Excessive drinking and history of unemployment and cohabitation in Danish men born in 1953

Union Status and Disability Pension

A lot is known about the association between marital status and mortality, and some of these studies have included data on cohabitation. Studies on the association with health problems, rather than mortality, are often based on self-reported health outcomes, and results from these studies are mixed. As cohabitation is now widespread, more studies that include data on cohabitation are needed. We use Norwegian register data that include detailed information about union status and all cases of disability pensioning from 2005 to 2016. We employ Cox regression analysis and a within-family design in order to control for hard to measure childhood characteristics. Compared to the married, the cohabiting have a somewhat higher risk of receiving disability pension due to mental disorders, and for men also due to physical disorders. Receipt of disability pension is most common among the never married, especially for men. The association between union status and disability pensioning is stronger for mental than for physical disorders.

Smoking and alcohol use in unemployed populations: a systematic review and meta-analysis

Unemployment is an economic and social phenomenon that has economic, social, personal, and health consequences. This study aimed to investigate the relationship between unemployment and alcohol use and smoking as a systematic review and meta-analysis.

The two databases PubMed and Scopus were selected for the search and using a set of keywords, these two sources of scientific information were searched from 2004 to June 2021 and 1996 until June 2021, respectively. To meta-analyze the relationship between unemployment and smoking and alcohol use, odds ratio and confidence interval were calculated for this relationship. The meta-analysis was performed based on a random-effects. Subgroups were also performed for men and women. Heterogeneity in studies as well as publication bias were also examined.

A total of 52 cross-sectional and cohort studies were included in the meta-analysis. In the relationship between unemployment and alcohol use, the odds ratio was 1.25 and the confidence interval was between 1.12 and 1.41. In the relationship between unemployment and smoking, the odds ratio was 1.43 and the confidence interval was between 1.13 and 1.81.

According to the results, it can be said that unemployment increases the likelihood of alcohol use and smoking. Therefore, policymakers must pay more attention to the health consequences of economic problems, especially unemployment.

Binge Drinking Among Public Sector Food Service Workers in Brazil: Physical and Psychosocial Demands on Focus

OBJECTIVE

To investigate occupational risk factors associated with binge drinking (BD) among public sector food service workers in a Brazilian capital.

METHODS

All workers from the Government-backed Economy Restaurant Program (GbERP) in Belo Horizonte city were evaluated. BD was defined as consumption of five or more doses (male) or four or more doses (female) of alcoholic beverages on a single occasion within 30 days. Occupational psychosocial and physical stressors were the main exposure variables; sociodemographic, health, and lifestyle variables were inserted as potential confounding factors. We performed logistic regression.

RESULTS

A total of 214 people participated in the study and 30.7% reported BD. Psychosocial (violence and high demands) and ergonomic aspects were associated with the outcome.

CONCLUSION

There was a high prevalence of BD among GbERP workers. Actions are necessary to reduce violence and high strain and consequently BD.

[Mental disorders and participation in the labor market: a multicenter national study in Brazil]

The objective was to explore the relationship between labor market participation and patient characteristics in a representative sample of 2,475 adults admitted to 26 Brazilian mental health institutions (15 Centers for Psychosocial Care and 11 hospitals). Socio-demographic, clinical, and behavioral characteristics were obtained with structured interviews. Multinomial regression was used. Increased likelihood of temporary absence from the work market was associated with female gender, single, divorced, or widowed conjugal status, lack of stable housing, and history of first admission or treatment before the age of 18. Increased likelihood of permanent absence from the labor market was associated with older age. Temporary or permanent leave from work was directly associated with low schooling, lifetime hospitalizations, and diagnosis of severe mental disorder and inversely associated with alcohol and drug use. The occupational vulnerabilities identified in the study raise the debate on specific policies for the mental health sector.

Increasing illness among people out of labor market - A Danish register-based study

In spite of decades of very active labor market policies, 25% of Denmark's population in the working ages are still out-of-work. The aim of this study was to investigate whether that is due to consistent or even increasing prevalence of ill health. For the period of 2002-2011, we investigated if i) the prevalence of four chronic diseases (cardiovascular disease, diabetes, cancer and mental disorders) among those out-of-work had changed, ii) the occurrence of new cases of those diseases were higher among those who were already out-of-work, or iii) if non-health-related benefits were disproportionately given to individuals recently diagnosed with a disease compared to those without disease. The study was register-based and comprised all Danish residents aged 20-60. During the study period, the prevalence of cardiovascular diseases and mental disorders increased among both employed and non-employed people. The increased prevalence for mental disorder was particularly high among people receiving means-tested benefits. Disease incidence was higher among people outside rather than inside the labor market, especially for mental disorders. Employed people with incident diseases had an unsurprisingly increased risk of leaving the labor market. However, a high proportion of people with incident mental disorders received low level means-tested benefits in the three years following this diagnosis, which is concerning. Men treated for mental disorders in 2006 had high excess probability of receiving a cash-benefit, OR = 4.83 (4.53-5.14) for the period 2007-2010. The estimates were similar for women.

Identification of alcohol abuse and transition from long-term unemployment to disability pension

AIMS

The aim of the study was to reveal potential gaps and inconsistencies in the identification of alcohol abuse in health care and in employment services and to analyse the granting of disability pensions with respect to the alcohol abuse identification pattern.

METHODS

The material consisted of documentary information on 505 long-term unemployed subjects with low employability sent to the development project entitled 'Eligibility for a Disability Pension' in 2001-2006 in Finland. The dichotomous variables 'Alcohol abuse identified in employment services' and 'Alcohol abuse identified in health care' were cross-tabulated to obtain a four-class variable 'Alcohol abuse identification pattern'. Logistic regression analyses were conducted to ascertain the association of alcohol abuse identification pattern with the granting of disability pensions.

RESULTS

Alcohol abuse was detected by both health care and employment services in 47% of those identified as abusers (41% of examinees). Each service systems also identified cases that the other did not. When alcohol abuse was identified in health care only, the OR for a disability pension being granted was 2.8 (95% CI 1.5-5.2) compared with applicants without identified alcohol abuse. The result remained the same and statistically significant after adjusting for confounders.

CONCLUSIONS

Alcohol abuse identified in health care was positively associated with the granting of a disability pension. Closer co-operation between employment services and health care could help to identify those long-term unemployed individuals with impaired work ability in need of thorough medical examination.

Adolescent Repeated Alcohol Intoxication as a Predictor of Young Adulthood Alcohol Abuse: The Role of Socioeconomic Context

AIMS

Trajectories of alcohol abuse from adolescence onwards are not well known. We examined the relationship between repeated alcohol intoxication in adolescence and later alcohol abuse, testing whether this association varies depending on individuals' socioeconomic context.

METHODS

Study participants (n = 674, age 22-35 years in 2009) belong to the French TEMPO cohort study; their parents also participate in an epidemiological study-the GAZEL cohort. Repeated alcohol intoxication was assessed by questionnaire in adolescence (1999) (defined by ≥3 episodes of alcohol intoxication in the preceding 12 months). In young adulthood (2009), alcohol abuse was assessed by the WHO AUDIT questionnaire. Socioeconomic characteristic studied was childhood family income. Data were analyzed using logistic regression models controlling for age, sex, childhood temperament, parental history of alcohol use, and the quality of family relations.

RESULTS

Among adolescents who reported repeated alcohol intoxication, 30.8% reported alcohol abuse in young adulthood (adjusted OR=4.27, 95%CI 2.21-8.27). This association appeared stronger in participants who grew up in families with low income (adjusted OR=11.86, 95%CI 3.35-41.94 vs. 2.49, 95%CI 1.09-5.68 for youths from families with intermediate or high income).

CONCLUSIONS

In most adolescents (69.2%), alcohol abuse is a time-limited behavior. Nonetheless, in participants from low income families, the likelihood of persistent alcohol abuse beyond adolescence may be increased. Although some limitations are noted, a preliminary conclusion is that alcohol abuse trajectories over time need to be monitored, particularly in certain subgroups.

Unemployment and substance outcomes in the United States 2002-2010

BACKGROUND

The economic shock of 2008-2009 provided an opportunity to study the robustness of observed statistical associations between unemployment and problematic substance use.

METHODS

Data from 405,000 non-institutionalized adult participants in the 2002 to 2010 U.S. National Survey on Drug Use and Health were used to compare substance outcomes among unemployed and employed persons. Association of unemployment with substance outcomes was examined for the years 2002-2004, 2005-2007, 2008, and 2009-2010, corresponding to periods prior to and after the economic downturn of 2008. Multivariate logistic regression models adjusted for age, sex, race/ethnicity, education, urban/rural residence, current DSM-IV Major Depression, and local county unemployment rates.

RESULTS

Higher rates of past month tobacco and illicit drug use, heavy alcohol use, and past-year drug or alcohol abuse/dependence were found among the unemployed. Markedly increased unemployment in 2009-2010 did not moderate the association between substance outcomes and employment. This association was not confounded by sex, age group, or race/ethnicity for tobacco and illicit drugs, although it varied for alcohol outcomes among 18-25 year-olds. Results based on retrospective data regarding marijuana use in the period prior to unemployment suggest its use was associated with future job loss.

CONCLUSIONS

Employment status was strongly and robustly associated with problematic use of substances. Prevention and treatment interventions are warranted for a group whose employment and resulting insurance status may impair access to much needed health care.

Unemployment and hospitalization owing to an alcohol-related diagnosis among middle-aged men in Sweden

BACKGROUND

Unemployment is associated with alcohol-related morbidity. However, the extent to which the association is causal is unclear, and it is not known whether other risk factors remain uncontrolled for. This study examines the association between unemployment and later alcohol-related hospitalization, adjusted for preexisting alcohol disorders, psychiatric diagnoses, behavioral risk factors, and social factors.

METHODS

The study was based on a military conscription cohort (men born in 1949 to 1951), with information on psychiatric diagnosis and psychological assessment and from a drug-use survey, which was then linked to national registers. The analyses were performed on data on the 37,798 individuals who were in paid employment in 1990 to 1991.

RESULTS

It was found that short- and long-term unemployment (1 to 89 days and ≥90 days) were associated with hospitalization owing to an alcohol-related diagnosis at 12-year follow-up (HR(crude) = 2.25, 95% CI 1.64 to 3.09 and HR(crude) = 2.95, 95% CI 2.51 to 3.48, respectively). After adjustment for confounders, the hazard ratios (HRs) decreased but were still significantly elevated (HR(adjusted) = 1.52, 95% CI 1.10 to 2.10 and HR(adjusted) = 1.61, 95% CI 1.36 to 1.92, respectively). When follow-up was split into 3 time bands, it was found that the short- and medium-term associations were about the same and independent of unemployment duration, with adjusted HRs ranging between 1.70 and 1.76. No significant long-term associations were found after adjustment.

CONCLUSIONS

Unemployment was related to becoming hospitalized owing to an alcohol-related diagnosis. A substantial part of the elevated relative risk of alcohol-related hospitalization related to unemployment was found to be associated with already existing individual risk factors.

Socio-demographic predictors of dimensions of the AUDIT score in a population sample of working-age men in Izhevsk, Russia

AIMS

To investigate the relationship between socio-demographic factors and alcohol drinking patterns identified through a formal analysis of the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) score in a population sample of working-age men in Russia.

METHODS

In 2008-2009, a sample of 1005 men aged 25-59 years living in Izhevsk, Russia were interviewed and information collected about socio-demographic circumstances. Responses to the AUDIT questions were obtained through a self-completed questionnaire. Latent dimensions of the AUDIT score were determined using confirmatory factor analysis and expressed as standard deviation (SD) units. Structural equation modelling was used to estimate the strength of association of these dimensions with socio-demographic variables.

RESULTS

The AUDIT was found to have a two-factor structure: alcohol consumption and alcohol-related problems. Both dimensions were higher in men who were unemployed seeking work compared with those in regular paid employment. For consumption, there was a difference of 0.59 SDs, (95% confidence interval (CI): 0.23, 0.88) and for alcohol-related problems one of 0.66 SD (95% CI: 0.31, 1.00). Alcohol-related problems were greater among less educated compared with more educated men (P-value for trend = 0.05), while consumption was not related to education. Similar results were found for associations with an amenity index based on car ownership and central heating. Neither dimension was associated with marital status. While we found evidence that the consumption component of AUDIT was underestimated, this did not appear to explain the associations of this dimension with socio-demographic factors.

CONCLUSIONS

Education and amenity index, both measures of socio-economic position, were inversely associated with alcohol-related problems but not with consumption. This discordance suggests that self-reported questions on frequency and volume may be less sensitive markers of socio-economic variation in drinking than are questions about dependence and harm. Further investigation of the validity of the consumption component of AUDIT in Russia is warranted as it appears that the concept of a standard 'drink' as used in the instrument is not understood.