Lifestyle changes with help from Health Profile Assessment in combination with support in individual interventions for persons with acquired brain injury – A pilot study

Self-Reported General Health, Overall and Work-Related Stress, Loneliness, and Sleeping Problems in 335,625 Swedish Adults from 2000 to 2016

The prevalence of poor health, in particular stress-related mental ill-health, is increasing over time and birth cohorts. As rapid societal changes have occurred in the last decade and still are occurring, there is an interest in investigating the trends in health-related factors. The aim of the present study was to investigate trends in self-reported general health, overall stress, work-related stress, feelings of loneliness, and sleeping problems in 335,625 Swedish adults across categories of gender, geographic regions, length of education, and age from 2000 to 2016. On population level, sleeping problems and poor general health have increased markedly and significantly, while experiences of work stress decreased between 2000 and 2016 (p < 0.05). Overall stress and level of loneliness were unchanged (p > 0.05). The risk of having ≥3 symptoms (any of poor or very poor general health, often or very often perceived overall stress, loneliness, or sleeping problems) has increased significantly from 2000 to 2016 (ß = 1034 (1027–1040)). This increase was significantly higher in young (ß = 1052 (1038–1065)) and individuals with lower education (ß = 1056 (1037–1076)) compared to older and high length of education.

Active commuting in Swedish workers between 1998 and 2015-Trends, characteristics, and cardiovascular disease risk

Background

Trend analyses of active commuting and potential variations in trends and association with cardiovascular disease (CVD) risk within subgroups are unknown.

Objectives

To (a) describe trends in active commuting between 1998 and 2015 and (b) to study the association between different amounts of active commuting and the incidence risk of CVD in a large sample of Swedish workers, and analyses of potential variations across subgroups of socio‐demographics, physical activity, and BMI.

Methods

A total of 318 309 participants (47% women, 18‐74 years) who participated in a nationwide occupational health service screening between 1998 and 2015 were included. Commuting habits were self‐reported, and data on first‐time CVD events were derived from national registers.

Results

Self‐reported passive commuters decreased between 1998 and 2015 (64% to 56%), transferring to an increase in mainly moderate/high‐dose active commuters (12% to 19%). Changes were seen in all subgroups. The characteristics and lifestyle habits of the typical passive and active commuter changed little over the study period. Low‐ and moderate/high‐dose active commuters had significantly decreased risks for a first time CVD during follow‐up. This was accentuated in men, middle‐aged, and in participants with light physical work situations, irregular exercise habits, being overweight/obese, and with low fitness.

Conclusion

Increases in active commuting were observed between 1998 and 2015, however still leaving a majority who do not actively commute. As active commuting, regardless dose, is associated with a lower CVD risk, encouraging more people to actively commute may provide an easily accessible and time‐efficient possibility to increase physical activity and health in the general population.

Non-participation in initial and repeated health risk appraisals - a drop-out analysis based on a health project

BACKGROUND

Health risk assessment (HRAs) are commonly used by occupational health services (OHS) to aid workplaces in keeping their employees healthy, but for unknown reasons, many employees choose not to participate in the HRAs. The aim of the study was to explore whether demographic, lifestyle and health-related factors in employees are associated with non-participation in initial and repeated HRAs.

METHODS

In an OHS-based health project, 2022 municipal employees were asked to participate in three repeated HRAs. Multiple logistic regression analyses were used so as to determine associations between non-participating and demographic, lifestyle and health-related factors (e.g. biomarkers).

RESULTS

Among the employees who were asked to participate in the health project, more than half did not participate in any HRA and among those who did, more than one third did not participate in repeated HRAs. Young age, male sex and being employed in the Technical department or Health and Social Care department in comparison with being employed in the department for Childcare and Education were factors significantly associated with non-participation in the initial HRA. These factors, together with being on sick leave and having unhealthy dietary habits, were factors associated with non-participation in repeated HRAs.

CONCLUSIONS

Among the non-participators in initial HRAs and in repeated HRAs younger men and those already related to ill-health were overrepresented. This implicates that health care providers to a higher extent should focus on "those most needed" and that employers should be more engaged in results of repeated HRA's. Future studies should focus on modifiable variables that could make the HRAs more attractive and inclusive.

Decline in cardiorespiratory fitness in the Swedish working force between 1995 and 2017

Background

Long‐term trend analyses of cardiorespiratory fitness (VO₂max) in the general population are limited.

Objectives

To describe trends in VO₂max from 1995 to 2017 in the Swedish working force and to study developments across categories of sex, age, education, and geographic regions.

Methods

A total of 354 277 participants (44% women, 18‐74 years) who participated in a nationwide occupational health service screening between 1995 and 2017 were included. Changes in standardized mean values of absolute (L/min) and relative (mL/min/kg) VO₂max, and the proportion with low (<32) relative VO₂max are reported. VO₂max was estimated using a submaximal cycle test.

Results

Absolute VO₂max decreased by −6.7% (−0.19 L/min) in the total population. Relative VO₂max decreased by −10.8% (−4.2 mL/min/kg) with approximately one‐third explained by a simultaneous increase in body mass. Decreases in absolute fitness were more pronounced in men vs women (8.7% vs 5.3%), in younger vs older (6.5% vs 2.3%), in short (11.4%) vs long (4.5%) education, and in rural vs urban regions (6.5% vs 3.5%), all P < 0.001. The proportions with low VO₂max increased from 27% to 46% (P < 0.001).

Conclusion

Between 1995 and 2017, there was a steady and pronounced decline in mean cardiorespiratory fitness in Swedish adults. Male gender, young age, short education, and living in a rural area were predictive of greater reductions. The proportion with low cardiorespiratory fitness almost doubled. Given the strong associations between cardiorespiratory fitness and multiple morbidities and mortality, preventing further decreases is a clear public health priority, especially for vulnerable groups.

Physical Education and Leisure-Time Physical Activity in Youth Are Both Important for Adulthood Activity, Physical Performance, and Health

BACKGROUND

The importance of youth physical activity (PA) for adulthood PA, performance, and health was retrospectively evaluated.

METHODS

A total of 258,146 participants (49% women), aged 19-70, with a first-time health-profile assessment between 1982 and 2015, provided self-reported data on current perceived health, PA, lifestyle, and physical education class participation, and PA outside school hours before age 20. Data on anthropometrics, blood pressure, and estimated maximal oxygen consumption (VO_2max) were obtained.

RESULTS

Women participating in physical education class, compared with those who did not, had significantly lower OR (range: 0.81-0.87) for perceiving poor overall health, general obesity, and high diastolic blood pressure after adjustment for potential confounders, and increased OR (range: 1.17-1.23) for exercising regularly and a normal/high VO_2max in adulthood. For men, the ORs were significantly lower (range: 0.66-0.86) for poor perceived overall health, general, and abdominal obesity. These associations were seen for participants up to 70 years. Increased PA outside school hours revealed even stronger beneficial associations. In joint analyses, both youth and current PA were important for lower OR of poor health and being obese in adulthood.

CONCLUSIONS

Physical education class participation and additional PA after school hours were both important for perceived health, PA, VO_2max, and metabolic health in adulthood up to 70 years.