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jenny Head
- Department of Epidemiology & Public Health, University College London, London, UK
| | - France Kittel
- IPSY, Université catholique de Louvain (UCLouvain), Louvain-la-Neuve & School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Anders Knutsson
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | | | - Maria Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Tuula Oksanen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
| | - Paula Salo
- Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Psychology, University of Turku, Turku, Finland
| | - Archana Singh-Manoux
- Department of Epidemiology & Public Health, University College London, London, UK
- INSERM, U 1018, Villejuif, France
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Sakari B Suominen
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Folkhälsan Research Center, Helsinki, Finland
- University of Skövde, Skövde, Sweden
| | - Töres Theorell
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Peter Westerholm
- Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Mika Kivimäki
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
- Department of Epidemiology & Public Health, University College London, London, UK
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Li J, Wege N, Loerbroks A, Riedel N. Does cognitive function predict changes in perception of stressful working conditions? INDUSTRIAL HEALTH 2020; 58:72-77. [PMID: 31155520 PMCID: PMC6997721 DOI: 10.2486/indhealth.2019-0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 05/24/2019] [Indexed: 06/09/2023]
Abstract
Cognitive health is a key resource for individuals to nurture their employability. We studied the longitudinal association of cognitive function with changes in stressful working conditions, testing a possible reversed causation. We used a sample of employees (N=1,355) participating in two surveys (2006 and 2011) within a German national representative study (GSOEP). Cognitive function was captured by perceptual speed (Symbol Digit Test) and word fluency (Animal Naming Test). Stressful working conditions were measured by the validated short version of the effort-reward imbalance questionnaire. Multivariate linear regression models assessed the impact of perceptual speed and verbal fluency in 2006 on changes in participants' perceptions of effort, reward, effort-reward ratio, and over-commitment between 2006 and 2011, adjusting for socio-demography, behaviours, physical and mental health at baseline. Neither perceptual speed nor verbal fluency was significantly related to changes in perceived working conditions. Our findings did not support the notion of reversed causation.
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Affiliation(s)
- Jian Li
- Institute of Occupational, Social, and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Germany
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, USA
| | - Natalia Wege
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Düsseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Germany
| | - Natalie Riedel
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Germany
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Günther S, Moor I, Knöchelmann A, Richter M. [Intergenerational mobility and health inequalities in East and West Germany : A trend analysis from 1992 to 2012]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 61:78-88. [PMID: 29138900 DOI: 10.1007/s00103-017-2655-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Social mobility processes, i. e. the movement of a person from one social position to another, are central mechanisms for explaining health inequalities. Social differences in health status or behaviour may also change with changes in social status. This article examines the importance of intergenerational mobility, i. e. the rise and fall of social status in relation to parental social position, for subjective health in East and West Germany and whether this relationship has changed over 20 years. MATERIAL AND METHODS The data basis is the socio-economic panel from 1992-2012. Employees aged between 25 and 59 were taken into account. Different mobility paths were determined by comparing their current occupational positions with those of their parents. For these, prevalence and logistic regression of subjective health were calculated. RESULTS Those in low occupational positions rated their health more often as being worse in all periods. Upwardly mobile individuals had a lower risk of poorer health (OR 0.72) compared to those who remained in their original position. Persons affected by downward mobility had a similarly worse self-rated health (OR 1.55 or OR 1.86). Significant differences in gender or region of origin (East-West Germany) could not be determined. Education and income contribute to explaining the relationship. CONCLUSION The results suggest that social advancement has a positive effect on health, whereas social decline is negative - regardless of gender, region of origin or time. It is therefore important to reinforce political efforts aimed at increasing the mobility opportunities of all social groups in a positive sense and thus reducing social inequalities.
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Affiliation(s)
- Sebastian Günther
- Medizinische Fakultät, Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Straße 8, 06097, Halle (Saale), Deutschland.
| | - Irene Moor
- Medizinische Fakultät, Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Straße 8, 06097, Halle (Saale), Deutschland
| | - Anja Knöchelmann
- Medizinische Fakultät, Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Straße 8, 06097, Halle (Saale), Deutschland
| | - Matthias Richter
- Medizinische Fakultät, Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Straße 8, 06097, Halle (Saale), Deutschland
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Nagy N, Johnston CS, Hirschi A. Do we act as old as we feel? An examination of subjective age and job crafting behaviour of late career employees. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2019. [DOI: 10.1080/1359432x.2019.1584183] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Noemi Nagy
- Work and Organizational Psychology, University of Bern, Bern, Switzerland
| | - Claire S. Johnston
- Work and Organizational Psychology, University of Bern, Bern, Switzerland
| | - Andreas Hirschi
- Work and Organizational Psychology, University of Bern, Bern, Switzerland
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Li J, Siegrist J. The role of compensation in explaining harmful effects of overtime work on self-reported heart disease: Preliminary evidence from a Germany prospective cohort study. Am J Ind Med 2018; 61:861-868. [PMID: 30101498 DOI: 10.1002/ajim.22895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Research evidence suggests harmful effects of overtime work on risk of heart disease. However, whether withdrawing compensation for overtime work (time-off or money) provides a relevant explanation of this association has not been explored. METHODS Using cohort data, we included 6345 employees from Germany (3079 men and 3266 women), and applied Poisson regression analysis to examine the prospective association of overtime work without compensation with risk of self-reported incident heart disease over 2 years. RESULTS Uncompensated overtime work was associated with an elevated risk of heart disease after adjustment for relevant variables (RR = 1.85, 95%CI: 1.05-3.25), compared to no overtime work. Stratified analyses indicated particularly strong effects among women and among employees with low socioeconomic position. CONCLUSIONS In line with the stress-theoretical model of effort-reward imbalance at work, these findings document an important role of compensation on heart disease in the frame of overtime work.
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Affiliation(s)
- Jian Li
- Institute of Occupational, Social and Environmental Medicine; Centre for Health and Society, Faculty of Medicine, University of Düsseldorf; Düsseldorf Germany
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14
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Moor I, Günther S, Knöchelmann A, Hoebel J, Pförtner TK, Lampert T, Richter M. Educational inequalities in subjective health in Germany from 1994 to 2014: a trend analysis using the German Socio-Economic Panel study (GSOEP). BMJ Open 2018; 8:e019755. [PMID: 29884694 PMCID: PMC6009455 DOI: 10.1136/bmjopen-2017-019755] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION As trend studies have shown, health inequalities by income and occupation have widened or remained stable. However, research on time trends in educational inequalities in health in Germany is scarce. The aim of this study is to analyse how educational inequalities in health evolved over a period of 21 years in the middle-aged population in Germany, and whether the trends differ by gender. METHODS Data were obtained from the German Socio-Economic Panel covering the period from 1994 to 2014. In total, n=16 339 participants (106 221 person years) aged 30-49 years were included in the study sample. Educational level was measured based on the 'Comparative Analysis of Social Mobility in Industrial Nations' (CASMIN) classification. Health outcomes were self-rated health (SRH) as well as (mental and physical) health-related quality of life (HRQOL, SF-12v2). Absolute Index of Inequality (Slope Index of Inequality (SII)) and Relative Index of Inequality (RII) were calculated using linear and logarithmic regression analyses with robust SEs. RESULTS Significant educational inequalities in SRH and physical HRQOL were found for almost every survey year from 1994 to 2014. Relative inequalities in SRH ranged from 1.50 to 2.10 in men and 1.25 to 1.87 in women (RII). Regarding physical HRQOL, the lowest educational group yielded 4.5 to 6.6 points (men) and 3.3 to 6.1 points (women) lower scores (SII). Although educational level increased over time, absolute and relative health inequalities remained largely stable over the last 21 years. For mental HRQOL, only few educational inequalities were found. DISCUSSION This study found persistent educational inequalities in SRH and physical HRQOL among adults in Germany from 1994 to 2014. Our findings highlight the need to intensify efforts in social and health policies to tackle these persistent inequalities.
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Affiliation(s)
- Irene Moor
- Institute of Medical Sociology, Medical Faculty, Martin-Luther University Halle-Wittenberg, Halle, Germany
| | - Sebastian Günther
- Institute of Medical Sociology, Medical Faculty, Martin-Luther University Halle-Wittenberg, Halle, Germany
| | - Anja Knöchelmann
- Institute of Medical Sociology, Medical Faculty, Martin-Luther University Halle-Wittenberg, Halle, Germany
| | - Jens Hoebel
- Unit of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Timo-Kolja Pförtner
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Thomas Lampert
- Unit of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Matthias Richter
- Institute of Medical Sociology, Medical Faculty, Martin-Luther University Halle-Wittenberg, Halle, Germany
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Wege N, Li J, Siegrist J. Are there gender differences in associations of effort–reward imbalance at work with self-reported doctor-diagnosed depression? Prospective evidence from the German Socio-Economic Panel. Int Arch Occup Environ Health 2018; 91:435-443. [DOI: 10.1007/s00420-018-1293-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 01/22/2018] [Indexed: 12/14/2022]
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Do Effort and Reward at Work Predict Changes in Cognitive Function? First Longitudinal Results from the Representative German Socio-Economic Panel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111390. [PMID: 29140258 PMCID: PMC5708029 DOI: 10.3390/ijerph14111390] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 11/09/2017] [Accepted: 11/13/2017] [Indexed: 12/13/2022]
Abstract
It has been suggested that work characteristics, such as mental demands, job control, and occupational complexity, are prospectively related to cognitive function. However, current evidence on links between psychosocial working conditions and cognitive change over time is inconsistent. In this study, we applied the effort–reward imbalance model that allows to build on previous research on mental demands and to introduce reward-based learning as a principle with beneficial effect on cognitive function. We aimed to investigate whether high effort, high reward, and low over-commitment in 2006 were associated with positive changes in cognitive function in terms of perceptual speed and word fluency (2006–2012), and whether the co-manifestation of high effort and high reward would yield the strongest association. To this end, we used data on 1031 employees who participated in a large and representative study. Multivariate linear regression analyses supported our main hypotheses (separate and combined effects of effort and reward), particularly on changes in perceptual speed, whereas the effects of over-commitment did not reach the level of statistical significance. Our findings extend available knowledge by examining the course of cognitive function over time. If corroborated by further evidence, organization-based measures in the workplace can enrich efforts towards preventing cognitive decline in ageing workforces.
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Effects of Lifetime Unemployment Experience and Job Insecurity on Two-Year Risk of Physician-Diagnosed Incident Depression in the German Working Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080904. [PMID: 28800069 PMCID: PMC5580607 DOI: 10.3390/ijerph14080904] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 08/06/2017] [Accepted: 08/08/2017] [Indexed: 01/20/2023]
Abstract
Unemployment and job insecurity have been reported to be associated with a higher risk of depression. The purpose of this study was to evaluate the separate and combined effects of lifetime unemployment experience and job insecurity on the incidence of depression in an unselected working population in Germany. Data from the German Socio-Economic Panel (GSOEP) study were used, as was a final sample of those currently employed, with complete data at baseline (2009) and follow-up (2011) restricted to those free of depression in 2009 (n = 7073). Poisson regression analysis was applied to test the prospective associations between unemployment, job insecurity, and a two-year incident of depression. Results showed that the experience of unemployment and perceived job insecurity were significantly associated with a higher risk of depression during the two-year follow-up (risk ratios 1.64; 95% confidence intervals (1.16, 2.31) and risk ratios 1.48; 95% confidence intervals (1.13, 1.92), respectively). Notably, the strongest risk was observed among participants with insecure jobs and past long-term unemployment (risk ratios 2.15; 95% confidence intervals (1.32; 3.52)). In conclusion, even during employment, the experience of lifetime unemployment led to a higher risk of depression. The combination of previous unemployment experience and anticipated job insecurity increased the risk of developing depression. Results support health promotion with special emphasis on unemployment and precarious working conditions.
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Riedel N, Loerbroks A, Bolte G, Li J. Do perceived job insecurity and annoyance due to air and noise pollution predict incident self-rated poor health? A prospective analysis of independent and joint associations using a German national representative cohort study. BMJ Open 2017; 7:e012815. [PMID: 28115332 PMCID: PMC5278244 DOI: 10.1136/bmjopen-2016-012815] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Current economic and social change has contributed to increasing job insecurity and traffic-related pollution in residential areas. Both job insecurity and exposure to noise and air pollution are known determinants of population health and can concur in peoples' lives. This may hold true particularly for socially disadvantaged subpopulations. Nevertheless, the potential independent and joint links of those exposures to health have been rarely examined so far. We aimed to contribute to the scarce body of evidence. METHODS Information on perceived job insecurity and exposures to noise and air pollution as expressed by annoyance as well as on self-rated health were gathered from 2 waves of the population-based German Socio-Economic Panel (2009 and 2011, N=6544). We performed multivariable Poisson regression to examine the independent and joint risk of poor health in 2011 by perceived job insecurity and annoyance due to noise and air pollution in 2009. RESULTS After the 2-year follow-up in 2011, 571 (8.7%) participants rated their health as poor. The risk of reporting incident poor health was increased by roughly 40% in employees reporting high versus low perceived job insecurity and annoyance due to noise and air pollution, respectively. This risk increased when both exposures were present at higher levels (risk ratio=1.95 (1.49 to 2.55)). CONCLUSIONS Work-related and environmental exposures may accumulate and have a joint health impact. Elaboration on the link between occupational and residential exposures is warranted in the light of their concurrence and their implications for health inequities.
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Affiliation(s)
- Natalie Riedel
- Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Adrian Loerbroks
- Institute for Occupational, Social, and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Gabriele Bolte
- Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Jian Li
- Institute for Occupational, Social, and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
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[Material deprivation and health among women and men in Germany: results from the German Socioeconomic Panel 2011]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 58:100-7. [PMID: 25410744 DOI: 10.1007/s00103-014-2080-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND A number of studies have shown that socioeconomic status is associated with health. This study aims to analyze the role of material deprivation in physical and psychological health. METHODS Analyzes are based on the German Socioeconomic Panel (GSOEP) of 2011. Health was indicated by various indicators (sleep disorder, diabetes, asthma, heart diseases, cancer, migraine, high blood pressure, depressive diseases, joint disorders, chronic back complaint). A person will be denoted as materially deprived if three or more out of eleven living standard items are missing due to financial reasons. To calculate the association between material deprivation and indicators of health, logistic regression models were applied adjusted for sociodemographic and socioeconomic indicators. RESULTS In 2011, significant associations between material deprivation and several indicators of health were observed. For men, material deprivation was significantly (P < 0.001) associated with migraine and sleep disorder after adjusting for sociodemographic and socioeconomic indicators. For women, inequalities in health were larger and highly significant (P < 0.001) for sleep disorder, migraine, depressive diseases, chronic back complaint, asthma and joint disorders. CONCLUSIONS Results indicate an independent and gender specific association of material wealth with several indicators of health. Material deprivation might therefore be used as a complementary measure of socioeconomic status in the description and explanation of inequalities in health.
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Personality and risk of adult asthma in a prospective cohort study. J Psychosom Res 2015; 79:13-7. [PMID: 25907968 DOI: 10.1016/j.jpsychores.2015.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 04/01/2015] [Accepted: 04/04/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Traits conceptualized according to the five-factor model of personality have been found to predict numerous health outcomes and may also be predictive of asthma. Prior longitudinal studies on personality and asthma remain however sparse, have been restricted to only two traits (i.e., neuroticism and extraversion), and yielded inconsistent results. We therefore aimed to examine the potential relationships of all five-factor personality traits with incident asthma. METHODS We combined the 2009 and 2011 data from the population-based German Socio-Economic Panel study for longitudinal analyses (n=12,202). Personality traits were measured by an established 15-item version of the Big Five Inventory. Asthma was measured by participant-reports of having ever received such a diagnosis by a physician. We estimated multivariable risk ratios (RRs) and corresponding 95% confidence intervals (CIs) of trait-specific scores (continuous or categorized by tertiles) and incident asthma by Poisson regression. RESULTS Neuroticism was the only trait which was predictive of asthma (RR for the z-score=1.17, 95% CI=1.02-1.34; RR for the highest versus the lowest tertile=1.59, 95% CI=1.12-2.25). Associations between personality traits and asthma risk did not differ by sex (p-values for interaction ≥0.07). There were no two-way interactions between personality traits when we tested all potential combinations (all p-values for interaction ≥0.20). CONCLUSION The present study suggests that high levels of neuroticism may predispose adults to develop asthma. Future longitudinal studies are needed to confirm our findings and to shed light on the potential psychophysiological processes underlying the observed association.
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Virtanen M, Jokela M, Nyberg ST, Madsen IEH, Lallukka T, Ahola K, Alfredsson L, Batty GD, Bjorner JB, Borritz M, Burr H, Casini A, Clays E, De Bacquer D, Dragano N, Erbel R, Ferrie JE, Fransson EI, Hamer M, Heikkilä K, Jöckel KH, Kittel F, Knutsson A, Koskenvuo M, Ladwig KH, Lunau T, Nielsen ML, Nordin M, Oksanen T, Pejtersen JH, Pentti J, Rugulies R, Salo P, Schupp J, Siegrist J, Singh-Manoux A, Steptoe A, Suominen SB, Theorell T, Vahtera J, Wagner GG, Westerholm PJM, Westerlund H, Kivimäki M. Long working hours and alcohol use: systematic review and meta-analysis of published studies and unpublished individual participant data. BMJ 2015; 350:g7772. [PMID: 25587065 PMCID: PMC4293546 DOI: 10.1136/bmj.g7772] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To quantify the association between long working hours and alcohol use. DESIGN Systematic review and meta-analysis of published studies and unpublished individual participant data. DATA SOURCES A systematic search of PubMed and Embase databases in April 2014 for published studies, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies. REVIEW METHODS The search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression. RESULTS Cross sectional analysis was based on 61 studies representing 333,693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100,602 participants from nine countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1.20) in the analysis of prospective published and unpublished data. In the 18 studies with individual participant data it was possible to assess the European Union Working Time Directive, which recommends an upper limit of 48 hours a week. Odds ratios of new onset risky alcohol use for those working 49-54 hours and ≥ 55 hours a week were 1.13 (1.02 to 1.26; adjusted difference in incidence 0.8 percentage points) and 1.12 (1.01 to 1.25; adjusted difference in incidence 0.7 percentage points), respectively, compared with working standard 35-40 hours (incidence of new onset risky alcohol use 6.2%). There was no difference in these associations between men and women or by age or socioeconomic groups, geographical regions, sample type (population based v occupational cohort), prevalence of risky alcohol use in the cohort, or sample attrition rate. CONCLUSIONS Individuals whose working hours exceed standard recommendations are more likely to increase their alcohol use to levels that pose a health risk.
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Affiliation(s)
| | - Markus Jokela
- Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland
| | - Solja T Nyberg
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Tea Lallukka
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
| | - Kirsi Ahola
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden
| | - G David Batty
- Department of Epidemiology and Public Health, University College London, London, UK Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Jakob B Bjorner
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Marianne Borritz
- Department of Occupational Medicine, Koge Hospital, Koge, Denmark
| | - Hermann Burr
- Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Annalisa Casini
- School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Els Clays
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Dirk De Bacquer
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Nico Dragano
- Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Raimund Erbel
- Department of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Essen, Germany
| | - Jane E Ferrie
- Department of Epidemiology and Public Health, University College London, London, UK School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Eleonor I Fransson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Stress Research Institute, Stockholm University, Stockholm, Sweden School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Mark Hamer
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry, and Epidemiology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - France Kittel
- School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Anders Knutsson
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Markku Koskenvuo
- Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
| | - Karl-Heinz Ladwig
- Helmholtz Zentrum München (German Research Center for Environmental Health (GmbH)), 85764 Oberschleißheim, Germany
| | - Thorsten Lunau
- Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Martin L Nielsen
- Unit of Social Medicine, Frederiksberg University Hospital, Copenhagen, Denmark
| | - Maria Nordin
- Stress Research Institute, Stockholm University, Stockholm, Sweden Department of Psychology, Umeå University, Umeå, Sweden
| | - Tuula Oksanen
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland
| | - Jan H Pejtersen
- Danish National Centre for Social Research, Copenhagen, Denmark
| | - Jaana Pentti
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark Department of Public Health and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Paula Salo
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland Department of Psychology, University of Turku, Turku, Finland
| | - Jürgen Schupp
- German Institute for Economic Research, Berlin, Germany Free University of Berlin, Berlin, Germany
| | - Johannes Siegrist
- Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Archana Singh-Manoux
- Department of Epidemiology and Public Health, University College London, London, UK Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Sakari B Suominen
- Department of Public Health, University of Turku, Turku, Finland Nordic School of Public Health, Gothenburg, Sweden Folkhälsan Research Center, Helsinki, Finland
| | - Töres Theorell
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Jussi Vahtera
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland Department of Public Health, University of Turku, Turku, Finland Turku University Hospital, Turku, Finland
| | - Gert G Wagner
- German Institute for Economic Research, Berlin, Germany Max Planck Institute for Human Development, Berlin, Germany Berlin University of Technology, Berlin, Germany
| | | | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland Department of Public Health, Faculty of Medicine, University of Helsinki, Finland Department of Epidemiology and Public Health, University College London, London, UK
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Loerbroks A, Herr RM, Li J, Bosch JA, Seegel M, Schneider M, Angerer P, Schmidt B. The association of effort-reward imbalance and asthma: findings from two cross-sectional studies. Int Arch Occup Environ Health 2014; 88:351-8. [PMID: 25064121 DOI: 10.1007/s00420-014-0962-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 07/10/2014] [Indexed: 01/17/2023]
Abstract
PURPOSE There is evidence to suggest that work stress is positively associated with the occurrence of asthma. A limitation is that the small number of prior studies utilized unestablished work stress measures, thus constraining interpretation and generalizability. The present study re-examined this association by assessing work stress based on the well-established effort-reward imbalance (ERI) model. METHODS We drew on data from two cross-sectional studies. Study 1 was conducted in a large pharmaceutical company in 2013 (n = 1,464). Study 2 was based on data from the 2011 wave of the population-based German Socio-Economic Panel (n = 8,388). ERI was assessed by validated questionnaires. Asthma was determined by self-report of a physician-based diagnosis. Associations between ERI or its subcomponents "effort", "reward" and "overcommitment" (z scores or categorized) with asthma were estimated by logistic regression models and reported as adjusted odds ratios (ORs) with 95 % confidence intervals (CIs). RESULTS A one standard deviation increase of the ERI score (reflecting higher work stress) was associated with a 22-48 % elevated odds of asthma (Study 1: OR 1.48, 95 % CI 1.13-1.95, and Study 2: OR 1.22, 95 % CI 1.10-1.36). Z score-based analyses of the separate ERI components generally suggested moderate associations of effort, reward and overcommitment with asthma in both studies (Study 1: OR effort 1.25, 95 % CI 0.95-1.64, OR reward 0.67, 95 % CI 0.51-0.87, OR overcommitment 1.32, 95 % CI 1.01-1.72; and Study 2: OR effort 1.21, 95 % CI 1.09-1.34, OR reward 0.83, 95 % CI 0.76-0.92, OR overcommitment 1.12, 95 % CI 1.01-1.25). Analyses of categorized exposures largely confirmed these observations. CONCLUSIONS This is the first study to demonstrate a link between an established work stress measure and asthma. Longitudinal studies are needed to determine the direction of these associations.
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Affiliation(s)
- Adrian Loerbroks
- Institute of Occupational and Social Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany,
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