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Wysokińska M, Kołota A. Assessment of the Prevalence of Alcoholic Beverage Consumption and Knowledge of the Impact of Alcohol on Health in a Group of Polish Young Adults Aged 18-35: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15425. [PMID: 36497500 PMCID: PMC9737381 DOI: 10.3390/ijerph192315425] [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: 08/25/2022] [Revised: 11/02/2022] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
Alcoholic beverages are widely consumed worldwide, especially by young adults. Their excessive consumption is associated with numerous health, social and financial damages. The level of knowledge of young adults about the health effects of consuming alcoholic beverages is low, and research in this area is conducted on small, unrepresentative groups. This cross-sectional study aimed to assess the prevalence of alcoholic beverage consumption and the level of knowledge about the impact of ethyl alcohol on health in a group of people aged 18−35. The survey results indicate that the majority of respondents regularly consume alcoholic beverages (94.6%), and they are at a low risk of excessive consumption (p < 0.0001). The most frequently chosen alcoholic beverage in the studied group was beer, and the least chosen one was vodka. The main motive for reaching for alcoholic beverages was the desire to improve mood. Respondents did not indicate significant changes in alcohol consumption during the COVID-19 pandemic, but participants in the high-risk group more often indicated an increase in alcohol consumption (p = 0.0025). The analysis of the level of knowledge showed that the participants in the study had an average or low level of knowledge about the effects of ethanol on health, with no significant relationships between the study groups. The obtained results indicate a strong need for the continuous education of young people on the effects of the excessive consumption of alcoholic beverages on the body, with particular emphasis on the consequences of using alcohol as a mood-enhancing agent.
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Berge LI, Gjestad R, Franck J, Javaras KN, Greenfield S, Haver B. Gender specific early treatment for women with alcohol addiction (EWA): Impact on work related outcomes. A 25-year registry follow-up of a randomized controlled trial (RCT). Drug Alcohol Depend 2022; 239:109600. [PMID: 36007448 PMCID: PMC9509484 DOI: 10.1016/j.drugalcdep.2022.109600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/30/2022] [Accepted: 08/04/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Alcohol contributes to substantial economic burden, at both individual and community levels. We investigated the effect of the Early treatment for Women with Alcohol Addiction (EWA) treatment program on sickness leave, income, unemployment and early retirement pension up to 25 years following intake to treatment. METHODS The EWA RCT included 200 women with alcohol use disorder from 1983 to 1984 at the Karolinska University Hospital, Sweden. Participants were randomized to the EWA program, a two-year specialized woman only treatment including psychiatric, interpersonal and family concerns, or treatment as usual (TAU) in a mixed gender setting. We followed the participants in the RCT from 1985 to 2009 through linkage with a national labor market registry and applied latent growth curve modeling to estimate level and change in sickness leave, income, unemployment and early retirement pension. FINDINGS Relative to TAU, the EWA group had less increase in sickness leave up to 21 years after treatment. Overall, we found no differences in income between treatment groups, yet, a two-year interval analysis showed greater rise in income up to 8 years after treatment for the EWA group. Level and change in unemployment and early retirement pension did not differ between treatment groups. CONCLUSIONS Gender specific treatment emphasizing psychiatric, interpersonal and family issues for women with alcohol addiction had long-term positive effects on sickness leave and income. These findings complement positive clinical outcomes of the EWA treatment program on drinking patterns, mental health and mortality.
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Affiliation(s)
- Line Iden Berge
- NKS Olaviken Gerontopsychiatric Hospital, 5306 Erdal, Norway; Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Årstadveien 19, 5009 Bergen, Norway
| | - Rolf Gjestad
- Research department, Division of Psychiatry, Haukeland University Hospital, Sandviksleitet 1, 5036 Bergen, Norway; Center for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Sandviksleitet 1, 5036 Bergen, Norway
| | - Johan Franck
- Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18 A, 17177 Stockholm, Sweden
| | - Kristin Nicole Javaras
- Division of Women's Mental Health, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States
| | - Shelly Greenfield
- Division of Women's Mental Health, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States; Division of Alcohol, Drugs and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States
| | - Brit Haver
- Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18 A, 17177 Stockholm, Sweden; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Haukelandsbakken, 5009 Bergen, Norway
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Christiansen SG, Moan IS. Employment trajectories among those treated for alcohol use disorder: A register-based cohort study. Addiction 2022; 117:913-924. [PMID: 34697851 DOI: 10.1111/add.15726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 09/30/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Employment during and following treatment for alcohol use disorder (AUD) is important for the individual's health and well-being and for reducing the societal costs associated with benefit payments. Nonetheless, this is an under-researched topic. This study aimed to identify trajectories of labour force participation among people enrolled in AUD treatment and describe the characteristics of those following contrasting pathways. DESIGN Using trajectory analysis, we modelled employment trajectory groups among AUD patients during the year of treatment entry and the 4 subsequent years, applying Norwegian longitudinal register data. SETTING Norway. PARTICIPANTS Patients who entered treatment with AUD as the primary diagnosis during 2009 and 2010 (9000 patients, age 20-61 years). MEASUREMENTS The outcome variable 'labour force attachment' was measured as being in full-time employment, partly employed, on temporary welfare benefits or on permanent disability pension. Predictors were age, gender, education and comorbid mental health and drug use disorders. FINDINGS We distinguished six employment trajectories among AUD patients: 15.8% were on permanent disability pension throughout, 8.7% exited the labour force on permanent disability pension during the observation period, 32.1% had a medium attachment throughout follow-up, and 9.2% had a decreasing attachment; 23.3% had a high labour force attachment throughout, and 10.9% experienced increasing attachment. High attachment throughout was negatively associated with being female (P < 0.001), having lower educational attainment (P < 0.001), and having comorbid mental health (P < 0.001) and drug use disorders (P < 0.001). CONCLUSIONS Norwegian patients treated for alcohol use disorder in 2009 and 2010 followed six employment trajectories during the 5 years following treatment entry and had lower labour force participation than the general population. Nearly a quarter had a high labour force attachment throughout treatment, which was positively associated with being male, having higher educational attainment and having fewer comorbid mental health and drug use disorders.
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Affiliation(s)
| | - Inger Synnøve Moan
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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4
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Kposowa AJ, Breault K. Disability Status, Unemployment, and Alcohol-Related Liver Disease (ALD) Mortality: A Large Sample Individual Level Longitudinal Study. Subst Abuse Rehabil 2021; 12:81-88. [PMID: 34703353 PMCID: PMC8541791 DOI: 10.2147/sar.s334851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 10/05/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Unlike previous research, we evaluate disability within expanded employment status factors and stratify gender, race and ethnicity in alcohol-related liver disease (ALD) mortality in a large sample individual level longitudinal study. Materials and Methods The National Longitudinal Mortality Study (NLMS) was used covering the period 1990–2011. Statistical analysis involved the use of proportional hazards regression on a sample of almost 1.4 million people aged 18 and older, of whom 2638 died of ALD by the end of the follow-up period. Results With expanded employment status factors, disability (HR=3.76 [95%] CI 3.22, 4.39), unemployment (HR=1.90, CI 1.56, 2.31), and those not otherwise in the labor force (HR=2.31, CI 2.08, 2.56) were strongly related to ALD mortality compared to the employed. When stratified, gender, race, and ethnicity were not important modifiers in the relationships between disability, unemployment, those not in the labor force and subsequent ALD mortality. Consistent with other studies, males, minority status, living in a highly urban area, renting as opposed to owning a home, lower educational attainment, marital statuses other than marriage, low income, and age were related to ALD mortality. Conclusion In addition to unemployment which has been previously studied in a large longitudinal sample, disabled people who were unable to work and those not looking for work had a higher risk of ALD mortality. Alcohol consumption, abuse and morbidity in these populations are of considerable clinical concern.
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Affiliation(s)
| | - Kevin Breault
- Department of Sociology and Anthropology, Middle Tennessee State University, Murfreesboro, TN, USA
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Abstract
Alcohol use during adolescence is an important and modifiable health risk behavior given the significant acute consequences and long-term impacts on the developing brain. Alcohol is the most common substance used by young adults 12 to 17 years old, with binge drinking, polysubstance use, and co-occurring mental health disorders posing particular concerns in this age group. Physicians can play a crucial role in screening and responding to alcohol use, with targeted brief interventions designed to delay or decrease use.
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Affiliation(s)
- Sarah M Bagley
- Boston Medical Center, 801 Massachusetts Avenue, 2nd floor, Boston, MA 02118, USA.
| | - Sharon Levy
- Division of Developmental Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
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Joensuu M, Mattila-Holappa P, Ahola K, Kivimäki M, Tuisku K, Koskinen A, Vahtera J, Virtanen M. Predictors of employment in young adults with psychiatric work disability. Early Interv Psychiatry 2019; 13:1083-1089. [PMID: 30125468 DOI: 10.1111/eip.12730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 06/05/2018] [Accepted: 07/29/2018] [Indexed: 11/28/2022]
Abstract
AIM Mental disorders are the leading cause of work disability among young adults in the industrialized world. Factors predicting employment after long-term psychiatric work disability are largely unknown. METHODS We linked personal and clinical information from the benefit applications and medical certificates of 1163 young adults (18-34 years) with a new-onset fixed-term psychiatric disability pension in 2008 with employment records between 2005 and 2013. The outcomes were starting employment during and being employed at the end of follow-up. RESULTS Of the participants, 48% had been employed during and 22% were employed at the end of follow-up. Sustained employment history, university education (master's degree) and no recorded psychological symptoms in childhood were associated with both subsequent employment outcomes. Women and participants under 25 years were more likely to start employment. Depression and other mental disorders (vs psychotic diagnose) and having no comorbid mental disorders or substance abuse were associated with employment at the end of follow-up. CONCLUSIONS Sustained employment history, university education and no recorded psychological symptoms during childhood predict a return to employment among young adults after a fixed-term psychiatric work disability pension. Pro-active interventions in psychological problems during childhood could enhance employment after a period of work disability.
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Affiliation(s)
- Matti Joensuu
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Kirsi Ahola
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland.,Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Katinka Tuisku
- Outpatient Clinic for Assessment of Ability to Work, Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
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Reitan T, Stenberg SÅ. From classroom to conscription. Leadership emergence in childhood and early adulthood. THE LEADERSHIP QUARTERLY 2019. [DOI: 10.1016/j.leaqua.2018.11.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Zhou Q, Glasgow NJ, Du W. Health-related lifestyles and obesity among adults with and without disability in Australia: Implication for mental health care. Disabil Health J 2018; 12:106-113. [PMID: 30177470 DOI: 10.1016/j.dhjo.2018.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/11/2018] [Accepted: 08/24/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND Numerous studies have reported people with disabilities are more likely to be obese and engaged in unhealthy lifestyles. Few studies explored the mechanism of health-related lifestyles and obesity among people with disabilities. OBJECTIVE We aimed to investigate health-related lifestyles and obesity in relation to disability among Australian adults. We further aimed to explore the potential mediating effect of psychological distress for disability in relation to health related lifestyles and obesity. METHODS Using the National Health Survey conducted in 2015 in Australia, we considered non-institutionalised adult participants (aged 18 + years old) as our study population (n = 11,598). Study outcomes included currently smoking, smoking daily, alcohol consumption, physical exercises, and obesity. We considered high psychological distress (Kessler 10 scores ≥ 22) a potential mediator for the disability-lifestyles and disability-obesity associations. Sample weights were calculated allowing for complex survey design. Adjusted Odds Ratios and 95% Confidence Intervals were evaluated using weighted Logistic regression models. RESULTS Compared to their disability-free counterparts, people with disabilities were more likely to be current smokers (aOR: 1.26, 95%CI: 1.08-1.47) and have obesity problems (1.44, 1.27-1.64), and were less likely to do physical exercises (0.67, 0.58-0.77), after controlling for socio-environmental factors. In the presence of high psychological distress, the disability-smoking association was no longer significant, and associations of disability-exercise (0.72, 0.62-0.84) and disability-obesity (1.38, 1.22-1.57) were influenced but remained significant. CONCLUSION High psychological distress demonstrated important mediating effects. Tailored mental health care for people with disabilities might have the utility to reduce unhealthy behaviors.
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Affiliation(s)
- Qin Zhou
- School of Public Administration, University of International Business and Economics, Ning Yuan Building, No. 10 Huixin Dongjie, Chaoyang District, Beijing, China.
| | - Nicholas J Glasgow
- Research School of Population Health, College of Health and Medicine, Australian National University, 62 Mills Road, Acton ACT, 2601, Canberra, Australia.
| | - Wei Du
- Research School of Population Health, College of Health and Medicine, Australian National University, 62 Mills Road, Acton ACT, 2601, Canberra, Australia.
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Sidorchuk A, Goodman A, Koupil I. Social class, social mobility and alcohol-related disorders in Swedish men and women: A study of four generations. PLoS One 2018; 13:e0191855. [PMID: 29444095 PMCID: PMC5812607 DOI: 10.1371/journal.pone.0191855] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 01/08/2018] [Indexed: 12/12/2022] Open
Abstract
Objectives To investigate whether and how social class and social mobility in grandparents and parents predict alcohol-related disorders (ARDs) in males and females aged 12+ years, and whether intergenerational social prediction of ARDs varies across time periods. Methods The study sample included four successive generations (G) of Swedish families from the Uppsala Birth Cohort Multigenerational Study: G0 born 1851–1912; G1 born 1915–1929; G2 born 1940–1964 and G3 born 1965–1989. Two study populations were created, each consisting of grandparents, parents and offspring: population I ‘G0-G1-G2’ (offspring n = 18 430) and population II ‘G1-G2-G3’ (offspring n = 26 469). Registers and archives provided data on ancestors’ socio-demographic factors and ARD history, together with offspring ARD development between 1964–2008. Cox regression models examined the hazard of offspring ARD development according to grandparental social class and grandparental-to-parental social trajectories, controlling for offspring birth year, grandmother’s and mother’s marital status and parental ARDs. Results Disadvantaged grandparental social class predicted increased ARD risk in offspring in population I, although the effect attenuated and became non-significant in males after adjusting for parental characteristics (adjusted hazard ratio (HR) = 1.80 (95%CI; 1.07, 3.03) in females, HR = 1.32 (95%CI; 0.93, 1.89) in males). In population II, no increase in ARD risk by grandparental social was evident. In both populations, males were at the highest ARD risk if both parents and grandparents belonged to disadvantaged social class (population I: HR = 1.82 (95%CI; 1.22–2.72); population II: HR = 1.68 (95%CI; 1.02–2.76)). Conclusions Intergenerational social patterning of ARDs appears to be time-contextual and gender-specific. The role of grandparental social class in developing ARDs in grandchildren seems to decline over time, while persistent grandparental-to-parental social disadvantage remains associated with higher ARD risk in males. When targeting higher risk groups, continuity of familial social disadvantage, particularly among males, should be considered.
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Affiliation(s)
- Anna Sidorchuk
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Anna Goodman
- Department of Public Health Sciences, Stockholm Unviersity, Stockholm, Sweden
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ilona Koupil
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health Sciences, Stockholm Unviersity, Stockholm, Sweden
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Demou E, Bhaskar A, Xu T, Mackay DF, Hunt K. Health, lifestyle and employment beyond state-pension age. BMC Public Health 2017; 17:971. [PMID: 29262819 PMCID: PMC5738753 DOI: 10.1186/s12889-017-4957-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 11/28/2017] [Indexed: 11/30/2022] Open
Abstract
Background The factors influencing one’s choice to retire vary, with financial and health considerations being some of the main factors impacting or associated with people’s timing of retirement. The aim of the study is to investigate the differences in current health and health-related behaviours, such as smoking, drinking and exercising, between people who kept on working beyond state-pension age and those who retired before or at state-pension age. Methods Data from six waves (2003, 2008–2012) of the Scottish Health Survey (SHeS) are used. Descriptive analyses were used to characterise the population. Multivariate logistic regression was undertaken to analyse the relationship between retirement groups and gender, age, deprivation, marital status, housing tenure, general health, longstanding illness, cigarette smoking status, amount of exercise and mental health, using Stata. Results Reporting poor self-rated health or having a long-standing illness was associated with increased odds of retiring before state pension age (SPA) in groups with a medium deprivation profile in almost all the survey years. For the least deprived there was little evidence of an association between poor health and extended-working-life, while significant associations were observed for the most deprived. An increasing trend was observed for both genders in the number of people extending their working life. Similar associations between reporting poorer self-rated health and extended working lives were observed for men and women. Distinct gender differences were observed for the associations with reporting poor mental health and no exercise. In the adjusted models, both were significantly associated with retiring at or before SPA in almost every year for women, whereas no significant associations were observed (except in 1 year) for men. Conclusions This study shows an increasing trend in the number of people extending their working lives and demonstrates significant associations between health and lifestyle behaviours and employment status past SPA. The results suggest that good health – both physically and mentally – along with either a need or a want to stay in employment could be important reasons for continuing to work beyond SPA. Electronic supplementary material The online version of this article (10.1186/s12889-017-4957-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, UK.
| | - Abita Bhaskar
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, UK
| | - Taoye Xu
- Public Health, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Daniel F Mackay
- Public Health, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Kate Hunt
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, UK
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Larm P, Åslund C, Raninen J, Nilsson KW. Adolescent non-drinkers: Who are they? Social relations, school performance, lifestyle factors and health behaviours. Drug Alcohol Rev 2017; 37 Suppl 1:S67-S75. [DOI: 10.1111/dar.12640] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 09/26/2017] [Accepted: 10/30/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Peter Larm
- The Swedish Council for Information on Alcohol and Other Drugs (CAN); Stockholm Sweden
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
- Centre for Clinical Research; Uppsala University, Västmanland County Hospital; Västerås Sweden
| | - Cecilia Åslund
- Centre for Clinical Research; Uppsala University, Västmanland County Hospital; Västerås Sweden
| | - Jonas Raninen
- The Swedish Council for Information on Alcohol and Other Drugs (CAN); Stockholm Sweden
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
| | - Kent W. Nilsson
- Centre for Clinical Research; Uppsala University, Västmanland County Hospital; Västerås Sweden
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Thern E, de Munter J, Hemmingsson T, Davey Smith G, Ramstedt M, Tynelius P, Rasmussen F. Effects of increased alcohol availability during adolescence on the risk of all-cause and cause-specific disability pension: a natural experiment. Addiction 2017; 112:1004-1012. [PMID: 28060450 PMCID: PMC5434812 DOI: 10.1111/add.13750] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 11/14/2016] [Accepted: 01/03/2017] [Indexed: 12/03/2022]
Abstract
AIM To test if being exposed to increased alcohol availability during adolescence is associated with an increased risk of receiving disability pension due to all-cause, alcohol use disorders and mental disorders. DESIGN Register-based population-based study using a natural experiment setting, the alcohol policy change in Sweden (1967-68), with increased access to strong beer in a narrow time window and geographical area. The individuals exposed to the policy change were compared with non-exposed individuals living in the rest of Sweden, excluding a border area. SETTING Sweden. PARTICIPANTS A total of 518 810 individuals (70 761 in the intervention group; 448 049 in the control group) born 1948-1953, aged 14-20 years during the policy change. MEASUREMENTS Date and diagnosis of the outcome variable of disability pension due to all-cause, alcohol use disorders and mental disorders were obtained from the Swedish National Social Insurance Agency database from 1971 to 2013. Individual and family level socio-demographic and health-related covariates, as well as a regional level covariate, were included. FINDINGS Compared with the control group, adolescents exposed to the alcohol policy change were at an increased risk of receiving disability pension due to all-causes [hazard ratio (HR) = 1.09, 95% confidence interval (CI) = 1.07-1.11], alcohol use disorders (HR = 1.17, 95% CI = 1.05-1.30) and mental disorders (HR = 1.19, 95% CI = 1.15-1.23). CONCLUSION In Sweden, a natural experiment with a 43-year follow-up suggests that exposure to increased alcohol availability during adolescence is associated with an increased risk of receiving a disability pension due to all-cause, alcohol use disorder and mental disorder diagnoses.
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Affiliation(s)
- Emelie Thern
- Child and Adolescent Public Health Epidemiology Unit, Department of Public Health SciencesKarolinska InstitutetStockholmSweden
| | - Jeroen de Munter
- Child and Adolescent Public Health Epidemiology Unit, Department of Public Health SciencesKarolinska InstitutetStockholmSweden
| | - Tomas Hemmingsson
- Unit of Occupational MedicineInstitute of Environmental Medicine, Karolinska InstitutetStockholmSweden,Centre for Social Research on Alcohol and DrugsStockholm UniversityStockholmSweden
| | - George Davey Smith
- MRC Integrative Epidemiology Unit (IEU)University of Bristol, School of Social and Community MedicineBristolUK
| | - Mats Ramstedt
- The Swedish Council for Information on Alcohol and Other Drugs (CAN)StockholmSweden
| | - Per Tynelius
- Child and Adolescent Public Health Epidemiology Unit, Department of Public Health SciencesKarolinska InstitutetStockholmSweden,Centre for Epidemiology and Community MedicineStockholm County Council, Health Care ServicesStockholmSweden
| | - Finn Rasmussen
- Child and Adolescent Public Health Epidemiology Unit, Department of Public Health SciencesKarolinska InstitutetStockholmSweden,Centre for Epidemiology and Community MedicineStockholm County Council, Health Care ServicesStockholmSweden
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Falkstedt D, Wolff V, Allebeck P, Hemmingsson T, Danielsson AK. Cannabis, Tobacco, Alcohol Use, and the Risk of Early Stroke: A Population-Based Cohort Study of 45 000 Swedish Men. Stroke 2017; 48:265-270. [PMID: 28028147 DOI: 10.1161/strokeaha.116.015565] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 11/23/2016] [Accepted: 11/28/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Current knowledge on cannabis use in relation to stroke is based almost exclusively on clinical reports. By using a population-based cohort, we aimed to find out whether there was an association between cannabis use and early-onset stroke, when accounting for the use of tobacco and alcohol. METHODS The cohort comprises 49 321 Swedish men, born between 1949 and 1951, who were conscripted into compulsory military service between the ages of 18 and 20. All men answered 2 detailed questionnaires at conscription and were subject to examinations of physical aptitude, psychological functioning, and medical status. Information on stroke events up to ≈60 years of age was obtained from national databases; this includes strokes experienced before 45 years of age. RESULTS No associations between cannabis use in young adulthood and strokes experienced ≤45 years of age or beyond were found in multivariable models: cannabis use >50 times, hazard ratios=0.93 (95% confidence interval [CI], 0.34-2.57) and 0.95 (95% CI, 0.59-1.53). Although an almost doubled risk of ischemic stroke was observed in those with cannabis use >50 times, this risk was attenuated when adjusted for tobacco usage: hazards ratio=1.47 (95% CI, 0.83-2.56). Smoking ≥20 cigarettes per day was clearly associated both with strokes before 45 years of age, hazards ratio=5.04 (95% CI, 2.80-9.06), and with strokes throughout the follow-up, hazards ratio=2.15 (95% CI, 1.61-2.88). CONCLUSIONS We found no evident association between cannabis use in young adulthood and stroke, including strokes before 45 years of age. Tobacco smoking, however, showed a clear, dose-response shaped association with stroke.
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Affiliation(s)
- Daniel Falkstedt
- From the Department of Public Health Sciences (D.F., P.A., A.-K.D.) and Institute of Environmental Medicine (T.H.), Karolinska Institutet, Stockholm, Sweden; Stroke Unit, Department of Neurology, Strasbourg University Hospital, University of Strasbourg, France (V.W.); Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden (P.A.); and Centre for Social Research on Alcohol and Drugs, Stockholm University, Sweden (T.H.)
| | - Valerie Wolff
- From the Department of Public Health Sciences (D.F., P.A., A.-K.D.) and Institute of Environmental Medicine (T.H.), Karolinska Institutet, Stockholm, Sweden; Stroke Unit, Department of Neurology, Strasbourg University Hospital, University of Strasbourg, France (V.W.); Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden (P.A.); and Centre for Social Research on Alcohol and Drugs, Stockholm University, Sweden (T.H.)
| | - Peter Allebeck
- From the Department of Public Health Sciences (D.F., P.A., A.-K.D.) and Institute of Environmental Medicine (T.H.), Karolinska Institutet, Stockholm, Sweden; Stroke Unit, Department of Neurology, Strasbourg University Hospital, University of Strasbourg, France (V.W.); Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden (P.A.); and Centre for Social Research on Alcohol and Drugs, Stockholm University, Sweden (T.H.)
| | - Tomas Hemmingsson
- From the Department of Public Health Sciences (D.F., P.A., A.-K.D.) and Institute of Environmental Medicine (T.H.), Karolinska Institutet, Stockholm, Sweden; Stroke Unit, Department of Neurology, Strasbourg University Hospital, University of Strasbourg, France (V.W.); Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden (P.A.); and Centre for Social Research on Alcohol and Drugs, Stockholm University, Sweden (T.H.)
| | - Anna-Karin Danielsson
- From the Department of Public Health Sciences (D.F., P.A., A.-K.D.) and Institute of Environmental Medicine (T.H.), Karolinska Institutet, Stockholm, Sweden; Stroke Unit, Department of Neurology, Strasbourg University Hospital, University of Strasbourg, France (V.W.); Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden (P.A.); and Centre for Social Research on Alcohol and Drugs, Stockholm University, Sweden (T.H.).
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High Job Demands, Job Strain, and Iso-Strain are Risk Factors for Sick Leave due to Mental Disorders: A Prospective Swedish Twin Study With a 5-Year Follow-Up. J Occup Environ Med 2016; 57:858-65. [PMID: 26247639 DOI: 10.1097/jom.0000000000000504] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To investigate whether psychosocial work environment and health behaviors are risk factors for sick leave due to mental disorders, and whether familial confounding (genetics and shared environment) explains the associations. METHODS Respondents (n = 11,729), given to complete a questionnaire in 2004 to 2006, were followed up approximately 5 years for sick leave spells due to mental disorders, using national registry data. Data were analyzed using logistic regression, and conditional logistic regression for twin pairs discordant for sick leave (cotwin control). RESULTS High job demands, job strain, and iso-strain were independent risk factors for sick leave due to mental disorders. Familial factors seem to be of importance in the associations between job support, smoking, a combination of unhealthy behaviors and sick leave. CONCLUSIONS Improving the psychosocial work environment may be effective in preventing sick leave due to mental disorders.
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15
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Mattila-Holappa P, Joensuu M, Ahola K, Vahtera J, Virtanen M. Attachment to employment and education before work disability pension due to a mental disorder among young adults. BMC Psychiatry 2016; 16:143. [PMID: 27177691 PMCID: PMC4866277 DOI: 10.1186/s12888-016-0854-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 05/09/2016] [Indexed: 11/23/2022] Open
Abstract
BACKROUND We examined attachment to employment and education among young adults before they were granted a fixed-term work disability pension due to psychiatric diagnosis, and the factors associated with this attachment. METHODS The data comprised all persons aged 18-34 who received a new-onset fixed-term disability pension compensation due to a mental disorder in Finland in 2008 (N = 1163). The data were derived from pension applications and the enclosed medical records, and were linked to employment records from a period of three years before the disability pension. We analysed the factors associated with attachment to employment or education with log-binomial regression analysis. RESULTS Fifty percent of the participants were attached to employment or education before work disability pension. The attached were more often women; had higher basic and vocational education; had mood disorder rather than psychosis diagnosis as a primary diagnosis; and had no record of harmful alcohol use or drug use, or recorded symptoms of mental disorders already at school-age. CONCLUSIONS The level of attachment to employment or education before work disability pension is low among young adults with mental disorders and several risk factors predict poor attachment; severe or comorbid mental disorder, early-life psychiatric morbidity, substance use, male sex, low basic education, and lacking vocational education.
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Affiliation(s)
| | - Matti Joensuu
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, Helsinki, FIN-00250 Finland
| | - Kirsi Ahola
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, Helsinki, FIN-00250 Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
| | - Marianna Virtanen
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, Helsinki, FIN-00250 Finland
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16
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Devil in disguise: Does drinking lead to a disability pension? Prev Med 2016; 86:130-5. [PMID: 26968779 DOI: 10.1016/j.ypmed.2016.03.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 02/29/2016] [Accepted: 03/07/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To examine whether alcohol consumption in adulthood is related to the incidence of receiving a disability pension later in life. METHODS Twin data for Finnish men and women born before 1958 were matched to register-based individual information on disability pensions. Twin differences were used to eliminate both shared environmental and genetic factors. The quantity of alcohol consumption was measured as the weekly average consumption using self-reported data from three surveys (1975, 1981 and 1990). The disability pension data were evaluated from 1990-2004. RESULTS The models that account for shared environmental and genetic factors reveal that heavy drinkers are significantly more likely to receive a disability pension than moderate drinkers or constant abstainers. Heavy drinking that leads to passing out is also positively related to receiving a disability pension. The results were robust to the use of potential confounders that twins do not share, such as education years, the number of chronic diseases, physical activity at work and leisure, and stressful life events. CONCLUSION Drinking profiles in early adulthood are an important predictor of receiving a disability pension later in life.
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17
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Joensuu M, Mattila-Holappa P, Ahola K, Ervasti J, Kivimäki M, Kivekäs T, Koskinen A, Vahtera J, Virtanen M. Clustering of adversity in young adults on disability pension due to mental disorders: a latent class analysis. Soc Psychiatry Psychiatr Epidemiol 2016; 51:281-7. [PMID: 26373775 DOI: 10.1007/s00127-015-1123-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 09/05/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Mental disorders are the leading cause of work disability among young adults. This study examined whether distinct classes could be identified among young adults on the basis of medical history before receiving a disability pension due to a mental disorder. METHODS Medical history was obtained from pension applications and attached medical certificates for 1163 individuals aged 18-34 years who, in 2008, received a disability pension due to a mental disorder. Using latent class analysis, 10 clinical and individual adversities and their associations with sex, age and diagnostic category were examined. RESULTS Three classes were identified: childhood adversity (prevalence, 33%), comorbidity (23%), and undefined (44%). The childhood adversity class was characterized by adverse events and symptoms reported during childhood and it associated with depressive disorders. The comorbidity class was characterized by comorbid mental disorders, suicide attempts and substance abuse and associated with younger age and bipolar disorder. The undefined class formed no distinct profile; individuals in this class had the lowest number of adversities and it associated with psychotic disorders. CONCLUSIONS The identification of subgroups characterized by childhood circumstances and comorbidity may help planning of prevention and support practices for young adults with mental disorders and risk of work disability.
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Affiliation(s)
- Matti Joensuu
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland.
| | | | - Kirsi Ahola
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland.,Clinicum, University of Helsinki, Helsinki, Finland.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Teija Kivekäs
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland
| | - Jussi Vahtera
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland.,Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
| | - Marianna Virtanen
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland
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18
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Lund IO, Bukten A. Harm to Others from Substance Use and Abuse: The Underused Potential in Nationwide Registers. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2015; 9:33-8. [PMID: 26560694 PMCID: PMC4629638 DOI: 10.4137/sart.s23545] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 09/16/2015] [Accepted: 09/18/2015] [Indexed: 11/05/2022]
Abstract
This article considers the potential in using nationwide registers to study harm to others from substance use and abuse. The advantages of using registry data include the opportunity to include the data on the entire population nationwide and continuously updated longitudinal datasets; they allow for studying small subpopulations and have little missing data. Personal identification numbers and family numbers enable linkage of data from different registers. Such datasets can include extensive information on individual and family levels. In this article, we provide an introduction to nationwide registers and explain how they can be applied to investigate two types of third-party harms: harm to children and harm to partners/spouses from substance use and abuse in parents and partners/spouses. Finally, we discuss challenges, benefits, and ethical considerations regarding the use of such data.
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Affiliation(s)
- Ingunn Olea Lund
- The Norwegian Institute of Alcohol and Drug Research (SIRUS), Oslo, Norway
| | - Anne Bukten
- Norwegian Centre for Addiction Research, Oslo, Norway
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19
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Sörberg Wallin A, Lundin A, Melin B, Hemmingsson T. Fathers' intelligence measured at age 18-20 years is associated with offspring smoking: linking the Swedish 1969 conscription cohort to the Swedish Survey of Living Conditions. J Epidemiol Community Health 2015; 70:396-401. [PMID: 26515987 PMCID: PMC4819658 DOI: 10.1136/jech-2015-206149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 10/09/2015] [Indexed: 11/30/2022]
Abstract
Background An association between lower IQ of parents, measured early in life, and smoking among their offspring has been reported. The extent to which other background factors account for this association is unknown. Methods Data on IQ, smoking, mental health, social class, parental divorce and social problems in a cohort of men born during 1949–1951 and conscripted for military service in 1969 were linked to smoking data on 682 offspring interviewed in the Swedish Surveys of Living Conditions 1984–2009. Results In an age-adjusted model, a one-step decrease on a stanine scale was associated with an OR of 1.19 (95% CI 1.04 to 1.35) for offspring smoking. Adjusting for father's socioeconomic background and smoking, mental illness and social problems in youth only marginally lowered the OR's. Conclusions Lower IQ among fathers measured at ages 18–20 years was associated with smoking in their offspring. The association was not explained by father's social class in childhood or a higher prevalence of mental illness, social problems or smoking measured among the fathers in their late adolescence.
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Affiliation(s)
- Alma Sörberg Wallin
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Lundin
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bo Melin
- Division of Psychology, Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Hemmingsson
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
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20
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Korhonen T, Smeds E, Silventoinen K, Heikkilä K, Kaprio J. Cigarette smoking and alcohol use as predictors of disability retirement: A population-based cohort study. Drug Alcohol Depend 2015; 155:260-6. [PMID: 26305074 DOI: 10.1016/j.drugalcdep.2015.06.047] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 06/11/2015] [Accepted: 06/12/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND This study investigated how cigarette smoking and alcohol use predict disability retirement. METHODS Data from the longitudinal nationwide Finnish Twin Cohort study were analyzed, with clustered study design applied when computing 95% confidence intervals (CI). The sample included 21,719 individuals. Smoking and alcohol use were assessed with a questionnaire in 1975. Registry data on retirement events up till end of 2004 were obtained from the Social Insurance Institution and the Finnish Centre for Pensions. RESULTS Disability pension was granted to 4251 participants. Among men, adjusted for age and alcohol use, former (HR=1.45, 95%CI 1.28, 1.65, p<.001) and daily smokers (HR=1.93, 95%CI 1.71, 2.17, p<.001) showed elevated disability pension risk compared to never smokers. Among women, daily smokers (HR=1.25, 95%CI 1.11, 1.40, <.001) had elevated risk. The age and smoking adjusted risk estimates for alcohol were elevated among abstainers (men HR=1.41, 95%CI 1.21, 1.65, p<.001; women HR=1.36, 95%CI 1.23, 1.52, p<.001) and heavy drinkers (men HR=1.30, 95%CI 1.18, 1.43, p<.001; women HR=1.34, 95%CI 1.04, 1.72, p=.026). Those being persistent smokers and binge drinkers had over three-fold disability risk compared to those who were binge drinkers but had only a few smoking years (men: HR=3.32, 95%CI 2.43, 4.54, p<.001; women: HR=4.05, 95%CI 2.05, 8.00, p<.001). Among men and women who were not binge drinkers, longer smoking duration was needed for elevated disability risk. CONCLUSIONS Both smoking and excess alcohol use significantly predict disability retirement. In order to extend working careers, more attention should be paid to health behaviors, in addition to working conditions.
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Affiliation(s)
- Tellervo Korhonen
- Department of Public Health, University of Helsinki, Helsinki, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; National Institute for Health and Welfare, Helsinki, Finland.
| | - Eero Smeds
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Karri Silventoinen
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Kauko Heikkilä
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland; Institute for Molecular Medicine Finland FIMM, Helsinki, Finland
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21
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Patients Undergoing Substance Abuse Treatment and Receiving Financial Assistance for a Physical Disability Respond Well to Contingency Management Treatment. J Subst Abuse Treat 2015; 58:67-71. [PMID: 26184649 DOI: 10.1016/j.jsat.2015.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/10/2015] [Accepted: 06/10/2015] [Indexed: 11/21/2022]
Abstract
Physical illness and disability are common in individuals with substance use disorders, but little is known about the impact of physical disability status on substance use treatment outcomes. This study examined the main and interactive effects of physical disability payment status on substance use treatment. Participants (N = 1,013) were enrolled in one of six prior randomized clinical trials comparing contingency management (CM) to standard care; 79 (7.8%) participants reported receiving disability payments, CM improved all three primary substance use outcomes: treatment retention, percent negative samples and longest duration of abstinence. There was no significant main effect of physical disability payment status on treatment outcomes; however, a significant treatment condition by physical disability status interaction effect emerged in terms of retention in treatment and duration of abstinence achieved. Patients who were receiving physical disability payments responded particularly well to CM, and their time in treatment and durations of drug and alcohol abstinence increased even more markedly with CM than did that of their counterparts who were not receiving physical disability assistance. These findings suggest an objectively defined cohort of patients receiving substance use treatment who respond particularly well to CM.
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Sagatun Å, Heyerdahl S, Wentzel-Larsen T, Lien L. Medical benefits in young adulthood: a population-based longitudinal study of health behaviour and mental health in adolescence and later receipt of medical benefits. BMJ Open 2015; 5:e007139. [PMID: 25967994 PMCID: PMC4431139 DOI: 10.1136/bmjopen-2014-007139] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 04/11/2015] [Accepted: 04/16/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To examine the extent to which smoking, alcohol, physical activity and mental health problems in 15-16-year-olds are associated with receipt of medical benefits in young adulthood, after adjustment for confounders. DESIGN Prospective population-based cohort survey linked to national registers. PARTICIPANTS In the 'Youth studies' from the Norwegian Institute of Public Health, 15 966 10th graders in 6 Norwegian counties answered a health behaviour and mental health questionnaire; 88% were linked to National Insurance Administration Registers (FD-Trygd). OUTCOME MEASURE Time to receipt of medical benefits, based on FD-Trygd. Follow-up was from age 18 years until participants were aged 22-26 years. METHOD We performed Cox regression analyses to examine the extent to which variations in health behaviour and mental health problems during 10th grade were associated with receipt of medical benefits during follow-up. RESULTS Daily smoking at age 15-16 years was associated with a significant increase in hazard of receiving health benefits at follow-up compared with not smoking for boys, HR (95% CI) 1.56 (1.23 to 1.98), and for girls 1.47 (1.12 to 1.93). Physical activity was associated with a decrease in hazard compared with inactivity from 23% to 53% in boys and from 21% to 59% in girls, while use of alcohol showed a mixed pattern. The hazard for benefits use rose with increasing levels of emotional symptoms, peer problems, conduct problems and hyperactivity-inattention problems (Strengths and Difficulties Questionnaire) at 15-16 years among both genders. CONCLUSIONS Health behaviour and mental health problems in adolescence are independent risk factors for receipt of medical benefits in young adulthood.
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Affiliation(s)
- Åse Sagatun
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Sonja Heyerdahl
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Tore Wentzel-Larsen
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Lars Lien
- National Centre for Dual Diagnosis, Innlandet Hospital Trust, Sanderud, Norway
- Faculty of Public Health, Hedmark University College, Elverum, Norway
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23
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Kaila-Kangas L, Kivekäs T, Laitinen J, Koskinen A, Härkänen T, Hirvonen L, Leino-Arjas P. Abstinence and current or former alcohol use as predictors of disability retirement in Finland. Scand J Public Health 2015; 43:373-80. [DOI: 10.1177/1403494815575194] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2015] [Indexed: 01/09/2023]
Abstract
Aim: According to previous studies, abstinence from alcohol increases the risk of disability retirement (DR). We studied whether former alcohol users’ poor mental or physical health might have contributed to this result. Methods: Prospective population-based study of 3621 occupationally active Finns aged 30–55 years at baseline. Disability pension data for 2000−2011 was retrieved from national pension records. We examined medically certified disability retirement due to all causes and due to mental disorders among lifelong abstainers, former drinkers, those with an alcohol use disorder irrespective of consumption and current users, further classified according to weekly intake of alcohol. Chronic somatic diseases were evaluated in a clinical examination and common mental and alcohol use disorders using the Composite International Diagnostic Interview. Cox regression was used. Results: Neither lifelong abstinence nor alcohol consumption, even at hazardous levels, without alcohol use disorder was associated with disability retirement. Compared with light drinkers, former drinkers’ hazard ratio for DR due to mental disorders was 2.67 (95% CI 1.39−5.13), allowing for somatic and mental morbidity, physical and psychosocial workload, health behaviour and socio-demographic factors. The respective hazard ratio of DR due to all causes for those with alcohol use disorder was 2.17 (1.49−3.16) and of DR due to mental disorders 4.04 (2.02 to 8.06). Conclusions: Lifelong abstinence did not predict disability retirement. Former drinkers and people with alcohol use disorders were at a multi-fold risk of work disability due to mental disorders compared with light drinkers, thus it is important to support their work ability.
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Affiliation(s)
- Leena Kaila-Kangas
- Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Teija Kivekäs
- Centre of Expertise for Work Organizations, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jaana Laitinen
- Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Aki Koskinen
- Creating Solutions, Statistics and Health Economics Team, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Tommi Härkänen
- Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | - Leena Hirvonen
- Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Päivi Leino-Arjas
- Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Health Sciences, University of Tampere, Finland
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Sjölund S, Hemmingsson T, Allebeck P. IQ and level of alcohol consumption—findings from a national survey of Swedish conscripts. Alcohol Clin Exp Res 2015; 39:548-55. [PMID: 25702705 PMCID: PMC4368388 DOI: 10.1111/acer.12656] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 12/03/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Studies of the association between IQ and alcohol consumption have shown conflicting results. The aim of this study was to investigate the association between IQ test results and alcohol consumption, measured as both total alcohol intake and pattern of alcohol use. METHODS The study population consists of 49,321 Swedish males born 1949 to 1951 who were conscripted for Swedish military service 1969 to 1970. IQ test results were available from tests performed at conscription. Questionnaires performed at conscription provided data on total alcohol intake (consumed grams of alcohol/wk) and pattern of drinking. Multinomial and binomial logistic regressions were performed on the cross-sectional data to estimate odds ratios (ORs) with 95% confidence intervals (CIs). Adjustments were made for socioeconomic position as a child, psychiatric symptoms and emotional stability, and father's alcohol habits. RESULTS We found an increased OR of 1.20 (1.17 to 1.23) for every step decrease on the stanine scale to be a high consumer versus a light consumer of alcohol. For binge drinking, an increased OR of 1.09 (95% CI = 1.08 to 1.11) was estimated for every step decrease on the stanine scale. Adjustment for confounders attenuated the associations. Also, IQ in adolescence was found to be inversely associated with moderate/high alcohol consumption measured in middle age. CONCLUSIONS We found that lower results on IQ tests are associated with higher consumption of alcohol measured in terms of both total alcohol intake and binge drinking in Swedish adolescent men.
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Affiliation(s)
- Sara Sjölund
- Department of Public Health Sciences, Karolinska InstitutetStockholm, Sweden
| | - Tomas Hemmingsson
- Centre for Social Research on Alcohol and Drugs, Stockholm UniversityStockholm, Sweden
- Institute of Environmental Medicine, Karolinska InstitutetStockholm, Sweden
| | - Peter Allebeck
- Department of Public Health Sciences, Karolinska InstitutetStockholm, Sweden
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25
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Kang M, Yoon C, Yoon J. Influence of illness and unhealthy behavior on health‐related early retirement in Korea: Results from a longitudinal study in Korea. J Occup Health 2015; 57:28-38. [DOI: 10.1539/joh.14-0117-oa] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Mo‐Yeol Kang
- Institute for Occupational and Environmental Health, Wonjin Green HospitalRepublic of Korea
- Department of Preventive MedicineSeoul National University College of MedicineRepublic of Korea
| | - Chang‐gyo Yoon
- Department of Preventive MedicineArmed Forces Medical CommandRepublic of Korea
| | - Jin‐Ha Yoon
- The Institute for Occupational Health, Yonsei University College of MedicineRepublic of Korea
- Department of Preventive MedicineYonsei University College of MedicineRepublic of Korea
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Cannabis use in adolescence and risk of future disability pension: a 39-year longitudinal cohort study. Drug Alcohol Depend 2014; 143:239-43. [PMID: 25155890 DOI: 10.1016/j.drugalcdep.2014.07.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 07/28/2014] [Accepted: 07/29/2014] [Indexed: 11/23/2022]
Abstract
AIMS This study aimed at examining a possible association between cannabis use in adolescence and future disability pension (DP). DP can be granted to any person in Sweden aged 16-65 years if working capacity is judged to be permanently reduced due to long-standing illness or injury. METHODS Data were obtained from a longitudinal cohort study comprising 49,321 Swedish men born in 1949-1951 who were conscripted to compulsory military service aged 18-20 years. Data on DP was collected from national registers. RESULTS Results showed that individuals who used cannabis in adolescence had considerably higher rates of disability pension throughout the follow-up until 59 years of age. In Cox proportional-hazards regression analyses, adjustment for covariates (social background, mental health, physical fitness, risky alcohol use, tobacco smoking and illicit drug use) attenuated the associations. However, when all covariates where entered simultaneously, about a 30% increased hazard ratio of DP from 40 to 59 years of age still remained in the group reporting cannabis use more than 50 times. CONCLUSIONS This study shows that heavy cannabis use in late adolescence was associated with an increased relative risk of labor market exclusion through disability pension.
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Paljärvi T, Martikainen P, Leinonen T, Pensola T, Mäkelä P. Non-employment histories of middle-aged men and women who died from alcohol-related causes: a longitudinal retrospective study. PLoS One 2014; 9:e98620. [PMID: 24874518 PMCID: PMC4038621 DOI: 10.1371/journal.pone.0098620] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 05/06/2014] [Indexed: 11/23/2022] Open
Abstract
Background Long-term patterning of non-employment among problem drinkers is poorly understood. We determined the level and timing of non-employment, and the relative contribution of various types of non-employment among middle-aged persons who died of alcohol-related causes. Methods We conducted a longitudinal retrospective register-based study of Finnish men and women aged 45–64 years who died of alcohol-related causes (n = 15 552) or other causes (n = 39 166) in the period 2000–07, or who survived (n = 204 422) until the end of 2007. We traced back the number of days in employment and non-employment for up to 17 years before death or before the end of the study period for the survivors. Results The majority (≥56%) of persons who died of alcohol-related causes were in employment up to ten years before death. Over the 17-year period before death, those who died of alcohol-related causes were in employment on average two years less (mean 6.3 years, 95%CI 6.2–6.4) than those dying of other causes (8.2, 8.1–8.3), and five years less than survivors (11.6, 11.5–11.7), when sex and age were adjusted for. The relative role of various types of non-employment differed markedly across the two mortality groups. Among those who died of alcohol-related causes, unemployment accounted for 54% of the total burden of non-employment, in comparison with 29% among those who died of other causes. In contrast, disability pension accounted for 41% of the total burden of non-employment among those who died of alcohol-related causes, but 65% among those who died of other causes. Conclusions The results indicate the feasibility of preventing movement out of employment among middle-aged men and women with severe alcohol-related harm, provided that they are identified early on during their working careers and offered effective interventions.
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Affiliation(s)
- Tapio Paljärvi
- Alcohol and Drugs Unit, National Institute for Health and Welfare, Helsinki, Finland
- * E-mail:
| | | | - Taina Leinonen
- Population Research Unit, University of Helsinki, Helsinki, Finland
| | - Tiina Pensola
- Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Pia Mäkelä
- Alcohol and Drugs Unit, National Institute for Health and Welfare, Helsinki, Finland
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Patton R, Deluca P, Kaner E, Newbury-Birch D, Phillips T, Drummond C. Alcohol screening and brief intervention for adolescents: the how, what and where of reducing alcohol consumption and related harm among young people. Alcohol Alcohol 2014; 49:207-12. [PMID: 24232178 PMCID: PMC3932830 DOI: 10.1093/alcalc/agt165] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
AIM The aim of the study was to explore the evidence base on alcohol screening and brief intervention for adolescents to determine age appropriate screening tools, effective brief interventions and appropriate locations to undertake these activities. METHODS A review of existing reviews (2003-2013) and a systematic review of recent research not included in earlier reviews. RESULTS The CRAFFT and AUDIT tools are recommended for identification of 'at risk' adolescents. Motivational interventions delivered over one or more sessions and based in health care or educational settings are effective at reducing levels of consumption and alcohol-related harm. CONCLUSION Further research to develop age appropriate screening tools needs to be undertaken. Screening and brief intervention activity should be undertaken in settings where young people are likely to present; further assessment at such venues as paediatric emergency departments, sexual health clinics and youth offending teams should be evaluated. The use of electronic (web/smart-phone based) screening and intervention shows promise and should also be the focus of future research.
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Affiliation(s)
- Robert Patton
- Corresponding author: Addictions Department, National Addiction Centre, Institute of Psychiatry, King's College London, 4 Windsor Walk, London SE5 8BB, UK
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Dalager-Pedersen M, Koch K, Wernich Thomsen R, Schønheyder HC, Nielsen H. The effect of community-acquired bacteraemia on return to workforce, risk of sick leave, permanent disability pension and death: a Danish population-based cohort study. BMJ Open 2014; 4:e004208. [PMID: 24477315 PMCID: PMC3913024 DOI: 10.1136/bmjopen-2013-004208] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES Little is known about the prognosis of community-acquired bacteraemia (CAB) in workforce adults. We assessed return to workforce, risk for sick leave, disability pension and mortality within 1 year after CAB in workforce adults compared with blood culture-negative controls and population controls. DESIGN Population-based cohort study. SETTING North Denmark, 1996-2011. PARTICIPANTS We used population-based healthcare registries to identify all patients aged 20-58 years who had first-time blood cultures obtained within 48 h of medical hospital admission, and who were part of the workforce (450 bacteraemia exposed patients and 6936 culture-negative control patients). For each bacteraemia patient, we included up to 10 matched population controls. PRIMARY AND SECONDARY OUTCOME MEASURES Return to workforce, risk of sick leave, permanent disability pension and mortality within 1 year after bacteraemia. Regression analyses were used to compute adjusted relative risks (RRs) with 95% CIs. RESULTS One year after admission, 78% of patients with CAB, 85.7% of culture-negative controls and 96.8% of population controls were alive and in the workforce, and free from sick leave or disability pension. Compared with culture-negative controls, bacteraemia was associated with an increased risk for long-term sick leave (4-week duration, 40.2% vs 23.9%, adjusted RR, 1.51; CI 1.34 to 1.70) and an increased risk for mortality (30-day mortality, 4% vs 1.4%, adjusted RR, 2.34, CI 1.22 to 4.50; 1-year mortality, 8% vs 3.9%, adjusted RR, 1.73; CI 1.18 to 2.55). Bacteraemia patients had a risk for disability pension similar to culture-negative controls (2.7% vs 2.6%, adjusted RR, 0.99, CI 0.48 to 2.02) but greater than population controls (adjusted RR, 5.20; 95% CI 2.16 to 12.50). CONCLUSIONS CAB is associated with long duration of sick leave and considerable mortality in working-age adults when compared with blood culture-negative controls, and an increased 1-year risk for disability pension when compared with population controls.
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Affiliation(s)
- Michael Dalager-Pedersen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus N, Denmark
| | - Kristoffer Koch
- Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus N, Denmark
- Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark
| | - Reimar Wernich Thomsen
- Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus N, Denmark
| | | | - Henrik Nielsen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
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Cognitive ability in late adolescence and disability pension in middle age: follow-up of a national cohort of Swedish males. PLoS One 2013; 8:e78268. [PMID: 24147128 PMCID: PMC3797835 DOI: 10.1371/journal.pone.0078268] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 09/11/2013] [Indexed: 11/19/2022] Open
Abstract
Low cognitive ability in late adolescence has previously been shown to be associated with disability pension (DP) in young adulthood. However, most DP's are granted later in working life, and the mechanisms of the association are not fully understood. We aimed to investigate the association between cognitive ability in late adolescence and DP at ages 40-59, and investigate the role of individual and socioeconomic factors. Information on cognitive ability, health status, personality aspects and health behaviours at age 18-20 was obtained from the 1969-70 conscription cohort, comprising 49,321 Swedish men. Data on DP's 1991-2008 was obtained from the Longitudinal Database of Education, Income and Employment. Information on socioeconomic and work-related factors in childhood and adulthood was obtained from national sociodemographic databases. Hazard ratios for DP during follow-up were estimated by Cox proportional hazards models. We found a graded relationship between cognitive ability in late adolescence and DP in middle age. One step decrease on the nine-point stanine scale of cognitive ability was associated with a crude hazard ratio of 1.26 (95% CI 1.24-1.27). Socioeconomic and work-related circumstances in adulthood explained much of the association, but factors measured already in late adolescence also showed importance. The findings suggest an accumulation of risks over the life course. Although attenuated, the graded relationship remained after adjusting for all factors.
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Samuelsson Å, Ropponen A, Alexanderson K, Svedberg P. A prospective cohort study of disability pension due to mental diagnoses: the importance of health factors and behaviors. BMC Public Health 2013; 13:621. [PMID: 23816331 PMCID: PMC3733696 DOI: 10.1186/1471-2458-13-621] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 06/27/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies have found associations between various health factors and behaviors and mental disorders. However, knowledge of such associations with disability pension (DP) due to mental diagnoses is scarce. Moreover, the influence of familial factors (genetics and family background) on the associations are mainly unknown. The aim of the study was to investigate associations between health factors and behaviors and future DP due to mental diagnoses in a twin cohort, accounting for familial confounding. METHODS A prospective cohort study of Swedish twins (N=28 613), including survey data and national register data on DP and other background factors was conducted. Cox proportional hazards regression models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI) for the whole twin cohort, and for discordant twin pairs. RESULTS During follow-up 1998-2008 (median 10 years), 2.2% of the cohort was granted a DP with a mental diagnosis. In the fully adjusted analyses of the whole cohort, the associations of poor or moderate self-rated health (SRH), under- or overweight, former or current tobacco use, or being an abstainer from alcohol were significantly associated with risk of DP due to mental diagnoses. Analyses of discordant twin pairs confirmed all these associations, except for current tobacco use, being independent from familial confounding. Exclusion of individuals with current or previous depression or anxiety at baseline did not influence the associations found. CONCLUSIONS Poor or moderate SRH, under- or overweight, former tobacco use or being an abstainer from alcohol seem to be strong direct predictors of DP due to mental diagnoses, independently of several confounders of this study, including familial factors.
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Affiliation(s)
- Åsa Samuelsson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm SE-171 77, Sweden
| | - Annina Ropponen
- School of Medicine, University of Eastern Finland, Kuopio, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm SE-171 77, Sweden
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm SE-171 77, Sweden
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Vie GÅ, Krokstad S, Johnsen R, Bjørngaard JH. The Health Hazards of Marriage. A cohort study of work related disability within 12,500 Norwegian couples - the HUNT Study. Scand J Public Health 2013; 41:500-7. [PMID: 23524409 DOI: 10.1177/1403494813482185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Work disability and sickness absence increase following partner's retirement, which similarities in spouses' health could explain. We therefore studied the risk of work disability within couples, taking account of baseline health, lifestyle and socioeconomic factors. METHODS A cohort of 12,511 couples from the HUNT Study (aged 20-67 years in HUNT2, 1995-1997) was linked to national registries, identifying all new cases of disability pension up until December 2007. Data were analysed with discrete time multilevel logistic regression and Cox regression models. Partners' disability pension was included as a time-varying covariate. Follow-up time was split to examine the association dependent of time. Analyses were adjusted for age only, adjusted for health, and for lifestyle and education along with health. RESULTS About 15% of an individual's propensity to receive a disability pension could be attributed couple similarity. There was an increased risk of work disability following the spouse's disability retirement [HR (hazard ratio) 1.43 (95% confidence interval 1.20-1.71) for men, HR 1.49 (95% confidence interval 1.28-1.74) for women]. The association was somewhat attenuated after adjustments for health, lifestyle and education. CONCLUSION There was a substantial clustering of disability pensions within couples, which cannot be explained by similarities in health, lifestyle and education. This suggests partners influence each other's work ability. From a clinical perspective, the family situation needs to be taken into account when addressing health promotion and work participation.
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Affiliation(s)
- Gunnhild Åberge Vie
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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