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Salonsalmi A, Kouvonen A, Rahkonen O, Lahelma E, Lallukka T. Work-family conflicts and sickness absence-a register-linked cohort study among young and early midlife employees. Eur J Public Health 2024; 34:316-321. [PMID: 38332545 PMCID: PMC10990516 DOI: 10.1093/eurpub/ckae012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Work-family conflicts (WFC) have been associated with poor mental health, poor self-rated health and sickness absence. However, studies on short sickness absence are lacking and more information is needed also about long sickness absence regarding the direction of WFC, and potential explaining factors particularly among young and early middle-aged employees. METHODS The Helsinki Health Study baseline survey (2017) among 19- to 39-year-old municipal employees (N = 3683, 80% women, response rate 51.5%) was linked to employer's sickness absence data. The associations of work-to-family conflicts (WTFC) and family-to-work conflicts (FTWC) with short (1-7 days) and long (over 7 days) sickness absence were analyzed using negative binomial regression analysis. Covariates were age, gender, family-related factors and work-related factors. Stratified analyses by occupational class were performed. The results are presented as rate ratios and their 95% confidence intervals. RESULTS High WTFC were associated with short (1.25, 1.12-1.40) and long (1.37, 1.11-1.70) sickness absence. High FTWC were also associated with short (1.12, 1.03-1.22) and long (1.24, 1.06-1.45) sickness absence. Adjustment for family-related factors strengthened the associations, whereas adjustment for work-related factors abolished the associations between WTFC and sickness absence. Associations between WFC and sickness absence were observed among two lowest occupational classes only. CONCLUSION WFC are associated with both short and long sickness absence. Work-related factors including the quality of supervisory work and shift work play a role in the association. Intervention studies could determine if improvements in combining work and family life lead to a reduction in sickness absence.
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Affiliation(s)
- Aino Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Suur-Uski J, Fagerlund P, Granroth-Wilding H, Salonsalmi A, Rahkonen O, Lallukka T. Dual trajectories of short-term and long-term sickness absence and their social- and health-related determinants among women in the public sector. Eur J Public Health 2024; 34:322-328. [PMID: 38379312 PMCID: PMC10990561 DOI: 10.1093/eurpub/ckae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Short- and long-term sickness absence (SA) vary in their determinants. We examined short- and long-term SA contemporaneously as two interconnected phenomena to characterize their temporal development, and to identify employees with increasing SA at an early stage. METHODS We extracted 46- to 55-year-old employed women from the Helsinki Health Study occupational cohort during 2000-17 (N = 3206) and examined the development of short- (1-14 days) and long-term (>14 days) SA using group-based dual trajectory modelling. In addition, we investigated the associations of social-, work- and health-related factors with trajectory group membership. RESULTS For short-term SA, we selected a three-group solution: 'no short-term SA' (50%), 'low frequency short-term SA' (40%), and 'high frequency short-term SA' (10%) (7 spells/year). For long-term SA, we also selected three trajectory groups: 'no long-term SA' (65%), 'low long-term SA' (27%), and 'high long-term SA' (8%). No SA in the short-term SA model, indicated a high probability of no SA in the long-term model and vice versa. The developmental pattern was far less certain if participant was assigned to a trajectory of high SA in either one of the models (short- or long-term SA model). Low occupational class and poor health behaviours were associated with the trajectory groups with more SA. CONCLUSION SA does not increase with age among most employees. If either SA rate was high, the developmental patterns were heterogenous. Employers' attention to health behaviours might aid in reducing both short- and long-term SA.
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Affiliation(s)
- Johanna Suur-Uski
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Pi Fagerlund
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Hanna Granroth-Wilding
- Biostatistics Consulting Service, Medical Faculty, University of Helsinki, Helsinki, Finland
| | - Aino Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Suur-Uski J, Pietiläinen O, Salonsalmi A, Pekkala J, Fagerlund P, Rahkonen O, Lallukka T. Long-term sickness absence trajectories among ageing municipal employees - the contribution of social and health-related factors. BMC Public Health 2023; 23:1429. [PMID: 37495983 PMCID: PMC10373243 DOI: 10.1186/s12889-023-16345-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/19/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND The ageing work force is heterogeneous, following distinct development in work ability. This study aims to identify trajectories of long-term sickness absence (SA) in later careers and to examine potentially modifiable factors associated with the development of SA. METHODS Data comprised of municipal employees of the city of Helsinki aged 50-60 years during 2004-2018 (N = 4729, 80% women). The developmental trajectories of long-term (> 10 working days) SA were examined with Group-based trajectory modelling (GBTM) using SA records of the Social Insurance Institution of Finland during 2004-2018. All-cause and diagnosis-specific (mental disorder- and musculoskeletal disease-related) SA days were analysed. The association of social and health-related factors with trajectory membership was examined using multinomial logistic regression (odds ratios and 95% confidence intervals). RESULTS A model with three trajectories was selected for both all-cause and diagnosis-specific SA. Regarding all-cause long-term SA trajectories, 42% had no long-term SA, 46% had low levels of SA, and 12% had a high rate of SA during follow-up. Lower occupational class, reporting smoking, overweight or obesity, moderate or low leisure-time physical activity, and sleep problems were associated with a higher likelihood of belonging to the trajectory with a high rate of SA in both all-cause and diagnosis-specific models. CONCLUSIONS Most ageing employees have no or little long-term SA. Modifiable factors associated with trajectories with more SA could be targeted when designing and timing interventions in occupational healthcare.
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Affiliation(s)
- Johanna Suur-Uski
- Department of Public Health, University of Helsinki, Tukholmankatu 8B, P.O. Box 20, Helsinki, 00014, Finland.
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, Tukholmankatu 8B, P.O. Box 20, Helsinki, 00014, Finland
| | - Aino Salonsalmi
- Department of Public Health, University of Helsinki, Tukholmankatu 8B, P.O. Box 20, Helsinki, 00014, Finland
| | - Johanna Pekkala
- Department of Public Health, University of Helsinki, Tukholmankatu 8B, P.O. Box 20, Helsinki, 00014, Finland
| | - Pi Fagerlund
- Department of Public Health, University of Helsinki, Tukholmankatu 8B, P.O. Box 20, Helsinki, 00014, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Tukholmankatu 8B, P.O. Box 20, Helsinki, 00014, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Tukholmankatu 8B, P.O. Box 20, Helsinki, 00014, Finland
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Karjala A, Pietiläinen O, Salonsalmi A, Lahti J, Lallukka T, Rahkonen O. Changes in occupational class differences in leisure-time physical activity and the contribution of retirement. Scand J Med Sci Sports 2023; 33:283-291. [PMID: 36326782 DOI: 10.1111/sms.14256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
Occupational class differences in leisure-time physical activity (LTPA) are well recognized. Less is known about how these differences develop as individuals age, and how retirement is associated with this change. We investigated how occupational class differences in LTPA change in a cohort over a 15-17 years follow-up. We further examined, how the transition into mandatory or disability retirement contributed to the change in LTPA levels and occupational class differences. We used the data from the Helsinki Health Study surveying the aging City of Helsinki employees. In all, 8773 individuals were included in the analyses. We evaluated LTPA levels using weekly metabolic equivalent task (MET) hours and used generalized linear mixed effect models (GLMM) to estimate the development of LTPA levels. Commuting was included in the LTPA measure. Occupational class differences in LTPA emerged and widened during the follow-up. The physical activity levels decreased in the lower occupational class and slightly increased in the higher occupational class, resulting in a difference of 4.3 MET-hours at the end of follow-up, accounting for 50 min of brisk walking per week. The occupational class differences emerged during transition into mandatory retirement and persisted after this. Transition into disability retirement temporarily widened the occupational class differences in LTPA levels, but the differences diminished during the follow-up. Research on interventions to counteract the declining LTPA is needed to discover ways to prevent the widening of occupational health disparities during aging. The transition into old-age retirement could be an optimal period for focusing these interventions.
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Affiliation(s)
- Anni Karjala
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Aino Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jouni Lahti
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
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5
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Fagerlund P, Salmela J, Pietiläinen O, Salonsalmi A, Rahkonen O, Lallukka T. Life-course socioeconomic circumstances in acute, chronic and disabling pain among young employees: a double suffering. Scand J Public Health 2023; 51:257-267. [PMID: 34965800 PMCID: PMC9969306 DOI: 10.1177/14034948211062314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Pain is known to be socioeconomically patterned and associated with disability. However, knowledge is scarce concerning life-course socioeconomic circumstances and pain among young adults. Our aim was to examine the associations of childhood and current socioeconomic circumstances with acute pain and chronic pain with low and high disability levels among young Finnish municipal employees. METHODS We analysed questionnaire data retrieved from the Young Helsinki Health Study (n=4683) covering 18-39-year-old employees of the City of Helsinki, Finland. We included multiple indicators of childhood and current socioeconomic circumstances and examined their associations with acute pain and with chronic pain with low and high disability levels. The level of chronic pain-related disability was assessed by the chronic pain grade questionnaire. Multinomial logistic regression analyses were conducted with stepwise adjustments for sociodemographic, socioeconomic and health-related covariates. RESULTS Childhood and current socioeconomic disadvantage were associated with acute and chronic pain, particularly with chronic pain with high disability level. The strongest associations after adjustments for covariates remained between chronic pain with high disability level and low educational level (odds ratio (OR) 3.38, 95% confidence interval (CI) 2.18-5.24), manual occupation (OR 3.75, 95% CI 1.92-7.34) and experiencing frequent economic difficulties (OR 3.07, 95% CI 2.00-4.70). CONCLUSIONS
Pain is a common complaint that contributes to disability among young employees, particularly the most socioeconomically vulnerable. There is a socioeconomic gradient in both pain chronicity and the level of chronic pain-related disability. Life-course socioeconomic factors should be considered in pain-preventing strategies and in clinical practice.
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Affiliation(s)
- Pi Fagerlund
- Pi Fagerlund, Department of Public Health,
University of Helsinki, P.O. Box 20, Tukholmankatu 8 B, 00014 Helsinki, Finland.
E-mail:
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Salonsalmi A, Mauramo E, Rahkonen O, Pietiläinen O, Lahelma E. Joint association of socioeconomic circumstances and minor mental health problems with antidepressant medication. Eur J Public Health 2022; 32:535-541. [PMID: 35656708 PMCID: PMC9341681 DOI: 10.1093/eurpub/ckac048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Disadvantageous socioeconomic circumstances and minor mental health problems have both been associated with mental disorders, such as depression, but their joint contribution remains unknown. Methods The Helsinki Health Study baseline survey (2000–02) of 40- to 60-year-old employees was linked with antidepressant medication data from registers of the Social Insurance Institution of Finland. The analyses were made using logistic regression with first prescribed antidepressant medication purchase during a 10-year follow-up as the outcome. Minor mental health problems were measured by the emotional well-being scale of the RAND-36. Odds ratios were calculated for joint association of the lowest quartile of the emotional well-being scale of the RAND-36 and socioeconomic circumstances. Childhood (parental education and childhood economic difficulties), conventional (education, occupational class and income) and material (housing tenure and current economic difficulties) socioeconomic circumstances were examined. This study included 5450 participants. Results Minor mental health problems dominated the joint associations. Minor mental health problems were associated with antidepressant medication irrespective of socioeconomic circumstances whereas only low income, current economic difficulties and living in rented housing showed an association without minor mental health problems at baseline. Marital status, working conditions and BMI and health behaviours had only minimal contributions to the associations. Conclusions Minor mental health problems were consistently and strongly associated with antidepressant medication and dominated the joint associations with socioeconomic circumstances. Paying attention to minor mental health problems might help prevent mental disorders such as depression.
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Affiliation(s)
- Aino Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Elina Mauramo
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
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7
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Salonsalmi A, Rahkonen O, Lahelma E, Pietiläinen O, Lallukka T. Associations between low parental education, childhood adversities and sickness absence in midlife public sector employees. Scand J Public Health 2022:14034948221087996. [PMID: 35546096 DOI: 10.1177/14034948221087996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
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.
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Affiliation(s)
- Aino Salonsalmi
- Department of Public Health, University of Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, Finland
| | | | - Tea Lallukka
- Department of Public Health, University of Helsinki, Finland
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8
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Koskenvuori M, Pietiläinen O, Elovainio M, Rahkonen O, Salonsalmi A. A longitudinal study of changes in interactional justice and subsequent short-term sickness absence among municipal employees. Scand J Work Environ Health 2021; 47:136-144. [PMID: 33011814 PMCID: PMC8114563 DOI: 10.5271/sjweh.3927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objectives Level of perceived interactional justice has been shown to be associated with sickness absence, but less is known about the effects of changes in interactional justice. It is also unknown to what extent unmeasured, time-invariant differences contribute to the association. We investigated the association between interactional justice changes and subsequent short-term (1-3 days) sickness absences over a 12-year follow-up using between- and within-individual modeling among ageing municipal employees. Methods The data was derived from Helsinki Health Study cohort with baseline survey in 2000-2002 (N=8960, response rate 67%) and follow-up surveys in 2007 and 2012 (response rates 79% and 83%, respectively). At baseline, participants were 40-60-year-old employees of the City of Helsinki, Finland. Sickness absences from the employer's registry were linked with the responses (78%). The analytic sample was 2109 and 2070 individuals for between-individual and 4433 individuals and 8425 observations for within-individual associations. Results Negative change in interactional justice was associated with an increased risk of short-term sickness absence in between-individual models after adjusting for age and gender. Adjustment for sickness absence history attenuated the association. In within-individual models, a negative change in perceived interactional justice was associated with an increased risk of short-term sickness absence spells [incidence rate ratios (IRR) 1.05 (95% confidence interval 1.01-1.09)]. This association was robust to adjustments for gender, age, health behaviors and sickness absence history. Conclusions Paying attention to management principles - especially managerial behavior and treatment of employees to avoid the deterioration of the level of interactional justice - may provide a way of reducing self-certified short-term sickness absence spells.
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Affiliation(s)
- Mika Koskenvuori
- Department of Public Health, PO BOX 20, FI-00014, University of Helsinki, Finland.
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9
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Abstract
Aims: Chronic pain is a notable burden on public health, with
past and present factors contributing to it. This study aimed to examine the
associations between childhood adversities and chronic pain.
Methods: Data on seven childhood adversities, chronic pain
and disabling pain were derived from questionnaire surveys conducted in 2000,
2001 and 2002 among 40- to 60-year-old employees (response rate of 67%) of the
City of Helsinki, Finland. The study included 8140 employees (80% women).
Logistic regression was used in the analyses, and the results are presented as
odds ratios (OR) and their 95% confidence intervals (CI). Age, sex, the father’s
education, the participant’s education, marital status, working conditions,
sleep problems and common mental disorders were included as covariates.
Results: In the age-adjusted models, childhood economic
difficulties (OR=1.60, 95% CI 1.41–1.81), childhood illness (OR=1.74, 95% CI
1.45–2.08), parental divorce (OR=1.26, 95% CI 1.07–1.48), parental alcohol
problems (OR=1.34, 95% CI 1.18–1.52) and bullying at school or among peers
(OR=1.59, 95% CI 1.37–1.89) were associated with chronic pain. Working
conditions, sleep problems and common mental disorders each slightly attenuated
the associations between childhood adversities and chronic pain. Childhood
economic difficulties among women (OR=1.72, 95% CI 1.40–2.10), childhood illness
(OR=1.40, 95% CI 1.07–1.82) and bullying at school or by peers (OR=1.91 95% CI
1.48–2.46) were also associated with disabling pain.
Conclusions:Childhood adversities were associated with chronic pain in mid-life, and
the associations mainly remained after adjustments. Investing in the
well-being of children might prevent pain and promote well-being in
mid-life.
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Affiliation(s)
- Aino Salonsalmi
- Department of Public Health, University of Helsinki, Finland
| | | | - Eero Lahelma
- Department of Public Health, University of Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Finland
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10
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Lahti J, Mauramo E, Lahelma E, Lallukka T, Pietiläinen O, Salmela J, Salonsalmi A, Rahkonen O. Healthy behaviours and risk of all-cause mortality. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Healthy behaviours are associated with better health in general but less is known about the combined associations of multiple healthy behaviours with mortality risk. We aimed to examine the associations of combined healthy behaviours with mortality risk over a 15-year follow-up among middle-aged employees.
Methods
Survey data, collected in 2000–2002 among 40–60-year-old employees of the City of Helsinki, Finland, was linked with complete register data on mortality from Statistics Finland (response rate 67%, written informed consent for register linkages 74%). Healthy behaviours included high leisure-time physical activity, non-smoking, no binge drinking and healthy food habits. Each healthy behaviour were dichotomized and assigned a value of one for healthy and zero for unhealthy. The number of healthy behaviours were summed together (score range 0-4). Cox regression models were fitted, and the follow-up continued until the end of 2015 (n = 6336). Confounders included age, sex, marital status, socioeconomic position and self-rated health.
Results
Of the respondents, 7% reported four healthy behaviours, 27% three, 34% two, 22% one and 9% no healthy behaviours. A total of 281 deaths occurred during the follow-up. Each healthy behaviour was individually associated with a reduced mortality risk, non-smoking having the strongest and healthy diet the weakest association. The combined association showed that those without any of the healthy behaviours (HR 2.8, 95% CI 1.51-5.29) and those with only one healthy behaviour (HR 1.89, 95% CI 1.04-3.43) had a higher mortality risk than those with four healthy behaviours. Instead, those with at least two healthy behaviours were not at an increased risk of mortality.
Conclusions
A low number of healthy behaviours predicted mortality among middle-aged employees. Efforts should be made to promote multiple healthy behaviours among the middle-aged to enhance health and prevent premature mortality.
Key messages
Almost one third of the respondents had no or only one healthy behaviour. A low number of healthy behaviours was associated with an increased risk of mortality.
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Affiliation(s)
- J Lahti
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - E Mauramo
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - E Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - T Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - J Salmela
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - A Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
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11
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Salonsalmi A, Lallukka T, Lahelma E, Pietiläinen O, Rahkonen O. Childhood adversities and chronic pain among midlife employees. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Chronic pain is common among employees. Childhood adversities are known determinants of adult health but their association with chronic pain in adulthood is largely unknown. We aimed to examine the associations between childhood adversities and chronic pain among midlife employees.
Methods
Data on seven childhood adversities and chronic pain (pain having lasted at least 3 months) were derived from the baseline survey of the Helsinki Health Study collected in 2000 to 2002 among 40 to 60-year-old employees of the City of Helsinki in Finland. The study included 8140 employees of whom 80% were women. The analyses were made by logistic regression and the results are presented as odds ratios (OR) and their 95% confidence intervals (CI). Age, gender, father’s education, own education, marital status, working conditions, sleep problems and common mental disorders were included as covariates.
Results
Economic difficulties in the childhood family (OR 1.60, 95% CI 1.41-1.81), childhood illness (1.74, 1.45-2.08), parental divorce (1.26, 1.07-1.48), parental alcohol problems (1.34, 1.18-1.52) and bullying in school or among peers (1.59, 1.37-1.89) were associated with an increased odds of chronic pain in midlife. Adjusting for father’s education, own education and marital status did not contribute to the associations. Working conditions, sleep problems and common mental disorders slightly attenuated the associations between childhood adversities and chronic pain.
Conclusions
Childhood adversities associate to chronic pain in midlife. The results suggest that promoting well-being among children might lead to less pain decades after childhood.
Key messages
Childhood adversities are associated with chronic pain in adulthood. Considering well-being among children might lead to less pain decades after childhood.
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Affiliation(s)
- A Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - T Lallukka
- Finnish Institute of Occupational Health, Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - E Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
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12
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Mauramo E, Salmela J, Kanerva N, Lahelma E, Lallukka T, Pietiläinen O, Rahkonen O, Salonsalmi A, Lahti J. Joint associations of fruit and vegetable consumption and physical activity with mortality risk. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Fruit and vegetable consumption (FVC) and leisure-time physical activity (LTPA) are associated with better health outcomes but less is known about their joint associations with the risk of mortality. We examined the joint associations of FVC and LTPA with premature mortality among midlife and ageing municipal employees, adjusting for key covariates.
Methods
Survey data collected in 2000–2002 among 40–60-year-old employees of the City of Helsinki, Finland, were linked with complete register data on mortality from Statistics Finland (4961 women, 1373 men; response rate 67%; written consent for register linkages 74%). FVC was dichotomised into daily or non-daily, and LTPA into high (>14 MET-hours/week including vigorous exercise) or low. Covariates included age, sex, marital status, socioeconomic position, binge drinking, smoking and self-rated health. Cox regression models were fitted. The follow-up continued until the event of death or the end of 2015.
Results
A total of 281 deaths occurred during the follow-up. The mortality rate was 7.1% in men and 3.7% in women. A gender interaction was found, showing differing associations for women and men. Men with both daily FVC and high LTPA had the lowest mortality risk (HR 0.19, 95% CI 0.06-0.63) after adjusting for covariates. Men with high LTPA and non-daily FVC also had a lower mortality risk (HR 0.51, 95% CI 0.29-0.90) compared to those with non-daily FVC and low LTPA. Women with daily FVC and high LTPA had a lower mortality risk initially, but after adjusting for covariates no statistically significant associations were observed.
Conclusions
The joint associations of FVC and LTPA with premature mortality differed between women and men. This could be related to gender differences in e.g. the causes of death, and further studies are needed to clarify this. Increasing FVC and LTPA might prevent premature mortality among men.
Key messages
Fruit and vegetable consumption jointly with physical activity decreased the risk of premature mortality among men only. Further studies are needed to clarify the gender difference which could be related to for example death causes.
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Affiliation(s)
- E Mauramo
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - J Salmela
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - N Kanerva
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - E Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - T Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - A Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - J Lahti
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Salonsalmi A, Pietiläinen O, Lahelma E, Rahkonen O. Childhood adversities, parental education and disability retirement among Finnish municipal employees. PLoS One 2019; 14:e0219421. [PMID: 31323034 PMCID: PMC6641080 DOI: 10.1371/journal.pone.0219421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/24/2019] [Indexed: 11/19/2022] Open
Abstract
Background There is increasing evidence that childhood socioeconomic position and childhood adversities influence adult health. However, the potential contribution of these factors to disability retirement is poorly understood. This study aimed to examine the associations between childhood adversities, parental education and disability retirement. Methods Data on parental education and childhood adversities were derived from the Helsinki Health Study baseline survey, conducted in 2000–02 among 40- to 60-year old employees of the City of Helsinki, Finland. Data on disability retirement and their diagnoses were obtained from the Finnish Centre of Pensions and followed until the end of 2016. The analyses included 5992 employees. The associations of parental education and childhood adversities with disability retirement due to any cause, musculoskeletal diseases and mental disorders were analysed using Cox regression analysis. Results Low parental education was associated with an increased risk of disability retirement due to any cause (maternal education: HR 1.74, 95% CI 1.16–2.62; paternal education: 1.86, 1.38–2.51) and due to musculoskeletal diseases (maternal education: 4.44, 1.66–11.92; paternal education: 3.81, 2.02–7.17). However, adjustment for own education mainly abolished the associations. Economic difficulties in the childhood family, parental alcohol problems and having been bullied at school or by peers increased the risk of disability retirement due to all studied diagnostic groups, whereas parental death or divorce had no effect. Childhood illness (1.53, 1.20–1.95) and parental mental illness (1.68, 1.28–2.20) were associated with disability retirement due to any cause and due to mental disorders (1.65, 1.05–2.59; 3.60, 2.46–5.26). The associations between childhood adversities and disability retirement remained after adjustment for own education, whereas working conditions, and weight and health behaviours somewhat attenuated the associations. Conclusions Parental education and childhood adversities contributed to disability retirement even in midlife. Policy actions investing in children’s well-being might promote work ability in midlife.
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Affiliation(s)
- Aino Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
- * E-mail:
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Salonsalmi A, Pietiläinen O, Lahelma E, Rahkonen O. Childhood conditions and midlife disability retirement due to mental disorders. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - E Lahelma
- University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- University of Helsinki, Helsinki, Finland
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Holstila A, Lahti J, Salonsalmi A, Lahelma E, Rahkonen O. Changes in alcohol drinking before and after the statutory retirement: a longitudinal cohort study. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Holstila
- Department of Public Health, Helsinki, Finland
| | - J Lahti
- Department of Public Health, Helsinki, Finland
| | | | - E Lahelma
- Department of Public Health, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, Helsinki, Finland
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Pietiläinen O, Laaksonen M, Lahelma E, Salonsalmi A, Rahkonen O. Occupational class inequalities in disability retirement after hospitalisation. Scand J Public Health 2017; 46:331-339. [PMID: 28823229 DOI: 10.1177/1403494817726618] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS This study aimed to investigate whether hospitalisation is associated with increased risk of disability retirement differently across four occupational classes. METHODS 170,510 employees of the City of Helsinki, Finland were followed from 1990 to 2013 using national registers for hospitalisations and disability retirement. Increases in the risk of disability retirement after hospitalisation for any cause, cardiovascular diseases, musculoskeletal disorders, mental disorders, malignant neoplasms, respiratory diseases and injuries were assessed across four occupational classes: professional, semi-professional, routine non-manual and manual, using competing risks models. RESULTS In general, hospitalisation showed a slightly more increased risk of disability retirement in the lower ranking occupational classes. Hospitalisation among women for mental disorders showed a more increased risk in the professional class (hazard ratio 14.73, 95% confidence interval 12.67 to 17.12) compared to the routine manual class (hazard ratio 7.27, 95% confidence interval 6.60 to 8.02). Occupational class differences were similar for men and women. The risk of disability retirement among women increased most in the routine non-manual class after hospitalisation for musculoskeletal disorders and injuries, and most in the professional class after hospitalisation for cardiovascular diseases. The corresponding risks among men increased most in the two lowest ranking classes after hospitalisation for injuries. CONCLUSIONS Ill-health as measured by hospitalisation affected disability retirement in four occupational classes differently, and the effects also varied by the diagnostic group of hospitalisation. Interventions that tackle work disability should consider the impact of ill-health on functioning while taking into account working conditions in each occupational class.
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Affiliation(s)
| | | | - Eero Lahelma
- 1 Department of Public Health, University of Helsinki, Finland
| | - Aino Salonsalmi
- 1 Department of Public Health, University of Helsinki, Finland
| | - Ossi Rahkonen
- 1 Department of Public Health, University of Helsinki, Finland
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Salonsalmi A, Rahkonen O, Lahelma E, Laaksonen M. The association between alcohol drinking and self-reported mental and physical functioning: a prospective cohort study among City of Helsinki employees. BMJ Open 2017; 7:e014368. [PMID: 28473511 PMCID: PMC5623368 DOI: 10.1136/bmjopen-2016-014368] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Alcohol drinking is associated with ill health but less is known about its contribution to overall functioning. We aimed to examine whether alcohol drinking predicts self-reported mental and physical functioning 5-7 years later. DESIGN A prospective cohort study. SETTING Helsinki, Finland. PARTICIPANTS 40-year-old to 60-year-old employees of the City of Helsinki (5301 women and 1230 men) who participated in a postal survey in 2000-2002 and a follow-up survey in 2007. PRIMARY AND SECONDARY OUTCOME MEASURES Mental and physical functioning measured by the Short Form 36 Health Survey. RESULTS Alcohol drinking was differently associated with mental and physical functioning. Heavy average drinking, binge drinking and problem drinking were all associated with subsequent poor mental functioning except for heavy average drinking among men, whereas only problem drinking was associated with poor physical functioning. Also, non-drinking was associated with poor physical functioning. Problem drinking was the drinking habit showing most widespread and strongest associations with health functioning. The associations between problem drinking and poor mental functioning and with poor physical functioning among women remained after adjusting for baseline mental functioning, sociodemographic factors, working conditions and other health behaviours. CONCLUSIONS Alcohol drinking is associated especially with poor mental functioning. Problem drinking was the drinking habit strongest associated with poor health functioning. The results call for early recognition and prevention of alcohol problems in order to improve health functioning among employees.
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Affiliation(s)
- Aino Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Salonsalmi A, Rahkonen O, Lahelma E, Lahti J. Drinking habits and subsequent antidepressant medication among middle-aged employees. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw172.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Salonsalmi A, Rahkonen O, Lahelma E, Laaksonen M. Changes in alcohol drinking and subsequent sickness absence. Scand J Public Health 2015; 43:364-72. [DOI: 10.1177/1403494815574154] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2015] [Indexed: 11/17/2022]
Abstract
Aims: The aim was to examine whether changes in alcohol drinking are associated with sickness absence. Methods: Repeated postal questionnaires on alcohol drinking were conducted among employees of the City of Helsinki in 2000–2 and 2007 to assess changes in drinking habits between these two time points. Data on the number of self-certified and medically confirmed sickness absences were derived from the employer’s register. Sickness absences were followed from 2007 until the end of 2010 among employees participating in both questionnaire surveys. The study includes 3252 female and 682 male employees 40–60 years old at baseline. Poisson regression was used in the data analysis and population attributable fractions (PAFs) were calculated. Results: Alcohol drinking was associated especially with self-certified sickness absence. Rate ratios (RRs) and 95% confidence intervals (CIs) for increasing weekly average drinking were 1.38, 1.18–1.62 among women and 1.58, 1.18–2.12 among men. Also stable problem drinking (for women 1.39, 1.26–1.54, for men 1.44, 1.10–1.87) and among women stable heavy drinking (1.53, 1.20–1.94) increased self-certified sickness absence. There were associations between alcohol drinking and medically confirmed sickness absence but these were mainly explained by health and health behaviours. Also, a decrease in weekly average drinking was associated with sickness absence among women whereas among men former problem drinking increased sickness absence. According to the PAF values, problem drinking had a stronger contribution to sickness absence than weekly average drinking. Conclusions: Alcohol drinking is particularly associated with self-certified sickness absence. Reducing adverse drinking habits is likely to prevent sickness absence.
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Affiliation(s)
- Aino Salonsalmi
- Department of Public Health, University of Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, Finland
| | - Mikko Laaksonen
- Department of Public Health, University of Helsinki, Finland
- Finnish Centre for Pensions, Finland
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Salonsalmi A, Rahkonen O, Lahelma E, Laaksonen M. Working conditions and subsequent drinking habits. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku164.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Salonsalmi A, Laaksonen M, Lahelma E, Rahkonen O. Associations between alcohol drinking and mental health – a prospective study among ageing employees. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
AIMS To examine associations between drinking habits and disability retirement, and to determine whether the associations differ between all-cause disability retirement and the main causes of disability retirement, i.e. musculoskeletal diseases and mental disorders. DESIGN A prospective cohort study with a mean follow-up time of 8 years. SETTING Middle-aged employees of the City of Helsinki, Finland. PARTICIPANTS A total of 6275 municipal employees (78% women) who were 40-60 years old at baseline. MEASUREMENTS Data on drinking habits, i.e. quantity and frequency of drinking, binge drinking and problem drinking, were derived from the baseline questionnaire. The data on disability retirement and its diagnoses came from the Finnish Centre for Pensions. The analyses were made using Cox regression analysis. FINDINGS Heavy average and frequent drinking were not associated with all-cause disability retirement, but increased the risk of disability retirement due to mental disorders even after adjusting for all covariates [hazard ratios (HR) and 95% confidence intervals (CI) 2.54 (1.26-5.12) and 2.10 (1.23-3.61), respectively]. Binge and problem drinking were both associated with all-cause disability retirement in the base models adjusted for age, gender and marital status. Problem drinking more than doubled the risk of disability retirement due to mental disorders even after all adjustments (HR 2.17, CI 1.53-3.08). Non-drinkers had an increased risk for disability retirement due to all mental and musculoskeletal diagnoses. CONCLUSIONS Adverse drinking habits may contribute to disability retirement among the middle-aged working population. Tackling unhealthy drinking habits may lessen the likelihood of early retirement due to poor mental health.
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Affiliation(s)
- Aino Salonsalmi
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland.
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Abstract
Aims: The main aim was to examine whether drinking habits including average, binge and problem drinking are associated with self-certified and medically confirmed sickness absence among middle-aged municipal employees. Another aim was to examine whether psychosocial and physical working conditions and work arrangements explain these associations. Methods: The data on drinking habits and working conditions of 5,119 female and 1,390 male middle-aged employees of the City of Helsinki was obtained from postal questionnaires collected in 2000—2002. The data on sickness absence (2000—2005) were derived from the employer’s registers. Poisson regression analysis with self-certified (1—3 days) and medically confirmed (over 3 days) sickness absence spells as outcomes was used in performing the analyses. Results: Heavy average, binge and problem drinking were all associated with an increase in self-certified sickness absence. Both non-drinkers and heavy drinkers had excess medically confirmed sickness absence compared to moderate drinkers. Problem drinking and among women also binge drinking were associated with medically confirmed sickness absence. Psychosocial working conditions slightly attenuated the association of drinking habits and sickness absence mainly among men. Physical working conditions and work arrangements slightly explained medically confirmed sickness absence among male problem drinkers. Conclusions: All studied drinking habits were associated with both self-certified and medically confirmed sickness absence. Thus, a decrease in unhealthy drinking habits among employees is likely to prevent sickness absence. The effects of working conditions were small but psychosocial working conditions slightly explained the associations between drinking habits and sickness absence mainly among men.
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Affiliation(s)
- Aino Salonsalmi
- Department of Public Health, University of Helsinki, Finland,
| | - Mikko Laaksonen
- Department of Public Health, University of Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Finland
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