Childhood adversities, parental education and disability retirement among Finnish municipal employees

Contribution of compositional changes in the workforce to sickness absence trends in Finland

In this study, we assessed whether the long-term decrease in sickness absences in Finland is explained by observed and unobserved compositional changes in the workforce. Utilizing register-based panel data on Finnish wage earners aged 30-62, we examined the annual onset of compensated sickness absence (granted after 10 weekdays) in the period 2005-2016. We applied random effects models adjusting for changes in the observed sociodemographic and occupational characteristics of the study population. We also applied fixed effects models, with corrections of the estimates for cohort ageing, to additionally account for the unobserved time-invariant characteristics of the study population over the years. Of the observed characteristics, increasing educational level partly explained the decreasing trend in sickness absences, and the further contribution of the occupational class was weak. Additionally, accounting for unobserved individual characteristics further explained the decreasing trend in sickness absences among those aged 30-47 years and led to a reverse increasing trend among those aged 48-62 years irrespective of sex and employment sector. Particularly for those over 47 years old, the decrease in sickness absences appeared to be more strongly influenced by compositional changes in characteristics that are established before fully entering the labour market - such as educational level as well as unmeasured individual characteristics that remain unchanged after childhood and early adulthood - than in the work environment or other factors contributing at working age. Sickness absence trends fluctuated during economic cycles, which did not appear to be explained by immediate changes in the observed or unobserved characteristics. Different mechanisms are likely to explain long-term sickness absence trends and trends around economic cycles. Attempts to improve work ability and labour market inclusion in long-term should rely more on increasing educational levels among the workforce and on interventions carried out early during the life course.

Childhood adversity and risk of later labor market marginalization in young employees in Sweden

BACKGROUND

The present study examined the independent and combined effects of childhood adversity (CA) and occupational class on the risk of future labor market marginalization (LMM) in young employees in Sweden. Occupational class (non-manual/manual workers) was also explored as a potential mediator.

METHODS

This population-based longitudinal cohort study included 556 793 employees, 19-29 years, residing in Sweden in 2009. CAs included parental death, parental mental and somatic disorders, parental separation, household public assistance, single-parent household and residential instability. Measures of LMM included long-term unemployment (LTU), long-term sickness absence (LTSA) and disability pension. Estimates of risk of each LMM measure, between 2010 and 2016 were calculated as hazard ratios (HRs) with 95% confidence intervals (CIs), using a Cox regression analysis.

RESULTS

Those exposed to CA had an elevated risk for all measures of LMM. Manual workers with a history of household public assistance had the highest risk estimates compared to non-manual workers with no CAs [adjusted HR spanning from 1.59 (LTSA) to 2.50 (LTU)]. Regardless of occupational class, the risk of LMM grew higher with increasing number of CAs (e.g. adjusted HR of LMM in manual workers with 3+ CAs: 1.87, 95% CI: 1.81-1.94). These patterns persisted after adjustments for a range of confounders, including psychiatric and somatic morbidity. Last, we found a small but significant mediating effect of occupational class in the association between CA and LMM.

CONCLUSIONS

Information on CAs are important determinants of LMM in young adults, and especially in manual workers.

Associations between low parental education, childhood adversities and sickness absence in midlife public sector employees

AIMS

Parental education and childhood adversities are associated with long-term work disability but their contribution to sickness absence is largely unknown. We aimed to examine the associations between parental education, childhood adversities and self-certified and medically-certified sickness absence among midlife employees.

METHODS

The Helsinki Health Study baseline survey data (2000-2002) of 40-to-60-year-old municipal employees were linked with sickness absence data from the employer's register. Self-certified (1-3 days) and medically-certified (>3 days) sickness absence spells were followed from 2003 until the end of 2008. The study included 5728 employees. The analyses were made by Poisson regression and the results are presented as rate ratios (RRs) and their 95% confidence intervals (CIs).

RESULTS

Low maternal education was associated with self-certified sickness absence (RR 1.32, 95% CI 1.13-1.55) among women only whereas both low maternal (1.49, 1.26-1.77) and low paternal education (1.48, 1.32-1.67) were associated with medically-certified sickness absence. Adjustment for own occupational class mainly abolished these associations. Having experienced any childhood adversity was associated with self-certified (1.18, 1.12-1.25) and medically-certified (1.22, 1.15-1.30) sickness absence. In addition, childhood economic difficulties, childhood illness, parental divorce, parental mental illness, parental alcohol problems and bullying were each associated both with self-certified and with medically-certified sickness absence. The associations mainly remained after adjustments for occupational class, marital status, working condition, body mass index and health behaviours.

CONCLUSIONS

Low parental education and childhood adversities contributed to midlife sickness absence. Promoting well-being of families with children might help sustain adult work ability and prevent sickness absence still in midlife.

Cause of parental death and child's health and education: The role of parental resources

Early parental death has been linked to problems in health and educational path. We added to the literature by examining disability pension and various educational outcomes after external (accident, violence, suicide) or natural parental death during childhood or adolescence, taking into account possible heterogeneous associations by parental resources. Using Finnish register data and linear random-effects models, we analysed outcomes of 90,620 and 88,859 children (paternal and maternal death samples, respectively) born between 1982 and 1990. Results indicated lower educational performance and attainment, and a higher probability of disability pension in the bereaved offspring, especially after external parental death. Half of these connections were explained after adjusting for childhood family characteristics. Having a highly educated surviving parent might protect from negative educational and health outcomes. The findings were partly similar for father's and mother's deaths. We demonstrated that the negative associations between parental death and child wellbeing differ by cause of death and parental resources. Cause of death and overall family circumstances should both be considered when analysing child outcomes after parental loss.