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Hahm S, Altweck L, Schmidt S, Fleischer T, Helmert C, Ulke C, Speerforck S, Schomerus G, Klinger-König J, Grabe HJ, Schmidt CO, Beutel ME, Brähler E, Muehlan H. How socio-political change is associated with the number of individually reported negative life events: a population-based study using the German reunification 1989/1990 as an example. J Epidemiol Community Health 2024; 78:311-318. [PMID: 38331562 DOI: 10.1136/jech-2023-221549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/21/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Socio-political change often leads to disruptions in employment and social networks, which can exacerbate health issues and increase mortality rates. These consequences are likely observed as an increase in negative life events (NLEs), serving as indicators of the broader social and health impacts. Using the German reunification in 1989/1990 as an example, this study investigates changes in reported numbers of NLEs and differences regarding sociodemographic characteristics. METHODS We used data from the population-based Study of Health in Pomerania (SHIP-START-0, SHIP-Life-Events and Gene-Environment Interaction in Depression; N=1932). Numbers of NLEs in different categories (work/financial, social/interpersonal, illness (own) and illness/death (others)) were measured retrospectively in 5-year intervals (1980-2004) using a semistructured interview. Pre-reunification and post-reunification changes were modelled using piecewise mixed-effects Poisson regressions with the 1990-1994 interval (reunification) as change point. Interactions with age, sex and education were examined. RESULTS The number of most NLE categories, except social/interpersonal NLEs, increased at reunification. Whereas work/financial NLEs slightly decreased post-reunification, illness-related NLEs continued to increase. Higher numbers of social/interpersonal NLEs were found with younger age. More illness-related NLEs were reported with older age, lower education (illness (own)) and by women (illness/death (others)). However, the majority reported no NLEs at reunification (68.2%-80.7%, varying by category). CONCLUSION Our findings suggest that although some individuals experience a marked increase in NLEs due to socio-political changes, many remain unaffected, emphasising the need for a differentiated understanding of these effects. This increase in NLEs may partly account for ongoing health and well-being disparities among countries with differing transformation histories.
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Affiliation(s)
- Stefanie Hahm
- Department Health and Prevention, University of Greifswald, Greifswald, Germany
| | - Laura Altweck
- Department Health and Prevention, University of Greifswald, Greifswald, Germany
| | - Silke Schmidt
- Department Health and Prevention, University of Greifswald, Greifswald, Germany
| | - Toni Fleischer
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Claudia Helmert
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Christine Ulke
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Sven Speerforck
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases Site Rostock/Greifswald, Rostock, Germany
| | | | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Holger Muehlan
- Department Health and Prevention, University of Greifswald, Greifswald, Germany
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2
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Lin W. Disparities in Healthcare and HBV Vaccination by Smoking Status: Findings from the National Health and Nutrition Examination Survey (NHANES) 2017-2018. Healthcare (Basel) 2023; 12:41. [PMID: 38200947 PMCID: PMC10779267 DOI: 10.3390/healthcare12010041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/12/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Cigarette smokers face greater challenges in accessing healthcare compared with non-smokers. In the US, approximately 2.2 million individuals are chronically infected with hepatitis B virus (HBV). I used data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 to investigate the association between smoking status (current, former, and never smoker) and different health outcomes, including healthcare accessibility, HBV vaccination, general health condition, and health insurance. Multivariable logistic regressions were used to analyze healthcare disparity by smoking status. I found that current smokers had 40% higher odds (AOR = 1.4, 95% CI: 1.1, 1.8) of lacking routine healthcare access compared with non-smokers. Regardless of smoking status, I observed a high rate of HBV non-vaccination among all participants. Specifically, 64% of current smokers, 67% of former smokers, and 57% of non-smokers had not received a single dose of HBV immunization. My study sheds light on the persisting gaps in healthcare access, particularly for smokers, and the urgent need to promote awareness and vaccination against hepatitis B.
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Affiliation(s)
- Wenxue Lin
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA 19122, USA
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3
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Schauer M, Motevalli M, Tanous D, Mair S, Burtscher M, Wirnitzer K. The Association of Physical Activity Level with Micronutrient and Health Status of Austrian Bank Employees. Nutrients 2023; 15:4884. [PMID: 38068742 PMCID: PMC10708120 DOI: 10.3390/nu15234884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/15/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Favorable health benefits of an active lifestyle have been clearly documented within the context of occupational health. However, a knowledge gap exists regarding the monitoring and comparison of micronutrient status across varying levels of physical activity (PA). This study aimed to investigate the association of PA level with micronutrient status and the associated health biomarkers among a cohort of Austrian bank employees. METHODS Using a cross-sectional design, this study involved the participation of bank employees (n = 123; average age: 43 years; 49% males) from the federal state of Tyrol, located in the western part of Austria. To assess PA levels and sedentary behavior, the Global Physical Activity Questionnaire (GPAQ; developed by the WHO) was administered. Accordingly, participants were categorized into three groups: low PA, moderate PA, and high PA. Participants' blood samples were obtained to measure blood levels of micronutrients, homocysteine, and CoQ10. The values of vitamins and minerals in whole-blood were compared to sex-specific reference ranges and grouped into three categories: below, within, or exceeding the reference range. RESULTS The prevalence of a high PA level was 61%, while 18% of participants had a low PA level. Overweight/obesity was significantly less prevalent among participants with high PA levels (22%) compared to those with moderate (50%) and low (50%) PA levels (p = 0.045). No significant differences between PA levels were found for sex, age, diet type, homocysteine, or CoQ10 markers (p > 0.05). There was no significant PA-based difference in blood concentrations of most vitamins and minerals (p > 0.05), except for vitamin D (p = 0.001) among females, as well as selenium (p = 0.040) and vitamin B12 (p = 0.048) among males. CONCLUSION The present findings offer initial insights into the link between PA behaviors, micronutrient status, and health, highlighting potential implications in occupational health and lifestyle, specifically in developing tailored approaches based on PA levels.
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Affiliation(s)
- Markus Schauer
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Mohamad Motevalli
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
| | - Derrick Tanous
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
| | - Susanne Mair
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Katharina Wirnitzer
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
- Research Center Medical Humanities, University of Innsbruck, 6020 Innsbruck, Austria
- Department of Pediatric Oncology and Hematology, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
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4
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Smits RLA, van Dongen LH, Blom MT, Tan HL, van Valkengoed IGM. Gender-related factors and out-of-hospital cardiac arrest incidence in women and men: analysis of a population-based cohort study in the Netherlands. J Epidemiol Community Health 2022; 76:800-808. [PMID: 35777920 PMCID: PMC9380488 DOI: 10.1136/jech-2021-218329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 06/08/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND The incidence of out-of-hospital cardiac arrest (OHCA) differs consistently between women and men. Besides sex-related (biological) factors, OHCA risk may relate to gender-related (sociocultural) factors. We explored the association of selected gender-related factors with OHCA incidence in women and men. METHODS We combined data on emergency medical services-attended OHCA with individual-level data from all women and men aged ≥25 years living in North Holland, the Netherlands. We estimated the associations between employment status, primary earner status, living with children and marital status and the OHCA incidence with Cox proportional hazards models stratified by sex and adjusted for age and socioeconomic status. To determine if metabolic factors explain the associations, we added hypertension, diabetes mellitus and dyslipidaemia to the models. Population attributable fractions (PAF) for all gender-related factors were calculated. RESULTS All four gender-related factors were associated with OHCA incidence (eg, unemployed vs employed; HR 1.98, 95% CI 1.67 to 2.35 in women; HR 1.60, 95% CI 1.44 to 1.79 in men). In both sexes, those unemployed, those who are not primary earners, those living without children, and married or divorced individuals had an increased OHCA risk. The PAF ranged from 4.9 to 40.3 in women and from 4.4 to 15.5 in men, with the highest PAF for employment status in both sexes. Metabolic risk factors did not explain the observed associations. CONCLUSION Gender-related factors were associated with risk of OHCA and contributed substantially to the OHCA burden at the population level, particularly in women. Employment status contributed most to the OHCA burden.
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Affiliation(s)
- Robin L A Smits
- Public and Occupational Health, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| | - Laura H van Dongen
- Clinical and Experimental Cardiology, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| | - Marieke T Blom
- Clinical and Experimental Cardiology, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| | - Hanno L Tan
- Clinical and Experimental Cardiology, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.,Netherlands Heart Institute, Utrecht, Netherlands
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5
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Ucieklak-Jeż P, Bem A. How the Labor Market Affects the Self-Perceived Health of Older Workers. The Evidence From Central and Eastern European Countries (CEECs). Front Public Health 2021; 9:655859. [PMID: 34291024 PMCID: PMC8287098 DOI: 10.3389/fpubh.2021.655859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The paper aims to analyze the impact of key labor market indicators on the self-assessed health of the population of older workers (aged 55-64). Methods: Authors build the econometric models where the dependent variable is the self-perceived health status (for women and men separately). Explanatory variables are selected key indicators of the labor market, covering unemployment, including long-term, inactivity, or under-employment. The average household income is used to control the effect of wealth. Additionally, the models incorporate the variable describing the proximity of retirement. The research sample consists of nine countries of Central and Eastern Europe: Poland, Czech Republic, Slovakia, Hungary, Lithuania, Latvia, Estonia, Bulgaria, and Romania. Results and Conclusions: The study confirms that in the group of elderly workers, the perceived state of health is influenced by long-term unemployment, inactivity, and, in the case of women, time-related underemployment.
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Affiliation(s)
| | - Agnieszka Bem
- Department of Corporate and Public Finance, Wrocław University of Economics and Business, Wrocław, Poland
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6
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Leonardi M, Guido D, Quintas R, Silvaggi F, Guastafierro E, Martinuzzi A, Chatterji S, Koskinen S, Tobiasz-Adamczyk B, Haro JM, Cabello M, Raggi A. Factors Related to Unemployment in Europe. A Cross-Sectional Study from the COURAGE Survey in Finland, Poland and Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040722. [PMID: 29641485 PMCID: PMC5923764 DOI: 10.3390/ijerph15040722] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/05/2018] [Accepted: 04/08/2018] [Indexed: 01/08/2023]
Abstract
Background: Research addressing the impact of a large number of factors on unemployment is scarce. We aimed to comprehensively identify factors related to unemployment in a sample of persons aged 18-64 from Finland, Poland and Spain. Methods: In this cross-sectional study, factors from different areas were considered: socio-demographic indicators, health habits, chronic conditions, health state markers, vision and hearing indicators, and social networks and built environment scores. Results: Complete data were available for 5003 participants, mean age 48.1 (SD 11.5), 45.4% males. The most important factors connected to unemployment were health status indicators such as physical disability (OR = 2.944), self-rated health (OR = 2.629), inpatient care (OR = 1.980), and difficulties with getting to the toilet (OR = 2.040), while the most relevant factor related to employment were moderate alcohol consumption (OR = 0.732 for non-heavy drinkers; OR = 0.573 for infrequent heavy drinkers), and being married (OR = 0.734), or having been married (OR = 0.584). Other factors that played a significant role included presence of depression (OR = 1.384) and difficulties with near vision (OR = 1.584) and conversation hearing (OR = 1.597). Conclusions: Our results highlight the importance of selected factors related to unemployment, and suggest public health indications that could support concrete actions on modifiable factors, such as those aimed to promote physical activity and healthy behaviors, tackling depression or promoting education, in particular for the younger.
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Affiliation(s)
- Matilde Leonardi
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, 20133 Milan, Italy.
| | - Davide Guido
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, 20133 Milan, Italy.
| | - Rui Quintas
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, 20133 Milan, Italy.
- Neurological Institute C. Besta IRCCS Foundation, Clinical and Experimental Epileptology Unit, 20133 Milan, Italy.
| | - Fabiola Silvaggi
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, 20133 Milan, Italy.
| | - Erika Guastafierro
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, 20133 Milan, Italy.
| | - Andrea Martinuzzi
- E. Medea Scientific Institute, Conegliano-Pieve di Soligo Research Centre, 31015 Conegliano Veneto, Italy.
| | - Somnath Chatterji
- Information, Evidence and Research Unit, World Health Organization, 1211 Geneva, Switzerland.
| | - Seppo Koskinen
- Ageing, Disability and Functioning Unit, National Institute for Health and Welfare, 00271 Helsinki, Finland.
| | - Beata Tobiasz-Adamczyk
- Department of Medical Sociology, Jagiellonian University Medical College, 31-034 Krakow, Poland.
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, University of Barcelona, CIBERSAM, 08830 Barcelona, Spain.
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 28029 Madrid, Spain.
| | - Maria Cabello
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 28029 Madrid, Spain.
- Department of Psychiatry, Universidad Autonoma de Madrid, 28029 Madrid, Spain.
| | - Alberto Raggi
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, 20133 Milan, Italy.
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7
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Zandara M, Garcia-Lluch M, Villada C, Hidalgo V, Salvador A. Searching for a job: Cardiac responses to acute stress and the mediating role of threat appraisal in young people. Stress Health 2018; 34:15-23. [PMID: 28417549 DOI: 10.1002/smi.2757] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 03/13/2017] [Accepted: 03/16/2017] [Indexed: 11/09/2022]
Abstract
Being unemployed and looking for a job has become a source of stress for many people in several European countries. However, little attention has been paid to the impact of this stressful situation on the individuals' psychophysiological stress responses. The aim of this study was to investigate the effect of being an unemployed job seeker on cognitive threat appraisal and cardiac responses to a psychosocial stressor. We exposed a group of unemployed job seekers (N = 42) and a matched group of unemployed non-job seekers (N = 40) to a standardized social stressor in form of job interview, the Trier Social Stress Test. Our results showed that unemployed job seekers manifest lower cardiac responses, along with a lower cognitive threat appraisal, compared to non-job seekers. Moreover, we observed a full mediating role of cognitive threat appraisal on the relationship between being an unemployed job seeker and cardiac responses to stress. These findings reveal that being unemployed and looking for a job has an effect on physiological responses to acute stress, as well as the importance of psychological process related to the situation. These responses might lead to negative health and motivational consequences. Theoretical and practical implications are discussed.
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Affiliation(s)
- M Zandara
- Research Institute on Personnel Psychology, Organizational Development and Quality of Working Life (IDOCAL), Department of Social Psychology, University of Valencia, Valencia, Spain
| | - M Garcia-Lluch
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, Valencia, Spain
| | - C Villada
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, Valencia, Spain.,Department of health psychology, Area of Psychobyology, Miguel Hernández de Elche University (UMH), Alicante, Spain
| | - V Hidalgo
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, Valencia, Spain.,Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - A Salvador
- Research Institute on Personnel Psychology, Organizational Development and Quality of Working Life (IDOCAL), Department of Social Psychology, University of Valencia, Valencia, Spain.,Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, Valencia, Spain
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8
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Łopuszańska-Dawid M, Szklarska A, Kołodziej H, Lipowicz A, Jankowska EA. The relationship between: occupational status, biological condition and androgen hormone level among Polish adult men: the Wroclaw Male Study. Aging Male 2016; 19:231-238. [PMID: 27690723 DOI: 10.1080/13685538.2016.1220519] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Population health and its determinants are one of the major challenges to social and economic policy. The aim of this study was to investigate the relationship between occupational activity and biological condition in adult working Polish men. The participants of the study were 300 men (30-65 years), healthy inhabitants of the city of Wroclaw, Poland. Seventeen measures of biological condition were examined. The subjects were divided into three different occupational groups: professionals, soldiers and skilled workers. A comparison of biological age profiles of three occupational groups showed that in the majority of characteristics, professionals had the youngest biological age, whereas skilled workers had the highest biological age. The results for soldiers were not as unambiguous, but biological parameters were generally closer to those for professionals. Inborn biological predispositions and long-term impact of the working environment can influence on the biological condition of various professional groups. Knowledge of the determinants of biological condition might result in efficient use of predisposition to work or may be of help in extending their time of work ability.
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Affiliation(s)
| | | | - Halina Kołodziej
- b The Faculty of Biology and Animal Science , Institute of Biology, Wroclaw University of Environmental and Life Sciences , Wroclaw , Poland , and
| | - Anna Lipowicz
- b The Faculty of Biology and Animal Science , Institute of Biology, Wroclaw University of Environmental and Life Sciences , Wroclaw , Poland , and
| | - Ewa A Jankowska
- c Department of Heart Diseases , Wroclaw Medical University , Wroclaw , Poland
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9
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Lipowicz A, Szklarska A, Mitas AW. Biological costs of economic transition: Stress levels during the transition from communism to capitalism in Poland. ECONOMICS AND HUMAN BIOLOGY 2016; 21:90-9. [PMID: 26799229 DOI: 10.1016/j.ehb.2015.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 12/21/2015] [Accepted: 12/23/2015] [Indexed: 05/17/2023]
Abstract
At the end of the 1980s, Poland began the transformation from an essentially one-party communist system to a politically pluralistic democratic system. These political and economic changes had major social consequences, among others unemployment and a sharp decrease in real personal income. The aim of the study was to investigate the possible relationship between stress in adult men, measured by the Allostatic Load, and the socio-economic deterioration during the first part of the economic transition. The Allostatic Load included eleven markers assessing adverse nutritional intake, cardiovascular activity, inflammatory processes, and lung, hepatic and renal functions. The results indicate a significantly higher risk of metabolic dysregulation in men examined after 1990, compared to men from previous years. After adjustment for socioeconomic variables and lifestyle variables, men examined in 1991 had a 31% greater risk of higher Allostatic Load compared with men examined in 1985 (OR=1.31; p=0.0541), in 1992, this risk was 50% greater (OR=1.50; p<0.01), and in 1993, the risk was 66% greater (OR=1.66; p<0.05). The conclusion is drawn that significantly more stressogenic factors for men were those directly connected with the financial situation of their families, than a sudden but short increase of prices for goods and services.
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Affiliation(s)
- Anna Lipowicz
- Department of Anthropology, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland.
| | - Alicja Szklarska
- Unit of Anthropology, Polish Academy of Sciences, Wroclaw, Poland
| | - Andrzej W Mitas
- Faculty of Biomedical Engineering, Department of Informatics and Medical Equipment, Silesian University of Technology, Gliwice, Poland
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10
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Bohley S, Kluttig A, Werdan K, Nuding S, Greiser KH, Kuss O, Markus MRP, Schmidt CO, Völzke H, Krabbe C, Haerting J. Changes of individual perception in psychosocial stressors related to German reunification in 1989/1990 and cardiovascular risk factors and cardiovascular diseases in a population-based study in East Germany. BMJ Open 2016; 6:e008703. [PMID: 26729378 PMCID: PMC4716160 DOI: 10.1136/bmjopen-2015-008703] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 10/21/2015] [Accepted: 11/03/2015] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Aim was to examine the relationship between individually perceived changes in psychosocial stressors associated with German reunification and cardiovascular effects. We hypothesised that higher levels of psychosocial stress related to German reunification were associated with an increase in cardiovascular risk factors and cardiovascular diseases (CVDs). DESIGN Cross-sectional data from 2 cohort studies in East Germany were used: Cardiovascular Disease, Living and Ageing in Halle Study (CARLA), and Study of Health in Pomerania (SHIP). SETTING 2 populations in East Germany. PARTICIPANTS CARLA study: 1779 participants, aged 45-83 years at baseline (812 women), SHIP study: 4308 participants, aged 20-79 years at baseline (2193 women). PRIMARY AND SECONDARY OUTCOME MEASURES Psychosocial stressors related to reunification were operationalised by the Reunification Stress Index (RSI; scale from 0 to 10). This index was composed of questions that were related to individually perceived changes in psychosocial stressors (occupational, financial and personal) after reunification. To examine the associations between the RSI and each stressor separately with cardiovascular risk factors and CVD, regression models were used. RESULTS RSI was associated with CVD in women (RR=1.15, 95% CI 1.00 to 1.33). Cardiovascular risk factors were associated with RSI for both men and women, with strongest associations between RSI and diabetes in women (RR=1.10, 95% CI 1.01 to 1.20) and depressive disorders in men (RR=1.15, 95% CI 1.07 to 2.77). The change in occupational situation related to reunification was the major contributing psychosocial stressor. We observed a strong association with CVD in women who experienced occupational deterioration after reunification (RR=4.04, 95% CI 1.21 to 13.43). CONCLUSIONS Individually perceived deterioration of psychosocial stressors (occupational, financial and personal) related to German reunification was associated with cardiovascular risk factors and CVD. The associations were stronger for women than for men. An explanation for these findings could be that women were more often affected by unemployment after reunification. Morbidity and mortality follow-up of both cohorts could enhance the results.
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Affiliation(s)
- Stefanie Bohley
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Karl Werdan
- Department of Medicine III, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Sebastian Nuding
- Department of Medicine III, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Karin Halina Greiser
- Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany
| | - Oliver Kuss
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
| | | | | | - Henry Völzke
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
| | - Christine Krabbe
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
| | - Johannes Haerting
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
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11
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Gomula A, Nowak-Szczepanska N, Danel DP, Koziel S. Overweight trends among Polish schoolchildren before and after the transition from communism to capitalism. ECONOMICS AND HUMAN BIOLOGY 2015; 19:246-257. [PMID: 26439757 DOI: 10.1016/j.ehb.2015.09.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 08/26/2015] [Accepted: 09/01/2015] [Indexed: 06/05/2023]
Abstract
This study aims to reveal the secular trends in body mass index (BMI) and the prevalence of overweight and obesity among Polish schoolchildren between the years 1966-2012, during which intense socio-political changes took place. Four surveys were conducted in several districts of Poland looking at 69,746 schoolchildren aged 7-18. Significant increase in mean BMI as well as in the prevalence of overweight and obesity was observed. During this time the highest increase in both mean BMI and excess weight was observed between 1988 and 2012, i.e. after the political transformation, resulting in the improvement of living conditions. However, with respect to girls in late adolescence, between these years, the mean BMI as well as the prevalence of overweight were leveling off, while the percentage of boys with excess body fat in the same developmental category significantly increased in 2012. In the years 1966-1978 and 1978-1988 the pattern of changes in the prevalence of overweight and obesity reflected the social and economic circumstances, i.e. temporary economic improvements, or deepening political crises and food shortage. In conclusion, the weight status of schoolchildren strongly reflects socio-political changes that took place in Poland, as well as in most of the Central European countries in the last half century.
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Affiliation(s)
- Aleksandra Gomula
- Polish Academy of Sciences, Unit of Anthropology, Podwale 75, 50-449 Wroclaw, Poland.
| | | | - Dariusz P Danel
- Polish Academy of Sciences, Unit of Anthropology, Podwale 75, 50-449 Wroclaw, Poland
| | - Slawomir Koziel
- Polish Academy of Sciences, Unit of Anthropology, Podwale 75, 50-449 Wroclaw, Poland
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Hanć T, Czapla Z, Szwed A, Durda M, Krotowska A, Cieślik J. Growth and nutritional status of children from dysfunctional families with alcohol addicted parents in Poland. ECONOMICS AND HUMAN BIOLOGY 2015; 18:101-109. [PMID: 26042531 DOI: 10.1016/j.ehb.2015.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 03/25/2015] [Accepted: 05/04/2015] [Indexed: 06/04/2023]
Abstract
The study was aimed at assessment of impact of parents' alcohol addiction on growth and prevalence of underweight and overweight in their children. Two groups of subjects were compared: 80 children of alcohol addicted parents (ChAAP) aged from 7 to 14 years and reference group (RG) of 1000 children selected in terms of age and place of residence. Differences in z scores for height and Body Mass Index (BMI), prevalence of underweight and overweight were assessed. Families of ChAAP were characterized by: lower parents' education, higher unemployment rate, a greater number of children than in RG. The differences between ChAAP and RG in z scores for height (z scores: -0.54 vs. 0.45, t = -7.01, p < 0.001) and BMI (z scores: -0.61 vs. 0.29, t = -6.28, p < 0.001) remained significant when impact of the parents' employment (for height: F = 8.88, p = 0.003; for BMI: F = 21.90, p < 0.001) and the number of children (for height: F = 30.89, p < 0.001; for BMI: F = 21.89, p < 0.001) were controlled. Children raised in families with alcohol addicted parents were shorter and had lower BMI than children of the reference group. Underweight was more frequent in that group, and overweight and obesity were more rare. The observed differences seem to result from other factors than bad living conditions, e.g.: chronic post-natal stress, or adverse events during fetal development.
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Affiliation(s)
- Tomasz Hanć
- Department of Human Biological Development, Institute of Anthropology, Adam Mickiewicz University, Poznań, Poland.
| | - Zbigniew Czapla
- Department of Human Biological Development, Institute of Anthropology, Adam Mickiewicz University, Poznań, Poland
| | - Anita Szwed
- Department of Human Biological Development, Institute of Anthropology, Adam Mickiewicz University, Poznań, Poland
| | - Magdalena Durda
- Department of Human Biological Development, Institute of Anthropology, Adam Mickiewicz University, Poznań, Poland
| | - Aleksandra Krotowska
- Department of Human Biological Development, Institute of Anthropology, Adam Mickiewicz University, Poznań, Poland
| | - Joachim Cieślik
- Department of Human Biological Development, Institute of Anthropology, Adam Mickiewicz University, Poznań, Poland
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Fiorillo D, Sabatini F. Structural social capital and health in Italy. ECONOMICS AND HUMAN BIOLOGY 2015; 17:129-142. [PMID: 25805101 DOI: 10.1016/j.ehb.2015.02.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 01/21/2015] [Accepted: 02/23/2015] [Indexed: 06/04/2023]
Abstract
This paper presents the first empirical assessment of the causal relationship between social capital and health in Italy. The analysis draws on the 2000 wave of the Multipurpose Survey on Household conducted by the Italian Institute of Statistics on a representative sample of the population (n=46,868). Our measure of social capital is the frequency of meetings with friends. Based on IV and bivariate probit estimates, we find that individuals who meet friends every day or more time times a week are approximately 11-16% more likely to report good health.
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Affiliation(s)
- Damiano Fiorillo
- Department of Business and Economics, University of Napoli Parthenope, Italy; Health, Econometrics and Data Group, University of York, United Kingdom.
| | - Fabio Sabatini
- Department of Economics and Law, Sapienza University of Rome, Italy; Laboratory for Comparative Social Research, National Research University Higher School of Economics, Russian Federation.
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Jandackova VK, Jackowska M. Low heart rate variability in unemployed men: The possible mediating effects of life satisfaction. PSYCHOL HEALTH MED 2014; 20:530-40. [PMID: 25482493 DOI: 10.1080/13548506.2014.987148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Unemployment has consistently been associated with increased risk of cardiovascular disease and premature mortality, and impaired autonomic modulation of the heart might be one mechanism partly explaining this. This study examined whether the possible effect of unemployment on cardiac autonomic modulation is in part mediated by lower psychological well-being. The sample comprised of 15 job-seeking men aged 30-49 years matched with 15 employed men on age, type of job, smoking habits, alcohol intake, frequency of physical activity, and body mass index. Heart rate variability (HRV) during a modified orthostatic test was the measure of cardiac autonomic modulation, and life satisfaction was the measure of psychological well-being. Unemployed men had significantly lower overall HRV (p = .040) than controls. This association was partially mediated through lower general life satisfaction, and in particular, by low financial satisfaction, independently of demographic and/or behavioral factors that influence HRV. These findings suggest that seeking a job is a potential stressor that may reduce overall HRV and contribute towards disturbance of cardiac autonomic modulation in men. Financial difficulties could be one mechanism through which the effects of unemployment are translated into impaired autonomic modulation.
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Affiliation(s)
- V K Jandackova
- a Department of Epidemiology and Public Health , University of Ostrava , Ostrava , Czech Republic
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15
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Zagożdżon P, Parszuto J, Wrotkowska M, Dydjow-Bendek D. Effect of unemployment on cardiovascular risk factors and mental health. Occup Med (Lond) 2014; 64:436-41. [PMID: 24727560 DOI: 10.1093/occmed/kqu044] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Following the economic changes in Poland, increasing health discrepancies were observed during a period of 20 years, which may be partly attributable to the consequences of unemployment. AIMS To assess the association between unemployment, major cardiovascular risk factors and mental health. METHODS A cross-sectional study in which data were collected between 2009 and 2010 during preventive health examinations by an occupational medicine service in Gdansk, Poland. Data on blood pressure, resting heart rate, information about smoking habits, body mass index and history of use of mental health services were collected during these assessments. Multiple logistic regression was used during data analysis to adjust for age, gender, education and length of employment. RESULTS Study participants comprised 3052 unemployed and 2059 employed individuals. After adjustment for age, gender, education and number of previous employments, the odds ratio (OR) for hypertension in relation to unemployment was 1.02 [95% confidence interval (95% CI) 0.84-1.23]. There was a statistically significant negative association between being overweight and unemployment (OR = 0.81, 95% CI: 0.66-0.99). Smoking was positively associated with unemployment after adjustment for age and sex (OR = 1.45, 95% CI: 1.25-1.67). There was a positive relationship between mental ill-health and unemployment among study participants (OR = 2.05, 95% CI: 0.91-4.65), but this was not statistically significant. CONCLUSIONS The patterns of major cardiovascular risk factors differed between unemployed and employed individuals in Poland. Our observations suggest employment status is a predictor of specific disease risk profiles; consequently, specific preventive measures are needed in unemployed individuals.
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Affiliation(s)
- P Zagożdżon
- Department of Hygiene and Epidemiology, Medical University of Gdansk, Gdynia 81-519, Poland,
| | - J Parszuto
- Regional Occupational Medicine Center, Gdansk 80-887, Poland
| | - M Wrotkowska
- Department of Hygiene and Epidemiology, Medical University of Gdansk, Gdynia 81-519, Poland
| | - D Dydjow-Bendek
- Department of Hygiene and Epidemiology, Medical University of Gdansk, Gdynia 81-519, Poland
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The impact of unemployment on heart rate variability: the evidence from the Czech Republic. Biol Psychol 2012; 91:238-44. [PMID: 22789730 DOI: 10.1016/j.biopsycho.2012.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 06/30/2012] [Accepted: 07/02/2012] [Indexed: 11/21/2022]
Abstract
We examined the relationship between unemployment and heart rate variability (HRV) in a region of high unemployment in the Czech Republic. The study involved 21 involuntarily unemployed and 21 employed men and women aged 30-49 years, matched on number of potentially confounding factors, including age, gender, type of job, health related behavior and body mass index. HRV was assessed in response to a modified orthostatic test. Compared with the employed group, unemployed participants had decreased high frequency HRV (p=0.018), lower root mean square of successive differences (p=0.050), and lower total spectral variability (p=0.022). These findings suggest that unemployment is a potential chronic stressor that may lead to suppression of vagal activity. This may be one mechanism linking unemployment with cardiovascular disease risk.
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17
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Medical certification: is it in the patient's best interest? Br J Gen Pract 2010; 60:931. [DOI: 10.3399/bjgp10x544140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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