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Farina R, Simonelli A, Tomasi C, Ioannidou E, Trombelli L. Sexual dimorphism in periodontal inflammation: A cross-sectional study. J Periodontol 2025. [PMID: 39903662 DOI: 10.1002/jper.24-0466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 11/04/2024] [Accepted: 12/18/2024] [Indexed: 02/06/2025]
Abstract
BACKGROUND The purpose of the present study was to evaluate the role of sexual dimorphism (SD) in the clinical manifestation of plaque-induced periodontal inflammation by analyzing the association between patient-related factors and the full-mouth prevalence of bleeding on probing (BOP%) within 2 cohorts of male and female individuals. METHODS Data on BOP (dichotomously recorded as present/absent after the assessment of probing depth [PD]) were retrospectively obtained from the files of adult patients undergoing a first periodontal visit at a University center. Two multiple regression models (1 for males, 1 for females) were built with BOP% as the dependent variable and patient-related factors (i.e., age; smoking status; daily cigarette consumption; history of diabetes diagnosis; number of teeth present; proportion of sites with PD ≥ 5 mm around teeth) as independent variables. RESULTS In males (n = 212), BOP% was 5.9% lower in smokers compared to non-smokers (p = 0.021). In females (n = 389), BOP% increased by 1.6% for each 10-year increase in age (p = 0.046). The proportion of sites with PD ≥ 5 mm showed a strongly significant, positive association with BOP% irrespective of biological sex (p < 0.001). CONCLUSION SD manifested as a sex-dependent diversity in the association between patient-related factors and periodontal inflammation expressed as BOP%. While smoking determined a lower BOP% only in males, aging was associated with increased BOP% only in females. PLAIN LANGUAGE SUMMARY Gingival bleeding upon mechanical stimulation of the bottom of the gingival sulcus/pocket with a periodontal probe (bleeding on probing [BOP]) is suggestive of the presence of an inflammatory infiltrate induced by dental plaque within the gingival tissue. The prevalence of BOP within the dentition (BOP%) has a diagnostic relevance, being one of the main parameters to discriminate between periodontal health and disease. Also, BOP% informs the probability for a patient to either develop destructive form of periodontal disease (i.e., periodontitis) or manifest periodontitis progression. Based on the documented influence of biological sex on the incidence, traits, and/or progression rate of several diseases, which goes under the name of sexual dimorphism (SD), the effect of SD was investigated in relation to the factors that were previously associated with BOP% in a cohort of patients with heterogeneous periodontal conditions undergoing their first periodontal visit. Interestingly, SD manifested as a sex-dependent diversity in the association between patient-related factors and periodontal inflammation expressed by BOP%. While smoking determined a lower BOP% only in males, aging was associated with increased BOP% only in females. The present findings may find potential applications in personalized periodontal medicine and inspire future studies in this field.
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Affiliation(s)
- Roberto Farina
- Research Center for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Anna Simonelli
- Research Center for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Cristiano Tomasi
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Effie Ioannidou
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Leonardo Trombelli
- Research Center for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
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Ngaruiya C. When women win, we all win-Call for a gendered global NCD agenda. FASEB Bioadv 2022; 4:741-757. [PMID: 36479209 PMCID: PMC9721093 DOI: 10.1096/fba.2021-00140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 08/24/2022] [Accepted: 10/03/2022] [Indexed: 11/05/2022] Open
Abstract
Gender is a social determinant of health, interacting with other factors such as income, education, and housing and affects health care access and health care outcomes. This paper reviews key literature and policies on health disparities and gender disparities within health. It examines noncommunicable disease (NCD) health outcomes through a gender lens and challenges existing prevailing measures of success for NCD outcomes that focus primarily on mortality. Chronic respiratory disease, one of the four leading contributors to NCD mortality, is highlighted as a case study to demonstrate the gender gap. Women have different risk factors and higher morbidity for chronic respiratory disease compared to men but morbidity is shadowed by a penultimate research focus on mortality, which results in less attention to the gap in women's NCD outcomes. This, in turn, affects how resources, programs, and interventions are implemented. It will likely slow progress in reducing overall NCD burden if we do not address risk factors in an equitable fashion. The article closes with recommendations to address these gender gaps in NCD outcomes. At the policy level, increasing representation and inclusion in global public health leadership, prioritizing NCDs among marginalized populations by global health societies and political organizations, aligning the gendered global NCD agenda with other well-established movements will each catalyze change for gender-based disparities in global NCDs specifically. Lastly, incorporating gender-based indicators and targets in major NCD-related goals and advancing gender-based NCD research will strengthen the evidence base for women's unique NCD risks and health outcomes.
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Affiliation(s)
- Christine Ngaruiya
- Section of Global Health and International Emergency Medicine, Department of Emergency MedicineYale School of MedicineNew HavenConnecticutUSA
- Yale Network for Global Noncommunicable Diseases (NGN)Yale School of MedicineNew HavenConnecticutUSA
- Women Lift Health Women Leaders in Global Health (2020)https://www.womenlifthealth.org/profile/christine‐ngaruiya/
- Kenyan Doctors USAhttps://www.kedusa.org
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Calderwood C, Minnen ME, Phetmisy CN, Kidwell KE, French KA, King DD. Understanding how family demands impair health behaviors in working sole mothers: The role of perceived control over leisure time. Appl Psychol Health Well Being 2021; 14:362-382. [PMID: 34491619 DOI: 10.1111/aphw.12307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 11/28/2022]
Abstract
Working sole mothers (i.e., nonpartnered women who work) may experience elevated family demands that impose barriers to pursuing health behaviors during their daily leisure time. We aimed to map the process through which evening family demands influence leisure-time health behaviors in this priority population of employees, in an effort to identify targets for intervention development and health disparity reduction. Conducting a 7-day daily survey study in a sample of 102 working sole mothers, we supported perceptions of control over leisure time as a key mechanism linking evening family demands to leisure-time exercise. Furthermore, we identified the individual difference of present focus (i.e., a tendency to focus on current experiences) as a key factor that alters how evening family demands affect control over leisure time, which ultimately mitigates the detrimental influence of these demands on evening exercise engagement. In contrast, we did not find evidence to support relationships of evening family demands with the health behaviors of leisure time consumption of alcohol or high sugar, high fat foods via control over leisure time. We discuss how our findings advance theory regarding how family demands influence health and inform practical efforts to reduce health disparities that working sole mothers face.
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Affiliation(s)
| | - Molly E Minnen
- Department of Psychology, Virginia Tech, Blacksburg, Virginia, USA
| | | | - Kate E Kidwell
- School of Psychology, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Kimberly A French
- School of Psychology, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Danielle D King
- Department of Psychological Sciences, Rice University, Houston, Texas, USA
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Abu-Freha N, Gat R, Philip A, Yousef B, Ben Shoshan L, Yardeni D, Nevo-Shor A, Novack V, Etzion O. Indications and Findings of Upper Endoscopies in Males and Females, Are They the Same or Different? J Clin Med 2021; 10:jcm10081620. [PMID: 33920408 PMCID: PMC8070302 DOI: 10.3390/jcm10081620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/30/2021] [Accepted: 04/08/2021] [Indexed: 11/16/2022] Open
Abstract
Sex and gender can affect the prevalence and prognosis of diseases. Our aim was to assess similarities and differences for males and females who underwent an upper endoscopy, with regards to indications and results. We reviewed all upper endoscopy reports from 2012 to 2016. Data regarding demographics, indications, and procedure findings were collected. The upper endoscopy findings were compared regarding the most common indications: gastroesophageal reflux, abdominal pain, gastrointestinal bleeding, and anemia. We investigated 12,213 gastroscopies among males (age, 56.7 ± 17.4) and 15,817 among females (age, 56.0 ± 17.3, p = 0.002). Males who underwent an upper endoscopy for gastroesophageal reflux had higher rates of esophagitis (7.7% vs. 3.4%, p < 0.001) and Barret's esophagus (4.4% vs. 1.5%, p < 0.001). Females who underwent an upper endoscopy for abdominal pain had a higher rate of hiatal hernia, whereas males had higher rates of esophagitis, helicobacter pylori infection, gastritis, gastric ulcer, duodenitis, and duodenal ulcer (p < 0.001). Gastrointestinal bleeding as an indication for upper endoscopy showed that helicobacter, duodenitis, and duodenal ulcers are more common among males compared to females (p < 0.001). Males with anemia who underwent an upper endoscopy had higher rates of esophagitis (p = 0.021) gastritis (p = 0.002), duodenitis (p < 0.001), and duodenal ulcer (p < 0.001). We found significant differences regarding the pathological gastroscopy findings between males and females in relation to the different indications.
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Affiliation(s)
- Naim Abu-Freha
- Soroka University Medical Center, Faculty of Health Sciences, The Institute of Gastroenterology and Hepatology, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel; (B.Y.); (L.B.S.); (D.Y.); (A.N.-S.); (O.E.)
- Correspondence: or ; Tel.: +972-8-640-2251; Fax: +972-8-623-3083
| | - Roni Gat
- Soroka Clinical Research Center, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84010, Israel; (R.G.); (V.N.)
| | - Aerin Philip
- Faculty of Health Sciences, Medical School for International Health, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel;
| | - Baha Yousef
- Soroka University Medical Center, Faculty of Health Sciences, The Institute of Gastroenterology and Hepatology, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel; (B.Y.); (L.B.S.); (D.Y.); (A.N.-S.); (O.E.)
| | - Liza Ben Shoshan
- Soroka University Medical Center, Faculty of Health Sciences, The Institute of Gastroenterology and Hepatology, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel; (B.Y.); (L.B.S.); (D.Y.); (A.N.-S.); (O.E.)
| | - David Yardeni
- Soroka University Medical Center, Faculty of Health Sciences, The Institute of Gastroenterology and Hepatology, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel; (B.Y.); (L.B.S.); (D.Y.); (A.N.-S.); (O.E.)
| | - Anat Nevo-Shor
- Soroka University Medical Center, Faculty of Health Sciences, The Institute of Gastroenterology and Hepatology, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel; (B.Y.); (L.B.S.); (D.Y.); (A.N.-S.); (O.E.)
| | - Victor Novack
- Soroka Clinical Research Center, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84010, Israel; (R.G.); (V.N.)
| | - Ohad Etzion
- Soroka University Medical Center, Faculty of Health Sciences, The Institute of Gastroenterology and Hepatology, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel; (B.Y.); (L.B.S.); (D.Y.); (A.N.-S.); (O.E.)
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Yang JW, Suh C, Lee CK, Son BC. The work-life balance and psychosocial well-being of South Korean workers. Ann Occup Environ Med 2018; 30:38. [PMID: 29928507 PMCID: PMC5989347 DOI: 10.1186/s40557-018-0250-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 05/28/2018] [Indexed: 11/13/2022] Open
Abstract
Background It is challenging to balance work and life, and little attention has been paid to the work–life balance and psychosocial well-being of South Koreans. We assessed the association between work–life balance and psychosocial well-being among paid Korean workers. Methods This study was based on data from the fourth Korean Working Conditions Survey. We evaluated only paid workers, which constituted 30,649 of the total of 50,007 subjects surveyed. Poor work–life balance was defined based on the goodness of fit between working hours and social commitments. Well-being was measured using the World Health Organization WHO-5 index. Poisson regression with robust variances was used to calculate the estimated prevalence ratios (PRs) with confidence intervals. Results Poor work–life balance was associated with poor psychosocial well-being (PR = 1.25; 95% CI 1.21 to 1.28) even after adjusting for work-related and individual characteristics. Poor well-being was associated with low-level job autonomy (PR = 1.06; 95% CI 1.03 to 1.09), working for ≥53 h per week (PR = 1.10; 95% CI 1.06 to 1.14), blue-collar status (PR = 1.16; 95% CI 1.11 to 1.21), low-level support at work (PR = 1.32; 95% CI 1.29 to 1.36), age ≥ 50 years (PR = 1.21; 95% CI 1.15 to 1.26), the female gender (95% CI PR = 1.04; 95% CI 1.01 to 1.07), and cohabitation (living with somebody) (PR = 1.08; 95% CI 1.04 to 1.12). Good well-being was associated with high-intensity work (PR = 0.96; 95% CI 0.94 to 0.99), being the secondary earner in a household (PR = 0.82; 95% CI 0.79 to 0.85), and higher income (PR = 0.75; 95% CI 0.71 to 0.79). Conclusion Work–life balance was associated with psychosocial well-being after adjusting for both work-related and individual characteristics.
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Affiliation(s)
- Jae Won Yang
- Department of Occupational and Environmental Medicine & Institute of Environmental and Occupational Medicine, Pusan Paik Hospital, Inje University, Hospital, 75, Bokji-ro, Busanjin-gu, Busan, 47392 Republic of Korea
| | - Chunhui Suh
- Department of Occupational and Environmental Medicine & Institute of Environmental and Occupational Medicine, Pusan Paik Hospital, Inje University, Hospital, 75, Bokji-ro, Busanjin-gu, Busan, 47392 Republic of Korea
| | - Chae Kwan Lee
- Department of Occupational and Environmental Medicine & Institute of Environmental and Occupational Medicine, Pusan Paik Hospital, Inje University, Hospital, 75, Bokji-ro, Busanjin-gu, Busan, 47392 Republic of Korea
| | - Byung Chul Son
- Department of Occupational and Environmental Medicine & Institute of Environmental and Occupational Medicine, Pusan Paik Hospital, Inje University, Hospital, 75, Bokji-ro, Busanjin-gu, Busan, 47392 Republic of Korea
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Griep RH, Toivanen S, van Diepen C, Guimarães JMN, Camelo LV, Juvanhol LL, Aquino EM, Chor D. Work-Family Conflict and Self-Rated Health: the Role of Gender and Educational Level. Baseline Data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Int J Behav Med 2017; 23:372-382. [PMID: 26597924 PMCID: PMC4863030 DOI: 10.1007/s12529-015-9523-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Purpose This study examined gender differences in the association between work–family conflict and self-rated health and evaluated the effect of educational attainment. Method We used baseline data from ELSA-Brasil, a cohort study of civil servants from six Brazilian state capitals. Our samples included 12,017 active workers aged 34–72 years. Work–family conflict was measured by four indicators measuring effects of work on family, effects of family in work and lack of time for leisure and personal care. Results Women experienced more frequent work–family conflict, but in both genders, increased work–family conflict directly correlated with poorer self-rated health. Women’s educational level interacted with three work–family conflict indicators. For time-based effects of work on family, highly educated women had higher odds of suboptimal self-rated health (OR = 1.54; 95 % CI = 1.19–1.99) than less educated women (OR = 1.14; 95 % CI = 0.92–1.42). For strain-based effects of work on family, women with higher and lower education levels had OR = 1.91 (95 % CI 1.48–2.47) and OR = 1.40 (95 % CI 1.12–1.75), respectively. For lack of time for leisure and personal care, women with higher and lower education levels had OR = 2.60 (95 % CI = 1.95–3.47) and OR = 1.11 (95 % CI = 0.90–1.38), respectively. Conclusion Women’s education level affects the relationship between work–family conflict and self-rated health. The results may contribute to prevention activities.
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Affiliation(s)
- Rosane Härter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil. .,Centre for Health Equity Studies, Stockholm University and Karolinska Institutet, Stockholm, Sweden.
| | - Susanna Toivanen
- Centre for Health Equity Studies, Stockholm University and Karolinska Institutet, Stockholm, Sweden
| | | | - Joanna M N Guimarães
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lidyane V Camelo
- Postgraduate Program in Public Health, Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Leidjaira Lopes Juvanhol
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Estela M Aquino
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Dóra Chor
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
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Griep RH, Toivanen S, Santos IS, Rotenberg L, Juvanhol LL, Goulart AC, Aquino EM, Benseñor I. Work-family conflict, lack of time for personal care and leisure, and job strain in migraine: Results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Am J Ind Med 2016; 59:987-1000. [PMID: 27373788 DOI: 10.1002/ajim.22620] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND Work-family conflict and time scarcity may affect health. We investigated the association between these issues and migraine, taking into account job strain. METHODS Baseline data from ELSA-Brasil (6,183 women; 5,664 men) included four indicators of work-family conflict: time- and strain-based interference of work with family (TB-WFC, SB-WFC), interference of family with work (FWC) and lack of time for personal care and leisure (LOT). Migraine was classified according to International Headache Society criteria. RESULTS Among women, definite migraine was associated with SB-WFC (odds ratio [OR] = 1.28; 95% confidence interval [CI] 1.06-1.55), FWC (OR = 1.32; 1.00-1.75), and LOT (OR = 1.30; 1.08-1.58). Probable migraine was associated with SB-WFC (OR = 1.17; 1.00-1.36). High psychological job demands and low social support interacted with LOT in association with definite migraine. Among men, probable migraine was associated with LOT (OR = 1.34; 1.09-1.64), and there were interactions between job strain and WFC for probable migraine. CONCLUSIONS Balancing the demands of professional and domestic spheres could be highly relevant in the management of migraines. Am. J. Ind. Med. 59:987-1000, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Rosane Härter Griep
- Laboratory of Health and Environment Education; Oswaldo Cruz Institute; Fundação Oswaldo Cruz; Manguinhos; Rio de Janeiro Brazil
- Centre for Health Equity Studies ∣ CHESS; Stockholm University/KarolinskaInstitutet; Stockholm Sweden
| | - Susanna Toivanen
- Centre for Health Equity Studies ∣ CHESS; Stockholm University/KarolinskaInstitutet; Stockholm Sweden
| | - Itamar S. Santos
- Departamento de Clínica Médica; Faculdade de Medicina da Universidade de São Paulo; Brazil
| | - Lucia Rotenberg
- Laboratory of Health and Environment Education; Oswaldo Cruz Institute; Fundação Oswaldo Cruz; Manguinhos; Rio de Janeiro Brazil
| | | | - Alessandra C. Goulart
- Centre for Clinical and Epidemiological Research; Hospital Universitário da Universidade de São Paulo; Brazil
| | - Estela M. Aquino
- Institute of Collective Health; Federal University of Bahia; Salvador Bahia Brazil
| | - Isabela Benseñor
- Centre for Clinical and Epidemiological Research; Hospital Universitário da Universidade de São Paulo; Brazil
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Gierc M, Locke S, Jung M, Brawley L. Attempting to be active: Self-efficacy and barrier limitation differentiate activity levels of working mothers. J Health Psychol 2016; 21:1351-60. [PMID: 27357921 DOI: 10.1177/1359105314553047] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Working mothers are less physically active than working women without children and mothers who do not work. The purpose of this study was to examine concurrent self-regulatory efficacy and barriers to physical activity in a sample of working mothers. Women completed a mixed-methods survey which included measures of physical activity, concurrent self-regulatory efficacy, and barriers. Sufficiently active women experienced significantly greater concurrent self-regulatory efficacy and significantly less barrier limitation and frequency. No significant group differences were found for age, domestic duties performed, and children's extracurricular activities. Thematic analysis of barriers revealed six themes of common and unique factors, including limited time and family activities.
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Affiliation(s)
| | | | - Mary Jung
- University of British Columbia - Okanagan Campus, Canada
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Pelletier R, Khan NA, Cox J, Daskalopoulou SS, Eisenberg MJ, Bacon SL, Lavoie KL, Daskupta K, Rabi D, Humphries KH, Norris CM, Thanassoulis G, Behlouli H, Pilote L. Sex Versus Gender-Related Characteristics: Which Predicts Outcome After Acute Coronary Syndrome in the Young? J Am Coll Cardiol 2016; 67:127-135. [PMID: 26791057 DOI: 10.1016/j.jacc.2015.10.067] [Citation(s) in RCA: 207] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 10/20/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND "Gender" reflects social norms for women and men, whereas "sex" defines biological characteristics. Gender-related characteristics explain some differences in access to care for premature acute coronary syndrome (ACS); whether they are associated with cardiovascular outcomes is unknown. OBJECTIVES This study estimated associations between gender and sex with recurrent ACS and major adverse cardiac events (MACE) (e.g., ACS, cardiac mortality, revascularization) over 12 months in patients with ACS. METHODS We studied 273 women and 636 men age 18 to 55 years from GENESIS-PRAXY (GENdEr and Sex determInantS of cardiovascular disease: from bench to beyond-Premature Acute Coronary SYndrome), a prospective observational cohort study, who were hospitalized for ACS between January 2009 and April 2013. Gender-related characteristics (e.g., social roles) were assessed using a self-administered questionnaire, and a composite measure of gender was derived. Outcomes included recurrent ACS and MACE over 12 months. RESULTS Feminine roles and personality traits were associated with higher rates of recurrent ACS and MACE compared with masculine characteristics. This difference persisted for recurrent ACS, after multivariable adjustment (hazard ratio from score 0 to 100: 4.50; 95% confidence interval: 1.05 to 19.27), and was a nonstatistically significant trend for MACE (hazard ratio: 1.54; 95% confidence interval: 0.90 to 2.66). A possible explanation is increased anxiety, the only condition that was more prevalent in patients with feminine characteristics and that rendered the association between gender and recurrent ACS nonstatistically significant (hazard ratio: 3.56; 95% confidence interval: 0.81 to 15.61). Female sex was not associated with outcomes post-ACS. CONCLUSIONS Younger adults with ACS with feminine gender are at an increased risk of recurrent ACS over 12 months, independent of female sex.
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Affiliation(s)
- Roxanne Pelletier
- Divisions of General Internal Medicine and of Clinical Epidemiology, Department of Medicine, The Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Nadia A Khan
- Department of Medicine, Center for Health Evaluation and Outcomes Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jafna Cox
- Division of Cardiology, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
| | - Stella S Daskalopoulou
- Division of Internal Medicine, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Mark J Eisenberg
- Divisions of Cardiology and Clinical Epidemiology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Simon L Bacon
- Department of Exercise Science, Concordia University, Montreal, Quebec, Canada
| | - Kim L Lavoie
- Department of Psychology, University of Quebec in Montreal, Montreal, Quebec, Canada
| | - Kaberi Daskupta
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Doreen Rabi
- Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Karin H Humphries
- Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Colleen M Norris
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - George Thanassoulis
- Division of Cardiology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Hassan Behlouli
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Louise Pilote
- Divisions of General Internal Medicine and of Clinical Epidemiology, Department of Medicine, The Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Division of Internal Medicine, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada.
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Antai D, Oke A, Braithwaite P, Anthony DS. A 'Balanced' Life: Work-Life Balance and Sickness Absence in Four Nordic Countries. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2016; 6:205-22. [PMID: 26498049 PMCID: PMC6977043 DOI: 10.15171/ijoem.2015.667] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 10/07/2015] [Indexed: 11/23/2022]
Abstract
Background: Little attention has been given to the relationship between work-life balance and sickness absence. Objective: To investigate the association between poor work-life balance and sickness absence in 4 Nordic welfare states. Methods: Multivariable logistic regression analysis was performed on pooled cross-sectional data of workers aged 15–65 years from Denmark, Finland, Sweden, and Norway (n=4186) obtained from the 2010 European Working Conditions Survey (EWCS). Poor work-life balance was defined based on the fit between working hours and family or social commitments outside work. Self-reported sickness absence was measured as absence for ≥7 days from work for health reasons. Results: Poor work-life balance was associated with elevated odds (OR 1.38, 95% CI 1.06 to 1.80) of self-reported sickness absence and more health problems in the 4 Nordic countries, even after adjusting for several important confounding factors. Work-related characteristics, no determination over schedule (OR 1.26, 95% CI 1.04 to 1.53), and job insecurity (OR 1.56, 95% CI 1.21 to 2.02) increased the likelihood of sickness absence, and household characteristics-cohabitation status (OR 0.75, 95% CI 0.58 to 0.96) reduced this likelihood. The associations were non-significant when performed separately for women and men. Conclusion: Sickness absence is predicted by poor work-life balance. Implementation of measures that prevent employee difficulties in combining work and family life seems necessary
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Affiliation(s)
- D Antai
- City University London, School of Health Sciences, Centre for Public Health Research, London, UK Division of Global Health & Inequalities, The Angels Trust-Nigeria, Abuja, Nigeria.
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SKINNER N, DORRIAN J. A work-life perspective on sleep and fatigue--looking beyond shift workers. INDUSTRIAL HEALTH 2015; 53:417-26. [PMID: 26027709 PMCID: PMC4591134 DOI: 10.2486/indhealth.2015-0009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
This study examines sleep and fatigue through a work-life lens. Whilst most often thought of as an issue for shift workers, this study observed that self-reported insufficient sleep and fatigue were prevalent for workers on standard daytime schedules. Using a representative sample of 573 daytime workers (51.3% men; 70.7% aged 25-54 yr) from one Australian state, it was observed that 26.4% of daytime workers never or rarely get the seven hours of sleep a night that is recommended for good health. Those with parenting responsibilites (29.4%) or working long (45+) hours (37.4%) were most likely to report insufficient sleep. Whereas mothers in full-time work were most likely to report frequent fatigue (42.5%). This study highlights the common experience of insufficient sleep and fatigue in a daytime workforce, with significant implications for health and safety at work and outside of work. Stronger and more effective legislation addressing safe and 'decent' working time is clearly needed, along with greater awareness and acceptance within workplace cultures of the need to support reasonable workloads and working hours.
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Affiliation(s)
- Natalie SKINNER
- School of Management, University of South Australia,
Australia
- *To whom correspondence should be addressed. E-mail:
| | - Jill DORRIAN
- School of Psychology, Social Work and Social Policy,
University of South Australia, Australia
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Sörlin A, Öhman A, Ng N, Lindholm L. Can the impact of gender equality on health be measured? A cross-sectional study comparing measures based on register data with individual survey-based data. BMC Public Health 2012; 12:795. [PMID: 22985388 PMCID: PMC3503856 DOI: 10.1186/1471-2458-12-795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 09/11/2012] [Indexed: 11/17/2022] Open
Abstract
Background The aim of this study was to investigate potential associations between gender equality at work and self-rated health. Methods 2861 employees in 21 companies were invited to participate in a survey. The mean response rate was 49.2%. The questionnaire contained 65 questions, mainly on gender equality and health. Two logistic regression analyses were conducted to assess associations between (i) self-rated health and a register-based company gender equality index (OGGI), and (ii) self-rated health and self-rated gender equality at work. Results Even though no association was found between the OGGI and health, women who rated their company as “completely equal” or “quite equal” had higher odds of reporting “good health” compared to women who perceived their company as “not equal” (OR = 2.8, 95% confidence interval = 1.4 – 5.5 and OR = 2.73, 95% CI = 1.6-4.6). Although not statistically significant, we observed the same trends in men. The results were adjusted for age, highest education level, income, full or part-time employment, and type of company based on the OGGI. Conclusions No association was found between gender equality in companies, measured by register-based index (OGGI), and health. However, perceived gender equality at work positively affected women’s self-rated health but not men’s. Further investigations are necessary to determine whether the results are fully credible given the contemporary health patterns and positions in the labour market of women and men or whether the results are driven by selection patterns.
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Affiliation(s)
- Ann Sörlin
- Department of Public Health and Clinical Medicine, Centre for Global Health Research, Umeå University, S-901 87 Umeå, Sweden.
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Park H, Wenzel JA. Experience of social role strain in Korean women with type 2 diabetes. J Adv Nurs 2012; 69:1400-9. [DOI: 10.1111/jan.12001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2012] [Indexed: 01/21/2023]
Affiliation(s)
- Hyunjeong Park
- School of Nursing; The Johns Hopkins University; Baltimore Maryland USA
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Gender inequality from beyond the grave: intra-household distribution and wellbeing after spousal loss. AGEING & SOCIETY 2012. [DOI: 10.1017/s0144686x12000268] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTThe present article integrates research on spousal loss among older people and research on intra-household income distribution and relates pre-loss intra-household distribution of incomes to post-loss wellbeing. Data are drawn from the Swedish Panel Survey of Ageing and the Elderly (PSAE) and consist of couples that were married in the mid-1990s (N=1,503) and that were either still married (N=1,262) or who had experienced spousal loss (N=241) in 2002–03. The results showed that large intra-household pre-loss income differences increased the occurrence of psycho-social problems among both widows and widowers. Hence, unequal intra-household distribution of resources makes the coping process harder for both men and women. It was also shown that unequal pre-loss distribution of incomes affected a measure of global wellbeing among widowers. Widows suffered to a greater degree from economic difficulties, but these difficulties were not related to pre-loss distribution of incomes. Thus, the overall results showed that a gendered labour market that generates an unequal intra-household distribution of incomes has repercussions not only for gender equality among intact households, but also for the coping process of both widows and widowers.
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Norström L, Lindberg L, Månsdotter A. Could gender equality in parental leave harm off-springs' mental health? A registry study of the Swedish parental/child cohort of 1988/89. Int J Equity Health 2012; 11:19. [PMID: 22463683 PMCID: PMC3364865 DOI: 10.1186/1475-9276-11-19] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 03/30/2012] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Mental ill-health among children and young adults is a growing public health problem and research into causes involves consideration of family life and gender practice. This study aimed at exploring the association between parents' degree of gender equality in childcare and children's mental ill-health. METHODS The population consisted of Swedish parents and their firstborn child in 1988-1989 (N = 118 595 family units) and the statistical method was multiple logistic regression. Gender equality of childcare was indicated by the division of parental leave (1988-1990), and child mental ill-health was indicated by outpatient mental care (2001-2006) and drug prescription (2005-2008), for anxiety and depression. RESULTS The overall finding was that boys with gender traditional parents (mother dominance in childcare) have lower risk of depression measured by outpatient mental care than boys with gender-equal parents, while girls with gender traditional and gender untraditional parents (father dominance in childcare) have lower risk of anxiety measured by drug prescription than girls with gender-equal parents. CONCLUSIONS This study suggests that unequal parenting regarding early childcare, whether traditional or untraditional, is more beneficial for offspring's mental health than equal parenting. However, further research is required to confirm our findings and to explore the pathways through which increased gender equality may influence child health.
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Affiliation(s)
- Lisa Norström
- Department of Public Health Sciences, Karolinska Institutet, SE-171 76 Stockholm, Sweden
| | - Lene Lindberg
- Department of Public Health Sciences, Karolinska Institutet, SE-171 76 Stockholm, Sweden
| | - Anna Månsdotter
- Department of Public Health Sciences, Karolinska Institutet, SE-171 76 Stockholm, Sweden
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Ahlgren C, Malmgren Olsson EB, Brulin C. Gender analysis of musculoskeletal disorders and emotional exhaustion: interactive effects from physical and psychosocial work exposures and engagement in domestic work. ERGONOMICS 2012; 55:212-228. [PMID: 22248390 DOI: 10.1080/00140139.2011.646319] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED The objective of this study was to assess the relationships between physical and psychosocial work exposures, engagement in domestic work and work-home imbalance in relation to symptoms of musculoskeletal disorders and emotional exhaustion in white- and blue-collar men and women. Three thousand employees from 21 companies were asked to answer a questionnaire on family structure, household and child care tasks, work exposure, work-home imbalance and symptoms of neck/shoulder disorders, low back disorders and emotional exhaustion. Women reported more musculoskeletal disorders and engagement in domestic work. Adverse at-work exposures were highest in blue-collar women. High engagement in domestic work was not separately associated with symptoms but paid work exposure factors were associated. High engagement in domestic work interacted with adverse work exposure and increased risk estimates for low back disorders and emotional exhaustion. Reported work-home imbalance was associated with neck/shoulder disorders in women and with emotional exhaustion in both women and men. PRACTITIONER SUMMARY The current article adds to earlier research by showing that high engagement in domestic work is not separately associated with increased symptoms, but interacts with psychosocial work exposure variables to produce emotional exhaustion in both women and men and low back disorders in women.
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Affiliation(s)
- Christina Ahlgren
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, SE-90187, Umeå, Sweden.
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Abstract
OBJECTIVES To examine the association of women's postpartum health with total workload (TWL), work and personal factors in the year after childbirth. METHODS Employed women from Minneapolis and St Paul, Minnesota, were recruited while hospitalized for childbirth. Longitudinal analyses, using fixed effects regression models, estimated the associations of TWL, job satisfaction and stress, social support, perceived control, breastfeeding and infant characteristics with women's health at 5 weeks, 11 weeks, 6 months, and 12 months postpartum. RESULTS Increased TWL over time was associated with significantly poorer mental health and increased symptoms. CONCLUSIONS High TWL--including reduced time for rest, recovery, and sleep--is a risk factor for women's mental health and symptoms 12 months after childbirth. Women's postpartum health was positively associated with social support, which may help to decrease the negative effects of excess work.
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von Thiele Schwarz U. Inability to Withdraw from Work as Related to Poor Next-Day Recovery and Fatigue among Women. APPLIED PSYCHOLOGY-AN INTERNATIONAL REVIEW-PSYCHOLOGIE APPLIQUEE-REVUE INTERNATIONALE 2011. [DOI: 10.1111/j.1464-0597.2011.00440.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Menopause and myocardial infarction risk among employed women in relation to work and family psychosocial factors in Lithuania. Maturitas 2010; 66:94-8. [DOI: 10.1016/j.maturitas.2010.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Revised: 02/12/2010] [Accepted: 02/22/2010] [Indexed: 01/08/2023]
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Lidwall U, Marklund S, Voss M. Work-family interference and long-term sickness absence: a longitudinal cohort study. Eur J Public Health 2009; 20:676-81. [PMID: 20008908 DOI: 10.1093/eurpub/ckp201] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Alongside work environment factors, interference between work and domestic life has been proposed as an important explanation for long-term sickness absence, particularly for women. The aim was to investigate the association between work-to-family interference, family-to-work interference and long-term sickness absence among women and men in different family- and work-related settings. METHODS The study population was a random sample of 2867 gainfully employed adults in Sweden aged 25-50. In 2004, telephone interview data were collected that included questions about family, work and health. The outcome measure was having at least one spell of long-term sickness absence (>14 days) in 2005 based on social insurance register data. Associations were analysed by logistic regression. RESULTS Work-to-family interference was more common than family-to-work interference and more often reported by women. The overall associations with long-term sickness absence were weak. However, after adjustment for age and self-reported health, work-to-family interference was associated with long-term sick leave among men with higher socioeconomic status (odds ratio 2.87; 95% CI 1.36-6.07), and there was also a tendency to association among women bearing the main responsibility for housework and family (1.59; 0.99-2.54). CONCLUSIONS These findings suggest that work-to-family interference is associated with long-term sickness absence in the working population, but in a gender- and situation-specific manner. Hence, extensive work responsibilities for men, and probably extensive family responsibilities for women, could hamper the balance between work and family and increase the risk of long-term sick leave. Further studies are warranted within this area.
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Affiliation(s)
- Ulrik Lidwall
- Department of Clinical Neuroscience, Section of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
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Rodriguez A. Finding balance. Nurs Womens Health 2009; 13:365. [PMID: 19821910 DOI: 10.1111/j.1751-486x.2009.01453.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Sandmark H. Job mismatching, unequal opportunities and long-term sickness absence in female white-collar workers in Sweden. Scand J Public Health 2008; 37:43-9. [DOI: 10.1177/1403494808098916] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim: To investigate associations between long-term sick-listing and factors at work and in family life. Methods: Associations were investigated in a cross-sectional case-referent study. The study base included women in white-collar jobs, aged 30—55 years, living in three urban areas in Sweden between February 2004 and October 2004. A postal questionnaire was constructed with questions on occupational and family circumstances, and sent to 513 randomly selected female white-collar workers, of whom 233 had ongoing sick-leave of 90 days or more. The response rate was 81% (n = 413). Results: Most of the women in this study were in managerial positions. The unadjusted associations showed that sick-listed women with children showed the highest estimates regarding reported long working hours, bullying, high mental strain, low control and low influence at work, and work—family imbalance. In a regression model, the strongest associations were: experiencing too high mental strain in work tasks (odds ratio (OR) = 2.57, 95% confidence interval (CI) = 2.09—3.15) and low control and influence at work (OR=2.17, 95% CI= 1.60—2.94). Sick-listed women reported an overall higher dissatisfaction with their workplace and working life. Conclusions: There seems to be a greater tendency for the sick-listed women in this study to experience low control and too high mental strain at work and to live in traditional family relationships with unequal opportunities. The women who were sick-listed were probably less able to cope with work stress and to find a balance between work and family life.
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Affiliation(s)
- Hélène Sandmark
- School of Health and Medical Sciences, Public Health Science, Örebro University, Örebro, Sweden, Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden,
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Work and family: associations with long-term sick-listing in Swedish women - a case-control study. BMC Public Health 2007; 7:287. [PMID: 17931411 PMCID: PMC2151941 DOI: 10.1186/1471-2458-7-287] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2007] [Accepted: 10/11/2007] [Indexed: 12/04/2022] Open
Abstract
Background The number of Swedish women who are long-term sick-listed is high, and twice as high as for men. Also the periods of sickness absence have on average been longer for women than for men. The objective of this study was to investigate the associations between factors in work- and family life and long-term sick-listing in Swedish women. Methods This case-control study included 283 women on long-term sick-listing ≥90 days, and 250 female referents, randomly chosen, living in five counties in Sweden. Bivariate and multivariate logistic regression analyses with odds ratios were calculated to estimate the associations between long-term sick-listing and factors related to occupational work and family life. Results Long-term sick-listing in women is associated with self-reported lack of competence for work tasks (OR 2.42 1.23–11.21 log reg), workplace dissatisfaction (OR 1.89 1.14–6.62 log reg), physical workload above capacity (1.78 1.50–5.94), too high mental strain in work tasks (1.61 1.08–5.01 log reg), number of employers during work life (OR 1.39 1.35–4.03 log reg), earlier part-time work (OR 1.39 1.18–4.03 log reg), and lack of influence on working hours (OR 1.35 1.47–3.86 log reg). A younger age at first child, number of children, and main responsibility for own children was also found to be associated with long-term sick-listing. Almost all of the sick-listed women (93%) wanted to return to working life, and 54% reported they could work immediately if adjustments at work or part-time work were possible. Conclusion Factors in work and in family life could be important to consider to prevent women from being long-term sick-listed and promote their opportunities to remain in working life. Measures ought to be taken to improve their mobility in work life and control over decisions and actions regarding theirs lives.
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