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Wassell M, Vitiello A, Butler-Henderson K, Verspoor K, Pollard H. Generalizability of a Musculoskeletal Therapist Electronic Health Record for Modelling Outcomes to Work-Related Musculoskeletal Disorders. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10196-w. [PMID: 38739344 DOI: 10.1007/s10926-024-10196-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/07/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE Electronic Health Records (EHRs) can contain vast amounts of clinical information that could be reused in modelling outcomes of work-related musculoskeletal disorders (WMSDs). Determining the generalizability of an EHR dataset is an important step in determining the appropriateness of its reuse. The study aims to describe the EHR dataset used by occupational musculoskeletal therapists and determine whether the EHR dataset is generalizable to the Australian workers' population and injury characteristics seen in workers' compensation claims. METHODS Variables were considered if they were associated with outcomes of WMSDs and variables data were available. Completeness and external validity assessment analysed frequency distributions, percentage of records and confidence intervals. RESULTS There were 48,434 patient care plans across 10 industries from 2014 to 2021. The EHR collects information related to clinical interventions, health and psychosocial factors, job demands, work accommodations as well as workplace culture, which have all been shown to be valuable variables in determining outcomes to WMSDs. Distributions of age, duration of employment, gender and region of birth were mostly similar to the Australian workforce. Upper limb WMSDs were higher in the EHR compared to workers' compensation claims and diagnoses were similar. CONCLUSION The study shows the EHR has strong potential to be used for further research into WMSDs as it has a similar population to the Australian workforce, manufacturing industry and workers' compensation claims. It contains many variables that may be relevant in modelling outcomes to WMSDs that are not typically available in existing datasets.
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Affiliation(s)
- M Wassell
- School of Computing Technologies, RMIT University, Melbourne, Australia.
| | - A Vitiello
- School of Health, Medical and Applied Sciences, Central Queensland University, Queensland, Australia
| | - K Butler-Henderson
- STEM|Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - K Verspoor
- School of Computing Technologies, RMIT University, Melbourne, Australia
| | - H Pollard
- Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
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Yu H, Duan S, Wang P, Fu R, Lv Z, Yu Y, Miao P, Shi J, Zhuang N, Hu H, Yuan N, Che S. Health-related quality of life and influencing factors of patients with paroxysmal nocturnal hemoglobinuria in China. Orphanet J Rare Dis 2024; 19:186. [PMID: 38702811 PMCID: PMC11067208 DOI: 10.1186/s13023-024-03178-x] [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] [Received: 01/01/2024] [Accepted: 03/30/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Paroxysmal nocturnal hemoglobinuria (PNH) is a rare blood disorder, leading to various complications and impairments in patients' health-related quality of life (HRQOL). Limited research has been conducted to evaluate the HRQOL of Chinese patients with PNH. Understanding the HRQOL in this specific population is crucial for providing effective healthcare interventions and improving patient' health outcomes. This study aimed to assess HRQOL of Chinese patients with PNH, and identify key determinants. METHODS A cross-sectional study was conducted during 2022 to recruit patients with PNH in China. The study population was recruited from PNH China, one of the largest public welfare PNH patient mutual aid organization in China. Data were collected via an online questionnaire including the EQ-5D-5L (5L), and social-demographic and clinical characteristics. Descriptive statistics were employed to summarize the characteristics of the participants and their HRQOL. Multiple linear and logistic regression analyses were adopted to explore key factors affecting HRQOL. RESULTS A total of 329 valid questionnaires were collected. The mean (SD) age of the patients was 35.3 (10.0) years, with 52.3% of them being male. The patients reported more problems in Anxiety/Depression (81.5%) and Pain/Discomfort (69.9%) dimensions compared to the other three 5L dimensions. The mean (SD) of 5L health utility score (HUS) and EQ-VAS score were 0.76 (0.21) and 62.61 (19.20), respectively. According to multiple linear regression, initial symptoms (i.e., Anemia [fatigue, tachycardia, shortness of breath, headache] and back pain) and complication of thrombosis were significant influencing factors affecting 5L HUS. Total personal income of the past year, initial symptom of hemoglobinuria and complication of thrombosis were significantly influencing factors of VAS score. Social-demographic and clinical characteristics, such as gender, income, and thrombosis, were also found to be significantly related to certain 5L health problems as well. CONCLUSION Our study manifested the HRQOL of PNH patients in China was markedly compromised, especially in two mental-health related dimensions, and revealed several socio-demographic and clinical factors of their HRQOL. These findings could be used as empirical evidence for enhancing the HRQOL of PNH patients in China.
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Affiliation(s)
- Huaxin Yu
- School of Public Health, Dalian Medical University, Dalian, China
| | - Shengnan Duan
- School of Public Health, Dalian Medical University, Dalian, China
| | - Pei Wang
- School of Public Health, Fudan University, 130 Dong An Road, Shanghai, China
| | - Rong Fu
- Tianjin Medical University General Hospital, 154 Anshan Road, Tianjin, China
| | - Zixuan Lv
- School of Public Health, Dalian Medical University, Dalian, China
| | | | | | | | | | | | - Ni Yuan
- School of Public Health, Dalian Medical University, Dalian, China.
- Global Health Research Center, Dalian Medical University, 9 Lvshun South Road, Dalian, Liaoning, China.
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Derbyshire DW, Jeanes E, Khedmati Morasae E, Reh S, Rogers M. Employer-focused interventions targeting disability employment: A systematic review. Soc Sci Med 2024; 347:116742. [PMID: 38484455 DOI: 10.1016/j.socscimed.2024.116742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 02/20/2024] [Accepted: 02/29/2024] [Indexed: 04/20/2024]
Abstract
There are a wide range of interventions that are designed to influence employer behaviour with respect to the employment of people with disabilities. This study presents the results of a systematic review looking at employer-focused interventions to improve disability employment, focusing on interventions or policies taking placing in high-income countries as per the OECD. This systematic review focuses on a broad range of potential employment-related outcomes, including the employment rate, time to return to work and length of sickness absence. The results of 71 papers that evaluate the effectiveness of a range of interventions were synthesised into a narrative review. Interventions are grouped into six broad categories: anti-discrimination legislation, quota systems, part-time sick leave, graded return to work and wage subsidy schemes. Anti-discrimination legislation is not effective at improving the employment prospects of people with disabilities. There is mixed evidence with respect to quota systems and wage subsidy schemes. However, the availability of part time sick leave or graded return to work are both consistently associated with improved work participation for people with disabilities.
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Affiliation(s)
- Daniel W Derbyshire
- Department of Public Health and Sports Science, University of Exeter, Exeter, United Kingdom.
| | - Emma Jeanes
- Department of Management, University of Exeter, Exeter, United Kingdom
| | | | - Susan Reh
- Department of Management, University of Exeter, Exeter, United Kingdom
| | - Morwenna Rogers
- NIHR ARC South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
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Peolsson A, Nilsing Strid E, Peterson G. Novel Internet Support for Neck-Specific Rehabilitation Improves Work-Related Outcomes to the Same Extent as Extensive Visits to a Physiotherapy Clinic in Individuals with Chronic Whiplash-Associated Disorders: A Prospective Randomised Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10176-0. [PMID: 38526764 DOI: 10.1007/s10926-024-10176-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/03/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE To address the current lack of information about work-related factors for individuals with whiplash-associated disorders (WAD) we investigated the effectiveness of 3 months of neck-specific rehabilitation with internet support in combination with four physiotherapy visits (NSEIT) compared to the same exercises performed twice a week (24 times) at a physiotherapy clinic (NSE). METHODS This is a prospective, multicentre, randomised controlled trial regarding secondary outcomes of work-related factors in 140 individuals with chronic moderate/severe WAD with 3- and 15-month follow-up. RESULTS There were no group differences between NSE and NSEIT in the Work Ability Scale or work subscales of the Neck Disability Index, Whiplash Disability Questionnaire or Fear Avoidance Beliefs Questionnaire (FABQ-work). Both groups improved in all work-related outcome measures, except for FABQ-work after the 3-month intervention and results were maintained at the 15-month follow-up. CONCLUSIONS Despite fewer physiotherapy visits for the NSEIT group, there were no group differences between NSEIT and NSE, with improvements in most work-related measures maintained at the 15-month follow-up. The results of the present study are promising for those with remaining work ability problems after a whiplash injury. Protocol registered before data collection started: clinicaltrials.gov NCT03022812.
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Affiliation(s)
- Anneli Peolsson
- Occupational and Environmental Medicine Centre, Department of Health, Medicine and Caring Sciences, Unit of Clinical Medicine, Linköping University, 58185, Linköping, Sweden.
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden.
| | - Emma Nilsing Strid
- Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden
| | - Gunnel Peterson
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden
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Jetha A, Navaratnerajah L, Kondratowski S, Parmassar M, Tucker LB, Gignac MAM. Impact of employment and income support interventions on the health of young adults with episodic disability: Findings from a systematic review. Scand J Work Environ Health 2024; 50:122-128. [PMID: 38060325 PMCID: PMC10928491 DOI: 10.5271/sjweh.4133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVE Young adults living with episodic disabilities face unpredictable disruptions to their employment and health. Our study aimed to examine the impact of employment and income support interventions on the health and well-being of young adults living with episodic disabilities. METHODS We conducted a systematic review of peer-reviewed intervention studies published in 2001-2021 in industrialized contexts. Two independent reviewers screened titles, abstracts and full-texts. We undertook a narrative synthesis of eligible articles. RESULTS Our search yielded 15 269 published articles, of which only five studies were eligible for evidence synthesis. All articles were appraised as being of medium quality. Four interventions focused on young adults living with mental health conditions. Two were based in clinical settings; three were based in community-based settings. Each employment intervention exhibited improvements in health outcomes. Three studies examined the impact of supported employment interventions that were particularly beneficial to improving work and health outcomes. CONCLUSION Involvement in employment interventions could provide benefits for the health of young adults living with episodic disabilities. Our systematic review highlights the need for research to elaborate on the ways in which employment interventions can impact the health and well-being of young adults living with different episodic disabilities.
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Affiliation(s)
- Arif Jetha
- Institute for Work & Health, Suite 1800, 400 University Avenue, Toronto, ON, Canada M5G 1S5.
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Ahn SK, Seo HJ, Choi MJ. Trends and regional distribution in health-related quality of life across sex and employment status: a repeated population-based cross-sectional study. J Occup Health 2024; 66:uiae017. [PMID: 38604179 PMCID: PMC11131014 DOI: 10.1093/joccuh/uiae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/26/2024] [Accepted: 03/28/2024] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVES This study investigated the association between sex and health-related quality of life (HRQoL) based on employment status. METHODS This was a population-based cross-sectional study. Data were collected from 1 996 153 adults aged ≥19 years who participated in the Korea Community Health Survey from 2011 to 2019. Low HRQoL was classified based on separate cutoff points (males: 0.92, females: 0.90) on the European Quality of Life-5 Dimensions index. Multivariable logistic regression analyses were used to estimate odds ratios (ORs) and 95% CIs. RESULTS From 2011 to 2019, the trend of the prevalence of low HRQoL levels was consistently high in the order of unemployed males, unemployed females, employed males, and employed females. Regarding the regional distribution of unemployed males, the prevalence of low HRQoL was 29.5% to 43.5%. Unemployed males had a higher prevalence of low HRQoL (OR: 1.15; 95% CI: 1.12-1.24) than employed males. CONCLUSIONS This study suggests that the prevalence of low HRQoL levels among unemployed males was consistently high at the annual trend and regional levels. Further research considering comprehensive health determinants and multidimensional public health interventions is required to prevent deterioration of HRQoL during unemployment.
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Affiliation(s)
- Soon-Ki Ahn
- Department of Preventive Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-Gu, Daejeon 35015, Republic of Korea
| | - Hyun-Ju Seo
- College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-Gu, Daejeon 35015, Republic of Korea
| | - Min-Jung Choi
- College of Nursing, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea
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Majeed H, Baumann S, Majeed H. Understanding the association between county-level unemployment and health stratified by education and income in the southwestern United States. Sci Rep 2023; 13:21988. [PMID: 38081866 PMCID: PMC10713646 DOI: 10.1038/s41598-023-49088-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
Past research on the relationship between unemployment rates and population health has produced mixed findings. The relationship can be influenced by the kinds of health outcomes observed, time frame, level of geographic aggregation, and other factors. Given these mixed findings, there is a need to add to our knowledge about how unemployment rates and population health are related. There is limited research that examines the association of unemployment rates with both physical and mental health, while simultaneously stratifying populations by income and education levels. Using survey-based self-reported data, this first population-based study examined the association between unemployment rates and physically and mentally unhealthy days in the southwestern United States, by county-level stratification of income (high and low) as well as education (high and low), from 2015 to 2019. After controlling for covariates, associations were modelled using negative binomial regression, with autocorrelative residuals, and were reported as rate ratios (RR). Overall, we found that a 1% rise in unemployment rates was significantly associated with an increase in physically unhealthy days [adjusted RR 1.007; 95% CI, 1.004-1.011, P < 0.001] and mentally unhealthy days [RR 1.006; 95% CI, 1.003-1.009, P < 0.001]. Upon stratification, a significant risk was found among the high education and high income category [RR 1.035; 95% CI, 1.021-1.049, P < 0.001], as well as for the high education and low income category [RR 1.026; 95% CI, 1.013-1.040, P < 0.001]. A better understanding of how unemployment is associated with the health of communities with different education and income levels could help reduce the burden on society through tailored interventions and social policies not only in the United States, but also in other developed nations.
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Affiliation(s)
- Hamnah Majeed
- Department of Sociology, University of Toronto, Toronto, ON, M5S 2J4, Canada
| | - Shyon Baumann
- Department of Sociology, University of Toronto, Toronto, ON, M5S 2J4, Canada
| | - Haris Majeed
- Institute of Medical Science, University of Toronto, Toronto, ON, M5S 1A8, Canada.
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Wind K, Poland B, HakemZadeh F, Jackson S, Tomlinson G, Jadad A. Using self-reported health as a social determinants of health outcome: a scoping review of reviews. Health Promot Int 2023; 38:daad165. [PMID: 38041807 DOI: 10.1093/heapro/daad165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023] Open
Abstract
Reducing disease prevalence rather than promoting health has long been the objective of significant population health initiatives, such as the social determinants of health (SDH) framework. However, empirical evidence suggests that people with diagnosed diseases often answer the self-reported health (SRH) question positively. In pursuit of a better proxy to understand, measure and improve health, this scoping review of reviews examines the potential of SRH to be used as an outcome of interest in population health policies. Following PRISMA-ScR guidelines, it synthesizes findings from 77 review papers (published until 11 May 2022) and reports a robust association between SDH and SRH. It also investigates inconsistencies within and between reviews to reveal how variation in population health can be explained by studying the impact of contextual factors, such as cultural, social, economic and political elements, on structural determinants such as socioeconomic situation, gender and ethnicity. These insights provide informed hypotheses for deeper explorations of the role of SDH in improving SRH. The review detects several gaps in the literature. Notably, more evidence syntheses are required, in general, on the pathway from contextual elements to population SRH and, in particular, on the social determinants of adolescents' SRH. This study reports a disease-oriented mindset in collecting, analysing and reporting SRH across the included reviews. Future studies should utilize the capability of SRH in interconnecting social, psychological and biological dimensions of health to actualize its full potential as a central public health measure.
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Affiliation(s)
- Keiwan Wind
- DeGroote School of Business, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4M4, Canada
| | - Blake Poland
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, Ontario M5T 3M7, Canada
| | - Farimah HakemZadeh
- Faculty of Liberal Arts and Professional Studies, School of Human Resources Management, York University, 4700 Keele Street, Toronto, Ontario M3J 1P3, Canada
| | - Suzanne Jackson
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, Ontario M5T 3M7, Canada
| | - George Tomlinson
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, Ontario M5T 3M7, Canada
| | - Alejandro Jadad
- Centre for Digital Therapeutics, R. Fraser Elliott Building, 4th Floor, 190 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
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Ye L, Kavanagh A, Petrie D, Dickinson H, Aitken Z. Part-time versus full-time employment and mental health for people with and without disability. SSM Popul Health 2023; 23:101446. [PMID: 37334329 PMCID: PMC10275711 DOI: 10.1016/j.ssmph.2023.101446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/22/2023] [Accepted: 06/06/2023] [Indexed: 06/20/2023] Open
Abstract
Objectives This paper investigates the relationship between part-time and full-time employment and mental health for people with and without disability, as well as differences in the relationship by age and sex. Methods Using data from 13,219 working-aged people (15-64 years) in the labour force who participated in five annual waves of a longitudinal cohort study in Australia, the analysis used fixed effect regression models to examine within-person changes in mental health associated with changes in employment status (full-time; part-time; unemployed). Differences in the relationship between employment status and mental health by disability, sex, and age were assessed. Results Among people with disability, there was evidence that working part-time and full-time were associated with a 4.2-point (95% CI 2.6, 5.7) and 6.0-point (95% CI 4.4, 7.6) increase in mental health scores compared with when they were unemployed. For people without disability, there were much smaller differences in mental health associated with working part-time (β = 1.0, 95% CI 0.2, 1.9) and full-time (β = 1.4, 95% CI 0.5, 2.2) compared with when they were unemployed. The positive effects of both part-time and full-time employment were of greater magnitude for people with disability aged younger than 45 years compared to those aged 45 years and older. Conclusions The results of this study suggest that both part-time and full-time employment may have beneficial effects on the mental health of people with disability, particularly for younger people. The findings underscore the value of employment for people with disability, given we found much larger beneficial mental health effects in comparison to people without disability.
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Affiliation(s)
- Lu Ye
- Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Anne Kavanagh
- Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Dennis Petrie
- Centre for Health Economics, Monash Business School, Monash University, Caulfield East, Victoria, Australia
| | - Helen Dickinson
- Public Service Research Group, School of Business, UNSW Canberra, Canberra, ACT, Australia
| | - Zoe Aitken
- Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
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Koskinen C, Nyholm L, Thorkildsen KM, Haga BM, Wallgren GC, Kaldestad K. Health as a movement between suffering of life and meaning in life for men who have experienced transitions in life. Scand J Caring Sci 2023; 37:732-739. [PMID: 36855261 DOI: 10.1111/scs.13156] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/27/2023] [Accepted: 02/13/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND AND AIM Previous studies show that life transitions can have negative effects on men's lives and lead to health problems and meaninglessness in life. This study aims to deepen the understanding of men's health by exploring the movement between suffering of life and meaning in life when experienced life transitions. THEORETICAL FRAMEWORK The study is anchored in Eriksson's caritative caring theory. Core concepts are health and the movement between suffering of life and meaning in life. METHODOLOGY AND METHODS The methodology is hermeneutical, and the study has a qualitative research design. Fifteen men from Norway participated in in-depth interviews in 2021. The interviews were analysed using reflexive thematic analysis. RESULTS Four themes emerged in relation to the suffering of life; enduring separation from community, shame at being useless as a human being, grief over what has been lost in life, and being powerless and vulnerable in the face of a hopeless struggle. Three themes emerged in relation to meaning in life; realising what is most important in one's life gives strength, decision to live one's life brings joy in life and a positive attitude towards life gives freedom and awakens a new spark for life. CONCLUSION Suffering of life emerges as a separation from relationships and society and as a perceived uselessness as a human being losing faith, control and feeling like a burden erodes dignity and trigger feelings of shame, guilt and degradation. Suffering of life manifests as loss of drive and spark for life. Life has meaning through finding the good in oneself, coming to know and believe in oneself and seeing new possibilities which bring about a spark for life, gratitude, dignity and freedom. Health exists in the movement between suffering of life and meaning in life, in pausing, recognising vulnerability, prioritising and reorienting oneself.
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Affiliation(s)
- Camilla Koskinen
- Faculty of Health Sciences, Department of Caring and Ethics, University of Stavanger, Stavanger, Norway
| | - Linda Nyholm
- Faculty of Education and Welfare Studies, Department of Caring Science, Åbo Akademi University, Vasa, Finland
| | - Kari Marie Thorkildsen
- Faculty of Health and Social Sciences, Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Stord, Norway
| | - Britt Marit Haga
- Faculty of Health Sciences, Department of Public Health, University of Stavanger, Stavanger, Norway
| | - Gry Ciekals Wallgren
- Faculty of Health Sciences, Department of Caring and Ethics, University of Stavanger, Stavanger, Norway
| | - Kari Kaldestad
- Faculty of Health Sciences, Department of Caring and Ethics, University of Stavanger, Stavanger, Norway
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Godoy-Bermúdez A, Rojo-Gallego-Burin A, Delgado-Márquez L, Martín-Martín JJ, Sánchez-Martínez MT, López del Amo-González MP. Variation in perceived health across gender, working status, educational level, and regional health care expenditure in Spain (2014-2017). PLoS One 2023; 18:e0269613. [PMID: 37450459 PMCID: PMC10348579 DOI: 10.1371/journal.pone.0269613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
A gender perspective was used to analyze whether and how education, unemployment, and per capita public health expenditure were associated with perceived health among the Spanish population between the years 2014 and 2017. Using multilevel methodologies (looking at year, individual, and region) and linear and logistic specifications, we analyzed longitudinal microdata files from the Survey on Living Conditions. The results suggest that women with lower educational levels tend to report worse health than their more educated counterparts. On the other hand, women's bad health was not associated with unemployment, unlike men's. Regional per capita public health expenditure was not associated with perceived health in either men or women.
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12
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Barbuscia A, Pailhé A, Solaz A. Do Income and Employment Uncertainty Affect Couple Stability? Evidence for France During the COVID-19 Pandemic. EUROPEAN JOURNAL OF POPULATION = REVUE EUROPEENNE DE DEMOGRAPHIE 2023; 39:19. [PMID: 37395827 PMCID: PMC10317946 DOI: 10.1007/s10680-023-09665-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 04/23/2023] [Indexed: 07/04/2023]
Abstract
Economic uncertainty and family dynamics are strictly connected. The increasing uncertainty generated by the Covid-19 pandemic is thus likely to affect couple relationships and stability, with potential opposite effects. Using data from the nationally representative EPICOV survey, that followed individuals throughout the first year of pandemic in France, we examined separation rates and how these were associated with different measures of employment and income uncertainty, including both pre-pandemic conditions and changes occurred during and after the first lockdown in Spring 2020 in France. Our results show increased rates of separation, especially among younger people, during the 6 months after the first lockdown, and a return to rates more similar to those observed in usual times, afterwards. Individuals who were unemployed and had lower income before the beginning of the pandemic were more likely to separate soon after the lockdown, while changes in employment conditions due to the lockdown were not linked with a higher separation risk. The job protection and the income compensation provided by the French state, as well a less stigmatising effect of unemployment occurred during the covid crisis, may explain the absence of effect. Self-declared deterioration in financial condition, especially when declared by men, was associated with higher separation risk for the whole year of observation.
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Affiliation(s)
| | - Ariane Pailhé
- Institut national d'études démographiques (INED), Aubervilliers, France
| | - Anne Solaz
- Institut national d'études démographiques (INED), Aubervilliers, France
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Connell C, Birken M, Carver H, Brown T, Greenhalgh J. Effectiveness of interventions to improve employment for people released from prison: systematic review and meta-analysis. HEALTH & JUSTICE 2023; 11:17. [PMID: 36914913 PMCID: PMC10010959 DOI: 10.1186/s40352-023-00217-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND People released from prison experience complex health challenges in addition to challenges resettling into the community. Consequently, employment rates are low. Participating in good quality employment can support good health and is protective against future reoffending. Multiple interventions are provided to support people into employment on release. The effectiveness of interventions for improving employment outcomes has not previously been evaluated in a meta-analysis. AIM Our objective was to examine the effectiveness of interventions to improve employment following release from prison. METHOD We searched seven databases and three trial registries for peer reviewed randomised controlled trials (RCTs), published since 2010, that included adults and measured an employment outcome(s). We conducted meta-analysis using random effects models with sub-group and sensitivity analyses. We appraised bias risk per outcome, and incorporated this into an assessment of the certainty estimates for each outcome. A group of people with experience of imprisonment met with us throughout the project to inform our search strategy and interpretation of results. RESULTS We included 12 RCTs (2,875 participants) which were all conducted in the USA. Few outcomes were of low risk of bias. Intervention participants were 2.5 times more likely to work at least one day (95% CI:1.82-3.43) and worked more days over 12 months (MD = 59.07, 95% CI:15.83-102.32) compared to controls. There was no effect on average employment status or employment at study end. There is moderate certainty in these estimates. CONCLUSION Interventions can improve some employment outcomes for people released from prison. More evidence is required to establish effective interventions for sustaining quality employment, particularly outside the USA, and which consider outcomes for different groups of people released, such as women or those with health or substance use needs.
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Affiliation(s)
- Catriona Connell
- Salvation Army Centre for Addiction Services and Research, University of Stirling, Stirling, UK.
| | - Mary Birken
- Division of Psychiatry, University College London, London, UK
| | - Hannah Carver
- Salvation Army Centre for Addiction Services and Research, University of Stirling, Stirling, UK
| | - Tamara Brown
- Salvation Army Centre for Addiction Services and Research, University of Stirling, Stirling, UK
- Leeds Beckett University, Leeds, UK
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Amundsen PA, Underwood M, Burton K, Grotle M, Malmberg-Heimonen I, Kisa A, Småstuen MC, Holmgard TE, Martinsen A, Lothe J, Irgens PMS, Højen M, Monsen SS, Froud R. Individual supported work placements (ReISE) for improving sustained return to work in unemployed people with persistent pain: study protocol for a cohort randomised controlled trial with embedded economic and process evaluations. Trials 2023; 24:179. [PMID: 36906593 PMCID: PMC10006572 DOI: 10.1186/s13063-023-07211-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/01/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Around one-third of workdays lost in Norway are due to musculoskeletal conditions, with persistent (chronic) pain being the most frequent cause of sick leave and work disability. Increasing work participation for people with persistent pain improves their health, quality of life, and well-being and reduces poverty; however, it is not clear how to best help unemployed people who have persistent pain to return to work. The aim of this study is to examine if a matched work placement intervention featuring case manager support and work-focused healthcare improves return to work rates and quality of life for unemployed people in Norway with persistent pain who want to work. METHODS We will use a cohort randomised controlled approach to test the effectiveness and cost-effectiveness of a matched work placement intervention featuring case manager support and work-focused healthcare compared to those receiving usual care in the cohort alone. We will recruit people aged 18-64, who have been out of work for at least 1 month, had pain for more than 3 months, and want to work. Initially, all (n = 228) will be recruited to an observational cohort study on the impact of being unemployed with persistent pain. We will then randomly select one in three to be offered the intervention. The primary outcome of sustained return to work will be measured using registry and self-reported data, while secondary outcomes include self-reported levels of health-related quality of life and physical and mental health. Outcomes will be measured at baseline and 3, 6, and 12 months post-randomisation. We will run a process evaluation parallel to the intervention exploring implementation, continuity of the intervention, reasons for participating, declining participation, and mechanisms behind cases of sustained return to work. An economic evaluation of the trial process will also be conducted. DISCUSSION The ReISE intervention is designed to increase work participation for people with persistent pain. The intervention has the potential to improve work ability by collaboratively navigating obstacles to working. If successful, the intervention may be a viable option for helping people in this population. TRIAL REGISTRATION ISRCTN Registry 85,437,524 Registered on 30 March 2022.
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Affiliation(s)
- Pål André Amundsen
- School of Health Sciences, Kristiana University College, PB 1190, Sentrum, 0107, Oslo, Norway.
| | - Martin Underwood
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Kim Burton
- Professor of Occupational Healthcare, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
| | - Margreth Grotle
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
| | - Ira Malmberg-Heimonen
- Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
| | - Adnan Kisa
- School of Health Sciences, Kristiana University College, PB 1190, Sentrum, 0107, Oslo, Norway
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Science, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
| | - Thor Einar Holmgard
- User representative from the Norwegian Back Pain Association, Fjellhagen, P.O. Box 9612, 3065, Drammen, Norway
| | - Amy Martinsen
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo University Hospital, Ullevål, Building 37B, P.O. Box 4956 Nydalen, 0424, Oslo, Norway
| | - Jakob Lothe
- Co/FORMI, The Norwegian Council for Musculoskeletal Health, Oslo Universitetssykehus, Nydalen, P.O. Box 4956, 0424, Oslo, Norway
| | | | - Magnus Højen
- School of Health Sciences, Kristiana University College, PB 1190, Sentrum, 0107, Oslo, Norway
| | | | - Robert Froud
- School of Health Sciences, Kristiana University College, PB 1190, Sentrum, 0107, Oslo, Norway.,Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
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15
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Kellogg AJ, Hancock DW, Cho GY, Reid AE. Reprint of: Community-level age bias and older adult mortality. Soc Sci Med 2023; 320:115699. [PMID: 36739253 DOI: 10.1016/j.socscimed.2023.115699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/30/2022] [Accepted: 10/08/2022] [Indexed: 01/31/2023]
Abstract
RATIONALE As the older adult population increases, understanding the health effects of bias against older adults is increasingly important. Whether structural forms of age bias predict worse health has received limited attention. OBJECTIVE We hypothesized that communities with greater age bias would have higher mortality among residents aged 65 and older. We expected the association to be unique to age bias, rather than general bias (i.e., sexual minority and racial bias), and that the age bias-mortality association would be strongest in predominantly White and younger communities. METHODS Explicit and implicit attitudes toward older adults (N = 1,001,735), sexual minorities (N = 791,966), and Black Americans (N = 2,255,808) were drawn from Project Implicit. Post-stratification relative to U.S. Census demographics was executed to improve the representativeness of county-level explicit and implicit bias estimates. County older adult mortality, estimated cross-sectionally with and longitudinally relative to bias scores, served as outcomes. Models controlled for relevant county-level covariates (e.g., median age) and included all U.S. counties (N = 3142). RESULTS Contrary to hypotheses but consistent with prior work, explicit age bias was cross-sectionally and longitudinally associated with lower mortality, over and above covariates and generalized community bias. The explicit age bias-lower mortality association only emerged in younger counties but did not depend on county ethnic composition. Implicit age bias was unassociated with outcomes. Post-hoc analyses supported that ageist communities may be associated with better health across the lifespan. Explicit age bias predicted lower mortality in young and middle adulthood; better mental health in middle adulthood, but not exercise or self-rated health, mediated the explicit age bias-older adult mortality association. CONCLUSIONS Results highlight the uniqueness of older age relative to other stigmatized identities. Further examination of the association of community-level age bias with better health may improve longevity for all communities.
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Affiliation(s)
- Alexander J Kellogg
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA
| | - David W Hancock
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA
| | - Grace Y Cho
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA
| | - Allecia E Reid
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA.
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Collett J, Brusco N, Cordell N, Cockroft A, Lawrie S, Coe S, Reed A, Dawes H. Lost employment potential and supporting people with Parkinson's to stay in work: insights from a Pan European cross-sectional survey. Disabil Rehabil 2023; 45:832-839. [PMID: 35249423 DOI: 10.1080/09638288.2022.2043460] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To explore, in a European cohort of people living with Parkinson's (PD), issues affecting employment and economic consequences, considering age at diagnosis. MATERIALS AND METHODS A cross-sectional survey (European convenience sample). Inclusion criteria were ≥18 years, a PD diagnosis and in work when diagnosed. Data were collected online on demographics, employment status, occupation, and perceived health. For those no longer in paid work, time from diagnosis until loss of employment, reasons for leaving and enablers to stay in work were ascertained. RESULTS Between April and November 2019, n = 692 enrolled and n = 560 were eligible. Those who had lost paid work (n = 190, 34%) reported worse fatigue, sleep, and general health than those still in work (p < 0.05). Average annual income reduced from €26973.48 ± 12013.22 (year-1) to €14843.85 ± 16969.84 (year-10). Post-diagnosis lost employment potential was 20.1 (95% confidence interval (CI): 16.6-23.6) years at career establishment, 9.8 (95%CI: 8.9-10.7) years at mid working and 1.2 (95%CI: 0.6-1.6) years for those nearing retirement age. A greater proportion of individuals at career establishment age reported dexterity, eating, sleep, fatigue, and anxiety as factors for leaving work (p < 0.05). CONCLUSIONS This study confirms lost productivity after a PD diagnosis, especially in those with many years of potential employment ahead. The study also identified potential targets for interventions. Clinical trial registration: Clincaltrials.gov (NCT03905954).Implications for rehabilitationPeople with Parkinson's diagnosed at career establishment or at mid working age risk losing many years of potential employment.Most people with Parkinson's do not receive early intervention to support self-management of problems identified with leaving work early, such as fatigue.Adaptations to the work environment and more flexible working patterns were identified factors that may help people remain in work.
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Affiliation(s)
- Johnny Collett
- Faculty of Health and Life Sciences, Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
| | - Natasha Brusco
- School of Primary and Allied Health Care, Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Australia
| | - Nikki Cordell
- Faculty of Health and Life Sciences, Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
- Cordell Health Ltd, Wokingham, UK
| | - Annette Cockroft
- Faculty of Health and Life Sciences, Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
- Buckinghamshire Healthcare NHS Trust, Amersham, UK
| | - Sophie Lawrie
- Faculty of Health and Life Sciences, Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
| | - Shelly Coe
- Faculty of Health and Life Sciences, Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
- Faculty of Health and Life Sciences, Oxford Brookes Centre for Nutrition and Health, Oxford Brookes University, Oxford, UK
| | - Alex Reed
- European Parkinsons Therapy Centre, Brescia, Italy
| | - Helen Dawes
- Faculty of Health and Life Sciences, Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
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17
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Li K, Lorgelly P, Jasim S, Morris T, Gomes M. Does a working day keep the doctor away? A critical review of the impact of unemployment and job insecurity on health and social care utilisation. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:179-186. [PMID: 35522390 PMCID: PMC9985560 DOI: 10.1007/s10198-022-01468-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
While the negative impact of unemployment on health is relatively well established, the extent to which that impact reflects on changes in health and social care utilisation is not well understood. This paper critically reviews the direction, magnitude and drivers of the impact of unemployment and job insecurity on health and social care utilisation across different care settings. We identified 28 relevant studies, which included 79 estimates of association between unemployment/job insecurity and healthcare utilisation. Positive associations dominated mental health services (N = 8 out of 11), but not necessarily primary care (N = 25 out of 43) or hospital care (N = 5 out of 22). We conducted a meta-analysis to summarise the magnitude of the impact and found that unemployed individuals were about 30% more likely to use health services compared to those employed, although this was largely driven by mental health service use. Key driving factors included financial pressure, health insurance, social network, disposable time and depression/anxiety. This review suggests that unemployment is likely to be associated with increased mental health service use, but there is considerable uncertainty around primary and hospital care utilisation. Future work to examine the impact across other settings, including community and social care, and further explore non-health determinants of utilisation is needed. The protocol was registered in PROSPERO (CRD42020177668).
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Affiliation(s)
- Keyi Li
- Department of Applied Health Research, Institute of Epidemiology and Health Care, University College London, London, UK.
| | - Paula Lorgelly
- Department of Applied Health Research, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Sarah Jasim
- Department of Applied Health Research, Institute of Epidemiology and Health Care, University College London, London, UK
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Tiyi Morris
- Department of Applied Health Research, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Manuel Gomes
- Department of Applied Health Research, Institute of Epidemiology and Health Care, University College London, London, UK
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18
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Bernt Jørgensen SM, Gerds TA, Johnsen NF, Gislason G, El-Chouli M, Brøndum S, Maribo T, Kristiansen M. Diagnostic group differences in return to work and subsequent detachment from employment following cardiovascular disease: a nationwide cohort study. Eur J Prev Cardiol 2023; 30:182-190. [PMID: 36316291 DOI: 10.1093/eurjpc/zwac249] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/14/2022] [Accepted: 10/26/2022] [Indexed: 01/27/2023]
Abstract
AIMS Return to work and employment maintenance following cardiovascular disease (CVD) are important rehabilitation goals for people of working age. To identify people in particular need of vocational rehabilitation, we examined differences in return to work and subsequent detachment from employment among people with atrial fibrillation (AF), heart failure (HF), heart valve disease, and ischaemic heart disease. METHODS AND RESULTS We conducted a nationwide cohort study and included all individuals of working age (35-65 years) who were employed when diagnosed with incident CVD in 2018. We estimated sex- and age-standardized probabilities of remaining employed at 3, 6, and 12 months after diagnosis, and of detachment from employment within 6 months after having returned to work. Of 46 912 individuals diagnosed in 2018, 8187 were of working age and employed at diagnosis. The mean age was 54.7 years (SD = 6.7), and 74.0% were men. Within 1 year, 89.8% had returned to work, but within the subsequent 6 months, 23.5% of these experienced detachment from employment. At 3, 6, and 12 months after diagnosis the highest standardized probability of being employed was found among people with AF, whereas the lowest probability was found among people with HF {78.9% [95% confidence interval (CI): 77.3-80.4] vs. 62.2% [95% CI: 59.0-65.4] at 12 months}. Similarly, the highest probability of detachment was found for people with HF [30.3% (95% CI: 26.9-33.7)]. CONCLUSION People with HF present the highest probability of not returning to work. There is a need for developing and documenting effects of vocational rehabilitation strategies within comprehensive cardiac rehabilitation programmes.
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Affiliation(s)
- Sidsel Marie Bernt Jørgensen
- The Danish Heart Foundation, Section of Cardiovascular Research, Vognmagergade 7, 3rd Floor, 1120 Copenhagen K, Denmark
- Department of Public Health & Center for Healthy Aging, Øster Farimagsgade 5, 1353 Copenhagen K, Denmark
| | - Thomas Alexander Gerds
- The Danish Heart Foundation, Section of Cardiovascular Research, Vognmagergade 7, 3rd Floor, 1120 Copenhagen K, Denmark
- Department of Public Health, Øster Farimagsgade 5, 1353 Copenhagen K, Denmark
| | - Nina Føns Johnsen
- The Danish Heart Foundation, Section of Cardiovascular Research, Vognmagergade 7, 3rd Floor, 1120 Copenhagen K, Denmark
| | - Gunnar Gislason
- The Danish Heart Foundation, Section of Cardiovascular Research, Vognmagergade 7, 3rd Floor, 1120 Copenhagen K, Denmark
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark
| | - Mohamad El-Chouli
- The Danish Heart Foundation, Section of Cardiovascular Research, Vognmagergade 7, 3rd Floor, 1120 Copenhagen K, Denmark
| | - Stig Brøndum
- The Danish Heart Foundation, Section of Cardiovascular Research, Vognmagergade 7, 3rd Floor, 1120 Copenhagen K, Denmark
| | - Thomas Maribo
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark
- DEFACTUM, Central Denmark Region, P. P. Ørums Gade 11, 8000 Aarhus C, Denmark
| | - Maria Kristiansen
- Department of Public Health & Center for Healthy Aging, Øster Farimagsgade 5, 1353 Copenhagen K, Denmark
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Wulandari RD, Laksono AD, Mubasyiroh R, Rachmalina R, Ipa M, Rohmah N. Hospital utilization among urban poor in Indonesia in 2018: is government-run insurance effective? BMC Public Health 2023; 23:92. [PMID: 36635640 PMCID: PMC9835297 DOI: 10.1186/s12889-023-15017-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/10/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND An urban poor is a vulnerable group that needs government financing support to access health services. Once they are sick, they will fall deeper into poverty. The study aims to analyze the effectiveness of government-run insurance in hospital utilization in urban poor in Indonesia. METHODS The research analyzed the 2018 Indonesian Basic Health Survey data. This cross-sectional survey collected 75,970 participants through stratification and multistage random sampling. Meanwhile, the study employed hospital utilization as an outcome variable and health insurance ownership as an exposure variable. Moreover, the study looked at age, gender, marital status, education, and occupation as control factors. The research employed a binary logistic regression to evaluate the data in the final step. RESULTS The results show that someone with government-run insurance is 4.261 times more likely than the uninsured to utilize the hospital (95% CI 4.238-4.285). Someone with private-run insurance is 4.866 times more likely than the uninsured to use the hospital (95% CI 4.802-4.931). Moreover, someone with government-run and private-run insurance has 11.974 times more likely than the uninsured to utilize the hospital (95% CI 11.752-12.200). CONCLUSION The study concluded that government-run insurance is more effective than the uninsured in improving hospital utilization among the urban poor in Indonesia. Meanwhile, private-run is more effective than government-run and uninsured in improving hospital utilization among the urban poor in Indonesia. Moreover, the most effective is to combine the kind of health insurance ownership (government-run and private-run).
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Affiliation(s)
- Ratna Dwi Wulandari
- grid.440745.60000 0001 0152 762XFaculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Agung Dwi Laksono
- National Research and Innovation Agency, the Republic of Indonesia, Jakarta, Indonesia
| | - Rofingatul Mubasyiroh
- National Research and Innovation Agency, the Republic of Indonesia, Jakarta, Indonesia
| | - Rika Rachmalina
- National Research and Innovation Agency, the Republic of Indonesia, Jakarta, Indonesia
| | - Mara Ipa
- National Research and Innovation Agency, the Republic of Indonesia, Jakarta, Indonesia
| | - Nikmatur Rohmah
- grid.443500.60000 0001 0556 8488Faculty of Health Science, Muhammadiyah University of Jember, East Java, Indonesia
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20
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Kellogg AJ, Hancock DW, Cho GY, Reid AE. Community-level age bias and older adult mortality. Soc Sci Med 2023; 317:115449. [PMID: 36494219 DOI: 10.1016/j.socscimed.2022.115449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/30/2022] [Accepted: 10/08/2022] [Indexed: 11/22/2022]
Abstract
RATIONALE As the older adult population increases, understanding the health effects of bias against older adults is increasingly important. Whether structural forms of age bias predict worse health has received limited attention. OBJECTIVE We hypothesized that communities with greater age bias would have higher mortality among residents aged 65 and older. We expected the association to be unique to age bias, rather than general bias (i.e., sexual minority and racial bias), and that the age bias-mortality association would be strongest in predominantly White and younger communities. METHODS Explicit and implicit attitudes toward older adults (N = 1,001,735), sexual minorities (N = 791,966), and Black Americans (N = 2,255,808) were drawn from Project Implicit. Post-stratification relative to U.S. Census demographics was executed to improve the representativeness of county-level explicit and implicit bias estimates. County older adult mortality, estimated cross-sectionally with and longitudinally relative to bias scores, served as outcomes. Models controlled for relevant county-level covariates (e.g., median age) and included all U.S. counties (N = 3142). RESULTS Contrary to hypotheses but consistent with prior work, explicit age bias was cross-sectionally and longitudinally associated with lower mortality, over and above covariates and generalized community bias. The explicit age bias-lower mortality association only emerged in younger counties but did not depend on county ethnic composition. Implicit age bias was unassociated with outcomes. Post-hoc analyses supported that ageist communities may be associated with better health across the lifespan. Explicit age bias predicted lower mortality in young and middle adulthood; better mental health in middle adulthood, but not exercise or self-rated health, mediated the explicit age bias-older adult mortality association. CONCLUSIONS Results highlight the uniqueness of older age relative to other stigmatized identities. Further examination of the association of community-level age bias with better health may improve longevity for all communities.
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Affiliation(s)
- Alexander J Kellogg
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA
| | - David W Hancock
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA
| | - Grace Y Cho
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA
| | - Allecia E Reid
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA.
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21
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Samper-Pardo M, León-Herrera S, Oliván-Blázquez B, Gascón-Santos S, Sánchez-Recio R. Clinical characterization and factors associated with quality of life in Long COVID patients: Secondary data analysis from a randomized clinical trial. PLoS One 2023; 18:e0278728. [PMID: 37192203 DOI: 10.1371/journal.pone.0278728] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 04/29/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Long COVID patients suffer a negative impact on their quality of life, as well as their functioning, productivity or socialization. There is a need to better understand the individual experience and circumstances surrounding these patients. OBJECTIVE To characterize clinical picture of Long COVID patients and to identify factors associated with quality of life. METHODS A secondary data analysis from a randomized clinical trial (RCT) was carried out with 100 Long COVID patients treated by Primary Health Care and residents in the territory of Aragon (northeast of Spain). The main variable of the study was quality of life, evaluated using the SF-36 Questionnaire, in relation to socio-demographic and clinical variables. In addition, ten validated scales were used that contemplated their cognitive, affective, functional and social status, as well as personal constructs. Correlation statistics and linear regression model were calculated. RESULTS Long COVID patients suffer a decrease in their levels of physical and mental health. On the one hand, the higher number of persistent symptoms (b = -0.900, p = 0.008), worse physical functioning (b = 1.587, p = 0.002) and sleep quality (b = -0.538, p = 0.035) are predictors of worse quality of life, physical subscale. On the other hand, higher educational level (b = 13.167, p = 0.017), lower number of persistent symptoms (b = -0.621, p = 0.057) and higher affective affectation (b = -1.402, p<0.001) are predictors of worse quality of life, mental subscale. CONCLUSION It is necessary to design rehabilitation programs that consider both the physical and mental health of these patients, thus obtaining an improvement in their quality of life.
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Affiliation(s)
| | - Sandra León-Herrera
- Institute for Health Research Aragon (IISAragon), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Bárbara Oliván-Blázquez
- Institute for Health Research Aragon (IISAragon), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
| | - Santiago Gascón-Santos
- Institute for Health Research Aragon (IISAragon), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Raquel Sánchez-Recio
- Institute for Health Research Aragon (IISAragon), Zaragoza, Spain
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
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22
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Heggebø K. Gendered health consequences of unemployment in Norway 2000-2017: a register-based study of hospital admissions, health-related benefit utilisation, and mortality. BMC Public Health 2022; 22:2447. [PMID: 36577971 PMCID: PMC9795737 DOI: 10.1186/s12889-022-14899-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The existing literature indicates that unemployment leads to deteriorated mental and somatic health, poorer self-assessed health, and higher mortality. However, it is not clear whether and to what extent the health consequences of unemployment differ between men and women. According to social role theory, women can alternate between several roles (mother, wife, friend, etc.) that make it easier to deal with unemployment, whereas the worker role is more important for men, and unemployment could therefore be more harmful to them. Thus, gender differences in the health consequences of unemployment should decrease as society grows more gender equal. Accordingly, this study examines changes over time in the gendered health consequences of unemployment in Norway. METHODS: Linked Norwegian administrative register data, covering the period from 2000 to 2017, were analysed by means of linear probability models and logistic regression. Four health outcomes were investigated: hospitalisation, receiving sick pay, disability benefit utilisation, and the likelihood of mortality. Two statistical models were estimated: adjusted for (1) age, and (2) additional sociodemographic covariates. All analyses were run split by gender. Three different unemployment cohorts (2000, 2006, and 2011) that experienced similar economic conditions were followed longitudinally until 2017. RESULTS The empirical findings show, first, that hospital admission is somewhat more common among unemployed males than among unemployed females. Second, receiving sick pay is much more common post-unemployment for men than for women. Third, excess mortality is higher among unemployed males than among unemployed females. Fourth, there is no gender component in disability benefit utilisation. There is a remarkable pattern of similarity when comparing the results for the three different unemployment cohorts (2000; 2006; 2011). Thus, the gendered health consequences of unemployment have hardly changed since the turn of the century. CONCLUSION This paper demonstrates that the health consequences of unemployment are serious, gendered, and enduring in Norway.
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Affiliation(s)
- Kristian Heggebø
- grid.412414.60000 0000 9151 4445NOVA, OsloMet, Oslo Metropolitan University, Oslo, Norway ,grid.5947.f0000 0001 1516 2393CHAIN, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
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Minh A, McLeod CB, Reijneveld SA, Veldman K, van Zon SK, Bültmann U. The role of low educational attainment on the pathway from adolescent internalizing and externalizing problems to early adult labour market disconnection in the Dutch TRAILS cohort. SSM Popul Health 2022; 21:101300. [PMID: 36647514 PMCID: PMC9840178 DOI: 10.1016/j.ssmph.2022.101300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/25/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
Mental health challenges in adolescence may affect labour market transitions in young adulthood. Policies addressing early labour market disconnection largely focus on early school-leaving and educational attainment; however, the role of low educational attainment on the path from adolescent mental health to labour market disconnection is unclear. Using the TRacking Adolescents' Individual Lives Survey from the Netherlands (n = 1,197), we examined the extent to which achieving a basic educational qualification (by age 22) in the contemporary Dutch education system, mediates the effect of adolescent mental health (age 11-19) on early adult labour market disconnection, defined as 'not in education, employment, or training' (NEET, age 26). We estimated the total effect, the natural direct and indirect effects, and the controlled direct effects of internalizing and externalizing symptoms on NEET by gender. Among young men, clinical levels of adolescent externalizing symptoms were associated with a 0.093 higher probability of NEET compared with no symptoms (95% confidence interval, CI: 0.001, 0.440). The indirect effect through educational attainment accounted for 15.1% of the total effect. No evidence of mediation was observed for the relationship between externalizing symptoms and NEET in young women. No evidence of mediation was observed for the relationship between adolescent internalizing symptoms and NEET in either gender. The findings imply that adolescent externalizing symptoms disrupts the achievement of a basic educational qualification, leading to a higher probability of NEET in young men. This mechanism may play a smaller role in the risk of NEET associated with internalizing symptoms and in young women.
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Affiliation(s)
- Anita Minh
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, Netherlands
- Corresponding author. School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC, V6T 1Z9, Canada.
| | - Christopher B. McLeod
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Institute for Work & Health, Toronto, Ontario, Canada
| | - Sijmen A. Reijneveld
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, Netherlands
| | - Karin Veldman
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, Netherlands
| | - Sander K.R. van Zon
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, Netherlands
| | - Ute Bültmann
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, Netherlands
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Offenberg LK, Sommer ST, Schmidt M, Kasten S, Bockheim F, Gavrilov B, Hunzelar C, Ikar N, Oberholz MPS, Paños-Willuhn JL, Weltermann B. Higher chronic stress and less satisfaction with GP communication in migrants with unemployment experience: data from the representative German DEGS1 and the GPCare-1 study. BMC PRIMARY CARE 2022; 23:89. [PMID: 35443617 PMCID: PMC9020157 DOI: 10.1186/s12875-022-01691-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 04/04/2022] [Indexed: 11/12/2022]
Abstract
Background The impact of unemployment on health is well studied. However, information on associations of unemployment, migration background and general practitioner-patient communication is scarce. Methods Data from the representative German Health Interview and Examination Survey for Adults (DEGS1) of individuals in working age (n = 5938) were analysed stratified by unemployment and migration background. Using official weighting factors, the prevalence of chronic stress, having ≥1 chronic disease, having a GP and GP visits in the last 12 months was determined. Multivariate regression models were analysed for associations between unemployment, migration background, and other socio-demographic characteristics with GP visits and chronic stress. Data from the General Practice Care-1 (GPCare-1) study (n = 813 patients) were analysed for differences in patient-physician communication between unemployed with and without migration background. Reverse proportional odds models were estimated for associations of unemployment and migration background with physician-patient communication. Results In the DEGS1, 21.5% had experienced unemployment (n = 1170). Of these, 31.6% had a migration background (n = 248). Compared to unemployed natives, unemployed with migration background had higher chronic stress (mean: 14.32 vs. 13.13, p = 0.02), while the prevalence of chronic disease was lower (21.7% vs. 30.2%, p = 0.03). They were less likely to have a GP (83.6% vs. 90%, p = 0.02), while GP visits were similar (mean: 3.7 vs. 3.3, p = 0.26). Migration background and unemployment experience were not associated with GP visits, while both factors were significantly associated with higher chronic stress (both: p < 0.01). In GPCare-1, 28.8% had ever experienced unemployment (n = 215). Of these, 60 had a migration background (28.6%). The unemployed with migration background reported less frequently that the GP gives them enough space to describe personal strains (46.5% vs. 58.2%; p = 0.03), and that their problems are taken very seriously by their GP (50.8% vs. 73.8%; p = 0.04). In multivariate analyses, migration background showed a lower probability of having enough space to describe personal strains and feeling that problems were taken very seriously. Conclusion Unemployment experience and migration background were associated with higher chronic stress. Only migration background was associated with less satisfaction regarding physician-patient communication.
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Instrumental variables in structural equation modelling: an application on the impact of labour factors on health and standard of livings. STAT METHOD APPL-GER 2022. [DOI: 10.1007/s10260-022-00663-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Mangot-Sala L, Smidt N, Liefbroer AC. Disentangling the association between alcohol consumption and employment status: causation, selection or confounding? Eur J Public Health 2022; 32:926-932. [PMID: 36215662 DOI: 10.1093/eurpub/ckac141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Alcohol use constitutes a major health risk and is related to unemployment. However, the direction of this relationship is unclear: unemployment may change drinking patterns (causation), but heavy drinkers may also be more prone to lose their job (selection). We simultaneously examined selection and causation, and assessed the role of residual confounding. Moreover, we paid attention to the subgroup of abstainers and occupationally disabled, often disregarded in the literature. METHODS Longitudinal data (three waves collected between 2006 and 2018) of the Lifelines Cohort study from the Netherlands were used (138 875 observations of 55 415 individuals, aged 18-60 at baseline). Alcohol use was categorized as 'abstaining', 'moderate drinking' and 'binge drinking' (≥5 drinks/occasion for male; ≥4 for women). Employment status included occupational disability, short (<6 months) and long-term (≥6 months) unemployment. Random- and fixed-effects multinomial regression models were fitted in order to account for residual confounding. Reciprocal causality was assessed through generalized structural equation modelling with fixed-effects. RESULTS Long unemployment spells increase the risk for both binge drinking (β = 0.23; 95% CI 0.04-0.42) and abstinence (β = 0.27; 95% CI 0.11-0.44), and the effects hold after accounting for reciprocal causality and time-constant confounding. Contrarily, the effect of binge drinking on unemployment is weak (β = 0.14; 95% CI -0.03 to 0.31). Abstinence is strongly associated with occupational disability (β = 0.40; 95% CI 0.24-0.57). CONCLUSIONS We find evidence supporting the causation hypothesis (unemployment altering drinking patterns), whereas evidence for the selection hypothesis is weak and mostly confounded by unobserved variables, such as poor health prior to baseline.
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Affiliation(s)
- Lluís Mangot-Sala
- Netherlands Interdisciplinary Demographic Institute (NIDI)-Royal Netherlands Academy of Sciences (KNAW), The Hague, The Netherlands.,Department of Epidemiology, Faculty of Medical Sciences, University Medical Center Groningen (UMCG), University of Groningen (RUG), Groningen, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, Faculty of Medical Sciences, University Medical Center Groningen (UMCG), University of Groningen (RUG), Groningen, The Netherlands
| | - Aart C Liefbroer
- Netherlands Interdisciplinary Demographic Institute (NIDI)-Royal Netherlands Academy of Sciences (KNAW), The Hague, The Netherlands.,Department of Epidemiology, Faculty of Medical Sciences, University Medical Center Groningen (UMCG), University of Groningen (RUG), Groningen, The Netherlands.,Department of Sociology, Vrije University of Amsterdam (VU), Amsterdam, The Netherlands
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Frech A, Damaske S, Ohler A. The Life Course of Unemployment and Midlife Health. J Aging Health 2022; 34:1081-1091. [PMID: 35521702 PMCID: PMC9578554 DOI: 10.1177/08982643221091775] [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: 11/16/2022]
Abstract
Objectives: We estimate associations between unemployment trajectories from ages 27-49 and physical and mental health at age 50. Methods: Data are from the U.S. National Longitudinal Survey of Youth, 1979 (N=6434). Group-based trajectory models are used to identify unemployment trajectories. Generalized linear models with a modified Bolck, Croon, and Hagenaars (BCH) correction are used to regress health on unemployment trajectory groups. Results: We identified "Consistently Low (70%)," "Decreasing Mid-Career (18%)," and "Persistently High (12%)" unemployment trajectories. Experiencing Decreasing Mid-Career or Persistently High trajectories was associated with worse physical and mental health at age 50 than Consistently Low trajectories. Experiencing a Persistently High trajectory was associated with worse physical and mental health than a Decreasing Mid-Career trajectory. Discussion: Timing and likelihood of unemployment are associated with midlife health. Mid-Career unemployment is associated with worse physical and mental health at age 50, but not to the same degree as Persistently High unemployment.
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Affiliation(s)
| | - Sarah Damaske
- The Pennsylvania State University, University Park, PA, USA
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Van Eersel JHW, Taris TW, Boelen PA. Job loss-related complicated grief symptoms: A cognitive-behavioral framework. Front Psychiatry 2022; 13:933995. [PMID: 35935428 PMCID: PMC9354410 DOI: 10.3389/fpsyt.2022.933995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
In a significant minority of people, involuntarily job loss can result in symptoms of job loss-related complicated grief (JLCG). The present cognitive-behavioral framework is introduced to explain the underlying processes that may lead to the development and maintenance of JLCG symptoms. Three core processes play a central role, namely (1) negative cognitions related to the job loss and misinterpretation of one's grief reactions; (2) anxious and depressive avoidance strategies to cope with the job loss and its consequences; and (3) insufficient integration of the job loss into the autobiographical memory. These core processes are assumed to interact and reinforce each other, leading to JLCG symptoms. The three core processes can be influenced by certain risk factors, including circumstances surrounding the loss, personality traits, and characteristics of the social environment. JLCG symptoms can lead to additional psychological and practical problems, such as anxiety and depressive symptoms, lower employability, and reduced likelihood of re-employment. This paper explains and illustrates the three core processes with vignettes. Implications of the model for preventive measures and psychological interventions are introduced. It concludes with suggestions for future research on JLCG symptoms.
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Affiliation(s)
| | - Toon W. Taris
- Department of Social, Health and Organizational Psychology, Utrecht University, Utrecht, Netherlands
| | - Paul A. Boelen
- Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands
- ARQ National Psychotrauma Centre, Diemen, Netherlands
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Norström F, Hammarström A. Methodological perspectives on the study of the health effects of unemployment - reviewing the mode of unemployment, the statistical analysis method and the role of confounding factors. BMC Med Res Methodol 2022; 22:199. [PMID: 35864450 PMCID: PMC9306210 DOI: 10.1186/s12874-022-01670-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 06/29/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction Studying the relationship between unemployment and health raises many methodological challenges. In the current study, the aim was to evaluate the sensitivity of estimates based on different ways of measuring unemployment and the choice of statistical model. Methods The Northern Swedish cohort was used, and two follow-up surveys thereof from 1995 and 2007, as well as register data about unemployment. Self-reported current unemployment, self-reported accumulated unemployment and register-based accumulated unemployment were used to measure unemployment and its effect on self-reported health was evaluated. Analyses were conducted with G-computation, logistic regression and three estimators for the inverse probability weighting propensity scores, and 11 potentially confounding variables were part of the analyses. Results were presented with absolute differences in the proportion with poor self-reported health between unemployed and employed individuals, except when logistic regression was used alone. Results Of the initial 1083 pupils in the cohort, our analyses vary between 488–693 individuals defined as employed and 61–214 individuals defined as unemployed. In the analyses, the deviation was large between the unemployment measures, with a difference of at least 2.5% in effect size when unemployed was compared with employed for the self-reported and register-based unemployment modes. The choice of statistical method only had a small influence on effect estimates and the deviation was in most cases lower than 1%. When models were compared based on the choice of potential confounders in the analytical model, the deviations were rarely above 0.6% when comparing models with 4 and 11 potential confounders. Our variable for health selection was the only one that strongly affected estimates when it was not part of the statistical model. Conclusions How unemployment is measured is highly important when the relationship between unemployment and health is estimated. However, misspecifications of the statistical model or choice of analytical method might not matter much for estimates except for the inclusion of a variable measuring health status before becoming unemployed. Our results can guide researchers when analysing similar research questions. Model diagnostics is commonly lacking in publications, but they remain very important for validation of analyses. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01670-1.
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Affiliation(s)
- Fredrik Norström
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden.
| | - Anne Hammarström
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden.,Institute of Environmental Medicine, Occupational Medicine, Karolinska Institutet, Stockholm, Sweden
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Vora P, Herrera R, Pietila A, Mansmann U, Brobert G, Peltonen M, Salomaa V. Risk factors for major gastrointestinal bleeding in the general population in Finland. World J Gastroenterol 2022; 28:2008-2020. [PMID: 35664959 PMCID: PMC9150061 DOI: 10.3748/wjg.v28.i18.2008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/22/2022] [Accepted: 03/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Data on non-drug related risk-factors for gastrointestinal bleeding (GIB) in the general population are limited, especially for life-style factors, clinical measurements and laboratory parameters.
AIM To identify and investigate non-drug risk factors for major GIB in the general population of Finland.
METHODS We performed a retrospective cohort study using data from the FINRISK health examination surveys, which have been conducted every 5 years across Finland from 1987 to 2007. Participants were adults aged 25 years to 74 years, excluding those with a previous hospitalization for GIB. Follow-up from enrollment was performed through linkage to national electronic health registers and ended at an event of GIB that led to hospitalization/death, death due to any other cause, or after 10 years. Covariates included demographics, socioeconomic and lifestyle factors, clinical measurements, laboratory parameters and comorbidities. Variable selection was undertaken using Least Absolute Shrinkage and Selection Operator (LASSO) and factors associated with GIB were identified using Cox regression.
RESULTS Among 33,508 participants, 403 (1.2%) experienced GIB [256 men (63.5%); mean age, 56.0 years (standard deviation (SD) ± 12.1)] and 33105 who did not experience GIB [15768 men (47.6%); mean age, 46.8 (SD ± 13) years], within 10 years of follow-up. Factors associated with a significantly increased risk of GIB were baseline age [per 10-year increase; hazard ratio (HR) 1.62, 95% confidence interval (CI): 1.42-1.86], unemployment (HR: 1.70, 95%CI: 1.11-2.59), body mass index (BMI) (HR: 1.15, 95%CI: 1.01-1.32), gamma-glutamyl transferase (GGT) (HR: 1.05, 95%CI: 1.02-1.09), precursors of GIB (HR: 1.90, 95%CI: 1.37-2.63), cancer (HR: 1.47, 95%CI: 1.10-1.97), psychiatric disorders (HR: 1.32, 95%CI: 1.01-1.71), heart failure (HR: 1.46, 95%CI: 1.04-2.05), and liver disorders (HR: 3.20, 95%CI: 2.06-4.97). Factors associated with a significantly decreased risk of GIB were systolic blood pressure (SBP) (HR: 0.78, 95%CI: 0.64-0.96), 6-10 cups of coffee a day (HR: 0.67, 95%CI: 0.46-0.99), or > 10 cups (HR: 0.43, 95%CI: 0.23-0.81).
CONCLUSION Our study confirms established risk-factors for GIB and identifies potential risk-factors not previously reported such as unemployment, BMI, GGT, SBP and coffee consumption.
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Affiliation(s)
- Pareen Vora
- Integrated Evidence Generation, Bayer AG, Berlin 13353, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig Maximilians Universität, Munich 81337, Germany
- Pettenkofer School of Public Health, Ludwig Maximilians Universität, Munich 81337, Germany
| | - Ronald Herrera
- Integrated Evidence Generation, Bayer AG, Berlin 13353, Germany
| | - Arto Pietila
- Department of Public Health and Welfare, National Institute for Health and Welfare (THL), Helsinki FI-00271, Finland
| | - Ulrich Mansmann
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig Maximilians Universität, Munich 81337, Germany
- Pettenkofer School of Public Health, Ludwig Maximilians Universität, Munich 81337, Germany
| | | | - Markku Peltonen
- Department of Public Health and Welfare, National Institute for Health and Welfare (THL), Helsinki FI-00271, Finland
| | - Veikko Salomaa
- Department of Public Health and Welfare, National Institute for Health and Welfare (THL), Helsinki FI-00271, Finland
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Morrish N, Mujica-Mota R, Medina-Lara A. Understanding the effect of loneliness on unemployment: propensity score matching. BMC Public Health 2022; 22:740. [PMID: 35477427 PMCID: PMC9045886 DOI: 10.1186/s12889-022-13107-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/24/2022] [Indexed: 01/19/2023] Open
Abstract
Background Loneliness and unemployment are each detrimental to health and well-being. Recent evidence suggests a potential bidirectional relationship between loneliness and unemployment in working age individuals. As most existing research focuses on the outcomes of unemployment, this paper seeks to understand the impact of loneliness on unemployment, potential interaction with physical health, and assess bidirectionality in the working age population. Methods This study utilised data from waves 9 (2017–19) and 10 (2018–2020) of the Understanding Society UK Household Longitudinal Study. Nearest-neighbour probit propensity score matching with at least one match was used to infer causality by mimicking randomisation. Analysis was conducted in three steps: propensity score estimation; matching; and stratification. Propensity scores were estimated controlling for age, gender, ethnicity, education, marital status, household composition, number of own children in household and region. Findings were confirmed in panel data random effect models, and heterogeneous treatment effects assessed by the matching-smoothing method. Results Experience of loneliness in at least one wave increased the probability of being unemployed in wave 10 by 17.5 [95%CI: 14.8, 20.2] percentage points. Subgroup analysis revealed a greater effect from sustained than transitory loneliness. Further exploratory analysis identified a positive average treatment effect, of smaller magnitude, for unemployment on loneliness suggesting bidirectionality in the relationship. The impact of loneliness on unemployment was further exacerbated by interaction with physical health. Conclusions This is the first study to directly consider the potentially bidirectional relationship between loneliness and unemployment through analysis of longitudinal data from a representative sample of the working age population. Findings reinforce the need for greater recognition of wider societal impacts of loneliness. Given the persisting and potentially scarring effects of both loneliness and unemployment on health and the economy, prevention of both experiences is key. Decreased loneliness could mitigate unemployment, and employment abate loneliness, which may in turn relate positively to other factors including health and quality of life. Thus, particular attention should be paid to loneliness with additional support from employers and government to improve health and well-being. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13107-x.
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Affiliation(s)
- N Morrish
- Health Economics Group, Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK.
| | - R Mujica-Mota
- Academic Unit of Health Economics, School of Medicine, University of Leeds, Leeds, UK
| | - A Medina-Lara
- Health Economics Group, Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
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32
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Brunes A, Heir T. Visual impairment and employment in Norway. BMC Public Health 2022; 22:648. [PMID: 35379220 PMCID: PMC8981612 DOI: 10.1186/s12889-022-13077-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Past studies have suggested lower employment of people with visual impairment. Reasons for this are less known. This study aimed to examine the employment rates among people with visual impairment, and its association with sociodemographic characteristics, vision-related factors, depression, and life satisfaction. METHODS This cross-sectional study included a stratified random sample of 574 working-age adults (18-67 years) who were members of the Norwegian Association of the Blind and Partially Sighted. Data were collected by telephone interviews between January and May 2017, and included information on work status, sociodemographic factors, vision-related characteristics, depression (Patient Health Questionnaire-9), and life satisfaction (Cantril's Ladder of Life Satisfaction). Associations with employment (full-time, part-time, or self-employment) were examined using regression analyses. RESULTS Of the participants, 51.2% of males and 38.1% of females reported to be employed. Employment was associated with being of middle age, male gender, higher education, residing in high-income municipalities, having a moderate degree of vision loss, lower onset-age of vision loss, and having no additional impairments. Employed participants had lower levels of depression compared to others (adjusted exponentiated beta: 0.80, 95% confidence interval (CI): 0.67, 0.96). They also had a higher odds of scoring higher on life satisfaction (adjusted exponentiated beta (odds ratio): 1.85, 95% CI: 1.32, 2.59). CONCLUSIONS Employment was lower in people with visual impairment than in the general population. Inclusion of the blind and partially sighted into the workforce could promote health and thus have socio-economic benefits.
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Affiliation(s)
- Audun Brunes
- Division of Mental Health and Addiction, Norwegian National Unit for Sensory Loss and Mental Health, Oslo University Hospital, Oslo, Norway.
| | - Trond Heir
- Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Andersen LN, Stochkendahl MJ, Roessler KK. Parked on the verge: vocational rehabilitation of long-term unemployed citizens - a mixed methods study. Arch Public Health 2022; 80:73. [PMID: 35255976 PMCID: PMC8902774 DOI: 10.1186/s13690-022-00838-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vocational rehabilitation programs (VRP) developing and improving work ability are used in Denmark to assist long-term unemployed citizens with complex problems. The aims of this study were to (1) describe VRP-participants in relation to general health, well-being, work ability and self-efficacy at baseline and one-year follow-up, (2) obtain an understanding of VRP-participants' personal development towards improving work ability, and (3) explore VRP-participants' hopes and thoughts about their future. METHODS In a mixed methods approach, data from a longitudinal survey and semi-structured interviews were collected. In the quantitative longitudinal survey, all participants completed paper questionnaires at baseline and one-year follow-up. For the qualitative semi-structured interviews, VRP participants were recruited with a maximum variation sampling strategy through VRP coordinators and personal contact. Data were analysed by descriptive statistics and systematic text condensation. Following analysis, data were merged and presented in combination according to identified themes. RESULTS At baseline and one-year follow-up 146 (response rate 34%) and 74 participants (response rate 52%) respectively, responded to the questionnaire. Seven participants were interviewed. The analysis revealed four themes: 1) Individual explanations of life situation and health; 2) Finding the path; 3) Work as giving meaning to life; 4) Hope for the future. Despite self-reported scores indicating poor general health, lack of well-being, low work ability and low self-efficacy, VRP-activities seemed to have assisted participants in finding meaning in life. VRP-components that may be drivers of successful recovery processes were identified. CONCLUSIONS VRP-participants experienced life situations that include multifactorial burdens, and low levels of general health, well-being, work ability, and self-efficacy at baseline and 1 year later. From the outset, most did not have a clear goal of employment, but over time, new goals were set as realistic opportunities for re-developing their work ability were explored. Successful core components of VRP were individually tailored programs and support, development of new relationships, and accommodated flexible internships and jobs. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02641704 , date of registration December 29, 2015.
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Affiliation(s)
- Lotte Nygaard Andersen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
| | - Mette Jensen Stochkendahl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Chiropractic Knowledge Hub, Odense, Denmark
| | - Kirsten K Roessler
- Department of Psychology, University of Southern Denmark, Odense, Denmark
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Aydın K. Self-rated health and chronic morbidity in the EU-28 and Turkey. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01328-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Tattarini G, Grotti R. Gender roles and selection mechanisms across contexts: a comparative analysis of the relationship between unemployment, self-perceived health and gender. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:641-662. [PMID: 35218011 DOI: 10.1111/1467-9566.13449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 06/14/2023]
Abstract
Health literature shows that unemployment has a gendered effect on health. However, whether men or women are more affected and why remains unclear. We assume that unemployment harms women less than men because of two mechanisms: social roles theories and health selection. First, the availability and centrality in individuals' lives of roles other than employment may reduce the detrimental effect of unemployment for women. Second, the gendered impact of unemployment on health results from the different ways selection mechanisms operate across genders. Moreover, these two mechanisms may operate differently in different contexts - for example, across different gender regimes. We investigate this by pursuing a three-step comparative approach. The analysis relies on EU-SILC data covering Italy and Sweden for 2004 to 2015 and SOEP data for Germany (1995-2017) and applies correlated dynamic random-effects probit models. While we find weak support for the role of health selection in shaping the relations between unemployment, health, and gender, our empirical results are in line with the hypothesis of a larger gendered effect in older (vs younger) cohorts, western (vs eastern) Germany and Italy (vs. Sweden). Future empirical research needs to directly address the role of gender regimes in moderating such complex relationships.
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Affiliation(s)
- Giulia Tattarini
- Department of Sociology and Social Research, University of Trento, Trento, Italy
- WZB Berlin Social Science Center, Berlin, Deutschland
| | - Raffaele Grotti
- Department of Sociology and Social Research, University of Trento, Trento, Italy
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South E, Rodgers M, Wright K, Whitehead M, Sowden A. Reducing lifestyle risk behaviours in disadvantaged groups in high-income countries: A scoping review of systematic reviews. Prev Med 2022; 154:106916. [PMID: 34922995 PMCID: PMC8803546 DOI: 10.1016/j.ypmed.2021.106916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/06/2021] [Accepted: 12/12/2021] [Indexed: 11/20/2022]
Abstract
High prevalence of risk behaviours may exacerbate existing poor health in disadvantaged groups. We aimed to identify and bring together systematic reviews with a focus on reducing risk behaviours in disadvantaged groups and highlight where evidence is lacking. We searched MEDLINE and Embase up to October 2020, with supplementary searching in Epistemonikos and Health Systems Evidence. We included systematic reviews that reported behavioural outcomes and targeted smoking, excessive alcohol use, unhealthy diet, or physical inactivity in groups with the following characteristics: low income or low socio-economic status (SES), unemployed people, homeless people, care leavers, prisoners, refugees or asylum seeker, Gypsies, Travellers, or Roma, people with learning disabilities and people living in disadvantaged areas. Reviews that included primary studies from any high-income country were eligible. Reviews were mapped based on the disadvantaged group(s) and behaviour(s) targeted. Ninety-two reviews were included, with the majority (n = 63) focusing on people with low income or low SES. We identified gaps in the evidence for care leavers; Gypsies, Travellers, and Roma and limited evidence for refugees and unemployed people. Few reviews targeted alcohol use. There was limited evidence on barriers and facilitators to behaviour change. This suggests there is insufficient evidence to inform policy and practice and new reviews or primary studies may be required.
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Affiliation(s)
- Emily South
- Centre for Reviews and Dissemination, University of York, York, United Kingdom.
| | - Mark Rodgers
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Margaret Whitehead
- Department of Public Health, Policy, and Systems, University of Liverpool, Liverpool, United Kingdom
| | - Amanda Sowden
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
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Silver SR, Li J, Quay B. Employment status, unemployment duration, and health-related metrics among US adults of prime working age: Behavioral Risk Factor Surveillance System, 2018-2019. Am J Ind Med 2022; 65:59-71. [PMID: 34748231 PMCID: PMC8678322 DOI: 10.1002/ajim.23308] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND While unemployment has been associated with poor health, few recent studies in the United States have comprehensively assessed associations between employment status (including duration unemployed) and healthcare access, health-related behaviors, and specific health outcomes. METHODS We assessed health-related metrics by employment status in 2018-2019 Behavioral Risk Factor Surveillance System respondents ages 25-54. We calculated the unadjusted prevalence and adjusted prevalence ratios to compare employed workers to respondents who were self-employed, short-term (<12 months) unemployed, long-term unemployed, and unable to work. RESULTS Adverse health outcomes increased with unemployment duration and were highest for those unable to work. Non-Hispanic Blacks were most likely to be unemployed or unable to work. Short-term unemployment and self-employment were associated with poor healthcare access. Health behaviors and outcomes declined with increasing duration of unemployment and were worst for those unable to work. CONCLUSIONS In the United States, access to affordable healthcare is problematic for both the self-employed and the short-term unemployed. Short-term unemployment is a particularly important locus for intervention and provision of resources to prevent health declines that may hinder re-employment.
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Affiliation(s)
- Sharon R. Silver
- National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Health Informatics Branch
| | - Jia Li
- National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Health Informatics Branch
| | - Brian Quay
- National Institute for Occupational Safety and Health, Office of the Director, Economic Research and Support Office
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Lipert A, Musiał K, Rasmus P. Working Mode and Physical Activity as Factors Determining Stress and Sleep Quality during COVID-19 Pandemic Lockdown in Poland. Life (Basel) 2021; 12:28. [PMID: 35054421 PMCID: PMC8778547 DOI: 10.3390/life12010028 10.3390/healthcare9091166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 11/09/2023] Open
Abstract
The coronavirus pandemic and related government restrictions have a significant impact on peoples' everyday functioning and working, which influences their physical and mental health. The aim of the study was to examine the associations between stress and sleep quality of people of different working modes: working in the workplace (WP), working remotely (RW), and nonworking (NW) in relation to their physical activity (PA) during COVID-19 pandemic lockdown in Poland. It was an online survey performed during governmental lockdown in April 2020. The data were collected form 1959 adults using International Physical Activity Questionnaire-Short Form (IPAQ-SF), Pittsburgh Sleep Quality Index (PSQI), and Perceived Stress Scale (PSS). The conducted analysis included t-Student test, analysis of variance (ANOVA), and mediation analysis (MANOVA). A moderate level of stress was reported in 57% of participants, and 34% of them reported a high stress level. Poor sleep quality was reported in 64% of participants. Total PA performed daily was, on average, 184.8 ± 170.5 min/day for WP, 120.6 ± 124.4 min/day for RW, and 124.6 ± 114.7 min/day for NW (p < 0.001). There was a relationship observed between the stress and sleep quality vs. PA habit and working mode, with p < 0.05. Being physically active can be beneficial to perceive less stress and sleep disturbances influencing sleep quality, especially in remotely or nonworking people. Planning future pandemic restrictions, the policymakers should be aware of the appropriate guidelines of work planning and PA recommendations for people of different working modes.
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Affiliation(s)
- Anna Lipert
- Department of Sports Medicine, Medical University of Lodz, 92-213 Lodz, Poland;
| | - Kamila Musiał
- Department of Sports Medicine, Medical University of Lodz, 92-213 Lodz, Poland;
| | - Paweł Rasmus
- Department of Medical Psychology, Medical University of Lodz, 90-131 Lodz, Poland;
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Working Mode and Physical Activity as Factors Determining Stress and Sleep Quality during COVID-19 Pandemic Lockdown in Poland. Life (Basel) 2021; 12:life12010028. [PMID: 35054421 PMCID: PMC8778547 DOI: 10.3390/life12010028] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 02/07/2023] Open
Abstract
The coronavirus pandemic and related government restrictions have a significant impact on peoples’ everyday functioning and working, which influences their physical and mental health. The aim of the study was to examine the associations between stress and sleep quality of people of different working modes: working in the workplace (WP), working remotely (RW), and nonworking (NW) in relation to their physical activity (PA) during COVID-19 pandemic lockdown in Poland. It was an online survey performed during governmental lockdown in April 2020. The data were collected form 1959 adults using International Physical Activity Questionnaire—Short Form (IPAQ-SF), Pittsburgh Sleep Quality Index (PSQI), and Perceived Stress Scale (PSS). The conducted analysis included t-Student test, analysis of variance (ANOVA), and mediation analysis (MANOVA). A moderate level of stress was reported in 57% of participants, and 34% of them reported a high stress level. Poor sleep quality was reported in 64% of participants. Total PA performed daily was, on average, 184.8 ± 170.5 min/day for WP, 120.6 ± 124.4 min/day for RW, and 124.6 ± 114.7 min/day for NW (p < 0.001). There was a relationship observed between the stress and sleep quality vs. PA habit and working mode, with p < 0.05. Being physically active can be beneficial to perceive less stress and sleep disturbances influencing sleep quality, especially in remotely or nonworking people. Planning future pandemic restrictions, the policymakers should be aware of the appropriate guidelines of work planning and PA recommendations for people of different working modes.
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Mangot-Sala L, Smidt N, Liefbroer AC. The association between unemployment trajectories and alcohol consumption patterns. Evidence from a large prospective cohort in The Netherlands. ADVANCES IN LIFE COURSE RESEARCH 2021; 50:100434. [PMID: 36661293 DOI: 10.1016/j.alcr.2021.100434] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/21/2021] [Accepted: 07/21/2021] [Indexed: 06/17/2023]
Abstract
Unemployment is expected to influence alcohol consumption, but studies show mixed results, partly because most studies concentrate on current employment status. However, unemployment could be particularly consequential if it is part of a trajectory of employment precariousness. Moreover, the association between unemployment and alcohol consumption may not be homogeneous across the population, but differ by subgroups (e.g. socioeconomic status). This study longitudinally analyses the association between different employment trajectories and alcohol consumption, and examines if the association is moderated by socioeconomic status (SES), partner status, age and gender. Four waves of data of the Lifelines Cohort study are used. Sample consists of individuals from 18-50 years old, active in the labor market (n = 104,766) from the northern provinces of the Netherlands. Employment trajectories are defined by employment status in each wave, duration of unemployment, and number of exposures to unemployment. Drinking patterns are divided into "abstainers", "moderate drinking" (<1.5 drinks/day), "heavy drinking" (≥1.5 drinks/day) and "binge drinking" (≥5 drinks/occasion; 4 for women). The associations are estimated with multinomial logistic regression models. Results show that recent, long-term unemployment (≥ 6 months) is associated with higher rates of heavy drinking (RRR = 1.26 [95 % CI 1.03-1.54]), whereas short-term unemployment does not show any association with the outcome. Being continuously unemployed throughout the observation period shows a strong association with binge drinking (RRR = 1.43 [95 % CI 1.06-1.93]), as well as reporting 2 or more long unemployment spells (RRR = 1.49 [95 % CI 1.21-1.83]). The group of abstainers (77.95 % women) have significantly lower SES, and poorer health than their peers. For some individuals, recent unemployment increases the likelihood for abstinence (RRR = 1.23 [95 % CI 1.00-1.51]). Evidence suggests that length of unemployment is key in order to grasp its effects in terms of changing drinking patterns.
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Affiliation(s)
- Lluís Mangot-Sala
- Netherlands Interdisciplinary Demographic Institute (NIDI) - Royal Netherlands Academy of Sciences (KNAW), the Netherlands; University Medical Center Groningen (UMCG) - Faculty of Medical Sciences, Department of Epidemiology, University of Groningen (RUG), the Netherlands.
| | - Nynke Smidt
- University Medical Center Groningen (UMCG) - Faculty of Medical Sciences, Department of Epidemiology, University of Groningen (RUG), the Netherlands
| | - Aart C Liefbroer
- Netherlands Interdisciplinary Demographic Institute (NIDI) - Royal Netherlands Academy of Sciences (KNAW), the Netherlands; University Medical Center Groningen (UMCG) - Faculty of Medical Sciences, Department of Epidemiology, University of Groningen (RUG), the Netherlands; Department of Sociology, Vrije University of Amsterdam (VU), the Netherlands
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Grammatikopoulou MG, Gkiouras K, Pepa A, Persynaki A, Taousani E, Milapidou M, Smyrnakis E, Goulis DG. Health status of women affected by homelessness: A cluster of in concreto human rights violations and a time for action. Maturitas 2021; 154:31-45. [PMID: 34736578 DOI: 10.1016/j.maturitas.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
Health problems of women experiencing homelessness are driven either from the usual background characteristics of this population, or from the homeless lifestyle. Apart from poverty and unemployment, transition to homelessness is often associated with substance abuse, history of victimization, stress, poor mental health and human immunodeficiency virus (HIV). Water insecurity can undermine bodily hygiene and dental health, posing a greater risk of dehydration and opportunistic infections. Exposure to extreme environmental conditions like heat waves and natural disasters increases morbidity, accelerates aging, and reduces life expectancy. Nutrition-wise, a high prevalence of food insecurity, obesity, and micronutrient deficiencies are apparent due to low diet quality and food waste. Poor hygiene, violence, and overcrowding increase the susceptibility of these women to communicable diseases, including sexually transmitted ones and COVID-19. Furthermore, established cardiovascular disease and diabetes mellitus are often either undertreated or neglected, and their complications are more widespread than in the general population. In addition, lack of medical screening and contraception non-use induce a variety of reproductive health issues. All these health conditions are tightly related to violations of human rights in this population, including the rights to housing, water, food, reproduction, health, work, and no discrimination. Thus, the care provided to women experiencing homelessness should be optimized at a multidimensional level, spanning beyond the provision of a warm bed, to include access to clean water and sanitation, psychological support and stress-coping strategies, disease management and acute health care, food of adequate quality, opportunities for employment and support for any minor dependants.
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Affiliation(s)
- Maria G Grammatikopoulou
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece; Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, Alexander Campus, International Hellenic University, Thessaloniki, Greece
| | - Konstantinos Gkiouras
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aleks Pepa
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Greece
| | | | - Eleftheria Taousani
- Department of Midwifery, Faculty of Health Sciences, International Hellenic University, Alexander Campus, Thessaloniki, Greece
| | - Maria Milapidou
- Dr. Juris, Post Doc Researcher, Faculty of Law, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Emmanouil Smyrnakis
- Laboratory of Primary Health Care, General Practice and Health Services Research, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Disability and life satisfaction in neurological disorders: The role of depression and perceived cognitive difficulties. Gen Hosp Psychiatry 2021; 73:16-23. [PMID: 34508992 DOI: 10.1016/j.genhosppsych.2021.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/23/2021] [Accepted: 08/30/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND This study assessed factors associated with disability and life satisfaction in a large cohort of 2246 Australian adults with neurological disorders who completed an online survey of mental health and wellbeing. It was hypothesised that depressive symptoms and perceived cognitive difficulties would be significantly associated with both outcomes, even after controlling for significant demographic/medical covariates (e.g., age, marital-status, employment, multi-morbidity, medication). Differences in profiles of four neurological subgroups (i.e., multiple sclerosis; n = 738, epilepsy; n = 672, Parkinson's disease; n = 263, and Acquired Bran Injury; n = 278) were explored. METHODS Multiple hierarchical linear regressions were run using cross-sectional data. RESULTS Depressive symptoms made a significant and large unique contribution to higher levels of disability (β = 0.333, p < .001), and poorer life satisfaction (β = -0.434, p < .001), in the overall sample and across all four neurological subgroups (β = 0.349 to 0.513, p < .001) Greater perceived cognitive difficulties were associated with disability in the overall sample (β = 0.318, p < .001) and across all neurological subgroups (β = 0.231 to 0.354, p < .001), but only life satisfaction in epilepsy (β = -0.107, p = 006). CONCLUSIONS The findings underscore the importance of managing psychological/neuropsychiatric comorbidities in neurological disorders.
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Gane EM, Plinsinga ML, Brakenridge CL, Smits EJ, Aplin T, Johnston V. The Impact of Musculoskeletal Injuries Sustained in Road Traffic Crashes on Work-Related Outcomes: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111504. [PMID: 34770019 PMCID: PMC8582890 DOI: 10.3390/ijerph182111504] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022]
Abstract
Musculoskeletal injuries occur frequently after road traffic crashes (RTCs), and the effect on work participation is not fully understood. The primary aim of this review was to determine the impact of sustaining a musculoskeletal injury during an RTC on the rate of return to work (RTW), sick leave, and other work outcomes. The secondary aim was to determine factors associated with these work-related outcomes. An electronic search of relevant databases to identify observational studies related to work and employment, RTC, and musculoskeletal injuries was conducted. Where possible, outcome data were pooled by follow-up period to answer the primary aim. Fifty-three studies were included in this review, of which 28 were included in meta-analyses. The pooled rate of RTW was 70% at 1 month, 67% at 3 months, 76% at 6 months, 83% at 12 months, and 70% at 24 months. Twenty-seven percent of participants took some sick leave by one month follow-up, 13% by 3 months, 23% by 6 months, 36% by 12 months, and 22% by 24 months. Most of the factors identified as associated with work outcomes were health-related, with some evidence also for sociodemographic factors. While 70% of people with RTC-related musculoskeletal injury RTW shortly after accident, many still have not RTW two years later.
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Affiliation(s)
- Elise M. Gane
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia; (T.A.); (V.J.)
- Recover Injury Research Centre, The University of Queensland, Brisbane 4066, Australia; (M.L.P.); (C.L.B.); (E.J.S.)
- Physiotherapy Department, Princess Alexandra Hospital, Brisbane 4102, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane 4102, Australia
- Correspondence:
| | - Melanie L. Plinsinga
- Recover Injury Research Centre, The University of Queensland, Brisbane 4066, Australia; (M.L.P.); (C.L.B.); (E.J.S.)
| | - Charlotte L. Brakenridge
- Recover Injury Research Centre, The University of Queensland, Brisbane 4066, Australia; (M.L.P.); (C.L.B.); (E.J.S.)
| | - Esther J. Smits
- Recover Injury Research Centre, The University of Queensland, Brisbane 4066, Australia; (M.L.P.); (C.L.B.); (E.J.S.)
| | - Tammy Aplin
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia; (T.A.); (V.J.)
- Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane 4032, Australia
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia; (T.A.); (V.J.)
- Recover Injury Research Centre, The University of Queensland, Brisbane 4066, Australia; (M.L.P.); (C.L.B.); (E.J.S.)
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Cinaroglu S. Interaction Between Self-rated Health and Labour Force Participation: A Panel Data Probit Model with Survival Estimates. JOURNAL OF HEALTH MANAGEMENT 2021. [DOI: 10.1177/09720634211050483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to reveal the relationship between health and labour in Turkey under the intervention of demographic variables. Four waves of the TurkStat Income and Living Conditions Panel Survey (2008–2011) were used. Demographic, education, self-rated health and labour force participation indicators were used to examine different generalised linear model (GLM)-like panel binomial probit model specifications using self-assessed health (SAH) status and self-reported working status (SRWS) as dependent variables. Kaplan–Meier (KM) estimates for the probability of survival in SAH and SRWS were examined using the X2 values of the log-rank and Peto–Peto–Prentice tests for equality of survivor functions by study variables. Study results reveal that the hazard of assessing good health and currently working increases for individuals who are married ( p < 0.001), highly educated ( p < 0.001), do not have any chronic disease ( p < 0.001), do not have any health restrictions ( p < 0.001) and occupy high-qualification jobs ( p < 0.001). KM estimates support the panel model results. The present study reveals that demographic, education, self-rated health and labour force participation are the driving forces in the interaction of health and labour dynamics. Reducing income inequality, increasing the minimum wage and improving working conditions, while promoting gender equality, are essentials of better management of health and labour markets.
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Melamed OC, Zawertailo L, Schwartz R, Buckley L, Selby P. Protecting vulnerable groups from tobacco-related harm during and following the COVID-19 pandemic. Health Promot Chronic Dis Prev Can 2021; 41:282-287. [PMID: 34164973 PMCID: PMC8565858 DOI: 10.24095/hpcdp.41.10.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Marginalized populations are being disproportionally affected by the current pandemic. Direct effects include higher infection rates with greater morbidity and mortality; indirect effects stem from the societal response to limit the spread of the virus. These same groups also have smoking rates that are significantly higher than the general population. In this commentary, we discuss how the pandemic has been acting to further increase the harm from tobacco endured by these groups by applying the syndemic framework. Using this approach, we elaborate on the factors that promote clustering of harms from tobacco with harms from COVID-19. These include the worsening of psychological distress, a potential increase in smoking behaviour, greater exposure to second-hand smoke and less access to smoking cessation services. Then, we offer mitigation strategies to protect disadvantaged groups from tobacco-related harm during and following the COVID-19 pandemic. These strategies include affordable smoking cessation services, a proactive approach for smoking treatment using information technology, opportunistic screening and treatment of tobacco dependence among individuals presenting for COVID-19 vaccination, policy interventions for universal coverage of cessation pharmacotherapy, comprehensive smoke-free policies and regulation of tobacco retail density. Now more than ever, coordinated action between clinicians, health care systems, public health organizations and health policy makers is needed to protect vulnerable groups from the harm of tobacco.
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Affiliation(s)
- Osnat C Melamed
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Laurie Zawertailo
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Robert Schwartz
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Ontario Tobacco Research Unit, Toronto, Ontario, Canada
| | - Leslie Buckley
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Peter Selby
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Morrish N, Medina-Lara A. Does unemployment lead to greater levels of loneliness? A systematic review. Soc Sci Med 2021; 287:114339. [PMID: 34455335 PMCID: PMC8505794 DOI: 10.1016/j.socscimed.2021.114339] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 01/10/2023]
Abstract
There is evidence that loneliness and unemployment each have a negative impact on public health. Both are experienced across the life course and are of increasing concern in light of the COVID-19 pandemic. This review seeks to examine the strength and direction of the relationship between loneliness and unemployment in working age individuals, and in particular the potential for a self-reinforcing cycle with combined healthcare outcomes. A systematic search was undertaken in Medline, PubMed, PsycINFO, Embase and EconLit from inception to December 2020. PRISMA reporting guidelines were followed throughout this review, study quality was assessed using the Joanna Briggs Institute checklist and results were summarised in a narrative synthesis. English language studies evaluating the relationship between loneliness and unemployment in higher income western countries were included. Thirty-seven studies were identified; 30 cross-sectional and 7 longitudinal. Loneliness was measured by a direct question or loneliness scale while unemployment was self-reported or retrieved from a national register. A positive association between unemployment and increased loneliness was observed across all studies. Thus, across the life-course a clear yet complex relationship exists between unemployment and greater experience of loneliness. The magnitude of this relationship increases with the severity of loneliness and appears to peak at age 30–34 and 50–59. Logistic regression provided the greatest consistency at statistical significance revealing at least a 40% increase in the likelihood of reporting loneliness when unemployed. Recent longitudinal studies identified in this review found higher levels of loneliness following job loss, but also that loneliness was predictive of unemployment suggesting potential bi-directionality in the relationship. This bi-directionality may create a multiplier effect between loneliness and unemployment to form a self-reinforcing relationship and greater health concerns for those most at risk. Thus, review findings suggest the need for cross-sector awareness and intervention to tackle both loneliness and unemployment. Unemployment is related to feeling lonely. Stronger association of unemployment with severe experience of loneliness. Greatest connection between loneliness and unemployment at age 30–34 and 50-59. Potential for a bi-directional relationship between loneliness and unemployment. Greater understanding is needed in the face of COVID-19 recovery.
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Affiliation(s)
- N Morrish
- Health Economics Group, Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK.
| | - A Medina-Lara
- Health Economics Group, Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
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Amiri S. Unemployment associated with major depression disorder and depressive symptoms: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:2080-2092. [PMID: 34259616 DOI: 10.1080/10803548.2021.1954793] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objectives. This study investigated the association between unemployment and depressive symptoms and major depression disorder worldwide using a systematic review and meta-analysis. Methods. Search time was limited to all articles published in English until December 2020. In the association between unemployment and depression, first, the results of qualified studies were extracted and, then, the results of each study were pooled with each other using the random effects method. Results. The prevalence of depression in the unemployed is 21%, 95% confidence interval (CI) [18, 24%]. This prevalence for depression symptoms is 24%, 95% CI [20, 28%] and for major depressive disorder is 16%, 95% CI [9-24%]. The association between unemployment and depressive symptoms was odds ratio (OR) 2.06, 95% CI [1.85, 2.30] and the association for major depressive disorder was OR 1.88, 95% CI [1.57, 2.25]. The association between unemployment and depression in men was OR 2.27, 95% CI [1.76, 2.93] and in women was OR 1.62, 95% CI [1.40, 1.87]. Conclusions. What is clear from the present study is that unemployment can lead to a higher prevalence of depressive symptoms and major depressive disorder, thereby undermining the mental health of the unemployed.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Soldevila-Domenech N, Forero CG, Alayo I, Capella J, Colom J, Malmusi D, Mompart A, Mortier P, Puértolas B, Sánchez N, Schiaffino A, Vilagut G, Alonso J. Mental well-being of the general population: direct and indirect effects of socioeconomic, relational and health factors. Qual Life Res 2021; 30:2171-2185. [PMID: 33847868 PMCID: PMC8298347 DOI: 10.1007/s11136-021-02813-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE The aim of this study was to analyse the association between individual mental well-being and social, economic, lifestyle and health factors. METHODS Cross-sectional study on a representative sample of 13,632 participants (> 15y/o) from the Catalan Health Interview Survey 2013-2016 editions. Mental well-being was assessed with the Warwick-Edinburg Mental Well-being Scale (WEMWBS). Linear regressions were fitted to associate well-being and sociodemographic, relational, lifestyle and health variables according to minimally sufficient adjustment sets identified using directed acyclic graphs. Predictors entered the model in blocks of variable types and analysed individually. Direct and total effects were estimated. RESULTS Health factors significantly contributed to mental well-being variance. Presence of a mental disorder and self-reported health had the largest effect size (eta2 = 13.4% and 16.3%). The higher individual impact from a variable came from social support (β = - 12.8, SE = 0.48, eta2 = 6.3%). A noticeable effect gradient (eta2 = 4.2%) from low to high mental well-being emerged according to economic difficulties (from β = 1.59, SE = 0.33 for moderate difficulties to β = 6.02 SE = 0.55 for no difficulties). Younger age (β = 5.21, SE = 0.26, eta2 = 3.4%) and being men (β = 1.32, SE = 0.15, eta2 = 0.6%) were associated with better mental well-being. Direct gender effects were negligible. CONCLUSIONS This study highlights health and social support as the most associated factors with individual mental well-being over socioeconomic factors. Interventions and policies aimed to these factors for health promotion would improve population mental well-being.
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Affiliation(s)
- Natalia Soldevila-Domenech
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
| | - Carlos G Forero
- School of Medicine, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Itxaso Alayo
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain
| | - Jordina Capella
- Programme on substance Abuse, Agency of Public Health of Catalonia, Carrer Roc Boronat, 81-95, 08005, Barcelona, Spain
- Direcció General d'Ordenació i Regulació Sanitàries, Departament de Salut, Generalitat de Catalunya, Travessera de les Corts, 131-159, 08028, Barcelona, Spain
| | - Joan Colom
- Programme on substance Abuse, Agency of Public Health of Catalonia, Carrer Roc Boronat, 81-95, 08005, Barcelona, Spain
| | - Davide Malmusi
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain
- Ajuntament de Barcelona, Barcelona, Spain
| | - Anna Mompart
- Direcció General de Planificació en Salut, Departament de Salut, Generalitat de Catalunya, Travessera de les Corts, 131-159, 08028, Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain
| | - Beatriz Puértolas
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain
| | - Néstor Sánchez
- School of Medicine, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Anna Schiaffino
- Direcció General de Planificació en Salut, Departament de Salut, Generalitat de Catalunya, Travessera de les Corts, 131-159, 08028, Barcelona, Spain
- Institut Català D'Oncologia, Gran Via de l'Hospitalet 199-203, 08908, l'Hospitalet de Llobregat, Spain
| | - Gemma Vilagut
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain.
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain.
| | - Jordi Alonso
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain.
- Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain.
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain.
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Unemployment Syndrome during COVID-19: A Comparison of Three Population Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147372. [PMID: 34299822 PMCID: PMC8304307 DOI: 10.3390/ijerph18147372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 01/04/2023]
Abstract
Introduction: Of the serious problems that characterise the current crisis in Spain, the most alarming and revealing is unemployment, which, despite being so common, continues to be quite a negative experience for most people, often with serious negative effects on their biopsychosocial health. The perpetuation of this situation has given rise to a new syndrome of the unemployed. If these effects of economic downsizing are accompanied by the magnitude of the current situation brought about by COVID-19, the results can be devastating for the individuals and families experiencing it. Objective: To compare the symptoms of the unemployed syndrome in three population groups. Method: Three groups were studied: short-term unemployed (n = 91), long-term unemployed (n = 150), and those unemployed during the COVID-19 pandemic (n = 94). Unemployment syndrome was assessed with the Unemployment Syndrome Scale (USS). The three population groups were contacted through web pages, social networks, etc. and answered the instruments online in a single session. Once the responses were obtained, their information was encoded in a database and analysed through the SPSS v. 21 program. Population groups were compared using the ANOVA analysis and the Bonferroni post hoc test. Results: The unemployed individuals who lost their job during the pandemic reported higher scores in the symptoms of the Unemployed Syndrome Scale compared to the long- and short-term unemployed individuals. ANOVA analyses for symptoms of USS were all significant in the different groups considering a significance level of <0.005. Participants who were unemployed for less than one year had lower scores in the USS than the long-term unemployed participants and those unemployed during the COVID-19 pandemic that reported a significantly higher number of symptoms in the USS.
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Mulia N, Ye Y, Karriker-Jaffe KJ, Li L, Kerr WC, Greenfield TK. The Great Recession, behavioral health, and self-rated health: An examination of racial/ethnic differences in the US. Addict Behav 2021; 118:106873. [PMID: 33652334 PMCID: PMC8483811 DOI: 10.1016/j.addbeh.2021.106873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 01/14/2023]
Abstract
The Great Recession has been associated with racial/ethnic disparities in economic loss, alcohol-related problems and mental health in the US. In this study, we examine its effect on overall health, the role of heavy drinking and mental health, and whether these relationships vary by race/ethnicity. Using US National Alcohol Survey data collected from White, African American and Latino individuals between June 2009 and March 2010 (N = 4656), we conducted gender-stratified simultaneous path modeling to test racial/ethnic differences in hypothesized paths from recession-related hardships to overall self-rated health through current depressive symptoms and heavy drinking. Recession impacts were measured using an index of job-related, financial and housing hardships. Models accounted for demographic characteristics and heavy drinking, health conditions and alcohol-related health harms occurring prior to the Great Recession. We found that in men and women of each racial/ethnic group, more accumulated recession hardships were associated with greater depressive symptoms and more frequent heavy drinking, and depressive symptoms were associated with poorer self-rated health. Further, heavy drinking was related to poorer self-rated health in Black men and depressive symptoms in Latino men, and for Black and Latina women, prior heavy drinking was associated with current depressive symptoms. Findings highlight adverse, behavioral and overall health consequences of a severe recession for men and women of diverse racial/ethnic groups, as well as unique risks for Black and Latino men and women. Findings suggest the need for behavioral health interventions alongside multisector strategies to bolster the labor market and social safety net during severe economic downturns.
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Affiliation(s)
- Nina Mulia
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA.
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | | | - Libo Li
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - William C Kerr
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Thomas K Greenfield
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
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