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Meulman I, Uiters E, Cloin M, Polder J, Stadhouders N. Systematic review of individual-level, community-level, and healthcare system-level factors contributing to socioeconomic differences in healthcare utilisation in OECD countries with universal health coverage. BMJ Open 2024; 14:e080559. [PMID: 38503421 PMCID: PMC10952876 DOI: 10.1136/bmjopen-2023-080559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/20/2024] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVES Countries with universal health coverage (UHC) strive for equal access for equal needs without users getting into financial distress. However, differences in healthcare utilisation (HCU) between socioeconomic groups have been reported in countries with UHC. This systematic review provides an overview individual-level, community-level, and system-level factors contributing to socioeconomic status-related differences in HCU (SES differences in HCU). DESIGN Systematic review following the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines. The review protocol was published in advance. DATA SOURCES Embase, PubMed, Web of Science, Scopus, Econlit, and PsycInfo were searched on 9 March 2021 and 9 November 2022. ELIGIBILITY CRITERIA Studies that quantified the contribution of one or more factors to SES difference in HCU in OECD countries with UHC. DATA EXTRACTION AND SYNTHESIS Studies were screened for eligibility by two independent reviewers. Data were extracted using a predeveloped data-extraction form. Risk of bias (ROB) was assessed using a tailored version of Hoy's ROB-tool. Findings were categorised according to level and a framework describing the pathway of HCU. RESULTS Of the 7172 articles screened, 314 were included in the review. 64% of the studies adjusted for differences in health needs between socioeconomic groups. The contribution of sex (53%), age (48%), financial situation (25%), and education (22%) to SES differences in HCU were studied most frequently. For most factors, mixed results were found regarding the direction of the contribution to SES differences in HCU. CONCLUSIONS SES differences in HCU extensively correlated to factors besides health needs, suggesting that equal access for equal needs is not consistently accomplished. The contribution of factors seemed highly context dependent as no unequivocal patterns were found of how they contributed to SES differences in HCU. Most studies examined the contribution of individual-level factors to SES differences in HCU, leaving the influence of healthcare system-level characteristics relatively unexplored.
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Affiliation(s)
- Iris Meulman
- School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Center for Public Health, Health Services and Society, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Ellen Uiters
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Mariëlle Cloin
- School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Johan Polder
- School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Center for Public Health, Health Services and Society, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Niek Stadhouders
- Scientific Center for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
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Dally D, Amith M, Mauldin RL, Thomas L, Dang Y, Tao C. A Semantic Approach to Describe Social and Economic Characteristics That Impact Health Outcomes (Social Determinants of Health): Ontology Development Study. Online J Public Health Inform 2024; 16:e52845. [PMID: 38477963 PMCID: PMC10973958 DOI: 10.2196/52845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/28/2023] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Social determinants of health (SDoH) have been described by the World Health Organization as the conditions in which individuals are born, live, work, and age. These conditions can be grouped into 3 interrelated levels known as macrolevel (societal), mesolevel (community), and microlevel (individual) determinants. The scope of SDoH expands beyond the biomedical level, and there remains a need to connect other areas such as economics, public policy, and social factors. OBJECTIVE Providing a computable artifact that can link health data to concepts involving the different levels of determinants may improve our understanding of the impact SDoH have on human populations. Modeling SDoH may help to reduce existing gaps in the literature through explicit links between the determinants and biological factors. This in turn can allow researchers and clinicians to make better sense of data and discover new knowledge through the use of semantic links. METHODS An experimental ontology was developed to represent knowledge of the social and economic characteristics of SDoH. Information from 27 literature sources was analyzed to gather concepts and encoded using Web Ontology Language, version 2 (OWL2) and Protégé. Four evaluators independently reviewed the ontology axioms using natural language translation. The analyses from the evaluations and selected terminologies from the Basic Formal Ontology were used to create a revised ontology with a broad spectrum of knowledge concepts ranging from the macrolevel to the microlevel determinants. RESULTS The literature search identified several topics of discussion for each determinant level. Publications for the macrolevel determinants centered around health policy, income inequality, welfare, and the environment. Articles relating to the mesolevel determinants discussed work, work conditions, psychosocial factors, socioeconomic position, outcomes, food, poverty, housing, and crime. Finally, sources found for the microlevel determinants examined gender, ethnicity, race, and behavior. Concepts were gathered from the literature and used to produce an ontology consisting of 383 classes, 109 object properties, and 748 logical axioms. A reasoning test revealed no inconsistent axioms. CONCLUSIONS This ontology models heterogeneous social and economic concepts to represent aspects of SDoH. The scope of SDoH is expansive, and although the ontology is broad, it is still in its early stages. To our current understanding, this ontology represents the first attempt to concentrate on knowledge concepts that are currently not covered by existing ontologies. Future direction will include further expanding the ontology to link with other biomedical ontologies, including alignment for granular semantics.
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Affiliation(s)
- Daniela Dally
- The University of Texas Health Science Center at Houston School of Public Health, The Brownsville Region, Brownsville, TX, United States
| | - Muhammad Amith
- Department of Biostatistics and Data Science, University of Texas Medical Branch, Galveston, TX, United States
- Department of Internal Medicine, University of Texas Medical Branch, Galveton, TX, United States
| | - Rebecca L Mauldin
- School of Social Work, The University of Texas at Arlington, Arlington, TX, United States
| | - Latisha Thomas
- School of Social Work, The University of Texas at Arlington, Arlington, TX, United States
| | - Yifang Dang
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Cui Tao
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Jacksonville, FL, United States
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der Meer SMV, Smit DJM, Hutting N, van Lankveld W, Engels J, Reneman M, Pelgrim T, Staal JB. Facilitators and Barriers to Implementing Interventions to Prevent Musculoskeletal Disorders in Blue-Collar Workers: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-023-10162-y. [PMID: 38218906 DOI: 10.1007/s10926-023-10162-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/15/2024]
Abstract
PURPOSE Blue-collar workers generally have less healthy lifestyles, poorer health, and a lower life expectancy than white-collar workers. At least in part this may be attributed to their work and working conditions. Employers increasingly provide interventions to improve health and wellbeing and prevent musculoskeletal disorders. However, they often do not reach blue-collar workers. The aim of this scoping review was to identify the facilitators for and barriers to implementing such interventions among blue-collar workers. METHODS A scoping review in which the study population of the selected studies consists of blue-collar workers (≥ 18 years old) in paid employment. Furthermore, included studies should report facilitators and barriers to implementing interventions to prevent musculoskeletal disorders. The literature search was conducted in six databases. The resulting studies were extracted with the help of the updated Consolidated Framework for Implementation Research. RESULTS 15 articles were included; these were reviews, intervention studies, qualitative studies and process evaluations. A main facilitator was a participatory approach, which involves the blue-collar worker in the entire process of defining, developing, and implementing a multidimensional preventive intervention. The main barriers on the worker level were unfavorable worker characteristics and unsupportive behavior/attitudes. The main barriers on the organization level were a culture with a high production standard, a hierarchical culture, inflexible work, and an unsupportive attitude from the employer. CONCLUSION This review showed the multifaceted nature of implementation. A tailored implementation plan that involves the stakeholders (including workers) is important.
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Affiliation(s)
- Suzan Mooren-van der Meer
- Musculoskeletal Rehabilitation Research Group, School for Allied Health, HAN University of Applied Sciences, Nijmegen, The Netherlands.
| | - Denise J M Smit
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Nathan Hutting
- Research Group Occupation and Health, School of Organisation and Development, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Wim van Lankveld
- Musculoskeletal Rehabilitation Research Group, School for Allied Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Josephine Engels
- Research Group Occupation and Health, School of Organisation and Development, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Michiel Reneman
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Thomas Pelgrim
- Research Department Emergency and Critical Care, Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - J Bart Staal
- Musculoskeletal Rehabilitation Research Group, School for Allied Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
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Martins LDTB, Fernandes AP, Cavalcanti A, Barcelos JLM, Dutra FCMS. Work ability of school servants and the mediating effects between personal characteristics, work conditions, and sickness absence1. Work 2024; 77:919-931. [PMID: 37781838 DOI: 10.3233/wor-220642] [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] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND School servants are professionals involved with cleaning and feeding activities in schools. Exposed to conditions of physical and psychosocial overload at work, they may face situations of morbidity and functional restrictions. OBJECTIVE To evaluate personal and work characteristics and work ability index (WAI) of school servants in Brazil and test the mediating effect of WAI in the duration of sickness absence. METHODS 163 Brazilian school servants participated in this cross-sectional study, that including the self-completion of a sociodemographic questionnaire, information about the Work Environment, the Protocol of Psychosocial Risks at Work's Evaluation, and the Work Ability Index. Also was collected, in a secondary health database, information about sickness absence. A linear regression model was constructed to identify the predictors of the duration of absence, followed by the analysis of mediation with the Path Analysis method. RESULTS The study found that the WAI partially mediates the relation of the personal characteristics and the work conditions with the duration of absence of the school servants. The predictors included the organizational aspects of work, mental exhaustion, physical damage, health self-evaluation, availability of personal protective equipment, and the need to assume inadequate postures at work. These predictors explained 33% of the duration of absence and 53% of the WAI of these workers. CONCLUSION This study indicated that inadequate working conditions and low WAI impact in the sickness absence, increasing by 33% the length of time off work of school servants.
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Affiliation(s)
- Lilian D T B Martins
- Post-Graduation in Occupational Studies, School of Physical Education, Physical Therapy, and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Center for Study and Researchers in Work, Social Participation, and Health (NETRAS), Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Ana Paula Fernandes
- Center for Study and Researchers in Work, Social Participation, and Health (NETRAS), Federal University of Triângulo Mineiro, Uberaba, Brazil
- Collective Health Department, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Alessandra Cavalcanti
- Post-Graduation in Occupational Studies, School of Physical Education, Physical Therapy, and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Occupational Therapy Department, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Joyce L M Barcelos
- Center for Study and Researchers in Work, Social Participation, and Health (NETRAS), Federal University of Triângulo Mineiro, Uberaba, Brazil
- Post-Graduation Health Care Program, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Fabiana C M S Dutra
- Post-Graduation in Occupational Studies, School of Physical Education, Physical Therapy, and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Center for Study and Researchers in Work, Social Participation, and Health (NETRAS), Federal University of Triângulo Mineiro, Uberaba, Brazil
- Occupational Therapy Department, Federal University of Triângulo Mineiro, Uberaba, Brazil
- Post-Graduation Health Care Program, Federal University of Triângulo Mineiro, Uberaba, Brazil
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Reuter M, Pischke CR, Rigo M, Diehl K, Spallek J, Richter M, Hövener C, Dragano N. Health inequalities among young workers: the mediating role of working conditions and company characteristics. Int Arch Occup Environ Health 2023; 96:1313-1324. [PMID: 37814035 PMCID: PMC10635983 DOI: 10.1007/s00420-023-02010-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/24/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE Few studies have investigated health inequalities among young workers. The objectives of this study are to assess the extent of health inequalities in a sample of job starters and to explore the contribution of job demands and organisational factors. METHODS We analyze data from the BIBB/BAuA Youth Employment Survey 2012. The cross-sectional survey includes a representative sample of 3214 German employees, apprentices, and trainees aged 15-24 years. Individuals were grouped by their years of schooling into low (< 12 years) and high levels of education (≥ 12 years). Regression analysis estimated the link between education and four health outcomes: self-rated health, number of health events, musculoskeletal symptoms, and mental health problems over the last 12 months. Counterfactual mediation analysis tested for indirect effects of education via working conditions (i.e., physical and psychosocial job demands) and company characteristics (i.e., company size, health prevention measures, financial situation, downsizing). All analyses were adjusted for age, sex, nationality, region, working hours, job tenure, employment relationship, and economic sector. RESULTS Highly educated workers reported better self-rated health (b = 0.24, 95% CI 0.18-0.31) and lower numbers of health events (Rate Ratio (RR) = 0.74, 95% CI 0.67-0.82), musculoskeletal symptoms (RR = 0.73, 95% CI 0.66-0.80) and mental health problems (RR = 0.84, 95% CI 0.76-0.93). Total job demands explained between 21.6% and 87.2% of the educational differences (depending on health outcome). Unfavourable company characteristics were associated with worse health, but showed no or only small mediation effects. CONCLUSIONS Health inequalities are already present at the early working career due to socio-economically stratified working hazards. To enhance prevention measures that aim at reducing inequalities in workplace health, we propose shifting attention towards earlier stages of life.
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Affiliation(s)
- Marvin Reuter
- Junior Professorship for Sociology, esp. Work and Health, Department of Sociology, University of Bamberg, Feldkirchenstraße 21, 96045, Bamberg, Germany.
| | - Claudia R Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Duesseldorf, 40225, Duesseldorf, Germany
| | - Mariann Rigo
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Duesseldorf, 40225, Duesseldorf, Germany
| | - Katharina Diehl
- Department of Medical Informatics, Biometry and Epidemiology, Chair of Epidemiology and Public Health, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University Cottbus-Senftenberg, 01968, Senftenberg, Germany
- Lausitz Center for Digital Public Health, Brandenburg University of Technology Cottbus-Senftenberg, 01968, Senftenberg, Germany
| | - Matthias Richter
- Department of Sport and Health Science, Technical University of Munich, 80992, Munich, Germany
| | - Claudia Hövener
- Unit of Social Determinants of Health, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Duesseldorf, 40225, Duesseldorf, Germany
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Wind K, Poland B, HakemZadeh F, Jackson S, Tomlinson G, Jadad A. Using self-reported health as a social determinants of health outcome: a scoping review of reviews. Health Promot Int 2023; 38:daad165. [PMID: 38041807 DOI: 10.1093/heapro/daad165] [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] [Indexed: 12/04/2023] Open
Abstract
Reducing disease prevalence rather than promoting health has long been the objective of significant population health initiatives, such as the social determinants of health (SDH) framework. However, empirical evidence suggests that people with diagnosed diseases often answer the self-reported health (SRH) question positively. In pursuit of a better proxy to understand, measure and improve health, this scoping review of reviews examines the potential of SRH to be used as an outcome of interest in population health policies. Following PRISMA-ScR guidelines, it synthesizes findings from 77 review papers (published until 11 May 2022) and reports a robust association between SDH and SRH. It also investigates inconsistencies within and between reviews to reveal how variation in population health can be explained by studying the impact of contextual factors, such as cultural, social, economic and political elements, on structural determinants such as socioeconomic situation, gender and ethnicity. These insights provide informed hypotheses for deeper explorations of the role of SDH in improving SRH. The review detects several gaps in the literature. Notably, more evidence syntheses are required, in general, on the pathway from contextual elements to population SRH and, in particular, on the social determinants of adolescents' SRH. This study reports a disease-oriented mindset in collecting, analysing and reporting SRH across the included reviews. Future studies should utilize the capability of SRH in interconnecting social, psychological and biological dimensions of health to actualize its full potential as a central public health measure.
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Affiliation(s)
- Keiwan Wind
- DeGroote School of Business, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4M4, Canada
| | - Blake Poland
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, Ontario M5T 3M7, Canada
| | - Farimah HakemZadeh
- Faculty of Liberal Arts and Professional Studies, School of Human Resources Management, York University, 4700 Keele Street, Toronto, Ontario M3J 1P3, Canada
| | - Suzanne Jackson
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, Ontario M5T 3M7, Canada
| | - George Tomlinson
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, Ontario M5T 3M7, Canada
| | - Alejandro Jadad
- Centre for Digital Therapeutics, R. Fraser Elliott Building, 4th Floor, 190 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
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Tari B, Künzi M, Pflanz CP, Raymont V, Bauermeister S. Education is power: preserving cognition in the UK biobank. Front Public Health 2023; 11:1244306. [PMID: 37841724 PMCID: PMC10568007 DOI: 10.3389/fpubh.2023.1244306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction Dementia is a debilitating syndrome characterized by the gradual loss of memory and cognitive function. Although there are currently limited, largely symptomatic treatments for the diseases that can lead to dementia, its onset may be prevented by identifying and modifying relevant life style risk factors. Commonly described modifiable risk factors include diet, physical inactivity, and educational attainment. Importantly, however, to maximize the utility of our understanding of these risk factors, tangible and meaningful changes to policy must also be addressed. Objectives Here, we aim to identify the mechanism(s) by which educational attainment influences cognition. Methods We investigated data from 502,357 individuals (Mage = 56.53, SDage = 8.09, 54.40% female) from the UK Biobank cohort via Structural Equation Modelling to illustrate links between predictor variables (i.e., Townsend Deprivation Index, coastal distance, greenspace, years of education), covariates (i.e., participant age) and cognitive function as outcome variables (i.e., pairs-matching, trail-making task B, fluid intelligence). Results Our model demonstrated that higher education was associated with better cognitive performance (ps < 0.001), and this relationship was mediated by indices of deprivation, and coastal distance. Conclusion Accordingly, our model evinces the mediating effect of socioeconomic and environmental factors on the relationship between years of education and cognitive function. These results further demonstrate the utility and necessity of adapting public policy to encourage equitable access to education and other supports in deprived areas.
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Affiliation(s)
- Benjamin Tari
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Morgane Künzi
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - C. Patrick Pflanz
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Vanessa Raymont
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Asthana S, Prime S. The role of digital transformation in addressing health inequalities in coastal communities: barriers and enablers. FRONTIERS IN HEALTH SERVICES 2023; 3:1225757. [PMID: 37711604 PMCID: PMC10498291 DOI: 10.3389/frhs.2023.1225757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/14/2023] [Indexed: 09/16/2023]
Abstract
Healthcare systems worldwide are striving for the "quadruple aim" of better population health and well-being, improved experience of care, healthcare team well-being (including that of carers) and lower system costs. By shifting the balance of care from reactive to preventive by facilitating the integration of data between patients and clinicians to support prevention, early diagnosis and care at home, many technological solutions exist to support this ambition. Yet few have been mainstreamed in the NHS. This is particularly the case in English coastal areas which, despite having a substantially higher burden of physical and mental health conditions and poorer health outcomes, also experience inequalities with respect to digital maturity. In this paper, we suggest ways in which digital health technologies (DHTs) can support a greater shift towards prevention; discuss barriers to digital transformation in coastal communities; and highlight ways in which central, regional and local bodes can enable transformation. Given a real risk that variations in digital maturity may be exacerbating coastal health inequalities, we call on health and care policy leaders and service managers to understands the potential benefits of a digital future and the risks of failing to address the digital divide.
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Affiliation(s)
- Sheena Asthana
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
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Rohrbacher M, Hasselhorn HM. The contribution of work and health-related lifestyle to educational inequalities in physical health among older workers in Germany. A causal mediation analysis with data from the lidA cohort study. PLoS One 2023; 18:e0285319. [PMID: 37556415 PMCID: PMC10411755 DOI: 10.1371/journal.pone.0285319] [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] [Received: 09/22/2022] [Accepted: 04/19/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVES The objective of the study was to investigate the contribution of work factors and health-related lifestyle to educational inequalities in physical health among older workers in Germany by applying causal mediation analysis with longitudinal data. METHODS Data from the German lidA study was used. 2653 persons (53% female, 47% male) aged 46 (born 1965) and 52 (born 1959) at baseline were followed up for seven years with exposure and outcome assessments in 2011 (t0), 2014 (t1) and 2018 (t2). The total effect of education on physical health was decomposed into a natural direct effect (NDE) and a natural indirect effect (NIE) by using a sex-stratified causal mediation analysis with an inverse odds weighting approach. Baseline health, partner status and working hours were entered as a first set of mediators preceding the putative mediators of interest. All analyses were adjusted for age and migrant status. RESULTS Independent of the first set of mediators, work factors explained 21% of educational inequalities in physical health between low and high educated women and 0% comparing moderate versus high educated women. The addition of health behaviors explained further 26% (low vs. high education) and 20% (moderate vs. high education), respectively. Among men, net of the first set of mediators, work factors explained 5% of educational inequalities in physical health between low and high educated and 6% comparing moderate versus high educated persons. Additional 24% (low vs. high education) and 27% (moderate vs. high education) were explained by adding health behaviors to the models. CONCLUSIONS To reduce educational inequalities in physical health among older workers in Germany, interventions to promote healthy behaviors are promising. Improving working conditions is likely an important prerequisite.
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Affiliation(s)
- Max Rohrbacher
- Department of Occupational Health Science, School of Mechanical Engineering and Safety Engineering, University of Wuppertal, Wuppertal, Germany
| | - Hans Martin Hasselhorn
- Department of Occupational Health Science, School of Mechanical Engineering and Safety Engineering, University of Wuppertal, Wuppertal, Germany
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Zhang D, Zhang G, Jiao Y, Wang Y, Wang P. "Digital Dividend" or "Digital Divide": What Role Does the Internet Play in the Health Inequalities among Chinese Residents? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15162. [PMID: 36429878 PMCID: PMC9690004 DOI: 10.3390/ijerph192215162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/08/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
With the vigorous development of the medical industry in China, residents' health has been significantly improved. However, along with the income gap, urban-rural gap, and healthcare resource gap caused by economic development, health inequality has become a fundamental barrier to the promotion of residents' health. The popularity of the Internet has helped close the gap to some extent, but it also has drawbacks. Using data from the China Family Panel Studies (CFPS) from 2014 to 2018, we evaluated the effects of Internet usage on health disparities among residents using fixed effect models, mediation effect models, and other methodologies. The findings indicate that Internet usage can help to minimize health inequality since it lowers income inequality, promotes health consciousness, and reduces depression. Furthermore, Internet usage plays a greater role on the health improvement of the middle-aged, the elderly, urban residents, and females. Although the Internet has brought "digital dividends" in general, the Internet usage rates among different groups also reveal that there is a clear "digital gap" among rural residents, elderly groups, and low-income groups. These results have significant implications for promoting healthcare equality.
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Sponselee HCS, Kroeze W, Robroek SJW, Renders CM, Steenhuis IHM. Perceptions of employees with a low and medium level of education towards workplace health promotion programmes: a mixed-methods study. BMC Public Health 2022; 22:1617. [PMID: 36008851 PMCID: PMC9404568 DOI: 10.1186/s12889-022-13976-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background Understanding the perceptions of lower socioeconomic groups towards workplace health promotion is important because they are underrepresented in workplace health promotion activities and generally engage in unhealthier lifestyle behaviour than high SEP groups. This study aims to explore interest in workplace health promotion programmes (WHPPs) among employees with a low and medium level of education regarding participation and desired programme characteristics (i.e. the employer’s role, the source, the channel, the involvement of the social environment and conditions of participation). Methods A mixed-methods design was used, consisting of a questionnaire study (n = 475) and a sequential focus group study (n = 27) to enrich the questionnaire’s results. Multiple logistic regression analysis was performed to analyse the associations between subgroups (i.e. demographics, weight status) and interest in a WHPP. The focus group data were analysed deductively through thematic analysis, using MAXQDA 2018 for qualitative data analysis. Results The questionnaire study showed that 36.8% of respondents were interested in an employer-provided WHPP, while 45.1% expressed no interest. Regarding subgroup differences, respondents with a low level of education were less likely to express interest in a WHPP than those with a medium level of education (OR = .54, 95%, CI = .35–.85). No significant differences were found concerning gender, age and weight status. The overall themes discussed in the focus groups were similar to the questionnaires (i.e. the employer’s role, the source, the channel, the involvement of the social environment and conditions of participation). The qualitative data showed that participants’ perceptions were often related to their jobs and working conditions. Conclusions Employees with a medium level of education were more inclined to be interested in a WHPP than those with a low level of education. Focus groups suggested preferences varied depending on job type and related tasks. Recommendations are to allow WHPP design to adapt to this variation and facilitate flexible participation. Future research investigating employers’ perceptions of WHPPs is needed to enable a mutual understanding of an effective programme design, possibly contributing to sustainable WHPP implementation.
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Affiliation(s)
- Hanne C S Sponselee
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, The Netherlands.
| | - Willemieke Kroeze
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, The Netherlands.,Care for Nutrition and Health Group, School of Nursing, Christian University of Applied Sciences, 6717 JS, Ede, The Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Carry M Renders
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, The Netherlands
| | - Ingrid H M Steenhuis
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, The Netherlands
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12
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Lelie L, van der Molen HF, van den Berge M, van der Feltz S, van der Beek AJ, Hulshof CTJ, Proper KI. The process evaluation of a citizen science approach to design and implement workplace health promotion programs. BMC Public Health 2022; 22:1610. [PMID: 36002884 PMCID: PMC9399973 DOI: 10.1186/s12889-022-14009-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many workplace health promotion programs (WHPPs) do not reach blue-collar workers. To enhance the fit and reach, a Citizen Science (CS) approach was applied to co-create and implement WHPPs. This study aims to evaluate i) the process of this CS approach and ii) the resulting WHPPs. METHODS The study was performed in two companies: a construction company and a container terminal company. Data were collected by questionnaires, interviews and logbooks. Using the framework of Nielsen and Randall, process measures were categorized in the intervention, context and mental models. Interviews were transcribed and thematically coded using MaxQDA software. RESULTS The involvement in the CS approach and co-creating the WHPPs was positively experienced. Information provision, sustained engagement over time and alignment with the workplace's culture resulted in barriers in the CS process. As to the resulting WHPPs, involvement and interaction during the intervention sessions were particularly experienced in small groups. The reach was affected by the unfavorable planning off the WHPPs and external events of re-originations and the covid-19 pandemic. DISCUSSION Continuous information provision and engagement over time, better alignment with the workplace's culture and favorable planning are considered to be important factors for facilitating involvement, reach and satisfaction of the workers in a Citizen science approach to design and implement a WHPP. Further studies continuously monitoring the process of WHPPs using the CS approach could be helpful to anticipate on external factors and increase the adaptability. CONCLUSIONS Workers were satisfied with the involvement in WHPPs. Organizational and social cultural factors were barriers for the CS approach and its reach. Involvement and interaction in WHPPs were particularly experienced in small grouped sessions. Consequently, contextual and personal factors need be considered in the design and implementation of WHPPs with CS approach among blue-collar workers.
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Affiliation(s)
- Lisa Lelie
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007, MB, Amsterdam, The Netherlands.
| | - Henk F van der Molen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam UMC location AMC, University of Amsterdam, 1100, DD, Amsterdam, The Netherlands
| | - Mandy van den Berge
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007, MB, Amsterdam, The Netherlands
| | - Sophie van der Feltz
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007, MB, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007, MB, Amsterdam, The Netherlands
| | - Carel T J Hulshof
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam UMC location AMC, University of Amsterdam, 1100, DD, Amsterdam, The Netherlands
| | - Karin I Proper
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007, MB, Amsterdam, The Netherlands. .,Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, 3721, MA, Bilthoven, The Netherlands.
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13
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Brandl C, Nitsch V. Future of work in Germany: Socially sustainable value creation in digitalized and artificial intelligence-supported work systems. Work 2022; 72:1493-1496. [DOI: 10.3233/wor-223639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Christopher Brandl
- Institute of Industrial Engineering and Ergonomics, RWTH Aachen University, Aachen, Germany
- Fraunhofer Institute for Communication, Information Processing and Ergonomics FKIE, Aachen, Germany
| | - Verena Nitsch
- Institute of Industrial Engineering and Ergonomics, RWTH Aachen University, Aachen, Germany
- Fraunhofer Institute for Communication, Information Processing and Ergonomics FKIE, Aachen, Germany
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14
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The relationship between telework from home and the psychosocial work environment: a systematic review. Int Arch Occup Environ Health 2022; 95:2025-2051. [PMID: 35829741 DOI: 10.1007/s00420-022-01901-4] [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: 04/22/2022] [Accepted: 06/12/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Telework from home (TWFH) has become routine for many, yet research on how this may affect the psychosocial work environment is sparse. To understand the effects that TWFH may have on the psychosocial work environment, this systematic literature review identified, evaluated, and summarized findings on the association of TWFH with factors of the psychosocial work environment. METHODS Searches were conducted in MEDLINE, Embase, Amed, PsycINFO, and PubMed. The topic of the study reflected TWFH, and subjects should be office workers employed at a company. Outcomes should reflect psychosocial work environment factors. Inclusion criteria stated that studies should be primary, quantitative, and published in a peer-reviewed journal. English language publications dating from January 2010 to February 2021 were included. Risk of bias was assessed using the Newcastle-Ottawa scale (NOS) and quality of overall evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS Searches resulted in 3354 publications, and after screening rounds 43 peer-reviewed original studies satisfying predetermined inclusion and exclusion criteria were included. Fourteen individual psychosocial work environment outcome categories were studied. Limited overall evidence to support effects of TWFH on the included work environment outcomes, with evidence being rated either of low or very low quality. Flexibility and autonomy are discussed as potential mediating variables in the relationship between TWFH and the psychosocial work environment. CONCLUSION There is a lack of high-quality research investigating effects of TWFH on the psychosocial work environment. To suggest TWFH guidelines or recommendations, there is a need for research with high-quality longitudinal designs, precise measures of time use and location of work, and validated measures of factors known to be of importance. PROSPERO registration number CRD42021233796.
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15
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van de Weijer MP, de Vries LP, Pelt DHM, Ligthart L, Willemsen G, Boomsma DI, de Geus E, Bartels M. Self-rated health when population health is challenged by the COVID-19 pandemic; a longitudinal study. Soc Sci Med 2022; 306:115156. [PMID: 35728461 PMCID: PMC9212653 DOI: 10.1016/j.socscimed.2022.115156] [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: 06/21/2021] [Revised: 03/28/2022] [Accepted: 06/14/2022] [Indexed: 11/02/2022]
Abstract
RATIONALE The coronavirus disease 2019 (COVID-19) pandemic and consequent lockdown measures have had a large impact on people's lives. Recent evidence suggests that self-rated health (SRH) scores remained relatively stable or increased during the pandemic. OBJECTIVE For the current project, we examine potential changes in the variance decomposition of SRH before and during the COVID-19 pandemic in the Netherlands. METHODS We analyse data from the Netherlands Twin Register to examine pre-pandemic SRH scores (N = 16,127), pandemic SRH scores (N = 17,451), and SRH difference scores (N = 7464). Additionally, we perform bivariate genetic analyses to estimate genetic and environmental variance components in pre-pandemic and pandemic SRH, and estimate the genetic correlation to assess potential gene-environment interaction. RESULTS The majority of the sample (66.7%) reported the same SRH before and during the pandemic, while 10.8% reported a decrease, and 22.5% an increase. Individuals who reported good/excellent SRH before the pandemic were most likely to report unchanged SRH during the pandemic, and individuals with bad/mediocre/reasonable SRH more often reported increased SRH. The bivariate longitudinal genetic model reveals no significant change in variance decomposition of SRH from before to during the pandemic, with a heritability estimate of 45% (CI 36%-52%). We found that the genetic correlation could be constrained to 1, and a moderate unique environmental correlation (rE = 0.49, CI = 0.37 to 0.60). CONCLUSIONS We theorize that the increases in SRH are explained by uninfected individuals evaluating their health more positively than under normal circumstances (partly through social comparison with infected individuals), rather than actual improvements. As the same genes are expressed under different environmental exposures, these results imply no evidence for gene-environment interaction. While different environmental factors might influence SRH at the two time-points, the influence of environmental factors does not become relatively more important during the pandemic.
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Affiliation(s)
- Margot P van de Weijer
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Lianne P de Vries
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Dirk H M Pelt
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Lannie Ligthart
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Gonneke Willemsen
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Dorret I Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Eco de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Meike Bartels
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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16
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Bermejo-Pareja F, Gómez de la Cámara A, Del Ser T, Contador I, Llamas-Velasco S, López-Arrieta JM, Martín-Arriscado C, Hernández-Gallego J, Vega S, Benito-León J. The health status: the ignored risk factor in dementia incidence. NEDICES cohort. Aging Clin Exp Res 2022; 34:1275-1283. [PMID: 35025095 DOI: 10.1007/s40520-021-02045-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/28/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND The causes of the dementia decrease in affluent countries are not well known but health amelioration could probably play a major role. Nevertheless, although many vascular and systemic disorders in adult life are well-known risk factors (RF) for dementia and Alzheimer disease (AD), health status is rarely considered as a single RF. AIM To analyse whether the health status and the self-perceived health (SPH) could be RF for dementia and AD and to discuss its biological basis. METHODS We analysed different objective health measures and SPH as RF for dementia and AD incidence in 4569 participants of the NEDICES cohort by means of Cox-regression models. The mean follow-up period was 3.2 (range: 0.03-6.6) years. RESULTS Ageing, low education, history of stroke, and "poor" SPH were the main RF for dementia and AD incidence, whereas physical activity was protective. "Poor" SPH had a hazard ratio = 1.66 (95% CI 1.17-2.46; p = 0.012) after controlling for different confounders. DISCUSSION According to data from NEDICES cohort, SPH is a better predictor of dementia and AD than other more objective health status proxies. SPH should be considered a holistic and biologically rooted indicator of health status, which can predict future development of dementia and AD in older adults. CONCLUSIONS Our data indicate that it is worthwhile to include the SPH status as a RF in the studies of dementia and AD incidence and to explore the effect of its improvement in the evolution of this incidence.
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Affiliation(s)
- Félix Bermejo-Pareja
- Research Institute (Imas12), Hospital Universitario 12 de Octubre, Avda. de Córdoba S/N, 28041, Madrid, Spain
| | - Agustín Gómez de la Cámara
- Research Institute (Imas12), Hospital Universitario 12 de Octubre, Avda. de Córdoba S/N, 28041, Madrid, Spain
| | - Teodoro Del Ser
- Alzheimer's Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofia Foundation Alzheimer Research Center, Madrid, Spain
| | - Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology of Behavioural Science, University of Salamanca, Salamanca, Spain
| | - Sara Llamas-Velasco
- Research Institute (Imas12), Hospital Universitario 12 de Octubre, Avda. de Córdoba S/N, 28041, Madrid, Spain.
| | | | - Cristina Martín-Arriscado
- Research Institute (Imas12), Hospital Universitario 12 de Octubre, Avda. de Córdoba S/N, 28041, Madrid, Spain
| | - Jesús Hernández-Gallego
- Research Institute (Imas12), Hospital Universitario 12 de Octubre, Avda. de Córdoba S/N, 28041, Madrid, Spain
- Department of Medicine, Faculty of Medicine, Complutense University of Madrid (UCM), Madrid, Spain
| | | | - Julián Benito-León
- Research Institute (Imas12), Hospital Universitario 12 de Octubre, Avda. de Córdoba S/N, 28041, Madrid, Spain
- Department of Medicine, Faculty of Medicine, Complutense University of Madrid (UCM), Madrid, Spain
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17
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Pförtner TK, Demirer I. How Working Conditions, Socioeconomic Insecurity, and Behavior-Related Factors Mediate the Association Between Working Poverty and Health in Germany. Int J Public Health 2022; 67:1604555. [PMID: 35645704 PMCID: PMC9130479 DOI: 10.3389/ijph.2022.1604555] [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: 10/26/2021] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: Aims of this study were to Schmitt (Advances in Life Course Research, 2021, 47: 100402) analyze the association of working poverty with mental and physical health-related quality of life and (Wang and Ford, J Organ Behav, 2020, 41 (9): 895–914) to explain these associations by behavior-related factors (heavy drinking, smoking status, body mass index), socioeconomic insecurity (deprivation in living standards, economic worries), and mental working conditions (effort-reward imbalance, job insecurity). Methods: A total of 11,500 employees aged 17–67 from the German Socioeconomic Panel (2014, 2015, and 2016) were used, and mediation analyses with inverse odds weighting stratified by gender were conducted. Results: Working poverty was significantly associated with both outcomes for both genders. Deprivation in living standards contributed the most to differences in mental health, with a mediated proportion of 60.3% (men) and 44.4% (women). Differences in physical health were significantly mediated by inadequate living standards in women, with a mediated proportion of 73.7%, whereas none of the mediators considered were significant in men. Conclusion: Indicators of socioeconomic insecurity contributed most to the association of working poverty with mental and physical health. Results highlight the relevance of policy initiatives to strengthen the socioeconomic living conditions of the working poor.
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Affiliation(s)
- Timo-Kolja Pförtner
- Research Methods Division, Faculty of Human Sciences, University of Cologne, Cologne, Germany
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Medical Faculty and Faculty of Human Sciences, University of Cologne, Cologne, Germany
- *Correspondence: Timo-Kolja Pförtner,
| | - Ibrahim Demirer
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Medical Faculty and Faculty of Human Sciences, University of Cologne, Cologne, Germany
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18
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van Heijster H, van Berkel J, Boot CRL, Abma T, de Vet E. Stakeholder dialogue on dilemmas at work as a workplace health promotion intervention including employees with a low SEP: a Responsive Evaluation. BMC Public Health 2022; 22:407. [PMID: 35227228 PMCID: PMC8883621 DOI: 10.1186/s12889-022-12802-z] [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: 09/10/2021] [Accepted: 02/11/2022] [Indexed: 11/14/2022] Open
Abstract
Background The aim of this study was to evaluate the perceived changes of an innovative workplace health promotion intervention and evaluation. In this study, a bottom-up approach was taken to define the central themes and relevant outcomes of an intervention. These central themes and relevant outcomes of the intervention were defined together with stakeholders, including employees with a low socioeconomic position. Methods The intervention consisted of a series of structured stakeholder dialogues in which dilemmas around the – by employees defined —health themes were discussed. The intervention was implemented in a harbor service provider with approximately 400 employees. Over a two-year period, 57 participants engaged in eight dialogues of one hour. 15 interviews and six participant observations took place for the evaluation of the intervention. Results Together with the stakeholders, high workload and mental health were defined as central themes for the dialogue intervention in the male-dominated workplace. The dialogue intervention contributed to changes, on different levels: individual, team, and organization. Overall, the stakeholder dialogues advanced the understanding of factors contributing to high workload and mental health. In reply to this, several actions were taken on a organizational level. Conclusions Taking a bottom-up approach in WHP allows to understand the health issues that are important in the daily reality of employees with a low socioeconomic position. Through this understanding, workplace health promotion can become more suitable and relevant for employees with a low socioeconomic position. Trial registration Netherlands Trial Register (NRT): NL8051. Registration date: 28/09/2019, Retrospectively registered https://www.trialregister.nl Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12802-z.
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Affiliation(s)
- Hanneke van Heijster
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, Netherlands.
| | - Jantien van Berkel
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University, Amsterdam, Netherlands
| | - Tineke Abma
- Department Public Health, Leiden University Medical Centre, Leiden University, Leiden, Netherlands
| | - Emely de Vet
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, Netherlands
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Lunde LK, Fløvik L, Christensen JO, Johannessen HA, Finne LB, Jørgensen IL, Mohr B, Vleeshouwers J. The relationship between telework from home and employee health: a systematic review. BMC Public Health 2022; 22:47. [PMID: 34996400 PMCID: PMC8741267 DOI: 10.1186/s12889-021-12481-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/24/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Globalization and technological progress have made telework arrangements such as telework from home (TWFH) well-established in modern economies. TWFH was rapidly and widely implemented to reduce virus spread during the Coronavirus disease (COVID-19) pandemic, and will probably be widespread also post-pandemic. How such work arrangements affect employee health is largely unknown. Main objective of this review was to assess the evidence on the relationship between TWFH and employee health. METHODS We conducted electronic searches in MEDLINE, Embase, Amed, PsycINFO, PubMed, and Scopus for peer-reviewed, original research with quantitative design published from January 2010 to February 2021. Our aim was to assess the evidence for associations between TWFH and health-related outcomes in employed office workers. Risk of bias in each study was evaluated by the Newcastle-Ottawa Scale and the collected body of evidence was evaluated using the the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS We included 14 relevant studies (22,919 participants) reporting on 28 outcomes, which were sorted into six outcome categories (general health, pain, well-being, stress, exhaustion & burnout, and satisfaction with overall life & leisure). Few studies, with many having suboptimal designs and/or other methodological issues, investigating a limited number of outcomes, resulted in the body of evidence for the detected outcome categories being GRADED either as low or very low. CONCLUSIONS The consisting evidence on the relationship between TWFH and employee health is scarce. The non-existence of studies on many relevant and important health outcomes indicates a vast knowledge gap that is crucial to fill when determining how to implement TWFH in the future working life. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO registration ID # CRD42021233796 .
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Affiliation(s)
- Lars-Kristian Lunde
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway.
| | - Lise Fløvik
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
| | - Jan Olav Christensen
- Department of Work Psychology, National Institute of Occupational Health, Oslo, Norway
| | - Håkon A Johannessen
- Department of Work Psychology, National Institute of Occupational Health, Oslo, Norway
| | - Live Bakke Finne
- Department of Work Psychology, National Institute of Occupational Health, Oslo, Norway
| | - Ingrid Løken Jørgensen
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
| | - Benedicte Mohr
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
| | - Jolien Vleeshouwers
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
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20
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Van den Berge M, Van Oostrom SH, Van der Molen HF, Robroek SJW, Hulshof CTJ, Van der Beek AJ, Proper KI. Do overweight/obesity and low levels of leisure-time vigorous physical activity moderate the effect of occupational physical activity on self-rated health of construction workers? Int Arch Occup Environ Health 2021; 95:465-475. [PMID: 34622342 PMCID: PMC8795025 DOI: 10.1007/s00420-021-01771-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/12/2021] [Indexed: 11/30/2022]
Abstract
Purpose To investigate the combined effects of occupational physical activity (OPA) and either overweight/obesity or low levels of leisure-time vigorous physical activity (LTVPA) on self-rated health. Methods A longitudinal study was performed among 29,987 construction workers with complete data on 2 Workers’ Health Surveillance Programs during 2010–2018. Self-reported OPA involved strenuous work postures and manual material handling. Low level of LTVPA was defined as self-reported vigorous activity for less than three times per week lasting at least 20 min per session. Overweight and obesity were based on Body Mass Index (BMI) (25.0 ≤ BMI < 30.0 kg/m2 and BMI ≥ 30.0 kg/m2, respectively) using measured body height and weight. Self-rated health was measured using a single item question. Logistic regression analysis was used to investigate the associations between the separate risk factors at baseline and self-rated health at follow-up. The combined effects of demanding OPA and either overweight/obesity or low level of LTVPA on self-rated health were analyzed using the relative excess risk due to interaction (RERI). Results Mean follow-up duration was 31.7 (SD = 14.9) months. Construction workers with strenuous work postures (OR 1.35 95% CI 1.25–1.46), manual material handling (OR 1.29 95% CI 1.19–1.40), obesity (OR 1.31 95% CI 1.17–1.47) and low LTVPA (OR 1.13 95% CI 1.01–1.25) were more likely to report poor self-rated health at follow-up. No statistically significant interaction effects were found for OPA and obesity or low LTVPA. Conclusions OPA, obesity and low level of LTVPA were separate risk factors for poor self-rated health, but did not appear to have a synergistic effect.
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Affiliation(s)
- M Van den Berge
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - S H Van Oostrom
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
| | - H F Van der Molen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - S J W Robroek
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - C T J Hulshof
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - A J Van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - K I Proper
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands. .,Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
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21
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Appel AM, Brønnum-Hansen H, Garde AH, Hansen ÅM, Ishtiak-Ahmed K, Islamoska S, Mortensen EL, Nabe-Nielsen K. Socioeconomic Position and Late-Onset Dementia: A Nationwide Register-Based Study. J Aging Health 2021; 34:184-195. [PMID: 34388948 DOI: 10.1177/08982643211037200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVES Previous research on the association between socioeconomic position (SEP) and dementia has not sufficiently accounted for the complex relationship between education and occupation. We investigated the independent and joint effects of educational attainment and occupation-based SEP on dementia. METHODS We used register-based information about educational attainment, occupation-based SEP, and dementia from 1,210,720 individuals. Information about cognitive ability at conscription was available for a subsample of men. RESULTS When mutually adjusted, lower educational attainment and occupation-based SEP were associated with higher dementia risk in a dose-response manner. Higher occupation-based SEP partly mitigated the higher dementia risk associated with lower educational attainment. After adjusting for cognitive ability in a subgroup of men, only unskilled work was associated with higher dementia risk. DISCUSSION Occupation-based SEP is independently associated with dementia and may mitigate the higher dementia risk associated with short education. Future research should elucidate the mechanisms underlying social inequality in dementia.
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Affiliation(s)
- Andreas M Appel
- Department of Public Health, 4321University of Copenhagen, Copenhagen, Denmark.,Danish Dementia Research Centre, 53146Rigshospitalet, Copenhagen, Denmark
| | | | - Anne H Garde
- Department of Public Health, 4321University of Copenhagen, Copenhagen, Denmark.,2686The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Åse Marie Hansen
- Department of Public Health, 4321University of Copenhagen, Copenhagen, Denmark.,2686The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Kazi Ishtiak-Ahmed
- Department of Depression and Anxiety, 1006Aarhus University Hospital Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, 1006Aarhus University, Aarhus, Denmark
| | - Sabrina Islamoska
- Department of Public Health, 4321University of Copenhagen, Copenhagen, Denmark
| | - Erik L Mortensen
- Department of Public Health, 4321University of Copenhagen, Copenhagen, Denmark
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22
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Proper KI, Jaarsma E, Robroek SJW, Schram JLD, Boshuizen H, Picavet HSJ, Verschuren WMM, van Oostrom SH. The mediating role of unhealthy behavior in the relationship between shift work and perceived health. BMC Public Health 2021; 21:1300. [PMID: 34215233 PMCID: PMC8254208 DOI: 10.1186/s12889-021-11350-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/21/2021] [Indexed: 11/19/2022] Open
Abstract
Background Little is known about the relationship between shift work and perceived health, including potential underlying mechanisms such as unhealthy behaviors. The aim of this study was to investigate whether unhealthy behaviors mediate the relationship between shift work and perceived mental and physical health, taking into account potential differences by level of education. Methods Data from 1633 workers participating in the Doetinchem Cohort Study during 1995–2016 were used. Being engaged in shift work was determined at 1 year preceding the assessment of health behaviors. Mental and physical health were assessed after 5 years of follow-up by the 5-item Mental Health Inventory and the physical functioning scale of the 36-item Short Form Health Survey. Smoking, physical inactivity, alcohol consumption, and overweight were considered as potential mediators and education was treated as moderator. Moderated mediation analyses using generalized estimated equations were performed. Results Shift work was not statistically significantly related to either mental or physical health. Despite this, statistically significant mediation effects of smoking (Beta − 0.09; 95% Confidence Interval − 0.20 - -0.01, respectively B -0.09; 95%CI -0.21 - -0.01) and physical inactivity (B 0.11; 95%CI 0.03–0.23, respectively B 0.08; 95%CI 0.01–0.18) were found in the relationship between shift work and mental or physical health. Direct and indirect effects outweighed each other in the relationship between shift work and mental health, since the direction of these effects was opposite. The relationship between shift work, unhealthy behavior, and health was not different by educational level. Conclusion Shift workers did not report lower mental or physical health than non-shift workers. Though mediation effects of unhealthy behavior were observed in the relationship between shift work and perceived health, these small effects had minor public health relevance.
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Affiliation(s)
- Karin I Proper
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Eva Jaarsma
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Jolinda L D Schram
- Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Hendriek Boshuizen
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - H Susan J Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands
| | - W M Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Sandra H van Oostrom
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands.
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23
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Asthana S, Gibson A. Averting a public health crisis in England's coastal communities: a call for public health research and policy. J Public Health (Oxf) 2021; 44:642-650. [PMID: 33982058 PMCID: PMC9424058 DOI: 10.1093/pubmed/fdab130] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 03/26/2021] [Accepted: 04/10/2021] [Indexed: 11/29/2022] Open
Abstract
Coastal communities have received little attention in the public health literature, perhaps because our mental maps tend to associate socio-economic deprivation and health inequalities with inner cities. Mapping a range of key health indicators at small area level, this paper reveals a distinct core-periphery pattern in disease prevalence, with coastal communities experiencing a high burden of ill health across almost all conditions included in the Quality and Outcomes Framework dataset. Other sources suggest poor outcomes for children and young people living in coastal areas. Low rates of participation in higher education contrast with high rates of hospitalisation for self-harm, alcohol and substance use. Reflecting a shift in the distribution of children living in poverty since the 1990s, this may be an early indicator of a future public health crisis in these communities. Exploring reasons for the health challenges facing the periphery, this perspective piece calls for more public health research that can accommodate the complex and interlinked problems facing coastal communities and a more concerted effort to align public health with economic, education, local government and transport policies at the national level.
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Affiliation(s)
- Sheena Asthana
- Plymouth Institute of Health and Care Research (PIHR), University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Alex Gibson
- Plymouth Institute of Health and Care Research (PIHR), University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
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24
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Cheng KJG, Rivera AS, Miguel RTDP, Lam HY. A cross-sectional study on the determinants of health-related quality of life in the Philippines using the EQ-5D-5L. Qual Life Res 2021; 30:2137-2147. [PMID: 33677770 DOI: 10.1007/s11136-021-02799-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this study was to identify the determinants of Filipinos' health-related quality of life (HRQoL). METHODS Data were collected from 1000 Filipinos across the nation who reported that they did not have known active disease or disability. HRQoL was measured through EuroQoL's (EQ) 5-level tool (EQ-5D-5L) and the EQ Visual Analog Scale (EQ-VAS). Both were implemented via the EQ Valuation Technology software. HRQoL was regressed on socioeconomic characteristics (age, sex, marital status, educational attainment, employment, poverty status, and availability of savings), social support factors (religion, religious attendance, and caregiving status), community- or societal-level factors (type and major island group of residence), and disease status. RESULTS Majority of respondents reported that they did not have any problems across all EQ-5D-5L dimensions, namely mobility, self-care, usual activity, pain or discomfort, and anxiety or depression. Pain or discomfort had the highest rate of respondents reporting slight to extreme problems followed by anxiety or depression. Having savings was positively associated with HRQoL, while religious attendance, caregiver status, living in an urban area, living in Visayas or Mindanao, and having a diagnosed disease were negatively associated with HRQoL. CONCLUSION This current study confirms that HRQoL varied across socioeconomic statuses and communities in the Philippines.
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Affiliation(s)
- Kent Jason G Cheng
- Social Science Department, Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, NY, USA
| | - Adovich S Rivera
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | | | - Hilton Y Lam
- Institute of Health Policy and Development Studies, National Institutes of Health, University of the Philippines, Manila, Philippines
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25
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Schram JL, Oude Groeniger J, Schuring M, Proper KI, van Oostrom SH, Robroek SJ, Burdorf A. Working conditions and health behavior as causes of educational inequalities in self-rated health: an inverse odds weighting approach. Scand J Work Environ Health 2021; 47:127-135. [PMID: 32815549 PMCID: PMC8114570 DOI: 10.5271/sjweh.3918] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objective: Using a novel mediation method that presents unbiased results even in the presence of exposure–mediator interactions, this study estimated the extent to which working conditions and health behaviors contribute to educational inequalities in self-rated health in the workforce. Methods: Respondents of the longitudinal Survey of Health, Ageing, and Retirement in Europe (SHARE) in 16 countries were selected, aged 50–64 years, in paid employment at baseline and with information on education and self-rated health (N=15 028). Education, health behaviors [including body mass index (BMI)] and working conditions were measured at baseline and self-rated health at baseline and two-year follow-up. Causal mediation analysis with inverse odds weighting was used to estimate the total effect of education on self-rated health, decomposed into a natural direct effect (NDE) and natural indirect effect (NIE). Results: Lower educated workers were more likely to perceive their health as poor than higher educated workers [relative risk (RR) 1.48, 95% confidence interval (CI) 1.37–1.60]. They were also more likely to have unfavorable working conditions and unhealthy behaviors, except for alcohol consumption. When all working conditions were included, the remaining NDE was RR 1.30 (95% CI 1.15–1.44). When BMI and health behaviors were included, the remaining NDE was RR 1.40 (95% CI 1.27–1.54). Working conditions explained 38% and health behaviors and BMI explained 16% of educational inequalities in health. Including all mediators explained 64% of educational inequalities in self-rated health. Conclusions: Working conditions and health behaviors explain over half of the educational inequalities in self-rated health. To reduce health inequalities, improving working conditions seems to be more important than introducing health promotion programs in the workforce.
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Affiliation(s)
- Jolinda Ld Schram
- Department of Public Health, Erasmus Medical Centre, Rotterdam 3000 CA, The Netherlands.
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26
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The effectiveness of workplace health promotion programs on self-perceived health of employees with a low socioeconomic position: An individual participant data meta-analysis. SSM Popul Health 2021; 13:100743. [PMID: 33604445 PMCID: PMC7873680 DOI: 10.1016/j.ssmph.2021.100743] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/21/2021] [Accepted: 01/21/2021] [Indexed: 11/21/2022] Open
Abstract
The aim of the current study was to evaluate whether workplace health promotion programs improve self-perceived health of employees with a low socioeconomic position (SEP), and whether differential effects exist between individuals with a low SEP for gender, marital status or age. Individual participant data from six Dutch intervention studies aiming at promoting healthy behavior and preventing obesity in the work setting, with a total of 1906 participants, were used. The overall intervention effect and interaction effects for gender, marital status and age were evaluated using two-stage meta-analyses with linear mixed regression models. In the first stage effect sizes of each study were estimated, which were pooled in the second stage. Compared to control conditions, workplace health promotion programs did not show an overall improvement in self-perceived health of employees with a low SEP (β0.03 (95%CI: −0.03 to 0.09)). Effects did not differ across gender, marital status and age. Future research could be focused on the determinants of self-perceived health next to health behavior to improve the health of employees with a low SEP.
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27
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van den Berge M, van der Beek AJ, Türkeli R, van Kalken M, Hulsegge G. Work-related physical and psychosocial risk factors cluster with obesity, smoking and physical inactivity. Int Arch Occup Environ Health 2021; 94:741-750. [PMID: 33409697 PMCID: PMC8068657 DOI: 10.1007/s00420-020-01627-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 12/01/2020] [Indexed: 01/08/2023]
Abstract
Objective This study investigated associations between the co-existence of multiple types of work-related psychosocial and physical risk factors, and (1) obesity; (2) smoking; and (3) leisure-time physical inactivity. It also aimed to identify sociodemographic characteristics related to clustering of work-related risk factors and lifestyle factors. Methods Cross-sectional data on work-related risk factors (e.g., decision authority and repetitive movements) and lifestyle was measured using a standardized questionnaire among 52,563 Dutch workers in health care, services, manufacturing and public sector. Multiple-adjusted logistic regression models assessed associations between the co-existence of multiple types of psychosocial and physical risk factors and lifestyle factors. Additionally, logistic regression models related age, gender and educational level to clustering of risk factors and lifestyle factors. Results The co-existence of multiple types of work-related psychosocial risk factors was associated with higher odds of smoking and being physically inactive. For example, workers exposed to three psychosocial risk factors had a 1.55 times higher odds of being physically inactive (95%CI: 1.42–1.70) compared to unexposed workers. A higher number of physical risk factors was also significantly associated with higher odds of smoking and obesity. The co-existence of multiple types of physical risk factors was not associated with higher odds of physical inactivity. Clustering of work-related risk factors and at least one unhealthy lifestyle factor occurred in particular among workers with low educational level. Conclusions Results imply that interventions are needed that focus on workers with a low educational level and address work-related physical and psychosocial risk factors as well as lifestyle. Supplementary Information The online version contains supplementary material available at 10.1007/s00420-020-01627-1.
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Affiliation(s)
- Mandy van den Berge
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands.
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands
| | - Rukiye Türkeli
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands
| | | | - Gerben Hulsegge
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands.,The Netherlands Organization for Applied Scientific Research, TNO, Schipholweg 77-89, 2316 ZL, Leiden, The Netherlands
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28
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de Breij S, Huisman M, Deeg DJH. Work characteristics and health in older workers: Educational inequalities. PLoS One 2020; 15:e0241051. [PMID: 33095831 PMCID: PMC7584163 DOI: 10.1371/journal.pone.0241051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 10/07/2020] [Indexed: 01/01/2023] Open
Abstract
To be able to extend working lives, maintaining good health in older workers is important. The aim of the present study was to identify which work characteristics are associated with physical and mental health outcomes in older workers in the Netherlands, and particularly whether there are educational differences in these associations. We used longitudinal tobit and ordered logistic regression analyses to examine the associations between physical demands, psychosocial demands, variation in tasks, autonomy, and job strain and self-rated health (SRH), functional limitations, and depressive symptoms. We included interaction terms between the work characteristics and education to examine effect modification by education. We found that high physical demands, low variation in tasks, low autonomy, and high job strain were associated with poorer physical and mental health. We found evidence for educational differences in the exposure to these work characteristics, as well as in the strengths of their associations with health, with lower educated workers being disadvantaged. The associations between physical demands (SRH: OR = 3.70 (95%CI:1.92;7.11); functional limitations: B = 1.27 (95%CI:.47;2.07)), autonomy (SRH: OR = .42(95%CI:.26;.69)), and job strain (active job; SRH: OR = .25 (95%CI:.09;.69); functional limitations: B = -1.51 (95%CI:-2.68;-.34), and health were strongest in the lower educated workers. In order to maintain good health in older workers and reduce health inequalities, it is recommended to implement workplace interventions to improve working conditions, especially among the lower educated workers.
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Affiliation(s)
- Sascha de Breij
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| | - Martijn Huisman
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dorly J. H. Deeg
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Brønholt RLL, Hansen MB, Islamoska S, Christensen U, Grynderup MB, Nabe-Nielsen K. Physical and psychosocial work factors as explanations for social inequalities in self-rated health. Int Arch Occup Environ Health 2020; 94:335-346. [PMID: 32975659 DOI: 10.1007/s00420-020-01582-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 09/09/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE We investigated the contribution of physical and psychosocial work factors to social inequalities in self-rated health (SRH) in a sample of Danish 40 and 50 years old occupationally active women and men. METHODS In this longitudinal study, the study population consisted of 3338 Danish women and men. Data were collected by postal questionnaires in 2000 (baseline) and 2006 (follow-up). The independent variable, socioeconomic position (SEP), was assessed by the highest achieved educational level at baseline. We conducted gender-stratified parallel multiple mediation analyses. In the mediation analyses, SEP was categorised as SEP I, II, III, VI and V among men. Among women, SEP was dichotomised into SEP I-IV and V. The outcome, SRH, was assessed at baseline and follow-up. A wide range of physical and psychosocial work factors were included as potential mediators. RESULTS We found a social gradient in SRH across all levels of SEP among men. Among women, we only found a poorer SRH among those with the lowest SEP. Mediation analyses showed that work factors together accounted for 56% of the social inequalities in SRH among men and 44% among women. In both genders, ergonomic exposures and job insecurity seemed to play the major role for social inequalities in SRH. For women only, we also found noise to contribute to the social inequalities in SRH. CONCLUSION Physical and psychosocial work factors partially explained social inequalities in SRH among both genders. Improvement of the working environment can potentially contribute to the reduction of social inequalities in health.
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Affiliation(s)
| | - Matilde Bøgelund Hansen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark
| | - Sabrina Islamoska
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark
| | - Ulla Christensen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark
| | | | - Kirsten Nabe-Nielsen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.
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30
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The mediating role of unhealthy behaviors and body mass index in the relationship between high job strain and self-rated poor health among lower educated workers. Int Arch Occup Environ Health 2020; 94:95-105. [PMID: 32889612 PMCID: PMC7826307 DOI: 10.1007/s00420-020-01565-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 08/25/2020] [Indexed: 12/02/2022]
Abstract
Objectives The objective of this study is to examine the mediating role of unhealthy behaviors and body mass index (BMI) in the relationship between high job strain and self-rated poor health in workers with a low education. Methods A total of 8369 low educated workers, who participated in the Lifelines cohort study during the period 2012–2017, were included. Self-reported job strain, health behaviors (smoking, physical activity, and fruit and vegetable consumption), and BMI were assessed at baseline, and self-rated health after 2 years. To assess mediation by the health behaviors and BMI, structural equation modeling with logistic and multinomial regression analyses were performed. Results Workers with high job strain had a higher odds of poor health (OR 1.34; 95% CI 1.13–1.60) compared to those with low job strain. Workers with high job strain were more likely to have a lack of physical activity (OR 1.14; 95% CI 1.01–1.28), but were not more likely to smoke, to be overweight or obese, or to have a low fruit or vegetable consumption. Workers who smoke, have a lack of physical activity or are overweight or obese are more likely to report poor health (OR 1.37; 95% CI 1.16–1.60, OR 1.25; 95% CI 1.08–1.43, OR 1.37; 95% CI 1.16–1.61, OR 2.25; 95% CI 1.86–2.72). Indirect (mediating) effects of unhealthy behaviors and BMI in the relationship between high job strain and poor health were small and not statistically significant. Conclusions No mediating effects of unhealthy behaviors or BMI were found in the relationship between high job strain and self-rated poor health among workers with a low educational level.
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31
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de Wind A, Sewdas R, Hoogendijk EO, van der Beek AJ, Deeg DJH, Boot CRL. Occupational Exposures Associated with Life Expectancy without and with Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176377. [PMID: 32882992 PMCID: PMC7503628 DOI: 10.3390/ijerph17176377] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 01/05/2023]
Abstract
Policies to extend working lives often do not take into account potentially important health inequalities arising from differences in occupational exposures. Little is known about which occupational exposures are associated with these inequalities. This study aims to examine differences in life expectancy without and with disability by occupational exposures. Longitudinal data (1992–2016) on disability and physical and psychosocial work demands and resources of 2513 (former) workers aged ≥55 years participating in the Longitudinal Aging Study Amsterdam were used. Gender specific life expectancies without and with disability by occupational exposures were calculated using multistate survival models. Women aged 55 years with high physical work demands had a lower life expectancy without disability than those with low exposure (1.02–1.57 years), whereas there was no difference for men. Men and women with high psychosocial work demands and resources had a longer life expectancy without disability than those with low exposure (1.19–2.14 years). Life expectancy with disability did not significantly differ across occupational exposures. Workers with higher psychosocial demands and resources and lower physical demands can expect to live more disability-free years. Information on occupational exposure helps to identify workers at risk for lower life expectancy, especially without disability, who may need specific support regarding their work environment.
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Affiliation(s)
- Astrid de Wind
- Behavioural Science Institute, Radboud University, 6500 Nijmegen, The Netherlands
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, 1081 Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, 1081 Amsterdam, The Netherlands; (R.S.); (A.J.v.d.B.); (C.R.L.B.)
- Correspondence: ; Tel.: +31-(0)20-566-3279
| | - Ranu Sewdas
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, 1081 Amsterdam, The Netherlands; (R.S.); (A.J.v.d.B.); (C.R.L.B.)
| | - Emiel O. Hoogendijk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, 1081 Amsterdam, The Netherlands; (E.O.H.); (D.J.H.D.)
| | - Allard J. van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, 1081 Amsterdam, The Netherlands; (R.S.); (A.J.v.d.B.); (C.R.L.B.)
| | - Dorly J. H. Deeg
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, 1081 Amsterdam, The Netherlands; (E.O.H.); (D.J.H.D.)
| | - Cécile R. L. Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, 1081 Amsterdam, The Netherlands; (R.S.); (A.J.v.d.B.); (C.R.L.B.)
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32
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Adapting Citizen Science to Improve Health in an Occupational Setting: Preliminary Results of a Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144917. [PMID: 32650415 PMCID: PMC7400330 DOI: 10.3390/ijerph17144917] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/30/2020] [Accepted: 07/05/2020] [Indexed: 11/16/2022]
Abstract
Health interventions often do not reach blue-collar workers. Citizen science engages target groups in the design and execution of health interventions, but has not yet been applied in an occupational setting. This preliminary study determines barriers and facilitators and feasible elements for citizen science to improve the health of blue-collar workers. The study was conducted in a terminal and construction company by performing semi-structured interviews and focus groups with employees, company management and experts. Interviews and focus groups were analyzed using thematic content analysis and the elements were pilot tested. Workers considered work pressure, work location and several personal factors as barriers for citizen science at the worksite, and (lack of) social support and (negative) social culture both as barriers and facilitators. Citizen science to improve health at the worksite may include three elements: (1) knowledge and skills, (2) social support and social culture, and (3) awareness about lifestyle behaviors. Strategies to implement these elements may be company specific. This study provides relevant indications on feasible elements and strategies for citizen science to improve health at the worksite. Further studies on the feasibility of citizen science in other settings, including a larger and more heterogeneous sample of blue-collar workers, are necessary.
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The Mediating Effect of Unhealthy Behaviors and Body Mass Index in the Relation Between High Physical Workload and Self-Rated Poor Health in Male Construction Workers. J Occup Environ Med 2020; 62:e414-e422. [PMID: 32541621 PMCID: PMC7409768 DOI: 10.1097/jom.0000000000001928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To examine the mediating role of unhealthy behaviors and body mass index (BMI) in the relation between high physical workload and self-rated health in male construction workers. METHODS Longitudinal data over 2010 to 2018 were used of 30,224 male construction workers in The Netherlands. Smoking, lack of physical activity, and alcohol consumption were self-reported. BMI was based on measured body weight and height. Multilevel modeling path analyses were used to determine the mediating role of unhealthy behaviors in the relation between physical workload and poor health. RESULTS A direct effect of high physical workload on poor health adjusted for unhealthy behaviors and BMI was found (odds ratio [OR] 1.49, 95% confidence interval [CI] 1.38 to 1.68). Indirect effects of the unhealthy behaviors and BMI in the relation between high physical workload and poor health were small (OR varying from 0.96 to 1.04). CONCLUSION The pathway of high physical workload and poor health through unhealthy behaviors and BMI was not supported.
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van der Put AC, Mandemakers JJ, de Wit JBF, van der Lippe T. Worksite health promotion and social inequalities in health. SSM Popul Health 2020; 10:100543. [PMID: 32021901 PMCID: PMC6994707 DOI: 10.1016/j.ssmph.2020.100543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 01/10/2020] [Accepted: 01/12/2020] [Indexed: 10/31/2022] Open
Abstract
It is well-documented that higher educated employees have better health than the lower educated. The workplace has been put forward as a contributor to this inequality. We extend previous work on workplace characteristics that could influence employee health by asking to what extent workplace health promotion (WHP) can account for the relation between education and health. Two ways in which WHP may relate to health inequalities are addressed: higher educated employees may be more likely to use WHP than lower educated employees and the effect of WHP on health may be stronger for higher educated than for lower educated employees. Using data from the European Sustainable Workforce Survey which contains information on over 11000 employees in 259 organisations, we test whether three types of WHP mediate or moderate the relation between education and health: healthy menus, sports facilities and health checks. We find that higher educated employees are in better health and that use of WHP positively relates to health. Use of healthy menus and sports facilities in the workplace can contribute to increasing health inequalities, as lower educated employees are less likely to make use of these. Health checks could contribute to diminishing health inequalities, as lower educated employees are more likely to use them compared to higher educated employees. The effect of WHP is not contingent on education. We advise stimulating lower educated employees to make more use of WHP, which can contribute to decreasing health inequalities.
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Affiliation(s)
- Anne C van der Put
- Department of Sociology, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands
| | - Jornt J Mandemakers
- Department of Sociology, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands
| | - John B F de Wit
- Interdisciplinary Social Science: Public Health, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands
| | - Tanja van der Lippe
- Department of Sociology, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands
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Lahelma E, Pietiläinen O, Pentala-Nikulainen O, Helakorpi S, Rahkonen O. 36-year trends in educational inequalities in self-rated health among Finnish adults. SSM Popul Health 2019; 9:100504. [PMID: 31720362 PMCID: PMC6838467 DOI: 10.1016/j.ssmph.2019.100504] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/27/2019] [Accepted: 10/16/2019] [Indexed: 12/29/2022] Open
Abstract
Health inequalities exist across countries and populations, but little is known about their long-term trends and even less about factors shaping the trends. We examined the magnitude of absolute and relative educational inequalities in self-rated health over 36 years among Finnish adults, considering individual covariates and macro-economic fluctuations. Our data were derived from representative annual cross-sectional surveys in 1979-2014 conducted among adult men and women. Participants aged 25-64 were included and nine periods used (n = 8870-14235). Our health outcome was less-than-good self-rated health (SRH) and our socioeconomic indicator was completed years of education as a continuous variable. Educational inequalities in self-rated health were analysed using the relative index of inequality (RII) and the slope index of inequality (SII). Nine time-variant sociodemographic and health-related covariates were included in the analyses. Linear trends suggested stable or slightly curvilinear overall trends in both absolute and relative health equalities over 36 years. Among men, absolute and relative inequalities narrowed immediately after economic recession in Finland in 1993-1994. Among women, inequalities narrowed during financial crisis in 2008-2009. Adjusting for most covariates reduced the magnitude of inequalities throughout the nine periods, but affected little the temporal patterning of health inequalities. Educational inequalities in self-rated health remained during 36 years in Finland. While among men and women health inequalities narrowed during and after recessions, they widened soon back to the pre-recession level. The perseverance of the trends calls for novel and powerful measures to tackle health inequalities.
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Affiliation(s)
- Eero Lahelma
- Department of Public Health, P.O.Box 20 (Tukholmankatu 8 2B), 00014, University of Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, P.O.Box 20 (Tukholmankatu 8 2B), 00014, University of Helsinki, Finland
| | | | - Satu Helakorpi
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, P.O.Box 20 (Tukholmankatu 8 2B), 00014, University of Helsinki, Finland
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de Breij S, Qvist JY, Holman D, Mäcken J, Seitsamo J, Huisman M, Deeg DJH. Educational inequalities in health after work exit: the role of work characteristics. BMC Public Health 2019; 19:1515. [PMID: 31718592 PMCID: PMC6852931 DOI: 10.1186/s12889-019-7872-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 10/30/2019] [Indexed: 11/15/2022] Open
Abstract
Background Educational inequalities in health have been widely reported. A low educational level is associated with more adverse working conditions. Working conditions, in turn, are associated with health and there is evidence that this association remains after work exit. Because many countries are raising the statutory retirement age, lower educated workers have to spend more years working under adverse conditions. Therefore, educational health inequalities may increase in the future. This study examined (1) whether there were educational differences over time in health after work exit and (2) whether work characteristics mediate these educational inequalities in health. Methods Data from five prospective cohort studies were used: The Netherlands (Longitudinal Aging Study Amsterdam), Denmark (Danish Longitudinal Study of Aging), England (English Longitudinal Study of Ageing), Germany (German Aging Study), and Finland (Finnish Longitudinal Study on Municipal Employees). In each dataset we used Generalized Estimating Equations to examine the relationship between education and self-rated health after work exit with a maximum follow-up of 15 years and possible mediation of work characteristics, including physical demands, psychosocial demands, autonomy, and variation in activities. Results The low educated reported significantly poorer health after work exit than the higher educated. Lower educated workers had a higher risk of high physical demands and a lower risk of high psychosocial demands, high variation in tasks, and high autonomy at work, compared to higher educated workers. These work characteristics were found to be mediators of the relationship between education and health after work exit, consistent across countries. Conclusion Educational inequalities in health are still present after work exit. If workers are to spend an extended part of their lives at work due to an increase in the statutory retirement age, these health inequalities may increase. Improving working conditions will likely reduce these inequalities in health.
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Affiliation(s)
- Sascha de Breij
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1089a, 1081, HV, Amsterdam, the Netherlands.
| | - Jeevitha Yogachandiran Qvist
- Centre for Comparative Welfare Studies, Department of Politics and Society, Aalborg University, Fibigerstræde 1 88a, 9220, Aalborg, Denmark
| | - Daniel Holman
- Department of Sociological Studies, University of Sheffield, Sheffield, S10 2TU, UK
| | - Jana Mäcken
- Institute of Sociology and Social Psychology, University of Cologne, Universitätsstr. 22a, 50937, Cologne, Germany
| | - Jorma Seitsamo
- Department of Work Ability and Working Careers, Finnish Institute of Occupational Health, Topeliuksenkatu 41b, FI-00250, Helsinki, Finland
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1089a, 1081, HV, Amsterdam, the Netherlands.,Department of Sociology, VU University Amsterdam, De Boelelaan, 1081, HV, Amsterdam, The Netherlands
| | - Dorly J H Deeg
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1089a, 1081, HV, Amsterdam, the Netherlands
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Occupational Diseases among Workers in Lower and Higher Socioeconomic Positions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122849. [PMID: 30551643 PMCID: PMC6313496 DOI: 10.3390/ijerph15122849] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/10/2018] [Accepted: 12/12/2018] [Indexed: 01/06/2023]
Abstract
Background: To determine differences between workers in lower and higher socioeconomic positions (SEP) in incidences of occupational disease (OD) and incapacity for work due to ODs. Methods: From a Dutch dynamic prospective cohort of occupational physicians (OPs), ODs assessed by OPs were retrieved for lower and higher SEP groups. Results: Among the lower SEP, musculoskeletal disorders, and noise-induced hearing loss (NIHL) comprised two-thirds of the OD diagnoses. Among the higher SEP, stress/burnout comprised 60% of the OD diagnoses. Temporary and permanent incapacity for work due to work-related lower back disorders and repetitive strain injuries differed significantly between workers in lower compared to higher SEP. Conclusions: Occupational diseases occur at a 2.7 higher incidence rate for workers in lower SEP compared with higher SEP. Incapacity for work varies between the type of OD and the level of SEP.
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