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Chen YY, Fong TCT, Yip PSF, Canetto SS. Female Labor-Force Participation as Suicide Prevention: A Population Study in Taiwan. Arch Suicide Res 2024:1-19. [PMID: 38661334 DOI: 10.1080/13811118.2024.2337182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
OBJECTIVE Female labor-force participation (FLFP) has been theorized as contributing to higher suicide rates, including among women. Evidence on this relationship, however, has been mixed. This study explored the association between FLFP and suicide in an understudied context, Taiwan, and across 40-years. METHODS Annual national labor-participation rates for women ages 25-64, and female and male suicide-rates, for 1980-2020, were obtained from Taiwan's Department of Statistics. The associations between FLFP rates and sex/age-stratified suicide-rates, and between FLFP rates and male-to-female suicide-rates ratios were assessed via time-series regression-analyses, accounting for autoregressive effects. RESULTS Higher FLFP rates were associated with lower female suicide-rates (ß = -0.06, 95% CI (Credibility Interval) = [-0.19, -0.01]) in the adjusted model. This association held in the age-stratified analyses. Associations for FLFP and lower male suicide-rates were observed in the ≥45 age-groups. FLFP rates were significantly and positively associated with widening male-to-female suicide-rates ratios in the adjusted model (ß = 0.24, 95% CI = [0.03, 0.59]). CONCLUSION This study's findings suggest that FLFP protects women from suicide, and point to the potential value of FLFP as a way of preventing suicide. In Taiwan, employed women carry a double-load of paid and family unpaid care-work. Child care-work is still done by mothers, often with grandmothers' support. Therefore, this study's findings contribute to evidence that doing both paid work and unpaid family care-work has more benefits than costs, including in terms of suicide-protection. Men's disengagement from family care-work may contribute to their high suicide rates, despite their substantial labor-force participation.
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Wang M, Svedberg P, Narusyte J, Ropponen A. Changes in family situation and concurrent changes in working life: a 15-year longitudinal analysis. Fam Med Community Health 2024; 12:e002438. [PMID: 38575348 PMCID: PMC11002427 DOI: 10.1136/fmch-2023-002438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE Currently, little is known regarding changes in family situation with concurrent changes in working life. This study aimed to examine whether changes in family situation (based on living with children and/or marrying/divorcing) were associated with changes in working life and whether the associations were influenced by sex, genetics and early life environment. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS Data from Swedish national registers of 16 410 twins were used. Fixed-effects logistic regression models assessing ORs with 95% CIs were applied to examine associations between changes in family situation and working life controlling for time-invariant effects and adjusted for covariates, and conditional models to account for confounding of genetics and early life environment. RESULTS Changes in individuals life situation from being single and living without children to married and living with children were associated with transitioning from unsustainable (ie, having unemployment or sickness absence/disability pension) to sustainable working life (men: OR 2.40, 95% CI 2.26 to 2.56; women: OR 1.68, 95% CI 1.59 to 1.78). Changes from being married to single, in contrast, attenuated the likelihood of transitioning to a sustainable working life. Moreover, changes in men's working life seem to be more dependent on changes in family situation compared with women. Genetic factors and early life environment play a role in the associations. CONCLUSIONS Family formation increases the likelihood of a more stable working life whereas divorce is a risk factor for work interruptions. Our study emphasises that family formation improves the work life situation and to a higher degree for men.
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Affiliation(s)
- Mo Wang
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Pia Svedberg
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jurgita Narusyte
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Annina Ropponen
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Finnish Institute of Occupational Health, Helsinki, Finland
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van Oosten AJ, van Mens K, Blonk RWB, Burdorf A, Tiemens B. The relationship between having a job and the outcome of brief therapy in patients with common mental disorders. BMC Psychiatry 2023; 23:910. [PMID: 38053035 PMCID: PMC10698972 DOI: 10.1186/s12888-023-05418-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/28/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Previous studies have shown that being employed is associated not only with patients' health but also with the outcome of their treatment for severe mental illness. This study examined what influence employment had on improvements in mental health and functioning among patients with common mental disorders who received brief treatment and how patients' diagnosis, environmental and individual factors moderated the association between being employed and treatment outcome. METHODS The study used naturalistic data from a cohort of patients in a large mental health franchise in the Netherlands. The data were obtained from electronic registration systems, intake questionnaires and Routine Outcome Monitoring (ROM). The International Classification of Functioning, Disability and Health (ICF) framework was used to identify potential subgroups of patients. Logistic regression models were used to analyze the relationship between employment status and treatment outcome and to determine how the relationship differed among ICF subgroups of patients. RESULTS A strong relationship was found between employment status and the outcome of brief therapy for patients with common mental disorders. After potential confounding variables had been controlled, patients who were employed were 54% more likely to recover compared to unemployed patients. Two significant interactions were identified. Among patients who were 60 years of age or younger, being employed was positively related to recovery, but this relationship disappeared in patients older than 60 years. Second, among patients in all living situations there was a positive effect of being employed on recovery, but this effect did not occur among children (18+) who were living with a single parent. CONCLUSIONS Being employed was positively associated with treatment outcome among both people with a severe mental illness and those with a common mental disorder (CMD). The main strength of this study was its use of a large dataset from a nationwide franchised company. Attention to work is important not only for people with a severe mental illness, but also for people with a CMD. This means that in addition to re-integration methods that focus on people with a severe mental illness, more interventions are needed for people with a CMD.
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Affiliation(s)
- Ard J van Oosten
- Parnassia Groep, The Hague, The Netherlands.
- U-center Epen, Epen, The Netherlands.
| | | | - Roland W B Blonk
- Department of Human Resource Studies, Tilburg University, Tilburg, The Netherlands
- Optentia Research Focus Area, North-West University Vaal Triangle Campus, Vanderbijlpark, South Africa
| | - Alex Burdorf
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
| | - Bea Tiemens
- Indigo Service Organization, Utrecht, The Netherlands
- Behavioral Science Institute, Radboud University, Nijmegen, The Netherlands
- Pro Persona Research, Wolfheze, The Netherlands
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A multi-state model approach for risk analysis of pensions for married couples with consideration of mortality difference by marital status. COMMUNICATIONS FOR STATISTICAL APPLICATIONS AND METHODS 2021. [DOI: 10.29220/csam.2021.28.6.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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5
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Männistö VT, Salomaa V, Färkkilä M, Jula A, Männistö S, Erlund I, Sundvall J, Lundqvist A, Perola M, Åberg F. Incidence of liver-related morbidity and mortality in a population cohort of non-alcoholic fatty liver disease. Liver Int 2021; 41:2590-2600. [PMID: 34219352 DOI: 10.1111/liv.15004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 06/03/2021] [Accepted: 06/22/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND & AIMS Non-alcoholic fatty liver disease (NAFLD) increases morbidity and mortality. However, patients in biopsy-based cohorts are highly selected and the absolute risks of liver- and non-liver outcomes in NAFLD in population remains undefined. We analysed both liver-related and non-liver-related outcomes in Finnish population cohorts of NAFLD. METHODS We included 10 993 individuals (6707 men, mean age 53.3 ± 12.6 years) with NAFLD (fatty liver index ≥60) from the Finnish population-based FINRISK and Health 2000 studies. Liver fibrosis was assessed by the dAAR score, and genetic risk by a recent polygenic risk score (PRS-5). Incident liver-related outcomes, cardiovascular disease (CVD), cancer and chronic kidney disease (CKD) were identified through linkage with national registries. RESULTS Mean follow-up was 12.1 years (1128 069 person-years). The crude incidence rate of liver-related outcomes in NAFLD was 0.97/1000 person-years. The cumulative incidence increased with age, being respectively 2.4% and 1.5% at 20 years in men and women aged 60 years at baseline, while the relative risks for CVD and cancer were 9-16 times higher. The risk of CKD exceeded that of liver outcomes at a baseline age around 50 years. 20-year cumulative incidence of liver-related outcomes was 4.3% in the high, and 1.5% in the low PRS-5 group. The dAAR score associated with liver outcomes, but not with extra-hepatic outcomes. CONCLUSION The absolute risk of liver-related outcomes in NAFLD is low, with much higher risk of CVD and cancer, emphasizing the need for more individualized and holistic risk-stratification in NAFLD.
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Affiliation(s)
- Ville T Männistö
- Departments of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.,Department of Experimental Vascular Medicine, Amsterdam UMC, Location AMC at University of Amsterdam, Amsterdam, The Netherlands
| | - Veikko Salomaa
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Martti Färkkilä
- Department of Gastroenterology, Helsinki University Hospital, Helsinki University, Helsinki, Finland
| | - Antti Jula
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Satu Männistö
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Iris Erlund
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jouko Sundvall
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Markus Perola
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Fredrik Åberg
- Transplantation and Liver Surgery Clinic, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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d'Errico A, Piccinelli C, Sebastiani G, Ricceri F, Sciannameo V, Demaria M, Di Filippo P, Costa G. Unemployment and mortality in a large Italian cohort. J Public Health (Oxf) 2021; 43:361-369. [PMID: 31740960 DOI: 10.1093/pubmed/fdz100] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 06/28/2019] [Accepted: 07/24/2019] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Aim of this study was to examine the association between unemployment and mortality, taking into account potential confounders of this association. A secondary objective was to assess whether the association between unemployment and mortality was modified by lack of household economic resources. METHODS Prospective cohort composed of a representative sample of Italian subjects 30-55 years who participated in the Italian National Health Survey 1999-2000, followed up for mortality up to 2012 (15 656 men and 11 463 women). Data were analyzed using Cox regression models, stratified by gender and adjusted for health status, behavioral risk factors, socioeconomic position and position in the household. The modifying effect of the lack of economic resources was assessed by testing its interaction with unemployment on mortality. RESULTS Among women, unemployment was not associated with mortality, whereas among men, higher mortality was found from all causes (HR = 1.82), which was not modified by lack of economic resources, and from neoplasms (HR = 1.59), cardiovascular diseases (HR = 2.58) and suicides (HR = 5.01). CONCLUSIONS Results for men were robust to the adjustment for main potential confounders, suggesting a causal relationship between unemployment and mortality. The lack of effect modification by economic resources supports the relevance of the loss of non-material benefits of work on mortality.
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Affiliation(s)
- Angelo d'Errico
- Epidemiology Department, Local Health Unit TO3, Piedmont Region, Grugliasco, Turin, Italy
| | - Cristiano Piccinelli
- Epidemiology Department, Local Health Unit TO3, Piedmont Region, Grugliasco, Turin, Italy.,Center for Epidemiology and Prevention in Oncology, Città della Salute e della Scienza, Turin, Italy
| | | | - Fulvio Ricceri
- Epidemiology Department, Local Health Unit TO3, Piedmont Region, Grugliasco, Turin, Italy.,Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Veronica Sciannameo
- Epidemiology Department, Local Health Unit TO3, Piedmont Region, Grugliasco, Turin, Italy
| | - Moreno Demaria
- Department of Environmental Epidemiology, Piedmont Environmental Protection Agency, Turin, Italy
| | | | - Giuseppe Costa
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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de Kock CA, Lucassen PL, Akkermans RP, Knottnerus JA, Buijs PC, Steenbeek R, Lagro-Janssen AL. Work-relatedness of the presented health problem and sickness absence. Fam Pract 2020; 37:360-366. [PMID: 31747001 PMCID: PMC7377345 DOI: 10.1093/fampra/cmz072] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Perception by workers of their health problems as work-related is possibly associated with sickness absence (SA). The aim of this study was to to study the relationship between perceived work-relatedness of health problems and SA among workers who visit their GP, taking the influence of other potential determinants into account and to study the influence of these determinants on SA. Design and setting prospective cohort study in 32 Dutch GP practices. METHODS A secondary analysis of RCT data among workers, aged 18-63 years, who visited their GP. We measured self-reported SA days in 12 months and high SA (>20 days in 12 months) and compared workers who perceived work-relatedness (WR+) with workers who did not (WR-). With multivariable linear and logistic regression models, we analyzed the influence of age, gender, experienced health, chronic illness, prior SA, number of GP consultations and perceived work ability. RESULTS We analyzed data of 209 workers, 31% perceived work-relatedness. Geometric mean of SA days was 1.6 (95% CI: 0.9-3.0) for WR+- workers and 1.2 (95% CI: 0.8-1.8) for WR- workers (P = 0.42). Incidence of high SA was 21.5 and 13.3%, respectively (odds ratio 1.79; 95% CI: 0.84-3.84). SA was positively associated with chronic illness, prior SA, low perceived work ability and age over 50. CONCLUSIONS Perceived work-relatedness was not associated with SA. SA was associated with chronic illness, prior SA, low perceived work ability and age over 50.
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Affiliation(s)
| | | | - Reinier P Akkermans
- Department of Primary and Community Care.,Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Peter C Buijs
- TNO Work, Health and Care, Leiden, (retired in 2014)
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Combes SJB, Simonnot N, Azzedine F, Aznague A, Chauvin P. Self-Perceived Health among Migrants Seen in Médecins du Monde Free Clinics in Europe: Impact of Length of Stay and Wealth of Country of Origin on Migrants' Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16244878. [PMID: 31817068 PMCID: PMC6950051 DOI: 10.3390/ijerph16244878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/29/2019] [Accepted: 11/30/2019] [Indexed: 11/16/2022]
Abstract
Health of migrants is a widely studied topic. It has been argued that migrant health may deteriorate over time. Though migrants are a “hard to reach” population in survey data, this paper builds on a unique dataset provided by Médecins du Monde from five countries. We study self-perceived health (SPH) in connection with socio-economic and demographic factors and length of stay. Results differ for men and women. Compared to other documented migrants, asylum seekers have a 50–70% greater chance of having worse health. Migrants with better living conditions have a 57–78% chance of being in better health. Male migrants with a job have between a 82–116% chance of being in good health. The probability for women from poorer countries to have a better physical SPH after three months of residing in the host country is six-fold that of women from richer countries. This paper contributes widely to the knowledge of health of migrants. Contrary to other evidence, health of women migrants from poorer countries tends to improve with length of stay.
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Affiliation(s)
- Simon Jean-Baptiste Combes
- Univ Rennes, EHESP, CNRS, ARENES–UMR 6051, 35000 Rennes, France; (F.A.); (A.A.)
- French Collaborative Institute on Migration, 93322 Aubervilliers, France
- Correspondence:
| | - Nathalie Simonnot
- Médecins du Monde–Doctors of the World, International Network, 75018 Paris, France;
| | - Fabienne Azzedine
- Univ Rennes, EHESP, CNRS, ARENES–UMR 6051, 35000 Rennes, France; (F.A.); (A.A.)
- French Collaborative Institute on Migration, 93322 Aubervilliers, France
| | - Abdessamad Aznague
- Univ Rennes, EHESP, CNRS, ARENES–UMR 6051, 35000 Rennes, France; (F.A.); (A.A.)
| | - Pierre Chauvin
- Department of Social Epidemiology, Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), 75012 Paris, France;
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Melaku YA, Gill TK, Appleton SL, Hill C, Boyd MA, Adams RJ. Sociodemographic, lifestyle and metabolic predictors of all-cause mortality in a cohort of community-dwelling population: an 18-year follow-up of the North West Adelaide Health Study. BMJ Open 2019; 9:e030079. [PMID: 31446418 PMCID: PMC6720239 DOI: 10.1136/bmjopen-2019-030079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Studies examining potential factors of all-cause mortality comprehensively at community level are rare. Using long-term community-based follow-up study, we examined the association of sociodemographic and behavioural characteristics, metabolic and chronic conditions, and medication and health service utilisation with all-cause mortality. METHODS We followed 4056 participants, aged 18-90 years, for 18 years in the North West Adelaide Health Study (NWAHS). Mortality data were obtained from South Australian (SA) public hospitals and registries including SA births, deaths and marriages, the National Death Index and the NWAHS follow-up. Predictors of all-cause mortality were explored using Cox proportional hazard model, adjusting for potential confounders. We performed subgroup analyses by sex and age. RESULTS Mean (SD) age at baseline was 50.4 (16.4) years. Less than half (47.8%) of the participants were men. A total of 64 689.7 person-years from 4033 participants with 18.7 years of follow-up were generated. The median follow-up time was 17.7 years; 614 deaths were recorded. The overall crude death rate was 9.6 (95% CI 8.9 to 10.4) per 1000 person-years. After adjusting for potential confounders, a reduced risk of mortality was significantly associated with being separated or divorced, being in the highest Socioeconomic Indexes for Areas quintile, engaging in moderate exercise, being overweight (body mass index: 25.0-29.9 kg/m2) and per 10% increase in per cent predicted forced expiratory volume in 1 s. We found that the most important predictors of all-cause mortality were sociodemographic and behavioural characteristics. Sociodemographic factors were more important predictors of all-cause mortality in young age bracket compared with older people. CONCLUSIONS Socioeconomic factors were found to be the most important predictors of all-cause mortality. The study highlights the need to address the social inequalities and strengthen behavioural interventions for different subgroups of population to prevent premature deaths.
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Affiliation(s)
- Yohannes Adama Melaku
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Tiffany K Gill
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Sarah L Appleton
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- The Health Observatory, Discipline of Medicine, The Queen Elizabeth Hospital Campus, University of Adelaide, Adelaide, South Australia, Australia
- Freemason's Centre for Men's Health, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Catherine Hill
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, South Australia, Australia
| | - Mark A Boyd
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Lyell McEwin Hospital, Adelaide, South Australia, Australia
| | - Robert J Adams
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- The Health Observatory, Discipline of Medicine, The Queen Elizabeth Hospital Campus, University of Adelaide, Adelaide, South Australia, Australia
- Freemason's Centre for Men's Health, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
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Kriegbaum M, Lund R, Schmidt L, Rod NH, Christensen U. The joint effect of unemployment and cynical hostility on all-cause mortality: results from a prospective cohort study. BMC Public Health 2019; 19:293. [PMID: 30866873 PMCID: PMC6417173 DOI: 10.1186/s12889-019-6622-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 03/04/2019] [Indexed: 11/15/2022] Open
Abstract
Background It is hypothesised that hostility accentuates the association between stressful conditions and health. This study aims to test this hypothesis by analysing the joint effect of unemployment and hostility on all-cause mortality among men and women. Methods The population was 3677 men and 4138 women from the Danish workforce who participated in a survey in 2000. The joint exposure variable was defined as 1) employed, not hostile, 2) unemployed, not hostile, 3) hostile and employed, 4) unemployed and hostile. Outcome was defined as all-cause mortality between 2000 and 2014. Data was analysed with Cox proportional hazards models with age as the underlying time scale. The interaction between unemployment and hostility was studied using the synergy index. Results Compared to employed non-hostile men, men who were both hostile and unemployed were at markedly higher risk of premature death with a hazard ratio (HR) of 3.19 (95% CI 2.22–4.69). A similar picture was found for hostile and unemployed women, with a HR of 1.97 (95% CI 1.24–3.12). However, the mortality in men and women exposed to both did not exceed what was expected from the combination of their individual effects. Hence, we did not find that hostility enhances the association between unemployment and all-cause mortality. Conclusion Men and women exposed to both unemployment and hostility were at markedly high risk of premature mortality. However, this study did not support the hypothesis that the deleterious health effect of the combination of unemployment and hostility exceeds their individual effects. Electronic supplementary material The online version of this article (10.1186/s12889-019-6622-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Margit Kriegbaum
- Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, 1014, Copenhagen K, Denmark.
| | - Rikke Lund
- Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, 1014, Copenhagen K, Denmark
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, 1014, Copenhagen K, Denmark
| | - Naja Hulvej Rod
- Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, 1014, Copenhagen K, Denmark
| | - Ulla Christensen
- Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, 1014, Copenhagen K, Denmark
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Cambois E, Garrouste C, Pailhé A. Gender career divide and women's disadvantage in depressive symptoms and physical limitations in France. SSM Popul Health 2017; 3:81-88. [PMID: 29349207 PMCID: PMC5768992 DOI: 10.1016/j.ssmph.2016.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 12/13/2016] [Accepted: 12/13/2016] [Indexed: 11/03/2022] Open
Abstract
This study investigated the relationship between women's disadvantage in mental health and physical functioning and gender differences in career backgrounds. Sexual division of labor persists and key career characteristics are overrepresented in women: low-skilled first job, downward occupational trajectory, interruptions. These interrelated characteristics are usually linked to poor health. Their overrepresentation in women may be related to the female-male health gap; however, it may not if overrepresentation transposed into substantially weaker associations with poor health outcomes. To address this question, we used the French population survey "Health and Occupational Trajectories" (2006) and focused on 45-74 year-old individuals who ever worked (n=7537). Past career characteristics were qualified by retrospective information. Logistic regressions identified past characteristics related to current depressive symptoms and physical limitations. Non-linear decomposition showed whether these characteristics contributed to the gender health gap, through their different distribution and/or association with health. The overrepresentation of unskilled first jobs, current and past inactivity and unemployment in women contributed to their excess depressive symptoms. These contributions were only slightly reduced by the weaker mental health-relatedness of current inactivity in women and increased by the stronger relatedness of low-skilled and self-employed first jobs. Overrepresentation of current inactivity, past interruptions and downward trajectories also contributed positively to women's excess physical limitations. Gender-specific career backgrounds were significantly linked to women's disadvantage in mental health and physical functioning. We need to further explore whether equalization of opportunities, especially at the early stages and in terms of career continuity, could help to reduce women's mental and physical health disadvantage.
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Affiliation(s)
- Emmanuelle Cambois
- Institut national d’études démographiques (INED),133 BD Davout, 75020 Paris, France
| | | | - Ariane Pailhé
- Institut national d’études démographiques (INED),133 BD Davout, 75020 Paris, France
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Alicandro G, Frova L, Sebastiani G, Boffetta P, La Vecchia C. Differences in education and premature mortality: a record linkage study of over 35 million Italians. Eur J Public Health 2017; 28:231-237. [DOI: 10.1093/eurpub/ckx125] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Gianfranco Alicandro
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Italian National Institute of Statistics (ISTAT), Rome, Italy
| | - Luisa Frova
- Italian National Institute of Statistics (ISTAT), Rome, Italy
| | | | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
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13
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de Kock CA, Lucassen PLBJ, Spinnewijn L, Knottnerus JA, Buijs PC, Steenbeek R, Lagro-Janssen ALM. How do Dutch GPs address work-related problems? A focus group study. Eur J Gen Pract 2016; 22:169-75. [PMID: 27248862 DOI: 10.1080/13814788.2016.1177507] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND In the Netherlands, there is a lack of knowledge about general practitioners' (GPs) perception of their role regarding patients' occupation and work related problems (WRP). As work and health are closely related, and patients expect help from their GPs in this area, a better understanding is needed of GPs' motivation to address WRP. OBJECTIVES To explore GPs' opinions on their role in the area of work and health. METHODS This is a qualitative study using three focus groups with Dutch GPs from the catchment area of a hospital in the Southeast of the Netherlands. The group was heterogeneous in characteristics such as sex, age, and practice setting. Three focus groups were convened with 18 GPs. The moderator used an interview guide. Two researchers analysed verbatim transcripts using constant comparative analysis. RESULTS We distinguished three items: (a) work context in a GP's integrated consultation style; (b) counselling about sick leave; (c) cooperation with occupational physicians (OPs). The participants are willing to address the topic and counsel about sick leave. They consider WRP in patients with medically unexplained symptoms (MUS) challenging. They tend to advise these patients to continue working as they think this will ultimately benefit them. CONCLUSION The participating GPs seemed well aware of the relation between work and health but need more knowledge, communication skills and better cooperation with occupational physicians to manage work-related problems. [Box: see text].
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Affiliation(s)
- Cornelis A de Kock
- a Department of Primary and Community Care, Gender & Women's Health , Radboud University Medical Centre , Nijmegen , the Netherlands
| | - Peter L B J Lucassen
- b Department of Primary and Community Care , Radboud University Medical Centre , Nijmegen , the Netherlands
| | - Laura Spinnewijn
- c Department of Obstetrics and Gynaecology , Hospital De Gelderse Vallei , Ede , the Netherlands
| | - J André Knottnerus
- d CAPHRI School for Public Health and Primary Care; Dept. of General Practice , Maastricht University , Maastricht , the Netherlands
| | - Peter C Buijs
- e TNO Work, Health and Care , Leiden , the Netherlands
| | | | - Antoine L M Lagro-Janssen
- a Department of Primary and Community Care, Gender & Women's Health , Radboud University Medical Centre , Nijmegen , the Netherlands
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