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Runge K, van Zon SKR, Henkens K, Bültmann U. Metabolic syndrome and poor self-rated health as risk factors for premature employment exit: a longitudinal study among 55 016 middle-aged and older workers from the Lifelines Cohort Study and Biobank. Eur J Public Health 2024; 34:309-315. [PMID: 38110727 PMCID: PMC10990532 DOI: 10.1093/eurpub/ckad219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Poor self-rated health (SRH) is a well-established risk factor for premature employment exit through unemployment, work disability, and early retirement. However, it is unclear whether the premature employment exit risk associated with underlying cardio-metabolic health conditions is fully captured by poor SRH. This study examines the metabolic syndrome (MetS), an early-stage risk factor for cardiovascular disease and type two diabetes mellitus, as a risk factor for premature employment exit while controlling for poor SRH. METHODS We analyzed data from N = 55 016 Dutch workers (40-64 years) from five waves of the Lifelines Cohort Study and Biobank. MetS components were based on physical measures, blood markers, and medication use. SRH and employment states were self-reported. The associations between MetS, SRH, and premature employment exit types were analyzed using competing risk regression analysis. RESULTS During 4.3 years of follow-up, MetS remained an independent risk factor for unemployment [adjusted subdistribution hazard ratio (SHR): 1.14, 95% CI: 1.03, 1.25] and work disability (adjusted SHR: 1.33, 95% CI: 1.11, 1.58) when adjusted for poor SRH, common chronic diseases related to labor market participation (i.e., cancer, musculoskeletal-, pulmonary-, and psychiatric diseases), and sociodemographic factors. MetS was not associated with early retirement. CONCLUSIONS Poor SRH did not fully capture the risk for unemployment and work disability associated with MetS. More awareness about MetS as a 'hidden' cardio-metabolic risk factor for premature employment exit is needed among workers, employers, and occupational health professionals. Regular health check-ups including MetS assessment and MetS prevention might help to prolong healthy working lives.
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Affiliation(s)
- Katharina Runge
- Work and retirement theme group, Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sander K R van Zon
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Kène Henkens
- Work and retirement theme group, Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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BMI, weight change, and incidence of disability among Korean adults: A nationwide retrospective cohort study. Disabil Health J 2021; 14:101104. [PMID: 33846111 DOI: 10.1016/j.dhjo.2021.101104] [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: 08/10/2020] [Revised: 03/21/2021] [Accepted: 03/25/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Little is known about the risk of acquired disability diagnosed by a physician in relation to baseline BMI and weight change, particularly in the Asian population. OBJECTIVE This study assessed the association of baseline BMI and weight change with incidence of disability. METHODS This study included 331,900 individuals aged ≥40 years who participated in two health-screening programs since 2002 or 2003 and who were followed up until 2013. This study measured the baseline BMI and weight change for two years and estimated the adjusted hazard ratio (aHR) of the risk of acquired disability diagnosed by a physician using a Cox proportional hazards model. RESULTS This study identified 1758 incident disability cases during an average follow-up period of 10.7 ± 1.3 years from baseline (9.1 ± 1.4 years from the follow-up health screening). Baseline underweight (BMI<18.5 kg/m2) was associated with an increased risk of acquired disability compared with those with normal BMI (aHR, 1.44; 95% confidence interval [CI], 1.14-1.83). The risk of acquired disability was higher in individuals with weight loss of 5-10% (aHR, 1.21; 95% CI, 1.04-1.40), weight loss of ≥10% (aHR, 1.61; 95% CI, 1.27-2.04), weight gain of 5-10% (aHR, 1.30; 95% CI, 1.12-1.52), or weight gain of ≥10% (aHR, 1.35; 95% CI, 1.09-1.75) compared to those with weight change of <5%. CONCLUSION This study demonstrated that baseline underweight and weight changes (both loss and gain) are associated with an increased risk of acquired disability.
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Lazarevič P, Brandt M. Diverging ideas of health? Comparing the basis of health ratings across gender, age, and country. Soc Sci Med 2020; 267:112913. [PMID: 32197880 PMCID: PMC7762812 DOI: 10.1016/j.socscimed.2020.112913] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/13/2019] [Accepted: 03/07/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Self-rated health (SRH) is arguably the most widely used generic health measurement in survey research. However, SRH remains a black box for researchers. In our paper, we want to gain a better understanding of SRH by identifying its determinants, quantifying the contribution of different health domains to explain SRH, and by exploring the moderating role of gender, age groups, and the country of residence. METHOD Using data from 61,365 participants of the fifth wave (2013) of the Survey of Health, Ageing and Retirement in Europe (SHARE) living in fifteen European countries, we explain SRH via linear regression models. The independent variables are grouped into five health domains: functioning, diseases, pain, mental health, and behavior. Via dominance analysis, we focus on their individual contribution to explaining SRH and compare these contributions across gender, three age groups, and fifteen European countries. RESULTS Our model explains SRH rather well (R2 = .51 for females/.48 for males) with functioning contributing most to the appraisal (.20/.18). Diseases were the second most relevant health dimension (.14/.16) followed by pain (.08/.07) and mental health (.07/.06). Health behavior (.02/.01) was less relevant for health ratings. This ranking held true for almost all countries with only little variance overall. A comparison of age groups indicated that the contribution of diseases and behavior to SRH decreased over the life-course while the contribution of functioning to R2 increased. CONCLUSION Our paper demonstrates that SRH is largely based on diverse health information with functioning and diseases being most important. However, there is still room for idiosyncrasies or even bias.
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Affiliation(s)
- Patrick Lazarevič
- Austrian Academy of Sciences, Vienna Institute of Demography, Vordere Zollamtsstraße 3, 1030, Vienna, Austria.
| | - Martina Brandt
- TU Dortmund, Institute for Sociology, Emil-Figge-Str. 50, 44227, Dortmund, Germany.
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Namatovu F, Lundevaller EH, Vikström L, Ng N. Adverse perinatal conditions and receiving a disability pension early in life. PLoS One 2020; 15:e0229285. [PMID: 32092090 PMCID: PMC7039457 DOI: 10.1371/journal.pone.0229285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 02/03/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The number of young adults on disability pension (DP) is increasing in European countries, creating a need to understand the related risk factors. This study aimed to determine whether adverse perinatal conditions are associated with receiving a DP early in life. METHODS This longitudinal cohort study consisted of all persons (N = 453,223) born in Sweden during 1973-1977, observed from 1991 through 2010 when they were aged between 16 and 37 years. Statistics Sweden provided linked national data on the children and their parents. We used logistic regression to assess the association between perinatal health conditions (birth defect, Apgar score, and small for gestational age) and receiving a DP, adjusting for maternal education and the sex of the child. RESULTS New recipients of DP were significantly more likely to have had a birth defect (adjusted odds ratio [AOR] 2.74, 95% CI: 2.49-3.00), to have had low Apgar score (AOR 2.12, 95% CI: 1.77-2.52), to have been small for gestational age (AOR 1.73, 95% CI: 1.54-1.94) and to be females (AOR 1.55, 95% CI: 1.46-1.64). Higher maternal education was associated with lower odds of receiving a DP (AOR 0.74, 95% CI: 0.69-0.79) for those with high school education and (AOR 0.67, 95% CI: 0.59-0.75) for those with university education. Age-stratified analysis confirmed increased odds of receiving a DP among those with birth defects and small for gestational age, but this effect reduced with increasing age. Apgar score was significantly associated with starting to receive a DP at ages 16-18 and 19-29, but not at ages 30-33. Women had lower odds of receiving a DP at ages 16-18 (AOR 0.73, 95% CI: 0.64-0.85); however, this reversed from age 19 and upwards (AOR 1.53, 95% CI: 1.41-1.67) and (AOR 2.16, 95% CI: 1.95-2.40) for the age groups of 19-29 and 30-33, respectively. Persons with high maternal education were less likely to receive a DP regardless of age at receiving a DP. CONCLUSION Having a birth defect was the strongest indicator of receiving a DP during early adulthood, followed by small for gestational age and low Apgar score. Overall, the effects of the studied perinatal health conditions were pronounced in those who received a DP at 16-18 years, but this effect weakened with increasing age at receiving a DP. Our findings suggest that policies and programs geared at promoting optimal health at birth might contribute to a reduction in receiving a DP.
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Affiliation(s)
- Fredinah Namatovu
- Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umeå, Sweden
- * E-mail:
| | | | - Lotta Vikström
- Department of Historical, Philosophical and Religious Studies, Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umeå, Sweden
| | - Nawi Ng
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden
- Global and Public Health, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Shiri R, Falah-Hassani K, Lallukka T. Body mass index and the risk of disability retirement: a systematic review and meta-analysis. Occup Environ Med 2019; 77:48-55. [DOI: 10.1136/oemed-2019-105876] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/25/2019] [Accepted: 07/30/2019] [Indexed: 01/19/2023]
Abstract
The aim of this study was to determine the associations of body mass index (BMI) with all-cause and cause-specific disability retirement. Literature searches were conducted in PubMed, Embase and Web of Science from their inception to May 2019. A total of 27 (25 prospective cohort and 2 nested case-control) studies consisting of 2 199 632 individuals qualified for a meta-analysis. Two reviewers independently assessed the methodological quality of the included studies. We used a random effects meta-analysis, assessed heterogeneity and publication bias, and performed sensitivity analyses. There were a large number of participants and the majority of studies were rated at low or moderate risk of bias. There was a J-shaped relationship between BMI and disability retirement. Underweight (hazard ratio (HR)/risk ratio (RR)=1.20, 95% CI 1.02 to 1.41), overweight (HR/RR=1.13, 95% CI 1.07 to 1.19) and obese individuals (HR/RR=1.52, 95% CI 1.36 to 1.71) were more commonly granted all-cause disability retirement than normal-weight individuals. Moreover, overweight increased the risk of disability retirement due to musculoskeletal disorders (HR/RR=1.26, 95% CI 1.15 to 1.39) and cardiovascular diseases (HR=1.73, 95% CI 1.24 to 2.41), and obesity increased the risk of disability retirement due to musculoskeletal disorders (HR/RR=1.66, 95% CI 1.42 to 1.94), mental disorders (HR=1.29, 95% CI 1.04 to 1.61) and cardiovascular diseases (HR=2.80, 95% CI 1.85 to 4.24). The association between excess body mass and all-cause disability retirement did not differ between men and women and was independent of selection bias, performance bias, confounding and adjustment for publication bias. Obesity markedly increases the risk of disability retirement due to musculoskeletal disorders, cardiovascular diseases and mental disorders. Since the prevalence of obesity is increasing globally, disease burden associated with excess body mass and disability retirement consequently are projected to increase. Reviewregistrationnumber: CRD42018103110.
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Moon K, Krems C, Heuer T, Roth A, Hoffmann I. Predictors of BMI Vary along the BMI Range of German Adults - Results of the German National Nutrition Survey II. Obes Facts 2017; 10:38-49. [PMID: 28219069 PMCID: PMC5644963 DOI: 10.1159/000456665] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 01/11/2017] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The objective of the study was to identify predictors of BMI in German adults by considering the BMI distribution and to determine whether the association between BMI and its predictors varies along the BMI distribution. METHODS The sample included 9,214 adults aged 18-80 years from the German National Nutrition Survey II (NVS II). Quantile regression analyses were conducted to examine the association between BMI and the following predictors: age, sports activities, socio-economic status (SES), healthy eating index-NVS II (HEI-NVS II), dietary knowledge, sleeping duration and energy intake as well as status of smoking, partner relationship and self-reported health. RESULTS Age, SES, self-reported health status, sports activities and energy intake were the strongest predictors of BMI. The important outcome of this study is that the association between BMI and its predictors varies along the BMI distribution. Especially, energy intake, health status and SES were marginally associated with BMI in normal-weight subjects; this relationships became stronger in the range of overweight, and were strongest in the range of obesity. CONCLUSIONS Predictors of BMI and the strength of these associations vary across the BMI distribution in German adults. Consequently, to identify predictors of BMI, the entire BMI distribution should be considered.
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Affiliation(s)
- Kilson Moon
- Department of Nutritional Behaviour, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany, Zurich, Switzerland
| | - Carolin Krems
- Department of Nutritional Behaviour, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany, Zurich, Switzerland
- *Dr. Carolin Krems, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Haid-und-Neu-Straße 9, 76131 Karlsruhe, Germany,
| | - Thorsten Heuer
- Department of Nutritional Behaviour, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany, Zurich, Switzerland
| | - Alexander Roth
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Ingrid Hoffmann
- Department of Nutritional Behaviour, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany, Zurich, Switzerland
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Karnehed N, Rasmussen F, Kark M. Obesity in young adulthood and later disability pension: A population-based cohort study of 366,929 Swedish men. Scand J Public Health 2016; 35:48-54. [PMID: 17366087 DOI: 10.1080/14034940600858524] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: The prevalence of obesity has increased threefold among Swedish men during recent decades. Knowledge from Sweden on how obese men manage in working life and become disability pensioners is sparse. The aim of this nationwide and population-based cohort study was to investigate to what extent body mass index (BMI) in young adulthood predicts later disability pension. Method: All Swedish men born 1952—59, who had their weight and height measured at age 18 years in the compulsory military conscription examinations, were followed up longitudinally from 1990 to 2001 with regard to receiving disability pension. Data on own socioeconomic position (1985), education and marital status (1990), parental socioeconomic position (1960), and education (1970) were obtained from censuses. For 366,929 men (81% of the eligible men) the hazard ratio for receiving disability pension was calculated with Cox regression controlling for own education, parental education, childhood and adult socioeconomic position, marital status, morbidity, and type of municipality. Results: Obesity in young adulthood increased the risk for disability pension later in life (1.35, 95% CI 1.19, 1.52) compared with men of normal weight. The relationship between BMI and disability pension was J-shaped with higher risks for underweight (1.14, 95% CI 1.09, 1.20) and obese men. Conclusions: Obese men in Sweden are at higher risk of receiving disability pension. The relationship between BMI and disability pension is J-shaped. An important future task is to estimate the societal costs due to disability pension of obese people.
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Affiliation(s)
- Nina Karnehed
- Child and Adolescent Public Health Epidemiology Group, Department of Public Health Sciences, Karolinska Institute, Sweden
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Park S, Ahn J, Lee BK. Self-rated Subjective Health Status Is Strongly Associated with Sociodemographic Factors, Lifestyle, Nutrient Intakes, and Biochemical Indices, but Not Smoking Status: KNHANES 2007-2012. J Korean Med Sci 2015; 30:1279-87. [PMID: 26339168 PMCID: PMC4553675 DOI: 10.3346/jkms.2015.30.9.1279] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 05/14/2015] [Indexed: 12/02/2022] Open
Abstract
Despite advertised health warnings regarding the deadly hazards of smoking, many people have not heeded recommendations to quit smoking. We examined factors that affect self-rated subjective health status (SRH) scores among lifestyle, nutrient intake and biochemical parameters, and the association of SRH scores and smoking status in a large Korean adult population. Adjusted odd ratios for SRH were calculated for smoking status, selected biochemical data, and food and nutrient intake obtained using the 24-hr recall method after covariate adjustment in the 2007-2012 Korean National Health and Nutrition Examination Survey (27,534 men and women aged ≥ 20 yr). Age, sex, income, education, drinking, exercise and stress levels were associated with SRH scores, regardless of smoking status (P < 0.001). Interestingly, people in any smoking status groups considered the well-known indicators for metabolic diseases (HDL cholesterol, glucose, aspartate aminotransferase, and alanine aminotransferase in the circulation), and the intake of fiber, total vitamins A, and vitamin C as indicators of SRH. Especially in current smokers, higher intake of nutritious food groups such as grains (OR = 1.227), vegetables (OR = 1.944), and milk (OR = 2.26) significantly increased the adjusted odds ratio of SRH. However, smoking status was not associated with SRH scores. In conclusion, SRH is affected by the indices related to health but not smoking status in Korean adults. The development of a new indicator of the direct adverse effects of smoking at regular health check-ups might be required to modulate the SRH in smokers and a nutritional education should not include the possible attenuation of adverse effects of smoking by good nutrition.
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Affiliation(s)
- Sunmin Park
- Department of Food and Nutrition, Hoseo University, Asan, Korea
| | - Jaeouk Ahn
- Department of Medical IT Engineering, Soonchunhyang University, Asan, Korea
| | - Byung-Kook Lee
- Department of Preventive Medicine, Soonchunhyang University, Asan, Korea
- Chungju Medical Center, Chungju, Korea
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Relation between overweight/obesity and self-rated health among adolescents in Germany. Do socio-economic status and type of school have an impact on that relation? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:2262-76. [PMID: 25690000 PMCID: PMC4344724 DOI: 10.3390/ijerph120202262] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 02/09/2015] [Accepted: 02/12/2015] [Indexed: 11/23/2022]
Abstract
This study investigates the relation between overweight/obesity and self-rated health (SRH), and whether this relation varies by social factors. Data was taken from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, baseline 2003‒2006). For the definition of overweight and obesity, body mass index was calculated based on standardized height and weight measurements. SRH of adolescents (n = 6813, 11‒17 years) was raised with the question: “How would you describe your health in general?” The response categories were “very good”, “good”, “fair”, “poor”, and “very poor”. We dichotomized these responses into: “very good/good” vs. “fair/poor/very poor”. Socio-economic status (SES) in the family of origin and adolescents’ school type were analyzed as modifying factors. Prevalence and age-adjusted odds ratios with 95% confidence intervals were calculated by binary logistic regression models. We found that overweight and obese boys and obese girls reported fair to very poor SRH more often than their normal weight peers, and that these differences were more apparent in early than late adolescence. In addition, the relation between obesity and SRH was similarly strong in all sub-groups, but there was seldom a relation between overweight and SRH. In summary, the results show that obesity is linked to poor SRH regardless of SES and school type, while the relation between overweight and SRH varies by social factors among adolescents.
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Prospective study of predictors of poor self-rated health in a 23-year cohort of earthquake survivors in Armenia. J Epidemiol Glob Health 2015; 5:265-74. [PMID: 26231402 PMCID: PMC7320530 DOI: 10.1016/j.jegh.2014.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 10/23/2014] [Accepted: 12/21/2014] [Indexed: 11/24/2022] Open
Abstract
Long-term prospective studies exploring general health outcomes among disaster survivors are rare. Self-rated health (SRH) – a proven correlate of morbidity and mortality prognosis – was used to investigate predictors of perceived health status among a 23-year cohort of survivors of 1988 Spitak earthquake in Armenia. A geographically-stratified subsample of 725 adults from a larger initial cohort was followed during the period of 1990–2012. A logistic regression model identified predictors of SRH. Adjusted relative risks for the long-term predictors of SRH were calculated. The rate of poor SRH among the survivors was 18.8%, fair 56.5%, and good/excellent 24.7%. In the fitted model, long-term risk factors of poor SRH included baseline body mass index, baseline multi-morbidity, number of experienced stressful life events, and perceived poor living standards during the post-earthquake decade, while participation in sports in the early 1990s was a protective factor. Short-term protective factors included socio-economic status score, social support, employment and dignity, while current household size was a risk factor for poor SRH. No association was found between earthquake exposure severity and SRH after 23 years. However, the identified predictors included a number of modifiable lifestyle, material and psychological factors. Thus, interventions targeting these factors could have a long-lasting impact on disaster victims’ health status.
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Somerville R, McKenzie K, Eslami S, Breen C, O'Shea D, Wall P. Poor mental health in severely obese patients is not explained by the presence of comorbidities. Clin Obes 2015; 5:12-21. [PMID: 25530046 DOI: 10.1111/cob.12081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 10/15/2014] [Accepted: 10/21/2014] [Indexed: 12/22/2022]
Abstract
The prevalence of obesity, especially severe obesity where body mass index (BMI) exceeds 40 kg m(-2) and where the physical risks are greatest, is increasing. However, little is known about the impact of severe obesity on psychological well-being and self-rated health (SRH). We aimed to investigate this relationship in patients attending an Irish weight management clinic. SRH was measured with a single-item inventory (excellent = 1, poor = 5). Well-being was measured with the validated World Health Organization-Five Well-being Index (WHO-5), in which scores <13 indicate poor well-being. Previous studies of the Irish population have reported mean SRH = 2.56 (males) and 2.53 (females) and mean well-being = 16.96. One hundred eighty-two (46.8%) completed questionnaires were returned. The sample was representative of the clinic population with a mean age of 47.1, mean baseline BMI of 51.9 kg m(-2) and 64.3% females. Mean SRH was 3.73 in males and 3.30 in females; mean well-being was 10.27 in males and 10.52 in females. In the final multivariable models, number of medications, depression and obstructive sleep apnoea, WHO-5 and current BMI were significant predictors of SRH, and secondary level education, social support and mindfulness scores were significant predictors of psychological well-being. Number of medications was not significant. The results suggest that the poor psychological well-being seen is not explained by the presence of comorbidities and that social support and mindfulness may be important targets for improving psychological well-being. Improving psychological well-being in addition to weight loss and effective management of comorbidities may be important for improving SRH.
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Affiliation(s)
- R Somerville
- School of Public Health Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
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Marklund S, Lundh G, Gustafsson K, Linder J, Svedberg P, Alexanderson K. The actions of the social insurance agency regarding long-term sickness absentees before and after a medical assessment--a study of 384 case files. Disabil Rehabil 2014; 37:1683-91. [PMID: 25354147 DOI: 10.3109/09638288.2014.976716] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The purpose of this article is to investigate actions taken by the Social Insurance Agency (SIA) for long-term sickness absentees and possible associations of this with future sick leave or disability pension. METHOD For 384 long-term sickness absentees who had had a multidisciplinary medical assessment (MMA) during 2001-2006, three types of data were obtained: (1) case file information about SIA actions, (2) suggested rehabilitation measures from the MMA and (3) sickness absence and disability pension data. RESULTS Most individuals had been subject to a range of actions by the SIA. Sixty percent had been invited to a coordination meeting, and half of those who assessed by the MMA for vocational rehabilitation were approved to get it by the SIA. Few SIA actions were associated with full or partial return to work. CONCLUSIONS Although the studied individuals had been on sick leave for a long time, the number of SIA actions related to vocational rehabilitation was limited and came late in the sick-leave spell. The information from the MMA was often not used as a basis for further SIA action and seldom resulted in return to work. The positive MMA views on the potential of vocational rehabilitation were not met by SIA actions. IMPLICATIONS FOR REHABILITATION Suggestions on vocational rehabilitation from a medical assessment was in many cases not used by the social insurance agency in relationship to long-term sickness absentees. Active rehabilitation measures by the social insurance agency were few and came late in the sickness absence process. Few of the activities taken by the social insurance agency enhanced return to work.
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Affiliation(s)
- Staffan Marklund
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet , Stockholm , Sweden
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Gustafsson K, Aronsson G, Marklund S, Wikman A, Hagman M, Floderus B. Social integration, socioeconomic conditions and type of ill health preceding disability pension in young women: a Swedish population-based study. Int J Behav Med 2014; 21:77-87. [PMID: 23307701 DOI: 10.1007/s12529-012-9287-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Disability pension has increased in recent decades and is seen as a public health and socioeconomic problem in Western Europe. In the Nordic countries, the increase has been particularly steep among young women. PURPOSE The aim was to analyze the influence of low social integration, socioeconomic risk conditions and different measures of self-reported ill health on the risk of receiving disability pension in young women. METHOD The study comprised all Swedish women born in 1960 to 1979, who had been interviewed in any of the annual Swedish Surveys of Living Conditions (1990-2002). The assumed predictors were related to disability pension by Cox proportional hazard regression. The mean number of years of follow-up for the 10,936 women was 7 years (SD 3.8), and the study base was restricted to the ages 16 to 43 years of age. RESULTS An increased risk of receiving a disability pension was found among lone women, those who had sparse contacts with others, job-seeking women, homemakers, as well as women with low education, and poor private financial situations. A tenfold increase in the risk of receiving a disability pension was found among women reporting a long-standing illness and poor self-rated health, compared to women without a long-standing illness and good self-rated health. Psychiatric diagnoses and symptoms/unspecified illness were the strongest predictors of disability pension, particularly before 30 years of age. CONCLUSION The study suggests that weak social relations and weak connections to working life contribute to increase the risk of disability pension in young women, also after control for socioeconomic conditions and self-reported ill health. Self-rated health was the strongest predictor, followed by long-standing illness and not having a job (job seekers and homemakers).
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Affiliation(s)
- Klas Gustafsson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden,
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Gustafsson K, Aronsson G, Marklund S, Wikman A, Floderus B. Does social isolation and low societal participation predict disability pension? A population based study. PLoS One 2013; 8:e80655. [PMID: 24223229 PMCID: PMC3819288 DOI: 10.1371/journal.pone.0080655] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 10/06/2013] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The aim was to examine the potential influence of social isolation and low societal participation on the future risk of receiving disability pension among individuals in Sweden. A specific aim was to describe differences depending on disability pension diagnoses, and how the results were modified by sex and age. METHOD The study comprised representative samples of Swedish women and men, who had been interviewed in any of the annual Swedish Surveys of Living Conditions between 1990 and 2007. Information on disability pension and diagnoses was added from the Swedish Social Insurance Agency's database (1991-2011). The mean number of years of follow-up for the 53920 women and men was twelve years (SD 5.5), and the study base was restricted to the ages 20 to 64 years of age. The predictors were related to disability pension by Cox's proportional hazards regression. RESULTS Social isolation and low societal participation were associated with future disability pension also after control for age, year of interview, socio demographic conditions and self reported longstanding illness. Lone individuals were at increased risk of disability pension, and the effect of living without children was modified by sex and age. An increase in risk was particularly noticeable among younger women who reported that they had sparse contacts with others, and no close friend. Both women and men who reported that they did not participate in political discussions and who could not appeal on a decision by a public authority were also at increased risk. The effects of social isolation were mainly attributed to disability pension with mental diagnoses, and to younger individuals. CONCLUSIONS The study suggests that social isolation and low societal participation are predictors of future disability pension. Social isolation and low societal participation increased particularly the risk of future disability pension in mental diagnoses among younger individuals.
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Affiliation(s)
- Klas Gustafsson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Gunnar Aronsson
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Staffan Marklund
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Anders Wikman
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Birgitta Floderus
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Self-reported general health and Body Mass Index: a U-shaped relationship? Public Health 2013; 127:938-45. [DOI: 10.1016/j.puhe.2013.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 02/11/2013] [Accepted: 07/08/2013] [Indexed: 12/11/2022]
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Samuelsson Å, Ropponen A, Alexanderson K, Svedberg P. A prospective cohort study of disability pension due to mental diagnoses: the importance of health factors and behaviors. BMC Public Health 2013; 13:621. [PMID: 23816331 PMCID: PMC3733696 DOI: 10.1186/1471-2458-13-621] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 06/27/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies have found associations between various health factors and behaviors and mental disorders. However, knowledge of such associations with disability pension (DP) due to mental diagnoses is scarce. Moreover, the influence of familial factors (genetics and family background) on the associations are mainly unknown. The aim of the study was to investigate associations between health factors and behaviors and future DP due to mental diagnoses in a twin cohort, accounting for familial confounding. METHODS A prospective cohort study of Swedish twins (N=28 613), including survey data and national register data on DP and other background factors was conducted. Cox proportional hazards regression models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI) for the whole twin cohort, and for discordant twin pairs. RESULTS During follow-up 1998-2008 (median 10 years), 2.2% of the cohort was granted a DP with a mental diagnosis. In the fully adjusted analyses of the whole cohort, the associations of poor or moderate self-rated health (SRH), under- or overweight, former or current tobacco use, or being an abstainer from alcohol were significantly associated with risk of DP due to mental diagnoses. Analyses of discordant twin pairs confirmed all these associations, except for current tobacco use, being independent from familial confounding. Exclusion of individuals with current or previous depression or anxiety at baseline did not influence the associations found. CONCLUSIONS Poor or moderate SRH, under- or overweight, former tobacco use or being an abstainer from alcohol seem to be strong direct predictors of DP due to mental diagnoses, independently of several confounders of this study, including familial factors.
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Affiliation(s)
- Åsa Samuelsson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm SE-171 77, Sweden
| | - Annina Ropponen
- School of Medicine, University of Eastern Finland, Kuopio, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm SE-171 77, Sweden
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm SE-171 77, Sweden
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Marques-Vidal P, Ravasco P, Paccaud F. Differing trends in the association between obesity and self-reported health in Portugal and Switzerland. Data from national health surveys 1992-2007. BMC Public Health 2012; 12:588. [PMID: 22852585 PMCID: PMC3532318 DOI: 10.1186/1471-2458-12-588] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Accepted: 06/05/2012] [Indexed: 11/29/2022] Open
Abstract
Background The escalating prevalence of obesity might prompt obese subjects to consider themselves as normal, as this condition is gradually becoming as frequent as normal weight. In this study, we aimed to assess the trends in the associations between obesity and self-rated health in two countries. Methods Data from the Portuguese (years 1995–6, 1998–6 and 2005–6) and Swiss (1992–3, 1997, 2002 and 2007) National Health Surveys were used, corresponding to more than 130,000 adults (64,793 for Portugal and 65,829 for Switzerland). Body mass index and self-rated health were derived from self-reported data. Results Obesity levels were higher in Portugal (17.5% in 2005–6 vs. 8.9% in 2007 in Switzerland, p < 0.001) and increased in both countries. The prevalence of participants rating their health as “bad” or “very bad” was higher in Portugal than in Switzerland (21.8% in 2005–6 vs 3.9% in 2007, p < 0.001). In both countries, obese participants rated more frequently their health as “bad” or “very bad” than participants with regular weight. In Switzerland, the prevalence of “bad” or “very bad” rates among obese participants, increased from 6.5% in 1992–3 to 9.8% in 2007, while in Portugal it decreased from 41.3% to 32.3%. After multivariate adjustment, the odds ratio (OR) of stating one self’s health as “bad” or “very bad” among obese relative to normal weight participants, almost doubled in Switzerland: from 1.38 (95% confidence interval, CI: 1.01–1.87) in 1992–3 to 2.64 (95% CI: 2.14–3.26) in 2007, and similar findings were obtained after sample weighting. Conversely, no such trend was found in Portugal: 1.35 (95% CI: 1.23–1.48) in 1995–6 and 1.52 (95% CI: 1.37–1.70) in 2005–6. Conclusion Obesity is increasing in Switzerland and Portugal. Obesity is increasingly associated with poorer self-health ratings in Switzerland but not in Portugal.
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Affiliation(s)
- Pedro Marques-Vidal
- Institute of Social and Preventive Medicine, CHUV and Faculty of biology and medicine, Lausanne, Switzerland.
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Johansson E, Leijon O, Falkstedt D, Farah A, Hemmingsson T. Educational differences in disability pension among Swedish middle-aged men: role of factors in late adolescence and work characteristics in adulthood. J Epidemiol Community Health 2011; 66:901-7. [DOI: 10.1136/jech-2011-200317] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Health-related and sociodemographic risk factors for disability pension due to low back disorders: a 30-year prospective Finnish Twin Cohort Study. J Occup Environ Med 2011; 53:488-96. [PMID: 21522028 DOI: 10.1097/jom.0b013e31821576dd] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate health-related and sociodemographic risk factors for disability pensions (DP) due to low back disorders (LBD). METHODS Questionnaire data in 1975 of the Finnish Twin Cohort Study with record linkage to information on DP due to LBD from the official pension registers during follow-up 1975 to 2004 was analyzed with Cox proportional hazard models. RESULTS Musculoskeletal pain (Hazards Ratio [HR] = 2.36 to 2.39; 95% CI 1.97 to 2.88), smoking (HR = 1.82; 1.49 to 2.22), frequent analgesics use (HR = 1.67; 1.38 to 2.02), and presence of other chronic disease (HR = 1.44; 1.22 to 1.70) increased the risk for DP due to LBD. Years of education decreased the risk (HR = 0.81; 0.77 to 0.85). Associations remained significant when adjusted for familial background. CONCLUSIONS Health-related and sociodemographic risk factors for DP due to LBD can be identified early in life, and they seem independent from familial effects.
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Gustafsson K, Lundh G, Svedberg P, Linder J, Alexanderson K, Marklund S. Disability, sickness, and unemployment benefits among long-term sickness absentees five years before, during, and after a multidisciplinary medical assessment. J Multidiscip Healthc 2011; 4:25-31. [PMID: 21468245 PMCID: PMC3065563 DOI: 10.2147/jmdh.s17138] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Indexed: 12/29/2022] Open
Abstract
AIM The aim was to describe how a multidisciplinary medical assessment changed the distribution of long-term sickness absentees between three different forms of social security support during a period of eleven years. METHODS The study group (n = 1002) consisted of persons on long-term sickness absence who were referred to a multidisciplinary medical assessment by the Social Insurance Office in Stockholm, Sweden between 1998 and 2007. Register data from the years 1993-2008 were linked to the study group. A calculation was provided for the number of days per person and year on unemployment benefits, sickness benefits, and disability pension, five years before, during, and five years after the assessment. Also, differences in the average number of days per person and year were calculated with one-way analysis of variance. RESULTS The number of days on sickness benefits increased up to the time of multidisciplinary medical assessment, from 69 to 218 days on average. After the assessment there was a decrease in the average number of days on sickness benefits, from 218 to 16 days. Before the assessment the number of days on disability pension was 21, but this increased after the assessment from 104 days to an average of 272 days five years after the assessment. There were age differences regarding number of compensated days, and these were particularly pronounced for disability days after the assessment. Further, there were significant differences between types of diagnosis in relation to average days on disability pension after the assessment. CONCLUSION The study shows that after a multidisciplinary medical assessment there is a rapid increase in disability pension and a dramatic decrease in sickness benefits. The results indicate that for a large number of persons, a Social Insurance Office referral to an assessment does not improve their chances of returning to work, but rather seems to justify disability pension.
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Affiliation(s)
- Klas Gustafsson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Göran Lundh
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Pia Svedberg
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jürgen Linder
- Diagnostic Centre, Karolinska University Hospital, Stockholm, Sweden
| | - Kristina Alexanderson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Staffan Marklund
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
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Claessen H, Brenner H, Drath C, Arndt V. Gamma-glutamyltransferase and disability pension: a cohort study of construction workers in Germany. Hepatology 2010; 51:482-90. [PMID: 19967717 DOI: 10.1002/hep.23324] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
UNLABELLED Given the accumulating evidence that gamma-glutamyltransferase (gamma-GT) is not merely a sensitive marker for liver and bile disorders but also a risk marker for a multiplicity of other chronic diseases, gamma-GT may represent a promising risk indicator for occupational disability, which has emerged as an important public health problem. The association between gamma-GT and disability pension was examined in a cohort of 16,520 male construction workers in Württemberg, Germany, who participated in routine occupational health examinations from 1986 to 1992 and who were followed until 2005. Using the Cox proportional hazards model, hazard ratios were calculated with gamma-GT concentrations in the lowest quartile (1 to 24 U/L) as reference category after adjustment for age and further adjustment for potential confounding factors such as nationality, type of occupation, smoking, alcohol consumption, cholesterol, and body mass index (BMI). Overall, a monotonically increasing association of gamma-GT with all-cause disability pension (total number: n = 2,998 cases) was observed, with the steepest increase at lower levels of gamma-GT. Particularly strong associations were observed for participants in the highest quartile (>67 U/L) and disability pension due to musculoskeletal disorders, diseases of the digestive system, and cardiovascular as well as mental diseases (age-adjusted hazard ratios with 95% confidence intervals: 1.53, 1.27-1.85; 9.68, 3.10-30.21; 1.76, 1.28-2.42; and 1.83, 1.23-2.72, respectively). CONCLUSION gamma-GT is a strong risk indicator of all-cause occupational disability even at levels of gamma-GT in the "normal range" and is in particular associated with disability pension due to diseases of the digestive system, musculoskeletal disorders, cardiovascular, and mental diseases.
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Affiliation(s)
- Heiner Claessen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
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Lund T, Labriola M, Feveile H, Christensen KB. The fraction of disability pensions attributable to smoking and obesity. Results from a 15-year follow-up study. J Public Health (Oxf) 2009. [DOI: 10.1007/s10389-009-0304-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Labriola M, Feveile H, Christensen KB, Strøyer J, Lund T. The impact of ergonomic work environment exposures on the risk of disability pension: Prospective results from DWECS/DREAM. ERGONOMICS 2009; 52:1419-1422. [PMID: 19851908 DOI: 10.1080/00140130903067771] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The objectives were to identify the impact of ergonomic work environment exposures on the risk of disability pension. A representative sample of 8475 employees of the total working population in Denmark were interviewed regarding work environment exposures and followed in a national register with data on granted disability pension. For women, approximately 34% of the disability pension cases were attributable to ergonomic work environment exposures. For men, 21% of the disability pension cases were attributable to ergonomic work environment. Ergonomic work environment, especially physically demanding work, working with hands lifted and repetitive work, are areas of intervention at the workplace that can facilitate and prolong labour market participation. The study provides estimates for the association between ergonomic exposures at work and administrative, cost-related measures of work disability in a large population-based longitudinal cohort study over 14 years. Approximately 21% for men and 34% for women of the disability pension cases were attributable to ergonomic work environment exposures.
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Affiliation(s)
- Merete Labriola
- Danish National Centre for Social Research, Copenhagen, Denmark.
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Wallman T, Wedel H, Palmer E, Rosengren A, Johansson S, Eriksson H, Svärdsudd K. Sick-leave track record and other potential predictors of a disability pension. A population based study of 8,218 men and women followed for 16 years. BMC Public Health 2009; 9:104. [PMID: 19368715 PMCID: PMC2674437 DOI: 10.1186/1471-2458-9-104] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2008] [Accepted: 04/15/2009] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND A number of previous studies have investigated various predictors for being granted a disability pension. The aim of this study was to test the efficacy of sick-leave track record as a predictor of being granted a disability pension in a large dataset based on subjects sampled from the general population and followed for a long time. METHODS Data from five ongoing population-based Swedish studies was used, supplemented with data on all compensated sick leave periods, disability pensions granted, and vital status, obtained from official registers. The data set included 8,218 men and women followed for 16 years, generated 109,369 person years of observation and 97,160 sickness spells. Various measures of days of sick leave during follow up were used as independent variables and disability pension grant was used as outcome. RESULTS There was a strong relationship between individual sickness spell duration and annual cumulative days of sick leave on the one hand and being granted a disability pension on the other, among both men and women, after adjustment for the effects of marital status, education, household size, smoking habits, geographical area and calendar time period, a proxy for position in the business cycle. The interval between sickness spells showed a corresponding inverse relationship. Of all the variables studied, the number of days of sick leave per year was the most powerful predictor of a disability pension. For both men and women 245 annual sick leave days were needed to reach a 50% probability of transition to disability. The independent variables, taken together, explained 96% of the variation in disability pension grantings. CONCLUSION The sick-leave track record was the most important predictor of the probability of being granted a disability pension in this study, even when the influences of other variables affecting the outcome were taken into account.
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Affiliation(s)
- Thorne Wallman
- Uppsala University, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology Section, University Hospital, Uppsala, Sweden
- R&D Center/Center for Clinical Research, Section of Primary Care (AmC), Sörmland County Council, Eskilstuna, Sweden
| | - Hans Wedel
- Nordic School of Public Health, Gothenburg, Sweden
| | - Edward Palmer
- National Social Insurance Agency, Stockholm, Sweden
- Uppsala University, Department of Economics, Uppsala, Sweden
| | - Annika Rosengren
- Department of Heart and Lung Diseases, Sahlgren Academy, Gothenburg, Sweden
| | - Saga Johansson
- Department of Heart and Lung Diseases, Sahlgren Academy, Gothenburg, Sweden
- Department of Epidemiology, AstraZeneca R&D Mölndal, Sweden
| | - Henry Eriksson
- Department of Heart and Lung Diseases, Sahlgren Academy, Gothenburg, Sweden
| | - Kurt Svärdsudd
- Uppsala University, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology Section, University Hospital, Uppsala, Sweden
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Gravseth HM, Bjerkedal T, Irgens LM, Aalen OO, Selmer R, Kristensen P. Influence of physical, mental and intellectual development on disability in young Norwegian men. Eur J Public Health 2008; 18:650-5. [DOI: 10.1093/eurpub/ckn055] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Roehling MV, Roehling PV, Odland LM. Investigating the Validity of Stereotypes About Overweight Employees. GROUP & ORGANIZATION MANAGEMENT 2008. [DOI: 10.1177/1059601108321518] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Research indicates that overweight job applicants and employees are stereo-typically viewed as being less conscientiousness, less agreeable, less emotionally stable, and less extraverted than their “normal-weight” counterparts. Together, the two reported studies investigate the validity of those stereotypes by examining the relationship between body weight and four relevant personality traits (conscientiousness, agreeableness, emotional stability, extraversion) using three measures of body weight (body mass index [BMI] based on self-reported height and weight, BMI based on clinically assessed height and weight, percentage body fat assessed by bio-impedance technology) in a diverse group of 3,496 adults from the United States. There is substantial convergence between the two studies, with findings tending to refute commonly held stereotypes about the personality traits of overweight employees.
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Markowitz S, Friedman MA, Arent SM. Understanding the relation between obesity and depression: Causal mechanisms and implications for treatment. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1468-2850.2008.00106.x] [Citation(s) in RCA: 155] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hannerz H, Mikkelsen KL, Nielsen ML, Tüchsen F, Spangenberg S. Social inequalities in injury occurrence and in disability retirement attributable to injuries: a 5 year follow-up study of a 2.1 million gainfully employed people. BMC Public Health 2007; 7:215. [PMID: 17716365 PMCID: PMC2174474 DOI: 10.1186/1471-2458-7-215] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Accepted: 08/23/2007] [Indexed: 05/16/2023] Open
Abstract
Background Inequalities in injury related disability retirement may be due to differences in injury risk and or differences in retirement given injury. The aim of the present study was to measure social inequalities in injury occurrence and injury related disability retirement. Methods All people in the Danish labour force aged 20–59 years 1 January 1997 were followed for injury related hospital contacts during 1997 and all people in the Danish labour force aged 21–54 years 1 January 1998 were followed for injury related hospital contacts during 1997 and for disability retirements during 1998–2002. As inequality indices we used excess fractions (EF) i.e. the proportions of the cases that would not have occurred if the risks in each social group had been as low as they were in the occupational group with the highest skill requirements. Results With regard to the risk that an injury will occur, the EF was 36% among men and 10% among women. With regard to the risk that an injury will lead to disability retirement, the EF was 43% among men and 47% among women. The combined effect of the two types of inequalities rendered an EF for injury related disability retirement of 64% among men and 53% among women. The correlation between the case disability rate ratios among men and those among women was low (r = -0.110, P = 0.795). Conclusion The social inequality in injury related disability retirement lies only to some degree in the differences in the injury risk. More important are differences in the consequences of an injury. This was especially pronounced among the women.
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Affiliation(s)
- Harald Hannerz
- National Institute of Occupational Health, Copenhagen, Denmark
| | - Kim L Mikkelsen
- National Institute of Occupational Health, Copenhagen, Denmark
| | - Martin L Nielsen
- Department of Occupational Medicine, Hillerød Hospital, Hillerød, Denmark
| | - Finn Tüchsen
- National Institute of Occupational Health, Copenhagen, Denmark
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Gravseth HM, Bjerkedal T, Irgens LM, Aalen OO, Selmer R, Kristensen P. Life course determinants for early disability pension: a follow-up of Norwegian men and women born 1967–1976. Eur J Epidemiol 2007; 22:533-43. [PMID: 17530421 DOI: 10.1007/s10654-007-9139-9] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2007] [Accepted: 05/01/2007] [Indexed: 11/25/2022]
Abstract
BACKGROUND Most studies on disability pension (DP) have focused on work conditions, socio-economic status and other contemporary factors. We wanted to study possible determinants of an early DP with a life course perspective within a large register-based cohort, with a main focus on the biological and social factors from childhood. METHODS We established a longitudinal, population-based cohort of all persons liveborn in Norway between 1967 and 1976. Through linkage between several national registers we obtained personal data on biological/health related as well as social background factors. After excluding persons who died, emigrated or were granted a DP before age 20 years (at which age follow-up started) and persons who did not become gainfully employed during the study period, the study population consisted of 595,393 persons. They were categorized into four strata according to gender and educational attainment. Adjusted hazard ratios (HR) for granting a DP until the end of 2003 and the corresponding population attributable risks (PAR) were computed. RESULTS A total of 9,649 persons (1.6%) were granted a DP during follow-up. The disability risk was slightly higher among women than among men (1.7% vs. 1,5%). The following PARs were found: birth weight below the mean 5.7%, chronic childhood disease 6.8%, maternal marital status 4.4% and parental disability 8.8%. Low educational achievement was highly associated with DP, with a PAR more than twice as high as the overall PAR for the childhood factors. CONCLUSIONS Early DP is associated with several biological and social background factors from childhood. It also shows a strong dependency on educational achievement.
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Affiliation(s)
- Hans Magne Gravseth
- National Institute of Occupational Health, P.O. Box 8149 Dep, 0033, Oslo, Norway.
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Hannerz H, Spangenberg S, Tüchsen F, Nielsen ML, Mikkelsen KL. Prospective analysis of disability retirement as a consequence of injuries in a labour force population. JOURNAL OF OCCUPATIONAL REHABILITATION 2007; 17:11-8. [PMID: 17245637 DOI: 10.1007/s10926-007-9067-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
UNLABELLED The aim of the present work was to investigate the influence of different types of injury on the risk for disability retirement among economically active people in Denmark. MATERIAL AND METHODS In this prospective study, all people in the Danish labour force aged 21-54 years 1 January 1997 (N = 2 211 057) were followed for disability retirement during 1997-2001. Age and gender standardised incidence ratios (SIR) were calculated to compare retirement rates among those who received treatment for an injury during 1996 (N = 252 468, including both work-related and non-work related types) with the rates in the total labour force. Life-table methodology was used to calculate years of lost economically active life (YLEAL) by injury type. RESULTS Among the injured people we observed a total number of 5580 cases of subsequent disability retirement and 45% of these could be statistically attributed to the injury. The SIR for disability retirement by injury type ranged from 1.38 to 7.00. The least severe types, superficial injuries and dislocations, sprains, and strains, were most prevalent and generated the highest numbers of YLEALs. CONCLUSION The high frequency of injuries and their influence on retirement rates suggest that injury prevention is a highly relevant approach to reduce future costs from disability retirement. YLEAL calculations can be used to set priorities.
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Affiliation(s)
- Harald Hannerz
- Department of Epidemiology and Surveillance, National Institute of Occupational Health, Lersø Parkallé 105, DK-2100 Copenhagen Ø, Copenhagen, Denmark
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Svedberg P, Bardage C, Sandin S, Pedersen NL. A prospective study of health, life-style and psychosocial predictors of self-rated health. Eur J Epidemiol 2006; 21:767-76. [PMID: 17106761 DOI: 10.1007/s10654-006-9064-3] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2006] [Accepted: 09/14/2006] [Indexed: 10/23/2022]
Abstract
The aim of this study was to investigate what psychosocial predictors, life-style factors and health behaviors in early adulthood are of importance for self-ratings of health after the age of 45. Like-sexed adult twins born 1926-1950 (n = 16,080) from the Swedish Twin Registry that participated in a questionnaire in 1973 and in a telephone interview conducted between 1998 and 2002 were included. Exposure data was collected in 1973 and information on self-rated health and covariates was collected at the second contact 25 years later. Logistic regression using Generalized Estimating Equations was used to evaluate the associations. Conditional logistic regression was used to control for familial and genetic effects in the sample. Pain, lack of exercise, smoking, obesity, unemployment, perceived stress and personality are associated with future poor self-rated health, after controlling for age, sex, illness, education and socio-economic status. Familial and genetic effects influence the associations between recurrent headache, exercise, obesity, and poor self-rated health. Overall, these findings provide support for long-term effects of health behavior and psychosocial risk factors on poor self-ratings of health, beyond the influence of obvious health consequences such as disorders or illnesses. Genetic and familial factors are of importance only for some of these associations.
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Affiliation(s)
- Pia Svedberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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Emmelin M, Nafziger AN, Stenlund H, Weinehall L, Wall S. Cardiovascular risk factor burden has a stronger association with self-rated poor health in adults in the US than in Sweden, especially for the lower educated. Scand J Public Health 2006; 34:140-9. [PMID: 16581706 DOI: 10.1080/14034940510032365] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND There is an ongoing debate about the importance of biomedical and sociodemographic risk factors in the prediction of self-rated health. OBJECTIVES To compare the association of sociodemographic and cardiovascular risk factors and self-rated health in Sweden and the US. DESIGN Data from two population-based cross-sectional health surveys, one in Sweden and one in the US. SUBJECTS The surveys included questionnaire and measured data from 5,461 adults in Sweden and 7,643 in the US. Participants were between 35 and 65 years of age. RESULTS The odds ratios for poor self-rated health for the included cardiovascular risk factors were greater in the US. Low education was significantly more prevalent among those with self-rated poor health in the US, but not in Sweden. Using Swedes with high education as reference group (OR = 1), adults in the US with low education and 2+ risk factors had a greater than threefold risk (OR = 6.3) of self-rated poor health compared with Swedish low-educated adults with the same risk factor burden (OR = 1.9). The better-educated US adults with 2+ risk factors were significantly more likely to report poor health (OR = 3.4) compared with their Swedish counterparts (OR = 2.4). CONCLUSIONS The interaction between risk factors, education, and self-rated health suggests a frightening picture, especially for the US. Public health interventions for reducing cardiovascular risk factors need to include both population and individual measures. Taking people's overall evaluation of their health into account when assessing total health risk is important.
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Affiliation(s)
- Maria Emmelin
- Epidemiology and Public Health Sciences, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
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Baron-Epel O, Kaplan G, Haviv-Messika A, Tarabeia J, Green MS, Kaluski DN. Self-reported health as a cultural health determinant in Arab and Jewish Israelis. Soc Sci Med 2005; 61:1256-66. [PMID: 15970235 DOI: 10.1016/j.socscimed.2005.01.022] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2004] [Accepted: 01/25/2005] [Indexed: 11/25/2022]
Abstract
Subjective health (SH) status serves as a measure of health in many studies of health-related issues as it is a good predictor of mortality, morbidity, and use of health services. The measure is used in many population groups. However, the degree to which it measures the same condition in different ethnic groups is not clear. Within Israel's first National Health and Nutrition Survey (MABAT) conducted during 1999-2001, face-to-face interviews were held with 3222 Israeli interviewees, 2379 Jews and 843 Arabs, aged between 25-64 years. Respondents reported their SH, co-morbidity, and other socioeconomic characteristics. Arabs reported higher levels of SH than Jews. In logistic regression analysis, co-morbidity was a much stronger correlate of poorer SH in the Arab than in the Jewish population. The association between socioeconomic variables depended on ethnic group and sex. The findings indicate that SH in Jews and Arabs does not necessarily have the same meaning in relation to objective measures of health, and caution should be exercised in the use of this measure in different population groups with different cultures. Arabs tend to evaluate health better than Jews even though life expectancy is lower and morbidity and mortality are higher in the former population group. Yet diagnosis of a disease increases the frequency of reporting lower SH, more in Arabs than in Jews.
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Affiliation(s)
- Orna Baron-Epel
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Israel.
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Allebeck P, Mastekaasa A. Swedish Council on Technology Assessment in Health Care (SBU). Chapter 5. Risk factors for sick leave - general studies. Scand J Public Health 2005; 63:49-108. [PMID: 15513654 DOI: 10.1080/14034950410021853] [Citation(s) in RCA: 301] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Extensive information is available from official statistics and descriptive studies on the association between different socio-demographic background factors and sickness absence. This information addresses age, gender, place of residence, and socio-economic status. However, few studies have thoroughly analysed these background factors, and rigorous scientific evidence on the causal relationship between these factors and sick leave is lacking. Regarding the family, we found no scientific evidence that marital status or children living at home were associated with sickness absence. However, we found limited scientific evidence for an effect of divorce. Regarding work-related factors, we found limited scientific evidence for an effect of physically stressful work, and moderate scientific evidence for low psychological control over the work situation. We found limited scientific evidence for a correlation in time between unemployment and sickness absence, but insufficient scientific evidence for the causes of the association. There was moderate scientific evidence that the amount of sickness absence is influenced by the design of the social insurance system, but insufficient evidence on the magnitude of change required to influence the level of sickness absence. Essentially the same results apply to disability pension, although the number of studies is small. However, we found moderate scientific evidence for the effects of socio-economic status, which could be explained partly by childhood experiences.
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Affiliation(s)
- Peter Allebeck
- Department of Public Health, Karolinska Institutet, Stockholm, Sweden.
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Karpansalo M, Lakka TA, Manninen P, Kauhanen J, Rauramaa R, Salonen JT. Cardiorespiratory fitness and risk of disability pension: a prospective population based study in Finnish men. Occup Environ Med 2003; 60:765-9. [PMID: 14504365 PMCID: PMC1740405 DOI: 10.1136/oem.60.10.765] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Early retiring is a major social problem in many western countries. AIM To investigate whether good cardiorespiratory fitness prevents disability pensioning in Finnish middle-aged men. METHODS Subjects were a random population based sample of 1307 men who were 42-60 years old at baseline, had not retired before baseline or died during follow up, and had undergone a cycle ergometer test at baseline. Cardiorespiratory fitness was assessed at baseline with a maximal but symptom limited exercise test on an electrically braked cycle ergometer. RESULTS During a follow up of 11 years on average, 790 (60.4%) men were awarded a disability pension, only 254 (19.4%) men reached the old-age pension without previous early pension, and 263 (20.1%) men were still working at the end of follow up. After adjustment for age, body mass index, alcohol consumption, smoking, education, occupation, and baseline chronic diseases, an inverse association was observed between cardiorespiratory fitness and the risk of disability pension. Men with VO2max <25.98 ml/kg/min (lowest fifth) had a 3.28-fold (95% CI 1.70 to 6.32) and men with the duration of exercise test <9.54 minutes (lowest fifth) had a 4.66-fold (95% CI 2.43 to 8.92) risk of disability pension due to cardiovascular diseases compared with men in the highest fifths. Men with lowest fitness level also had an increased risk of disability pension due to musculoskeletal disorders, or all reasons combined. CONCLUSIONS Physical fitness is inversely associated with the risk of disability pension and especially with the risk of disability due to cardiovascular diseases.
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Affiliation(s)
- M Karpansalo
- Research Institute of Public Health, University of Kuopio, Finland.
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