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Pekkurnaz D. Causal effect of obesity on the probability of employment in women in Turkey. Econ Hum Biol 2023; 51:101301. [PMID: 37651829 DOI: 10.1016/j.ehb.2023.101301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 07/11/2023] [Accepted: 08/17/2023] [Indexed: 09/02/2023]
Abstract
This study aims to investigate the causal effect of obesity on the employment probability of women in Turkey via the instrumental variable approach by using data from the 2018 Turkey and Demographic Health Survey. Obesity prevalence in the area of living and the overweight status of the oldest child, which are the most common types of instruments seen in the literature, are used as instruments. Consistent with the OLS result, the 2SLS estimate indicates that obese women are statistically significantly less likely to be employed when the overweight status of the child is used as an instrument. On the other hand, the statistically significant effect of obesity disappears when the area level obesity prevalence is used as the instrument. In addition, obesity in women decreases the likelihood of employment in the services sector and full-time jobs and employment with social security. Although the results of this study do not indicate the source of the effect found, the presence of a causal relationship for women should not be ignored when the economic burden of obesity for Turkey is considered.
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Affiliation(s)
- Didem Pekkurnaz
- Başkent University, Faculty of Economics and Administrative Sciences, Department of Economics, Bağlıca Campus, Fatih Sultan Mahallesi, Eskişehir Yolu 18. Km, Etimesgut, 06790 Ankara, Turkey.
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Halvachizadeh S, Muller D, Baechtold M, Hauswirth F, Probst P, Muller MK. Bariatric metabolic surgery eliminates body mass index as a risk factor for unemployment. Surg Obes Relat Dis 2023; 19:356-363. [PMID: 36424328 DOI: 10.1016/j.soard.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 09/26/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The effects of bariatric metabolic surgery (BMS) on health and comorbidities are well-known. Socioeconomic factors have been increasingly in focus in recent investigations. OBJECTIVE The aim of this study was to analyze the effects of BMS on predictive variables for unemployment. SETTING This study as performed in one reference center for BMS. Patients were treated between 2011 and 2017. METHODS The study design was a retrospective cohort study. Inclusion criteria were Roux-en-Y gastric bypass surgery, follow-up of 60 months, and complete data on employment rate. Exclusion criteria were secondary BMS, secondary referral, loss of follow-up, or patients aged 60 years and above. Patients were stratified as employed independent of part-time work and as unemployed if the patient had no current employment at the time of the visit. Follow-up visits were performed after 6, 12, 24, 48, and 60 months. RESULTS This study included 623 patients; prior to BMS, 239 (38.36%) patients were employed and 384 (61.64%) unemployed. Risk factors for baseline unemployment included increased body mass index (BMI) (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01 to 1.05; P = .010) and increased American Society of Anesthesiology (ASA) score (OR, 3.55; 95% CI, 2.56 to 4.90; P < .001). Unemployment rate dropped to 32.4% after 24 months (P < .001) and increased to 62.8% after 60 months. The BMI continuously decreased. Following BMS, the unemployment rate was no longer associated with BMI (24 months: OR, 0.97; 95% CI, 0.95 to 1.01; P = .220; 60 months: 1.04; 95% CI, 0.97 to 1.11; P = .269). The initial ASA status remained associated with unemployment (OR, 2.20; 95% CI, 1.60 to 3.01; P < .001). CONCLUSION BMI showed some association with the unemployment rate prior to BMI. The unemployment rate significantly decreased 24 months after BMS but increased to baseline values after 60 months. Following BMS, BMI was no longer associated with unemployment.
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Affiliation(s)
- Sascha Halvachizadeh
- Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Frauenfeld, Switzerland.
| | - Domink Muller
- Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Frauenfeld, Switzerland
| | - Matthias Baechtold
- Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Frauenfeld, Switzerland
| | - Fabian Hauswirth
- Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Frauenfeld, Switzerland
| | - Pascal Probst
- Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Frauenfeld, Switzerland
| | - Markus K Muller
- Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Frauenfeld, Switzerland
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Arnold C, Linden M, Warnke MH. Obesity Classification of the Body Mass Index Does Not Predict Participation Restrictions at Work. J Occup Environ Med 2022; 64:e833-8. [PMID: 36136664 DOI: 10.1097/JOM.0000000000002712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The objective was to explore the differences of the three body mass index (BMI) obesity classes regarding sociodemographic data, medical and psychological well-being, but especially participation restrictions at work. METHODS A specialist in psychosomatic medicine reported on the health and occupational status of 190 patients (BMI >30), who were treated as inpatients in a psychosomatic rehabilitation unit. RESULTS Significant increases in severity or work limitations were found for higher BMI groups concerning metabolic, cardiologic, and orthopedic comorbidity. There were no differences regarding indicators of occupational participation. Independent of the obesity status, about three quarters were seen as fit for work. CONCLUSIONS The initial hypothesis is rejected, as no difference concerning objective parameters of work participation were found between the BMI classes. The data suggest that BMI class I to BMI class III do not allow predictions of the ability to work.
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Amenyah SD, Waters D, Tang W, Fenge LA, Murphy JL. Systematic realist synthesis of health-related and lifestyle interventions designed to decrease overweight, obesity and unemployment in adults. BMC Public Health 2022; 22:2100. [PMCID: PMC9668709 DOI: 10.1186/s12889-022-14518-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 11/01/2022] [Indexed: 11/18/2022] Open
Abstract
Abstract
Background
Obesity and unemployment are complex social and health issues with underlying causes that are interconnected. While a clear link has been established, there is lack of evidence on the underlying causal pathways and how health-related interventions could reduce obesity and unemployment using a holistic approach.
Objectives
The aim of this realist synthesis was to identify the common strategies used by health-related interventions to reduce obesity, overweight and unemployment and to determine for whom and under what circumstances these interventions were successful or unsuccessful and why.
Methods
A realist synthesis approach was used. Systematic literature searches were conducted in Cochrane library, Medline, SocIndex, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and PsychInfo. The evidence from included studies were synthesised into Context-Mechanism-Outcome configurations (CMOcs) to better understand when and how programmes work, for which participants and to refine the final programme theory.
Results
A total of 83 articles met the inclusion criteria. 8 CMOcs elucidating the contexts of the health-related interventions, underlying mechanisms and outcomes were identified. Interventions that were tailored to the target population using multiple strategies, addressing different aspects of individual and external environments led to positive outcomes for reemployment and reduction of obesity.
Conclusion
This realist synthesis presents a broad array of contexts, mechanisms underlying the success of health-related interventions to reduce obesity and unemployment. It provides novel insights and key factors that influence the success of such interventions and highlights a need for participatory and holistic approaches to maximise the effectiveness of programmes designed to reduce obesity and unemployment.
Trial registration
PROSPERO 2020 CRD42020219897.
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Christensen AI, Lau CJ, Kristensen PL, Poulsen HS, Breinholt Larsen F. 35 Years of health surveys in Denmark: a backbone of public health practice and research. Scand J Public Health 2022; 50:914-918. [PMID: 35548941 DOI: 10.1177/14034948221083113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Denmark has a 35-year history of monitoring health status in the general population through health surveys. In this commentary, we outline the development of health surveys in Denmark from the beginning in 1987 to the present time. We describe how the current systematic framework for the Danish National Health Survey (DNHS) developed. We discuss the methodological basis for the DNHS and describe its application in public health practice and research. Over the years, the DNHS has become an important part of the Danish public health environment. Challenges for the DNHS in the future are to adapt to new trends in public health and at the same time to be able to monitor important changes consistently over time.
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Affiliation(s)
- Anne I Christensen
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Cathrine J Lau
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Denmark
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Bramming M, Becker U, Jørgensen MB, Neermark S, Bisgaard T, Tolstrup JS. Bariatric Surgery and Risk of Unemployment and Sickness Absence. Obes Surg 2022; 32:720-728. [PMID: 35091901 DOI: 10.1007/s11695-021-05802-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Obesity is associated with adverse labor market outcomes. We examine whether undergoing bariatric surgery is associated with better labor market outcomes such as lower risks of unemployment and sickness absence. METHODS This is a register-based cohort study of 9126 patients undergoing bariatric surgery from 2005 to 2013 and a reference group of 10,328 individuals with obesity. Age: 18-60 years, body mass index (BMI): 32-60 kg/m2. Participants were either working, unemployed, or on sickness absence at baseline. Inverse probability of treatment weighting was used to account for baseline differences between the two groups. Relative risk ratios of labor market participation were estimated at 1 year, 3 years, and 5 years of follow-up. RESULTS Women who had undergone bariatric surgery had a higher risk of unemployment 1 year (RRR = 1.20 (95% CI: 1.02-1.41)) and 5 years (RRR = 1.23 (95% CI: 1.05-1.44)) after surgery; however, men with bariatric surgery had a lower risk of unemployment after 5 years (RRR = 0.71 (95% CI: 0.55-0.92)). The risk of sickness absence was higher at all follow-up time points for both men and women who had undergone bariatric surgery compared with non-operated references with obesity. CONCLUSIONS Men undergoing bariatric surgery had a lower risk of unemployment 5 years after surgery compared with non-operated men with obesity; however, women presented a higher risk of unemployment after 5 years. The risk of sickness absence was higher for both men and women up to 5 years after undergoing bariatric surgery.
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Affiliation(s)
- Maja Bramming
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark
| | - Ulrik Becker
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark.,Gastrounit Medical Division, Copenhagen University Hospital Hvidovre, 2650, Hvidovre, Denmark
| | - Maja B Jørgensen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark.,Health Promotion and Inequality, Danish Health Authority, 2300, Copenhagen S, Denmark
| | - Søren Neermark
- Gastrounit Medical Division, Copenhagen University Hospital Hvidovre, 2650, Hvidovre, Denmark.,Center of Planning, Danish Health Authority, 2300, Copenhagen S, Denmark
| | - Thue Bisgaard
- Zealand University Hospital, Region Zealand, 4600, Køge, Denmark
| | - Janne S Tolstrup
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark.
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De Wet T, Kruger WH, Joubert G. Obesity and sickness absenteeism among health workers in a private hospital in South Africa. S Afr Fam Pract (2004) 2022; 64:e1-e8. [PMID: 35144463 PMCID: PMC8905506 DOI: 10.4102/safp.v64i1.5418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 11/27/2022] Open
Abstract
Background There is a worldwide trend among the general population including health workers to become more overweight and obese. Such obesity can reduce work ability as manifested through sickness absenteeism. The aim of this study was to describe the obesity among health workers in a private hospital in central South Africa, as measured by the body mass index (BMI) as well as the association of obesity and sickness absenteeism. Methods A cohort analytical study was conducted to describe changes in the BMI of employed health workers as well as the association of obesity and absenteeism in a private hospital in South Africa. The BMI measurement on employment, a repeat BMI at the time of the study as well as the sick leave days taken since employment of all health workers who had been employed for more than one year were analysed. Results Full time employees (n = 344) participated in the study of whom 33.7% were obese; 26.2% were overweight; 36.3% had normal weight and 3.7% were underweight at employment. On repeat BMI done in February 2016, 43.0% were obese; 27.6% were overweight; 28.2% had normal weight and 1.2% were underweight. There was no difference in the amount of sick leaves taken between the normal weight, overweight and obese groups. Conclusion A trend among health workers to change to a higher BMI category during employment is concerning, but there was no statistically significant association between the different weight groups and sickness absenteeism. The negative impact of obesity on the productivity of workers cannot be ignored.
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Affiliation(s)
- Therese De Wet
- Department of Community Health, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa; and, Kimberley Gariep Mediclinic Hospital, Kimberley.
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Li P, Chen X, Stafford F, Ou J. Body shape and stable employment opportunity analysis of China's nonagricultural labor market. SSM Popul Health 2022; 17:101014. [PMID: 35024421 PMCID: PMC8733337 DOI: 10.1016/j.ssmph.2021.101014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/11/2021] [Accepted: 12/20/2021] [Indexed: 10/31/2022] Open
Abstract
Based on the integrated data of the China General Social Survey (CGSS) from 2010 to 2017, this study observes that body shape - being overweight or underweight - is important for labor market outcomes. Body shape significantly affects the employment opportunities of Chinese individuals, and this effect differs by gender and across the occupational hierarchy. Women face both slim premium and obesity penalty effects. Slim women, those with normal and lower but not excessively lower body weight, are more likely to gain long-term employment contracts in the labor market, while the opposite is observed for overweight individuals. The relationship between women's body shape and employment opportunities also varies by occupation. The obesity penalty is more pronounced in occupations with a higher International Socio-Economic Index (ISEI), while the slim premium is more evident in occupations with a low ISEI. The results suggest that the Chinese labor market is highly demanding regarding women's figures, while it is relatively tolerant of men's figures. By mechanism analysis, health capital is found to be the leading cause of the body shape effect. In addition, socialization is also a possible pathway of action. This paper has extended implications for the study of stature and employment stability, enriching the empirical research on labor market discrimination.
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Affiliation(s)
- Ping Li
- Associate Professor of Economics, School of Economics and Management, South China Normal University, Guangzhou, 510006, China
| | - Xiaozhou Chen
- Associate Professor of Economics, School of Business Administration, Guangdong University of Finance, Guangzhou, 510006, China
| | - Frank Stafford
- Professor of Economics, Department of Economics and Institute for Social Research, University of Michigan, Ann arbor, Michigan, 48108, United States
| | - Jinyun Ou
- Ph.D. Candidate, School of Economics and Management, South China Normal University, Guangzhou, 510006, China
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Viinikainen J, Tikka S, Laaksonen M, Jääskeläinen T, Böckerman P, Karvanen J. Body weight and premature retirement: population-based evidence from Finland. Eur J Public Health 2021; 31:731-736. [PMID: 34293128 PMCID: PMC8514174 DOI: 10.1093/eurpub/ckab116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Health status is a principal determinant of labour market participation. In this study, we examined whether excess weight is associated with withdrawal from the labour market owing to premature retirement. METHODS The analyses were based on nationally representative data from Finland over the period 2001-15 (N ∼ 2500). The longitudinal data included objective measures of body weight (i.e. body mass index and waist circumference) linked to register-based information on actual retirement age. The association between the body weight measures and premature retirement was modelled using cubic b-splines via logistic regression. The models accounted for other possible risk factors and potential confounders, such as smoking and education. RESULTS Excess weight was associated with an increased risk of premature retirement for both men and women. A closer examination revealed that the probability of retirement varied across the weight distribution and the results differed between sexes and weight measures. CONCLUSION Body weight outside a recommended range elevates the risk of premature retirement.
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Affiliation(s)
- Jutta Viinikainen
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland
| | - Santtu Tikka
- Department of Mathematics and Statistics, University of Jyväskylä, Jyväskylä, Finland
| | | | | | - Petri Böckerman
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland
- Labour Institute for Economic Research, Helsinki, Finland
- IZA Institute of Labor Economics, Bonn, Germany
| | - Juha Karvanen
- Department of Mathematics and Statistics, University of Jyväskylä, Jyväskylä, Finland
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Carrello J, Lung T, Killedar A, Baur LA, Hayes A. Relationship between obesity and school absenteeism in Australian children: Implications for carer productivity. Obes Res Clin Pract 2021; 15:587-592. [PMID: 34625400 DOI: 10.1016/j.orcp.2021.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Economic evaluations of childhood obesity interventions are often used to assist decision making when presented with alternative course of action. Including indirect costs related to productivity losses is recommended; in children this would include school absenteeism. Our aim was to determine the association between school absenteeism and weight status among Australian children and estimate the indirect costs of this. METHODS We used data from a nationally representative sample of 8551 Australian children in the Longitudinal study of Australian Children (LSAC) with follow-up between 2006 and 2018. A mixed-effects negative binomial regression model was used to investigate the relationship between school absenteeism and weight status, controlling for age, sex, socio-economic position, indigenous status, rural/remote status and long-term medical conditions. We used average daily wages for the year 2018 to value the indirect costs of school absenteeism (through caregiver lost productivity). RESULTS Australian children with obesity aged 6-13 years missed on average an extra day of school annually compared to children of a healthy weight (p = 0.004), while adolescents with obesity aged 14-17 years missed on average an extra 0.69 days of school annually (p = 0.006). The estimated national cost for children with obesity aged 6-13 years was approximately $64 million AUD ($43 million USD) or $338 AUD ($230 USD) per child through caregiver lost productivity in 2018. CONCLUSIONS There is a small but significant association between school absenteeism and childhood obesity in Australia which is estimated to generate a considerable national cost through caregiver productivity losses. Our results will assist health economists evaluating childhood obesity interventions capture the full extent of the associated costs with this condition.
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Affiliation(s)
- Joseph Carrello
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia.
| | - Thomas Lung
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia; The George Institute for Global Health, The University of New South Wales, Sydney, NSW, Australia
| | - Anagha Killedar
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia; Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia
| | - Alison Hayes
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia
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Li P, Chen X, Yao Q. Body Mass and Income: Gender and Occupational Differences. Int J Environ Res Public Health 2021; 18:ijerph18189599. [PMID: 34574522 PMCID: PMC8468324 DOI: 10.3390/ijerph18189599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/04/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022]
Abstract
This paper aims to examine the influence of body shape on income, which varies with gender and occupational structure in China. The data were obtained from the CGSS (Chinese General Social Survey) 2010-2017 Survey. The overall finding in this paper is that women and men face different body shape-income effects. For females, the obesity penalty is significant and is reinforced with increasing occupational rank. For men, the thinness penalty (or weight premium) is enhanced as the occupational class decreases. Body shape-income gaps are mainly caused by the occupational structure. Twenty-nine percent of the income gap between overweight and average weight women can be explained by the obesity penalty, 37% of the income gap between overweight and average weight men can be interpreted by the weight premium, and 11% of the gap between underweight and normal weight men can be explained by the thinness penalty. The findings also suggest that the effect of body shape on income consists of two pathways: body shape affects health capital and socialization, and therefore income. Healthy lifestyles and scientific employment concepts should be promoted, and measures to close the gender gap should be implemented.
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Affiliation(s)
- Ping Li
- School of Economics and Management, South China Normal University, Guangzhou 510006, China; (P.L.); (Q.Y.)
| | - Xiaozhou Chen
- School of Business Administration, Guangdong University of Finance, Guangzhou 510521, China
- Correspondence:
| | - Qi Yao
- School of Economics and Management, South China Normal University, Guangzhou 510006, China; (P.L.); (Q.Y.)
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Abstract
BACKGROUND Severe obesity is associated with a reduced ability to work. Bariatric surgery is the most effective method to achieve a sustained weight loss. Previous studies have reported conflicting results regarding the effect of bariatric surgery on employment status. To address this, we investigated the effect of bariatric surgery on employment status in the Danish population. METHODS In this nationwide study, we identified 5450 subjects who underwent bariatric surgery and 10 900 control subjects matched for age, sex and municipality. From accessible registries, we extracted data regarding employment, absenteeism, sick leave and pension. Using a multistate model, we compared time in occupational states and transitions between these states to determine the effect of bariatric surgery on employment status. FINDINGS Before surgery, cases had an absolute risk increase (95% CI)(ARI (CI)) and a relative risk (RR (CI)) of being in full-time employment of -0.12 (-0.14 to -0.10) and 0.84 (0.82 to 0.86) and were more often unemployed or in a subsidised job than the background population. Taking into account the employment status before surgery, the bariatric surgery group increased their probability of being in full-time employment 1-3 years after bariatric surgery. However, this positive effect was not present with a longer duration of follow-up. Being male, above 50 years of age, or employed as a craftsman or office worker were associated with a sustained positive effect of being in full-time employment (ARI (CI) and RR (CI) 0.05 (0.04 to 0.05) and 1.05 (1.04 to 1.06), 0.06 (0.06 to 0.07) and 1.08 (1.07 to 1.09) and 0.05 (0.05 to 0.06) and 1.05 (1.05 to 1.06), respectively). INTERPRETATION Compared with a matched control group, those undergoing bariatric surgery did not improve their employment status in the long term. Certain subgroups had a more sustained positive effect.
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Affiliation(s)
- Claus Bogh Juhl
- Department of Endocrinology, Sydvestjysk Sygehus Esbjerg, Esbjerg, Denmark
- Steno Diabetes Center, Odense University Hospital, Odense, Denmark
| | - René Holst
- Oslo Centre for Biostatistics and Epidemiology, Faculty of Medicine, University of Oslo, Oslo, Norway
- Internal Medicine, Østfold Hospital, Gralum, Norway
| | | | - Charlotte Stolberg
- Department of Endocrinology, Hospital of South West Jutland, Esbjerg, Denmark
| | - Jon Michael Gran
- Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway
| | - Gert Frank Thomsen
- Department of Occupational Medicine, Hospital of South West Jutland, Esbjerg, Denmark
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Campbell DD, Green M, Davies N, Demou E, Ward J, Howe LD, Harrison S, Johnston KJA, Strawbridge RJ, Popham F, Smith DJ, Munafò MR, Katikireddi SV. Effects of increased body mass index on employment status: a Mendelian randomisation study. Int J Obes (Lond) 2021; 45:1790-1801. [PMID: 34158612 PMCID: PMC8310793 DOI: 10.1038/s41366-021-00846-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 02/26/2021] [Accepted: 04/27/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The obesity epidemic may have substantial implications for the global workforce, including causal effects on employment, but clear evidence is lacking. Obesity may prevent people from being in paid work through poor health or through social discrimination. We studied genetic variants robustly associated with body mass index (BMI) to investigate its causal effects on employment. DATASET/METHODS White UK ethnicity participants of working age (men 40-64 years, women 40-59 years), with suitable genetic data were selected in the UK Biobank study (N = 230,791). Employment status was categorised in two ways: first, contrasting being in paid employment with any other status; and second, contrasting being in paid employment with sickness/disability, unemployment, early retirement and caring for home/family. Socioeconomic indicators also investigated were hours worked, household income, educational attainment and Townsend deprivation index (TDI). We conducted observational and two-sample Mendelian randomisation (MR) analyses to investigate the effect of increased BMI on employment-related outcomes. RESULTS Regressions showed BMI associated with all the employment-related outcomes investigated. MR analyses provided evidence for higher BMI causing increased risk of sickness/disability (OR 1.08, 95% CI 1.04, 1.11, per 1 Kg/m2 BMI increase) and decreased caring for home/family (OR 0.96, 95% CI 0.93, 0.99), higher TDI (Beta 0.038, 95% CI 0.018, 0.059), and lower household income (OR 0.98, 95% CI 0.96, 0.99). In contrast, MR provided evidence for no causal effect of BMI on unemployment, early retirement, non-employment, hours worked or educational attainment. There was little evidence for causal effects differing by sex or age. Robustness tests yielded consistent results. DISCUSSION BMI appears to exert a causal effect on employment status, largely by affecting an individual's health rather than through increased unemployment arising from social discrimination. The obesity epidemic may be contributing to increased worklessness and therefore could impose a substantial societal burden.
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Affiliation(s)
- Desmond D. Campbell
- grid.8756.c0000 0001 2193 314XMRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Michael Green
- grid.8756.c0000 0001 2193 314XMRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Neil Davies
- grid.5337.20000 0004 1936 7603MRC Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, University of Bristol, Bristol, UK ,grid.5947.f0000 0001 1516 2393K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Evangelia Demou
- grid.8756.c0000 0001 2193 314XMRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Joey Ward
- grid.8756.c0000 0001 2193 314XMental Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Laura D. Howe
- grid.5337.20000 0004 1936 7603MRC Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, University of Bristol, Bristol, UK
| | - Sean Harrison
- grid.5337.20000 0004 1936 7603MRC Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, University of Bristol, Bristol, UK
| | - Keira J. A. Johnston
- grid.8756.c0000 0001 2193 314XMental Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Rona J. Strawbridge
- grid.8756.c0000 0001 2193 314XMental Health & Wellbeing, University of Glasgow, Glasgow, UK ,Health Data Research, Glasgow, UK ,grid.4714.60000 0004 1937 0626Cardiovascular Medicine, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Frank Popham
- grid.8756.c0000 0001 2193 314XMRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Daniel J. Smith
- grid.8756.c0000 0001 2193 314XMental Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Marcus R. Munafò
- grid.5337.20000 0004 1936 7603MRC Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, University of Bristol, Bristol, UK ,grid.5337.20000 0004 1936 7603School of Psychological Science, University of Bristol, Bristol, UK
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14
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Singer G, Cohen I. An Objective-Based Entropy Approach for Interpretable Decision Tree Models in Support of Human Resource Management: The Case of Absenteeism at Work. Entropy (Basel) 2020; 22:E821. [PMID: 33286593 DOI: 10.3390/e22080821] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/20/2020] [Accepted: 07/25/2020] [Indexed: 12/02/2022]
Abstract
The negative impact of absenteeism on organizations’ productivity and profitability is well established. To decrease absenteeism, it is imperative to understand its underlying causes and to identify susceptible employee subgroups. Most research studies apply hypotheses testing and regression models to identify features that are correlated with absenteeism—typically, these models are limited to finding simple correlations. We illustrate the use of interpretable classification algorithms for uncovering subgroups of employees with common characteristics and a similar level of absenteeism. This process may assist human resource managers in understanding the underlying reasons for absenteeism, which, in turn, could stimulate measures to decrease it. Our proposed methodology makes use of an objective-based information gain measure in conjunction with an ordinal CART model. Our results indicate that the ordinal CART model outperforms conventional classifiers and, more importantly, identifies patterns in the data that have not been revealed by other models. We demonstrate the importance of interpretability for human resource management through three examples. The main contributions of this research are (1) the development of an information-based ordinal classifier for a published absenteeism dataset and (2) the illustration of an interpretable approach that could be of considerable value in supporting human resource management decision-making.
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15
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Linaker CH, D'Angelo S, Syddall HE, Harris EC, Cooper C, Walker-Bone K. Body Mass Index (BMI) and Work Ability in Older Workers: Results from the Health and Employment after Fifty (HEAF) Prospective Cohort Study. Int J Environ Res Public Health 2020; 17:E1647. [PMID: 32138365 DOI: 10.3390/ijerph17051647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 02/25/2020] [Accepted: 02/28/2020] [Indexed: 11/17/2022]
Abstract
This study explores associations between BMI and prolonged sickness absence; cutting down at work; and health-related job loss (HRJL) over two years of follow-up among workers aged ≥50 years. A cohort of 2299 men and 2425 women (aged 50–64 years) self-reported height and weight at baseline and provided information about work ability at 12 and 24 months for the Health and Employment after Fifty (HEAF) Study. Associations between BMI and work ability were assessed by logistic regression and HRJL by multiple-record Cox’s proportional hazards models, with adjustment for other risk factors. The prevalence of obesity/severe obesity was 22.6%/1.2% amongst men and 21.4%/2.6% amongst women, respectively. In men and women, obesity and severe obesity predicted having to cut down at work for health over two years. In women, severe obesity predicted prolonged sickness absence, and also HRJL even after adjustment for age, proximity to retirement, financial difficulties, and lifestyle factors (hazard ratio [HR] 2.93, 95% CI 1.38, 6.23), and additional adjustment for health conditions (HR 2.52, 95% CI 1.12, 5.67). Obesity, and particularly severe obesity, negatively impacts work ability amongst people aged 50–64 years, with greatest effects in women. Obesity can be expected to hinder attempts to encourage work to older ages.
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16
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Endo M, Inoue Y, Kuwahara K, Nishiura C, Hori A, Ogasawara T, Yamaguchi M, Nakagawa T, Honda T, Yamamoto S, Okazaki H, Imai T, Nishihara A, Miyamoto T, Sasaki N, Uehara A, Yamamoto M, Murakami T, Shimizu M, Eguchi M, Kochi T, Nagahama S, Tomita K, Kunugita N, Tanigawa T, Konishi M, Nanri A, Kabe I, Mizoue T, Dohi S. BMI and Medically Certified Long-Term Sickness Absence Among Japanese Employees. Obesity (Silver Spring) 2020; 28:437-444. [PMID: 31970914 PMCID: PMC7004170 DOI: 10.1002/oby.22703] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 10/02/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE In contrast to the association between excess weight and sickness absence (SA), the association in relation to underweight has been under-researched. This study aimed to examine the effects of BMI at both extremes of its distribution on SA. METHODS Data came from the Japan Epidemiology Collaboration on Occupational Health study of 77,760 workers aged 20 to 59 years (66,166 males, 11,594 females). Information was collected on medically certified long-term SA (LTSA) (i.e., SA lasting ≥ 30 consecutive days) from April 2012 to March 2017. A sex-specific Cox proportional hazards model was used to investigate the associations. RESULTS Among males, both obesity (hazard ratio [HR] = 1.81, 95% CI: 1.50-2.17) and underweight (HR = 1.56, 95% CI: 1.23-1.96) were significantly associated with LTSA compared with normal weight. This U-shaped association between BMI categories and LTSA was observed both for mental and physical disorders. Among females, an elevated risk was observed among those with overweight (HR = 1.54, 95% CI: 1.16-2.05). CONCLUSIONS In a cohort of the Japanese working-age population, both obesity and underweight were associated with a greater risk of LTSA in males. Future research should not overlook the excess risk of LTSA associated with underweight.
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Affiliation(s)
- Motoki Endo
- Department of Public HealthJuntendo University Graduate School of MedicineTokyoJapan
- Department of Epidemiology and PreventionNational Center for Global Health and MedicineTokyoJapan
| | - Yosuke Inoue
- Department of Epidemiology and PreventionNational Center for Global Health and MedicineTokyoJapan
| | - Keisuke Kuwahara
- Department of Epidemiology and PreventionNational Center for Global Health and MedicineTokyoJapan
- Graduate School of Public HealthTeikyo UniversityTokyoJapan
| | | | - Ai Hori
- Department of Global Public HealthFaculty of MedicineUniversity of TsukubaIbarakiJapan
| | | | - Miwa Yamaguchi
- Department of Epidemiology and PreventionNational Center for Global Health and MedicineTokyoJapan
| | | | | | | | | | | | | | | | - Naoko Sasaki
- Mitsubishi Fuso Truck and Bus CorporationKanagawaJapan
| | | | | | - Taizo Murakami
- Mizue Medical ClinicKeihin Occupational Health CenterKanagawaJapan
| | - Makiko Shimizu
- East Japan Works (Keihin)JFE Steel CorporationKanagawaJapan
| | | | | | | | | | - Naoki Kunugita
- School of Health SciencesUniversity of Occupational and Environmental HealthFukuokaJapan
| | - Takeshi Tanigawa
- Department of Public HealthJuntendo University Graduate School of MedicineTokyoJapan
| | - Maki Konishi
- Department of Epidemiology and PreventionNational Center for Global Health and MedicineTokyoJapan
| | - Akiko Nanri
- Department of Epidemiology and PreventionNational Center for Global Health and MedicineTokyoJapan
- Department of Food and Health SciencesInternational College of Arts and SciencesFukuoka Women's UniversityFukuokaJapan
| | | | - Tetsuya Mizoue
- Department of Epidemiology and PreventionNational Center for Global Health and MedicineTokyoJapan
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