Labour market attachment among parents and self-rated health of their offspring: an intergenerational study

Education, employment, and income among people living with cystic fibrosis across three decades - A matched cohort study using Danish health registries

BACKGROUND

Past and ongoing advancements in cystic fibrosis (CF) care warrant long-term analysis of the societal impact of the condition. This study aims to evaluate changes in key socioeconomic factors across three decades among people living with CF (pwCF), compared with both the general population and an early-onset chronic disease population.

METHODS

This nationwide, registry-based, matched cohort study included all pwCF ≥ 18 years in Denmark in the years 1990, 2000, 2010, and 2018. Each person living with CF was matched to five individuals in the general population and five individuals living with type 1 diabetes or juvenile arthritis based on age, sex, and municipality.

RESULTS

The Danish adult CF population increased nearly fourfold from 88 in 1990 to 331 in 2018, and mean age increased by ten years. The educational level of pwCF was similar to the two comparator cohorts, while pwCF were less often in employment and more often permanently outside the labor force. Personal and household income levels of the CF cohort were higher than those of the comparator cohorts.

CONCLUSIONS

The disadvantage in employment for pwCF remained, but, over time, the societal profiles of the one-year CF cohorts increasingly converged with those of the comparator cohorts, indicative of improved clinical management, extended life expectancy, and the supportive role of the Danish welfare system in reducing health inequalities. Further research should be done to evaluate the effects of the newly introduced modulator therapies on employment, considering the broader societal impact and impact on quality of life.

Treatment-resistant depression and labor market affiliation in the Danish welfare society: a register-based study

PURPOSE

We explored if patients with treatment-resistant depression (TRD) go through different states of labor market affiliation during their course of illness before they return to work or obtain early retirement as compared to patients without TRD.

METHODS

All adults between 18 and 58 years with a first-time hospital contact due to depression in Danish patients' registers from 2000 to 2014 were followed in a nationwide labor market database. At time of TRD (index week), TRD patients were matched with patients without TRD in a 1:2 ratio. Sequence analysis and logistic regression were applied to explore the association of TRD and labor market affiliation and measures of transitions between labor market states 52 weeks before and after the index week.

RESULTS

At the index week, 14.1% of patients with TRD were in employment, whereas the proportion was 26.4% among non-TRD patients. Over time, the proportion of patients in employment increased slightly to 25.5% for TRD and 33.7% for non-TRD patients. The proportion of TRD patients with sickness absence at index was 47.0%, while the proportion was 26.2% for non-TRD patients. The adjusted odds of a below mean volatility of labor market transitions, characterized by more episodes in passive social transfer payments and disability pension, were higher among patients with TRD compared with non-TRD patients (OR 1.63, 95% CI [1.56-1.69]). Similarly, the adjusted odds of a below mean integration into employment were 1.63 higher among TRD patients compared with non-TRD patients (95% CI [1.56-1.70]).

CONCLUSION

Patients with TRD have higher levels of sickness absence and lower levels of reintegration into the labor market after meeting the criteria for TRD compared with patients without TRD.

Socioeconomic position and self-rated health among female and male adolescents: The role of familial determinants in explaining health inequalities. Results of the German KiGGS study

OBJECTIVE

Although health inequalities in adolescence are well documented, the underlying mechanisms remain unclear. Few studies have examined the role of the family in explaining the association between the family's socioeconomic position and adolescents' self-rated health. The current study aimed to explore whether the association between socioeconomic position and self-rated health was mediated by familial determinants.

METHODS

Using data from wave 2 of the"German Health Interview and Examination Survey for Children and Adolescents" (KiGGS) (1,838 female and 1,718 male 11- to 17-year-olds), linear regression analyses were conducted to decompose the total effects of income, education, occupational status, socioeconomic position index and adolescents' subjective social status on self-rated health into direct effects and indirect effects through familial determinants (family cohesion, parental well-being, parental stress, parenting styles, parental obesity, smoking and sporting activity).

RESULTS

A significant total effect of all socioeconomic position indicators on self-rated health was found, except for income in male adolescents. In female adolescents, more than 70% of the total effects of each socioeconomic position indicator were explained by familial mediators, whereas no significant direct effects remained. The most important mediator was parental well-being, followed by family cohesion, parental smoking and sporting activity. In male adolescents, the associations between income, parental education, the socioeconomic position index and subjective social status were also mediated by familial determinants (family cohesion, parental smoking, obesity and living in a single-mother family). However, a significant direct effect of subjective social status remained.

CONCLUSION

The analysis revealed how a family's position of socioeconomic disadvantage can lead to poorer health in adolescents through different family practices. The family appears to play an important role in explaining health inequalities, particularly in female adolescents. Reducing health inequalities in adolescence requires policy interventions (macro-level), community-based strategies (meso-level) and programs to improve parenting and family functioning (micro-level).

Perceived stress among adolescents as a marker for future mental disorders: A prospective cohort study

Aim:

The mental health problems of adolescents are important in relation to their future health and life course. The aim of this study was to investigate perceived stress in adolescence as a marker for later mental disorders.

Methods:

The data consisted of a combination of questionnaire and register data for 11,929 adolescents. Perceived stress was measured using Cohen’s Perceived Stress Scale divided into low, moderate and high perceived stress. Mental disorder was identified using the ICD-10 codes for Mental and Behavioural Disorders classified into whether the adolescents were diagnosed or not. Logistic regression was used to examine the prospective association between perceived stress and mental disorders during about 12 months of follow-up, including the adolescents self-rated health, sex and parental education.

Results:

In total, 247 adolescents (2.1%) were diagnosed with a mental disorder during follow-up. The perceived stress of the adolescents was associated with mental disorders, yielding two-fold higher odds of developing a mental disorder for adolescents reporting moderate perceived stress and six-fold higher odds among adolescents reporting high perceived stress in the adjusted model.

Conclusions:

Adolescents with high levels of perceived stress were more likely to develop a mental disorder. Interventions to reduce perceived stress among adolescents could therefore potentially help to identify groups at high risk for later mental disorders.