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Pinna Pintor M, Fumagalli E, Suhrcke M. The impact of health on labour market outcomes: A rapid systematic review. Health Policy 2024; 143:105057. [PMID: 38581968 DOI: 10.1016/j.healthpol.2024.105057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 04/08/2024]
Abstract
The relationship between an individual's health and their labour market outcomes has long been a subject of health economics research. This review aims to provide an up-to-date, global review of the substantive findings in the existing literature. We pay particular attention to causal effects, acknowledging the methodological complexities that have long challenged the research and emphasizing the importance of overcoming them to present robust, policy-relevant evidence. The recent literature shows a notable advancement in addressing these methodological issues compared to previous work. The evidence reviewed suggests that individuals with better health overwhelmingly exhibit higher earnings and often enhanced labour supply. These findings extend beyond geographical boundaries, as evidence from diverse regions underscores the global significance of this association. The review covers evidence from a wide range of health indicators and conditions - including e.g. self-reported health, chronic diseases, disability, nutritional health, infections, mental health, addictions and others. Within and across the different health domains, the health-related factors exert varying degrees of influence on labour market outcomes, highlighting the multifaceted nature of the health-labour relationship and its potentially profound implications for individuals, communities, and economies.
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Affiliation(s)
- Matteo Pinna Pintor
- Luxembourg Institute of Socio-economic Research (LISER), Esch, Belval, Luxembourg
| | | | - Marc Suhrcke
- Luxembourg Institute of Socio-economic Research (LISER), Esch, Belval, Luxembourg; Centre for Health Economics, University of York, United Kingdom.
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McInnis N. Long-term health effects of childhood parental income. Soc Sci Med 2023; 317:115607. [PMID: 36525787 PMCID: PMC10765958 DOI: 10.1016/j.socscimed.2022.115607] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/01/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
While research on the link between socio-economic status and health spans several decades, our understanding of this relationship is still severely constrained. We estimate the long-term effects of parental income from birth to age 18 on health and risky health behaviors in adulthood. We use over 4 decades of data from the Panel Study of Income Dynamics, from 1968 to 2017, to construct a unique data set that links 49,459 person-year outcomes in adulthood, to several parental and family level variables when they were born and throughout their childhood. To mitigate concerns that parental income is likely correlated with unobserved factors that determine children's outcomes in adulthood, we estimate an instrumental variables model. We construct a simulated income variable that is used to instrument for parental income. This approach breaks the link between an individual's own parental income and unobserved characteristics that are possibly correlated with their health in the long run. We find that a $10,000 increase in annual parental income increases the likelihood of very good or excellent health in adulthood by 3.7%, reduces the likelihood of physical limitation by 10.3%, and reduces the likelihood of smoking and the number of cigarettes smoked per day by 12.7% and 16.7%, respectively. We also find that the pathways by which income improves health are increased education, employment, annual hours worked, pre-tax hourly earnings and pre-tax annual earnings. Our results highlight the lasting impact of economic resources in childhood and the importance of growing up in a financially stable environment.
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Zhou HL, Su GH, Zhang RY, Di DS, Wang Q. Association of volatile organic compounds co-exposure with bone health indicators and potential mediators. CHEMOSPHERE 2022; 308:136208. [PMID: 36041527 DOI: 10.1016/j.chemosphere.2022.136208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/05/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
Limited evidence was found in the associations of volatile organic compound (VOC) exposure with bone health indicators. This study aimed to explore the associations of individual and combined metabolites of VOCs (mVOCs) in urine, a representative of the internal exposure level of VOCs, with bone mineral density (BMD), osteoporosis (OP) and fracture, and potential mediators. Data of the National Health Examination and Nutrition Survey 2005-2006 and 2013-2014 was used. Multiple linear and logistic regression modeling were performed to analyze the associations of individual mVOC with bone health indicators. The least absolute shrinkage and selection operator (LASSO) regression was adopted to select mVOCs that were more relevant to bone health indicators for further weight quantile sum (WQS) analysis used for analyzing the associations between multiple VOC co-exposure and bone health indicators. Mediation analysis was used to identify potential mediators. Seventeen mVOC members with detection rate of >50% in urine of all 3478 participants aged ≥20 years (1829 females) were involved. Levels of most mVOCs were higher in women than men. Eight mVOCs were negatively associated with BMDs, and two and four mVOCs were positively associated with OP and fracture risks, respectively. WQS regression revealed decreased femoral neck BMD (β = -0.010 g/cm2, 95% CI: -0.020, -0.0001) and total spine BMD (β = -0.015 g/cm2, 95% CI: -0.028, -0.002) in response to increasing mVOC mixture levels. And alkaline phosphatase (ALP), body mass index (BMI), fasting insulin (FI) and high-density lipoprotein (HDL), were mediators in the associations with proportions of mediating effect ranging from 4.6% to 10.2%. Individual and combined VOC (co-)exposure were associated with reduced BMDs in American adults. ALP, BMI, FI and HDL were demonstrated to be mediators in the association of multiple VOC co-exposure with BMD.
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Affiliation(s)
- Hao-Long Zhou
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Guan-Hua Su
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Ru-Yi Zhang
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Dong-Sheng Di
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qi Wang
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Nemoto Y, Sakurai R, Matsunaga H, Hasebe M, Fujiwara Y. Examining health risk behaviors of self-employed and employed workers in Japan: a cross-sectional study. Public Health 2022; 211:149-156. [PMID: 36115138 DOI: 10.1016/j.puhe.2022.07.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/14/2022] [Accepted: 07/22/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Self-employed workers have a higher risk for adverse health outcomes than employed workers. However, the differences in health risk behaviors by employment status are largely unknown. This study examined differences in health risk behaviors between self-employed and employed (permanent/non-permanent) workers by sex and age (20-59 years, 60-79 years). STUDY DESIGN This was a cross-sectional study involving community-dwelling adults living in urban cities in Japan. METHODS In 2019, we conducted a mail survey in Wako city, Saitama, and Fuchu city, Tokyo. In total, 30,315 adults aged ≥18 years were randomly selected, and 14,185 completed the survey (response rate: 46.8%). The participants for analysis were 8538 workers. Health risk behaviors included physical inactivity (<150 min/wk of moderate-to-vigorous physical activity), prolonged sitting (>480 min/d), high-frequency drinking (≥3 d/wk), tobacco use (current smoker), and overweight (body mass index ≥ 25 kg/m2). We also calculated the total number of health risk behaviors. RESULTS Self-employed workers had more health risk behaviors than permanent and non-permanent employees, with this difference more significant among younger males. In younger males, compared with self-employment, permanent employment was associated with less tobacco use, and non-permanent employment was associated with less physical inactivity, prolonged sitting, high-frequency drinking, and overweight. In younger females, non-permanent employment was associated with less prolonged sitting and overweight than self-employment. In older males and females, the prevalence of physical inactivity was lower in non-permanent employed than in self-employed workers. CONCLUSIONS Promoting health behaviors among self-employed may be beneficial for reducing health inequalities between self-employed and employed workers.
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Affiliation(s)
- Yuta Nemoto
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi, Tokyo 173-0015, Japan; Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku, Tokyo 160-8402, Japan.
| | - Ryota Sakurai
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi, Tokyo 173-0015, Japan
| | - Hiroko Matsunaga
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi, Tokyo 173-0015, Japan
| | - Masami Hasebe
- Department of Human Welfare, Seigakuin University, 1-1 Tosaki, Ageo, Saitama 362-8585, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi, Tokyo 173-0015, Japan
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Liao J, Scholes S, Mawditt C, Mejía ST, Lu W. Comparing relationships between health-related behaviour clustering and episodic memory trajectories in the United States of America and England: a longitudinal study. BMC Public Health 2022; 22:1367. [PMID: 35842626 PMCID: PMC9288697 DOI: 10.1186/s12889-022-13785-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/12/2022] [Indexed: 12/03/2022] Open
Abstract
Background Health-related behaviours (HRBs) cluster within individuals. Evidence for the association between HRB clustering and cognitive functioning is limited. We aimed to examine and compare the associations between three HRB clusters: “multi-HRB cluster”, “inactive cluster” and “(ex-)smoking cluster” (identified in previous work based on HRBs including smoking, alcohol consumption, physical activity and social activity) and episodic memory trajectories among men and women, separately, in the United States of America (USA) and England. Methods Data were from the waves 10–14 (2010–2018) of the Health and Retirement Study in the USA and the waves 5–9 (2010–2018) of the English Longitudinal Study of Ageing in England. We included 17,750 US and 8,491 English participants aged 50 years and over. The gender-specific HRB clustering was identified at the baseline wave in 2010, including the multi-HRB (multiple positive behaviours), inactive and ex-smoking clusters in both US and English women, the multi-HRB, inactive and smoking clusters in US men, and only the multi-HRB and inactive clusters in English men. Episodic memory was measured by a sum score of immediate and delayed word recall tests across waves. For within country associations, a quadratic growth curve model (age-cohort model, allowing for random intercepts and slopes) was applied to assess the gender-stratified associations between HRB clustering and episodic memory trajectories, considering a range of confounding factors. For between country comparisons, we combined country-specific data into one pooled dataset and generated a country variable (0 = USA and 1 = England), which allowed us to quantify between-country inequalities in the trajectories of episodic memory over age across the HRB clusters. This hypothesis was formally tested by examining a quadratic growth curve model with the inclusion of a three-way interaction term (age × HRB clustering × country). Results We found that within countries, US and English participants within the multi-HRB cluster had higher scores of episodic memory than their counterparts within the inactive and (ex-)smoking clusters. Between countries, among both men and women within each HRB cluster, faster declines in episodic memory were observed in England than in the USA (e.g., b England versus the USA for men: multi-HRB cluster = -0.05, 95%CI: -0.06, -0.03, b England versus the USA for women: ex-smoking cluster = -0.06, 95%CI: -0.07, -0.04). Additionally, the range of mean memory scores was larger in England than in the USA when comparing means between two cluster groups, including the range of means between inactive and multi-HRB cluster for men (b England versus the USA = -0.56, 95%CI: -0.85, -0.27), and between ex-smoking and multi-HRB cluster for women (b England versus the USA = -1.73, 95%CI: -1.97, -1.49). Conclusions HRB clustering was associated with trajectories of episodic memory in both the USA and England. The effect of HRB clustering on episodic memory seemed larger in England than in the USA. Our study highlighted the importance of being aware of the interconnections between health behaviours for a better understanding of how these behaviours affect cognitive health. Governments, particularly in England, could pay more attention to the adverse effects of health behaviours on cognitive health in the ageing population. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13785-7.
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Affiliation(s)
- Jing Liao
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China.,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Shaun Scholes
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Claire Mawditt
- Graduate School of Public Health, St Luke's International University, Tokyo, Japan
| | - Shannon T Mejía
- Department of Kinesiology & Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, USA
| | - Wentian Lu
- Research Department of Epidemiology and Public Health, University College London, London, UK.
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Wang M, Svedberg P, Narusyte J, Silventoinen K, Ropponen A. The role of familial confounding in the associations of physical activity, smoking and alcohol consumption with early exit from the labour market. Prev Med 2021; 150:106717. [PMID: 34242665 DOI: 10.1016/j.ypmed.2021.106717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/28/2021] [Accepted: 07/03/2021] [Indexed: 10/20/2022]
Abstract
We investigated the associations between health behaviors and sustainable working life outcomes including all-cause disability pension, disability pensions due to musculoskeletal and mental diagnoses and unemployment. The role of familial factors behind these associations was studied by analysing discordant twin pairs. Our data included Swedish twins born in 1925-1986 (51891 twin individuals). Baseline data based on two independent surveys in 1998-2003 and 2005-2006 for health behaviors were linked to national registers on disability pension and unemployment until 2016. Cox proportional hazards models for hazard ratios (HR) with 95% confidence intervals (CI) were estimated for the whole sample adjusting for covariates. Analyses of health behavior discordant twin pairs (n = 5903 pairs) were conducted using conditional Cox models. In the whole cohort, the combination of healthy behaviors was associated with lower risk for all-cause disability pension, disability pension due to musculoskeletal diagnoses or mental diagnoses, and for unemployment (HRs 0.56-0.86, 95% CIs 0.51-0.92) as did being physically active (HRs 0.69-0.87, 95% CI 0.65-0.92). The discordant pair analyses confirmed the lower risk among those having healthy behaviors (HR 0.70-0.86) or being physically active (HR 0.86-0.87) for all-cause disability pension, disability pension due to musculoskeletal diagnoses, and for unemployment. To conclude, controlling the effects of covariates or familial confounding (i.e. discordant twin pair analyses) shows that being physically active or having several healthy behaviors predict better working life outcomes. This points towards independent association between healthy behavior and longer working life.
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Affiliation(s)
- Mo Wang
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jurgita Narusyte
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Center of Epidemiology and Community Medicine, Stockholm County Council, Sweden
| | - Karri Silventoinen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Annina Ropponen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Finnish Institute of Occupational Health, Helsinki, Finland.
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Bentley R, Baker E, Martino E, Li Y, Mason K. Alcohol and tobacco consumption: What is the role of economic security? Addiction 2021; 116:1882-1891. [PMID: 33404137 DOI: 10.1111/add.15400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/19/2020] [Accepted: 12/23/2020] [Indexed: 11/26/2022]
Abstract
AIMS To better understand the longstanding inequalities concerning alcohol and tobacco use, we aimed to quantify the effect of household economic security on alcohol and tobacco consumption and expenditure. DESIGN Longitudinal analysis using data from the Household, Income and Labour Dynamics in Australia survey (2001-2018). SETTING Australia PARTICIPANTS: A nationally representative cohort of 24 134 adults aged 25-64 years (187 378 observations). MEASUREMENTS Tobacco and alcohol use (Yes/No), frequency of use of each per week, household expenditure on each per week, household weekly income (Consumer Price Index [CPI]-adjusted), employment security (based on conditions of employment) and housing affordability (housing costs relative to household income). FINDINGS At baseline, one-quarter of the sample used tobacco and 87% used alcohol. Annual increases in household income were associated with the increased use of both tobacco and alcohol for people in households in the lowest 40% of the national income distribution (OR = 1.13, 95% CI = 1.03-1.23 and OR = 1.12, 95% CI = 1.04-1.20, respectively) with no similar income effect observed for higher-income households. In relation to smoking, the odds of a resident's tobacco use increased when their household was unemployed (OR = 1.32, 95% CI = 1.07-1.62). In relation to alcohol, the odds of use decreased when households were insecurely employed or unemployed, or housing costs were unaffordable (OR = 0.87, 95% CI = 0.77-0.98, OR = 0.66, 95% CI = 0.55-0.80 and OR = 0.84, 95% CI = 0.75-0.93, respectively). This was also reflected in the reduced odds of risky drinking (defined in accordance with Australian guidelines) when housing became unaffordable or households became unemployed (OR = 0.90, 95% CI = 0.81-0.99; OR = 0.82, 95% CI = 0.69-0.98, respectively). CONCLUSIONS In Australia, smoking and drinking appear to exhibit different socio-behavioural characteristics and household unemployment appears to be a strong determinant of smoking.
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Affiliation(s)
- Rebecca Bentley
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
| | - Emma Baker
- School of Social Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Erika Martino
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
| | - Yuxi Li
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
| | - Kate Mason
- Department of Public Health, Policy & Systems, University of Liverpool, Brownlow Street, Liverpool, UK
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Nabifo SC, Izudi J, Bajunirwe F. Alcohol consumption and sports-betting among young male motorcycle taxi boda boda riders in urban southwestern Uganda. BMC Public Health 2021; 21:363. [PMID: 33593353 PMCID: PMC7885426 DOI: 10.1186/s12889-021-10406-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background The popularity of sports-betting is growing globally and may be associated with alcohol consumption among young adults. In this study, we examine the relationship between alcohol consumption plus other substances with sports-betting in a group of young adult males in Uganda. Methods We conducted a cross-sectional study and interviewed male motorcycle taxi boda boda riders in the southwestern Uganda town of Mbarara. We asked questions about alcohol consumption, smoking plus history and frequency of sports-betting. Results We enrolled 401 riders. The median age was 29.0 years, interquartile range 25–32 years. Seventy four (18.5%) had engaged in sports-betting in the past 30 days. Among those that reported sports-betting, 16(21.6%) engaged daily or almost daily. Alcohol use was significantly associated with sports-betting with an adjusted risk ratio (aRR) of 2.08(95% CI 1.36, 3.18) among moderate drinkers but not among heavy drinkers in comparison to low or non-drinkers. Cigarette smoking was significantly associated with sports-betting with an aRR 1.85(95% CI 1.13, 3.01). Conclusion Sports-betting is common among these young male motorcycle riders, and is associated with both alcohol consumption and cigarette smoking. Interventions to regulate sports-betting may be co-packaged with those to reduce alcohol consumption and cigarette smoking among young adult males. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10406-7.
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Affiliation(s)
- Stella Cheryl Nabifo
- Department of Community Health, Mbarara University of Science and Technology, P.O.BOX 1410, Mbarara, Uganda
| | - Jonathan Izudi
- Department of Community Health, Mbarara University of Science and Technology, P.O.BOX 1410, Mbarara, Uganda
| | - Francis Bajunirwe
- Department of Community Health, Mbarara University of Science and Technology, P.O.BOX 1410, Mbarara, Uganda.
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Berro J, Akel M, Hallit S, Obeid S. Relationships between inappropriate eating habits and problematic alcohol use, cigarette and waterpipe dependence among male adolescents in Lebanon. BMC Public Health 2021; 21:140. [PMID: 33446162 PMCID: PMC7809860 DOI: 10.1186/s12889-021-10184-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/06/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND it is important to investigate the relationship between disordered eating in male adolescents and smoking and alcohol consumption as they are risk factors to other diseases as well. For example, high levels of alcohol accompanied by the acidic damage and nutritional deficit exhibited in people with disordered eating habits - due to induced vomiting - has been shown to increase risk of esophageal cancer. Considering the very few studies done on disordered eating prevailing in males and the prevalence of smoking and drinking habits, our study aims to investigate the correlation between inappropriate eating habits and one's dependence on cigarettes, waterpipes, and alcohol all the while focusing on male adolescents. METHODS This was a cross-sectional observational study that enrolled 389 male students (13-17 years of age) drawn from five Lebanese schools between October and December 2019. RESULTS The MANCOVA analysis was performed taking the addiction scales as the dependent variables and the EAT-26 score as an independent variable, adjusting for the covariates (age, BMI and household crowding index). Higher EAT-26 scores (more inappropriate eating attitudes) were significantly associated with higher waterpipe dependence (B = 0.11; CI 0.06-0.17) and more problematic alcohol use (B = 0.08; CI 0.04-0.12), but not cigarette dependence. CONCLUSIONS This study revealed an association between inappropriate eating and increased drinking and smoking the waterpipe, but not cigarettes. The manifestation of inappropriate eating habits was found to be significant among male adolescents; in the literature, this is also true for female adolescents. In Lebanon, the engagement of adolescents in alcohol drinking and waterpipe smoking is frequent as they are accessible due to the lack of law enforcement and supervision in the country. In addition, while this study found an association between inappropriate eating habits and dependency on smoking and drinking, further investigation should be done on the role of one's psychology in their exhibition of disordered eating as means to prevent the manifestation of these habits.
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Affiliation(s)
- Jana Berro
- Faculty of Arts & Sciences, Lebanese American University, Byblos, Lebanon
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Sahar Obeid
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
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Nystrand C, Gebreslassie M, Ssegonja R, Feldman I, Sampaio F. A systematic review of economic evaluations of public health interventions targeting alcohol, tobacco, illicit drug use and problematic gambling: Using a case study to assess transferability. Health Policy 2021; 125:54-74. [PMID: 33069504 DOI: 10.1016/j.healthpol.2020.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 08/05/2020] [Accepted: 09/01/2020] [Indexed: 11/17/2022]
Abstract
AIMS To identify and assess the cost-effectiveness of public health interventions targeting the use of alcohol, illicit drugs and tobacco, as well as problematic gambling behavior (ANDTS), and consider whether the results from these evaluations are transferable to the Swedish setting. METHODS A systematic review of economic evaluations within the area of ANDTS was conducted including studies published between January 2000 and November 2018, identified through Medline, PsychINFO, Web of Science, the National Health Service Economic Evaluation Database and Health Technology Assessment. The quality of relevant studies and the possibilities of transferring results were assessed using criteria set out by the Swedish Agency for Health Technology Assessment. RESULTS Out of 54 relevant studies, 39 were of moderate to high quality and included in the review, however none for problematic gambling. Eighty-one out of a total of 91 interventions were cost-effective. The interventions largely focusing on taxed-based policies or screening and brief interventions. Thirteen of these studies were deemed to have high potential for transferability, with effect estimates considered relevant, and with good feasibility for implementation in Sweden. CONCLUSIONS Interventions targeting alcohol- and illicit-drug use and tobacco use are cost-effective approaches, and results may be transferred to the Swedish setting. Caution must be taken regarding cost estimates and the quality of the evidence which the studies are based upon.
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Affiliation(s)
- Camilla Nystrand
- Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, P.O Box 564, 751 22, Uppsala, Sweden.
| | - Mihretab Gebreslassie
- Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, P.O Box 564, 751 22, Uppsala, Sweden
| | - Richard Ssegonja
- Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, P.O Box 564, 751 22, Uppsala, Sweden
| | - Inna Feldman
- Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, P.O Box 564, 751 22, Uppsala, Sweden
| | - Filipa Sampaio
- Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, P.O Box 564, 751 22, Uppsala, Sweden
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Heikkala E, Ala-Mursula L, Taimela S, Paananen M, Vaaramo E, Auvinen J, Karppinen J. Accumulated unhealthy behaviors and psychosocial problems in adolescence are associated with labor market exclusion in early adulthood - a northern Finland birth cohort 1986 study. BMC Public Health 2020; 20:869. [PMID: 32503491 PMCID: PMC7275307 DOI: 10.1186/s12889-020-08995-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 05/27/2020] [Indexed: 12/26/2022] Open
Abstract
Background The relevance of health-related behaviors to exclusion from the labor market in early adulthood remains poorly studied in relation to the magnitude of the problem. We explored whether adolescents’ accumulated unhealthy behaviors and psychosocial problems are associated with later labor market exclusion, and whether multisite musculoskeletal pain (MMSP) impacts these relations. Methods We gathered questionnaire data on unhealthy behaviors and psychosocial problems and MMSP among adolescents aged 15 to 16 belonging to the Northern Finland Birth Cohort 1986. The findings were combined with registry data on unemployment, employment and permanent work disability during a five-year follow-up between the ages of 25 and 29 (n = 6692). In the statistical modeling we used education, family leave and socioeconomic status of childhood family as potential confounders, as well as latent class and logistic regression analyses. Results The Externalizing behavior cluster associated with over one year of unemployment (RR 1.64, CI 1.25–2.14) and permanent work disability (OR 2.49, CI 1.07–5.78) in the follow-up among the men. The Sedentary cluster also associated with over one year (RR 1.41, CI 1.13–1.75) and under one year of unemployment (RR 1.25, CI 1.02–1.52) and no employment days (RR 1.93, CI 1.26–2.95) among the men. Obese male participants were at risk of over one year of unemployment (RR 1.50, CI 1.08–2.09) and no employment days (RR 1.93, CI 1.07–3.50). Among the women, the Multiple risk behavior cluster related significantly to over one year of unemployment (RR 1.77, CI 1.37–2.28). MMSP had no influence on the associations. Conclusions Unhealthy behavior patterns and psychosocial problems in adolescence have long-term consequences for exclusion from the labor market in early adulthood, especially among men. Simultaneously supporting psychological well-being and healthy behaviors in adolescence may reduce labor market inclusion difficulties in the early phase of working life.
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Affiliation(s)
- Eveliina Heikkala
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014, Oulu, Finland. .,Rovaniemi Health Center, Koskikatu 25, 96200, Rovaniemi, Finland.
| | - Leena Ala-Mursula
- Center for Life Course Health Research, University of Oulu, Aapistie 5B, 90150, Oulu, Finland
| | - Simo Taimela
- Department of Orthopedics and Traumatology, Helsinki University Hospital, Töölö hospital, Topeliuksenkatu 5, 00260, Helsinki, Finland.,Clinicum, Department of Orthopedics and Traumatology, University of Helsinki, PO Box 266, 00029 HUS, Helsinki, Finland
| | - Markus Paananen
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014, Oulu, Finland
| | - Eeva Vaaramo
- Intrastructure for Population Studies, Faculty of Medicine, University of Oulu, Aapistie 5B, 90150, Oulu, Finland
| | - Juha Auvinen
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014, Oulu, Finland.,Oulunkaari Health Center, Piisilta 1, 90110, Ii, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Aapistie 5B, 90150, Oulu, Finland.,Finnish Institute of Occupational Health, Aapistie 1, 90220, Oulu, Finland
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Gc VS, Suhrcke M, Atkin AJ, van Sluijs E, Turner D. Cost-effectiveness of physical activity interventions in adolescents: model development and illustration using two exemplar interventions. BMJ Open 2019; 9:e027566. [PMID: 31427318 PMCID: PMC6701678 DOI: 10.1136/bmjopen-2018-027566] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 06/27/2019] [Accepted: 07/01/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To develop a model to assess the long-term costs and health outcomes of physical activity interventions targeting adolescents. DESIGN A Markov cohort simulation model was constructed with the intention of being capable of estimating long-term costs and health impacts of changes in activity levels during adolescence. The model parameters were informed by published literature and the analysis took a National Health Service perspective over a lifetime horizon. Univariate and probabilistic sensitivity analyses were undertaken. SETTING School and community. PARTICIPANTS A hypothetical cohort of adolescents aged 16 years at baseline. INTERVENTIONS Two exemplar school-based: a comparatively simple, after-school intervention and a more complex multicomponent intervention compared with usual care. PRIMARY AND SECONDARY OUTCOME MEASURES Incremental cost-effectiveness ratio as measured by cost per quality-adjusted life year gained. RESULTS The model gave plausible estimates of the long-term effect of changes in physical activity. The use of two exemplar interventions suggests that the model could potentially be used to evaluate a number of different physical activity interventions in adolescents. The key model driver was the degree to which intervention effects were maintained over time. CONCLUSIONS The model developed here has the potential to assess long-term value for money of physical activity interventions in adolescents. The two applications of the model indicate that complex interventions may not necessarily be the ones considered the most cost-effective when longer-term costs and consequences are taken into account.
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Affiliation(s)
- Vijay S Gc
- Centre for Health Economics, University of York, York, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Marc Suhrcke
- Centre for Health Economics, University of York, York, UK
- Luxembourg Institute of Socio-Economic Research, Esch-sur-Alzette, Luxembourg
| | - Andrew J Atkin
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | | | - David Turner
- Norwich Medical School, University of East Anglia, Norwich, UK
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