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Mellanen E, Kauppila T, Kautiainen H, Lehto M, Rahkonen O, Pitkälä K, Laine MK. Use of primary health care services and mortality in older patients with type 2 diabetes with or without comorbidities. Scand J Prim Health Care 2023; 41:392-399. [PMID: 37706640 PMCID: PMC11001330 DOI: 10.1080/02813432.2023.2255062] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023] Open
Abstract
OBJECTIVE This study aimed to examine primary health care (PHC) service utilization and mortality in older patients with type 2 diabetes (T2D) with or without comorbidities. DESIGN AND SETTING A cohort study in PHC in the city of Vantaa, Finland. Follow-up period was set between the years 2011 and 2018. SUBJECTS PHC patients aged 60 years or more with a T2D were included. MAIN OUTCOME MEASURES Service utilization was defined as the number of face-to-face appointments and telephone contacts between a patient and general practitioner (GP) or nurse. The presence of comorbidities was defined using the Charlson Comorbidity Index (CCI). Mortality was assessed using hazard ratio (HR) and standardized mortality ratio (SMR). RESULTS In total, 11,020 patients were included and followed for 71,596 person years. Mean age of the women and men in the beginning of follow-up were 71 and 69 years, respectively. The patients in the study cohort had a mean of eight appointments per person year to the GPs or nurses. Patients with T2D with comorbidities had more appointments than patients with T2D without comorbidities (incidence rate ratio (IRR) 1.44 [95% CI 1.39-1.49]). Increase in the number of all appointments reduced mortality in patients with T2D with and without comorbidities. Between patients with T2D with comorbidities and patients with T2D without comorbidities, the age and sex adjusted HR for death was 1.50 (95% CI 1.39-1.62). The SMR was higher in patients with T2D with comorbidities (1.83 [95% CI 1.74-1.92]) than in patients with T2D without comorbidities (0.91 [95% CI 0.86-0.96]). CONCLUSIONS In older patients with T2D, the presence of comorbidities was associated with increased use of PHC services and increased mortality. Increase in the number of appointments was associated with reduced mortality in patients with T2D with or without comorbidities.Key PointsIn older patients with T2D, it has not been studied whether and to what extend multimorbidity affects use of PHC services and mortality.The presence of comorbidities according to the Charlson Comorbidity Index (CCI) was associated with increased use of PHC services.The number of appointments to GPs or nurses was associated with reduced mortality in patients with T2D with or without comorbidities according to the CCI.
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Affiliation(s)
- E. Mellanen
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - T. Kauppila
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - H. Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
| | - M. Lehto
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- City of Vantaa, Vantaa, Finland
| | - O. Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - K. Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - M. K. Laine
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
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Fagerlund P, Shiri R, Suur-Uski J, Kaartinen S, Rahkonen O, Lallukka T. Pain and mental health - separate and joint associations with sickness absence among young employees. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Both pain and mental illness associate with work disability. However, few studies have examined the association of concurrent pain and mental distress with sickness absence (SA). We examined separate and joint associations of chronic pain, multisite pain, and mental distress with total and long-term all-cause SA among young and midlife municipal employees.
Methods
As part of the Young Helsinki Health study, baseline data were collected in 2017 from 19-39-year-old employees of the City of Helsinki, Finland. Chronic (≥3 months) pain, multisite (≥2 body sites) pain and mental distress (RAND-36 emotional wellbeing subscale below median) were reported by 3911 respondents. Register data on total (>1 day) and long-term ((>11 workdays) SA for the following year were obtained from the employer and the Social Insurance Institute of Finland with respondents’ informed consent. Negative binomial regression analyses were performed with sociodemographic, socioeconomic, and health-related factors as confounders. The interaction of gender was examined.
Results
Chronic pain, multisite pain, and mental distress were associated with total SA. Chronic multisite pain was associated with long-term SA (rate ratio [RR] 2.51, 95% CI 1.17-5.42), and chronic pain (RR 5.04, 95% CI 2.14-11.87) and multisite pain (RR 4.88, 95% CI 2.30-10.33) with long-term SA among those with mental distress. For women, there was a synergistic interaction of multisite pain to the association with total SA (synergy index 1.80, 95% CI 1.27-2.54).
Conclusions
Chronic and multisite pain associate with SA among young and midlife employees. The associations are generally stronger among women and particularly among those with concurrent mental distress. Interventional studies are needed to confirm if early symptom recognition and support could reduce sickness absence.
Key messages
• Chronic pain and pain at multiple body sites associate with sickness absence among young and midlife employees, particularly among women and those with concurrent mental distress.
• Interventional studies are needed to confirm if sickness absence could be reduced by early recognizing pain and mental distress among employees and providing preventive and therapeutic services.
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Affiliation(s)
- P Fagerlund
- Department of Public Health, University of Helsinki , Helsinki, Finland
| | - R Shiri
- Finnish Institute of Occupational Health , Helsinki, Finland
| | - J Suur-Uski
- Department of Public Health, University of Helsinki , Helsinki, Finland
| | - S Kaartinen
- Department of Public Health, University of Helsinki , Helsinki, Finland
- Department of Physical and Rehabilitation Medicine, Helsinki University Hospital , Hyvinkää, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki , Helsinki, Finland
| | - T Lallukka
- Department of Public Health, University of Helsinki , Helsinki, Finland
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Lahti J, Pietiläinen O, Rahkonen O, Lallukka T. Class inequalities in physical functioning trajectories before and after retirement. Eur J Public Health 2022. [PMCID: PMC9593451 DOI: 10.1093/eurpub/ckac131.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Longer work careers are discussed, but inequalities in health trajectories among employees facing retirement remain poorly understood. We examined social class trajectories in physical functioning among ageing female employees ten years before and after transition to old-age or disability retirement. Methods We used Helsinki Health Study cohort data. The baseline (2000-02) included 7168 women, aged 40-60, employed by the City of Helsinki, Finland (response 67%). Follow-ups took place in 2007, 2012 and 2017 (response 78-83%). The outcome was RAND-36 Physical Functioning subscale, range 0-100, with higher scores indicating better functioning. Social classes were upper and lower class, and covariates age, work conditions and health behaviours. Mixed-effect growth curve models were used to predict functioning scores and 95% confidence intervals (CI) 10 years before and after mandatory old-age or disability retirement. Results Old-age and disability retirees lacked class inequalities in functioning 10 years prior retirement. Towards retirement transition, functioning declined and inequalities emerged. Among old-age retirees, the predicted score was 86.1 (CI 85.2-86.9) for upper class and 82.2 (81.5-83.0) for lower class. Among disability retirees, the score was 70.3 (67.8-72.9) for upper class and 62.2 (60.4-63.9) for lower class. Among old-age retirees, functioning declined and inequalities slightly widened. Among disability retirees, the decline plateaued and inequalities narrowed. Physical work and BMI somewhat attenuated the inequalities. Conclusions Among female employees, functioning declined and class inequalities emerged towards retirement transition. Widening inequalities were seen among old-age retirees, but not among disability retirees. Preventing the decline of functioning and related inequalities would help safeguard a healthy and successful ageing among female retirees. Key messages • As functioning shows a constant decline before and after old-age retirement, there is a need for slowing down the pace of the decline. • Class inequalities in functioning tend to widen among old-age retirees; egalitarian measures are needed to turn the development to narrowing inequalities.
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Affiliation(s)
- J Lahti
- Department of Public Health, University of Helsinki , Helsinki, Finland
| | - O Pietiläinen
- Department of Public Health, University of Helsinki , Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki , Helsinki, Finland
| | - T Lallukka
- Department of Public Health, University of Helsinki , Helsinki, Finland
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Salmela J, Lahti J, Kanerva N, Rahkonen O, Kouvonen A, Lallukka T. Clustering of unhealthy behaviours and subsequent sickness absence among Finnish municipal employees. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Unhealthy behaviours are associated with increased sickness absence (SA), but few studies have explored these associations using person-oriented approach. We aimed to identify latent classes of unhealthy behaviours among female and male employees and examined their associations with subsequent SA.
Methods
Health behaviours (leisure-time physical activity, sedentary behaviour, fruit and vegetable [F&V] consumption, sleep, binge drinking, and use of tobacco products) were derived from the Helsinki Health Study questionnaire survey, collected in 2017 among 19-39-year-old employees of the City of Helsinki, Finland. The questionnaire data were linked to employer's SA register. Latent class analysis was used to identify underlying profiles of unhealthy behaviours and negative binomial regression was used to examine their associations with subsequent SA (≤7 days, >7 days, and all lengths) among 3228 women and 771 men. The mean follow-up time was 2.1 years.
Results
Among women, we identified 3 latent classes: 1) healthy behaviours (81% of women), 2) binge drinking and tobacco use (12%), and 3) inadequate F&V consumption and insufficient sleep (7%). Classes 2 and 3 showed increased rates for subsequent SA compared to class 1, regardless of the length of SA spells (age-adjusted rate ratios [RR] 1.37-1.42 and 1.35-1.64, respectively). Among men, we identified 3 latent classes: 1) healthy behaviours (51% of men), 2) binge drinking and tobacco use (19%), and 3) inadequate F&V consumption, binge drinking and tobacco use (30%). While classes 1 and 2 were not different in terms of subsequent SA, class 3 had increased rates of subsequent, particularly short-term SA (RR 1.24, 95% CI 1.03-1.48).
Conclusions
Preventive actions should consider simultaneously several unhealthy behaviours while aiming to reduce employees’ SA. These actions might benefit from regarding potential gender differences in the clustering of unhealthy behaviours and their associations with SA.
Key messages
• Preventive actions to reduce sickness absence should consider clustering of unhealthy behaviours among employees.
• Potential gender differences need to be regarded in these actions.
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Affiliation(s)
- J Salmela
- Department of Public Health, University of Helsinki , Helsinki, Finland
| | - J Lahti
- Department of Public Health, University of Helsinki , Helsinki, Finland
| | - N Kanerva
- Department of Food and Nutrition, University of Helsinki , Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki , Helsinki, Finland
| | - A Kouvonen
- Faculty of Social Sciences, University of Helsinki , Helsinki, Finland
- Centre for Public Health, Queen’s University Belfast , Belfast, UK
| | - T Lallukka
- Department of Public Health, University of Helsinki , Helsinki, Finland
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Mänty M, Kouvonen A, Nordquist H, Harkko J, Pietiläinen O, Halonen JI, Rahkonen O, Lallukka T. Physical working conditions and subsequent sickness absence: a record linkage follow-up study among 19-39-year-old municipal employees. Int Arch Occup Environ Health 2021; 95:489-497. [PMID: 34687341 PMCID: PMC8795030 DOI: 10.1007/s00420-021-01791-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 03/23/2021] [Accepted: 06/14/2021] [Indexed: 11/25/2022]
Abstract
Purpose Physical work exposures are associated with sickness absence among older employees. We aimed to examine if they similarly contribute to all-cause sickness absence during early and mid-careers. Methods We used questionnaire data on physical work exposures linked to register data on sickness absence from 3542 municipal employees aged 19–39 years. Follow-up for the number of sickness absence days was 12 months. Exposures to physical workload, occupational environmental hazards, and sedentary work were divided into quartiles. In addition, duration of daily exposure to heavy work was included. Negative binomial regression models were used. Results Higher exposure to physical workload or hazardous exposures was associated with a higher number of sickness absence days. The age and gender adjusted rate ratios for sickness absence days among the participants whose exposure to physical workload was in the highest exposure quartile were 2.1 (95% CI 1.8‒2.5) compared with those whose exposure was in the lowest quartile. In addition, rate ratios for sickness absence days among participants who reported that they do heavy physical work 1.1‒2.0 h, 2.1‒4.0 h or over 4 h daily were 1.6 (1.3‒1.9), 1.5 (1.3‒1.8) and 1.7 (1.5‒2.1), respectively, compared with those who reported not doing physical work. Further adjustment for lifestyle factors or health characteristics attenuated the associations only slightly. Conclusion Exposure to physically demanding work is associated with a higher number of sickness absence days among municipal employees below 40 years of age. Physical working conditions should be considered when aiming to support later work ability. Supplementary Information The online version contains supplementary material available at 10.1007/s00420-021-01791-y.
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Affiliation(s)
- M Mänty
- Department of Public Health, University of Helsinki, Helsinki, Finland. .,Unit of Strategy and Research, City of Vantaa, Vantaa, Finland.
| | - A Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.,Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - H Nordquist
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.,Department of Health Care and Emergency Care, South-Eastern Finland University of Applied Sciences, Kotka, Finland
| | - J Harkko
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - O Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - J I Halonen
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - T Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Erkkola M, Uusitalo L, Puputti K, Saari T, Jallinoja P, Rahkonen O, Nevalainen J, Walsh H. Food insecurity among Finnish private sector service workers and food pantry clients. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
There is a paucity of comparable quantitative data on the prevalence and predictors of food insecurity in high-income countries. We applied the Household Food Insecurity Access Scale (HFIAS) to assess food insecurity among i) the Service Union United members; female-dominated, low-income employees of the Finnish private service sector, and ii) a convenience sample of Finnish food pantry clients.
Methods
The HFIAS classification was based on 9 validated questions capturing respondents' perceptions on food scarcity and behavioural responses to food insecurity due to lack of resources during the past month. The resulting indicator categorized respondents as food secure, and mildly, moderately and severely food insecure. We performed cross-tabulations and regression models to assess if education, housing, self-perceived health, income, and resource scarcity associated with levels of food insecurity. In addition, gender, age, and self-perceived disadvantage were assessed among the food pantry clients.
Results
Among the service workers (n = 6 573, 6% of those invited), 35% were food secure, 29% mildly or moderately food insecure, and 36% severely food insecure. The respective proportions were 28%, 26%, and 46% among the 129 food pantry clients. All assessed variables were associated to food insecurity status in the service workers (p < 0.01 for all). Among the food pantry clients, men (OR 1.60; 95% CI 1.09 − 4.80) and homeless/tenants in community rental units (OR 7.12; 95% CI 2.42 − 20.95) were most likely to experience severe food insecurity.
Conclusions
Alongside the food pantry clients the majority of the service workers demonstrated some degree of food insecurity, with a considerable proportion being severely food-insecure. This predominantly low-income group is subject to rapid changes in the labour market and social security systems. The data demonstrated that well-known SES indicators and self-perceived health are linked to food insecurity.
Key messages
Severe food insecurity was common among predominantly low-income private sector service workers and food pantry clients. Food insecurity is linked to SES indicators and wellbeing.
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Affiliation(s)
- M Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - L Uusitalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - K Puputti
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - T Saari
- Work Research Centre, University of Tampere, Tampere, Finland
| | - P Jallinoja
- Faculty of Social Sciences, Health Sciences Unit, University of Tampere, Tampere, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - J Nevalainen
- Faculty of Social Sciences, Health Sciences Unit, University of Tampere, Tampere, Finland
| | - H Walsh
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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Lintonen T, Uusitalo L, Erkkola M, Rahkonen O, Saarijärvi H, Fogelholm M, Nevalainen J. Grocery purchase data in the study of alcohol use - A validity study. Drug Alcohol Depend 2020; 214:108145. [PMID: 32663761 DOI: 10.1016/j.drugalcdep.2020.108145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 04/01/2020] [Revised: 06/17/2020] [Accepted: 06/29/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Alcohol use epidemiology is facing challenges as survey response rates decline. In addition, population surveys fail to capture a large proportion of alcohol consumed and are expensive to conduct. This study aims to aid in complementing traditional epidemiological methods by validate grocery purchase data in the research on population alcohol use. METHODS The LoCard study subjects were loyalty card holders of a grocery retail co-operative, which possessed more than 45 % market share in Finland. One third of those who consented to the analyses of their grocery purchases were presented a questionnaire including a Food Frequency Questionnaire on the web; N = 11,818 responded. The relationship between beer purchase frequency and self-reported beer drinking frequency was studied for association and agreement in different subgroups using crosstabulations and Poisson regression modeling. RESULTS The association between beer purchase frequency and self-reported beer drinking frequency was good (Gamma = .556). The agreement between beer purchase frequency and drinking frequency was only fair (Kappa = .189). Limiting the data to those single adult households that reported making at least 61 % of their grocery purchases from this grocery retailer and collapsing the frequency categories to three instead of six increased the agreement to good (Kappa = .463). CONCLUSIONS Information on beer purchase frequency from the loyalty card database can be used to rank people according to their drinking frequency and to estimate beer drinking frequency with fair to good accuracy, depending on what share of grocery purchases they make from the grocery retailer in question.
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Affiliation(s)
- T Lintonen
- Finnish Foundation for Alcohol Studies, Mannerheimintie 166, Helsinki, FI-00271, Finland; Tampere University, Faculty of Social Sciences, Health Sciences, Arvo Ylpön katu 34, Tampere, FI-33014 Tampere University, Finland.
| | - L Uusitalo
- Finnish Foundation for Alcohol Studies, Mannerheimintie 166, Helsinki, FI-00271, Finland; University of Helsinki, Faculty of Agriculture and Forestry, Department of Food and Nutrition, Agnes Sjöbergin katu 2, Helsinki, FI-00014 University of Helsinki, Finland
| | - M Erkkola
- University of Helsinki, Faculty of Agriculture and Forestry, Department of Food and Nutrition, Agnes Sjöbergin katu 2, Helsinki, FI-00014 University of Helsinki, Finland
| | - O Rahkonen
- University of Helsinki, Faculty of Medicine, Department of Public Health, Tukholmankatu 8 B, Helsinki, FI-00014 University of Helsinki, Finland
| | - H Saarijärvi
- Tampere University, Faculty of Management and Business, Kalevantie 4, Tampere, FI-33014 Tampere University, Finland
| | - M Fogelholm
- University of Helsinki, Faculty of Agriculture and Forestry, Department of Food and Nutrition, Agnes Sjöbergin katu 2, Helsinki, FI-00014 University of Helsinki, Finland
| | - J Nevalainen
- Tampere University, Faculty of Social Sciences, Health Sciences, Arvo Ylpön katu 34, Tampere, FI-33014 Tampere University, Finland
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Lahti J, Harkko J, Sumanen H, Piha K, Pietiläinen O, Mänty M, Rahkonen O, Lallukka T, Kouvonen A. Does seeing a psychologist reduce sickness absence due to mental disorders? A quasi-experiment. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Mental ill-health in young adults is a major public health and work-life problem. We examined in a quasi-experimental design whether occupational psychologist appointment can reduce subsequent sickness absence due to mental disorders among young Finnish employees.
Methods
The present study was conducted among 18-39-year-old employees of the City of Helsinki using register data from the City of Helsinki and the Social lnsurance Institution of Finland. We used Wald test to compare the differences in sickness absence days due to mental disorders (ICD-10, F-diagnosed) between those treated (occupational psychologist appointment for work ability support) and the non-treated (no psychologist appointment) during a one year follow-up. The full sample (n = 2156, 84% women) consisted of employees with mental disorder diagnosed sickness absence during 2009-2014. To account for the systematic differences between the treated and non-treated, the participants were matched according to their characteristics (age, sex, occupational class, education, previous sickness absence and psychotropic medication). The matched sample included 886 participants. We excluded those with treatment before the treatment screening time (± 3 months to the end of sickness absence period), non-treated with treatment during the follow-up and those that could not be matched (lack of common support).
Results
In the full sample, the mean of sickness absence days due to mental disorders was 17.7 (95% CI, 11.4, 24.1) days for those treated (n = 240) and 23.2 (95% CI, 20.5, 25.9) days for non-treated (n = 1916), difference being non-significant. The corresponding figures in the matched sample were (16.8, 95% CI, 9.5-24.1) for those treated (n = 195) and (27.8, 95% CI, 22.6-32.9) for non-treated (n = 691), difference being statistically significant (p = 0.02).
Conclusions
This quasi-experiment suggests that seeing an occupational psychologist to support work ability may be reduce mental health related sickness absence.
Key messages
We showed that supporting work ability at an early stage may prevent sickness absence due to mental disorders. More efforts to provide early stage support for maintaining work ability may prove useful in reducing sickness absence rates in younger employees.
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Affiliation(s)
- J Lahti
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - J Harkko
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - H Sumanen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
- South-Eastern Finland University of Applied Sciences, Kotka, Finland
| | - K Piha
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - O Pietiläinen
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - M Mänty
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
- City of Vantaa, Vantaa, Finland
| | - O Rahkonen
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - T Lallukka
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - A Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Administrative Data Research Centre (Northern Ireland), Queen’s University, Belfast, UK
- Research Institute of Psychology, SWPS University, Wroclaw, Poland
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9
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Uusitalo L, Nevalainen J, Rahkonen O, Erkkola M, Saarijärvi H, Fogelholm M, Lintonen T. Alcohol purchases from a large Finnish retail chain before and after a change in alcohol legislation. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In January 2018, the legal limit for alcoholic beverages in grocery stores changed from 4.7 to 5.5 % alcohol. The increased availability of stronger beer, cider and ready-to-drink beverages was expected to increase the total amount of 100% alcohol bought. The study aimed to examine how the change in alcohol legislation affected the purchasing of 100% alcohol from grocery stores by comparing the years 2017 and 2018.
Methods
The study data consisted of 47,066 loyalty card holders of Finland's largest retail chain, who gave their consent and provided background information by an online questionnaire. The data contained the type, volume and alcoholic content of the purchases, from which we calculated the amount of 100% alcohol bought. The mean individual alcohol purchases in the years 2017 and 2018 were compared by age, gender, level of education and household income using repeated measurements ANOVA models.
Results
There was only a small, non-significant change in the total amount of 100% alcohol between 2017 and 2018 (mean 1.9 l and 2.0 l, respectively, p = 0.220). Lower income was associated with a decrease in total 100% alcohol purchased, whereas higher income groups showed an increase. Increase in 100% alcohol bought as ready-to-drink beverages was seen in all population groups.
Conclusions
The availability of stronger alcoholic beverages in grocery stores did not result in a notable overall increase in total purchases of 100% alcohol. The increased purchases of alcohol as ready-to-drink beverages were, on the average, compensated for by decreased purchases of alcohol as other beverages. The association of income with total alcohol purchases may indicate the effect of price in consumer behavior.
Key messages
The raise in the legal limit of alcohol content raised did not result in a significant increase in the total amount of 100% alcohol bought from grocery stores. Alcohol purchased as ready-to-drink beverages increased in all population groups.
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Affiliation(s)
- L Uusitalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - J Nevalainen
- Faculty of Social Sciences (Health Sciences), Tampere University, Tampere, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - M Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - H Saarijärvi
- Faculty of Management and Business, Tampere University, Tampere, Finland
| | - M Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - T Lintonen
- The Finnish Foundation for Alcohol Studies, Helsinki, Finland
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Lahti J, Mauramo E, Lahelma E, Lallukka T, Pietiläinen O, Salmela J, Salonsalmi A, Rahkonen O. Healthy behaviours and risk of all-cause mortality. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Healthy behaviours are associated with better health in general but less is known about the combined associations of multiple healthy behaviours with mortality risk. We aimed to examine the associations of combined healthy behaviours with mortality risk over a 15-year follow-up among middle-aged employees.
Methods
Survey data, collected in 2000–2002 among 40–60-year-old employees of the City of Helsinki, Finland, was linked with complete register data on mortality from Statistics Finland (response rate 67%, written informed consent for register linkages 74%). Healthy behaviours included high leisure-time physical activity, non-smoking, no binge drinking and healthy food habits. Each healthy behaviour were dichotomized and assigned a value of one for healthy and zero for unhealthy. The number of healthy behaviours were summed together (score range 0-4). Cox regression models were fitted, and the follow-up continued until the end of 2015 (n = 6336). Confounders included age, sex, marital status, socioeconomic position and self-rated health.
Results
Of the respondents, 7% reported four healthy behaviours, 27% three, 34% two, 22% one and 9% no healthy behaviours. A total of 281 deaths occurred during the follow-up. Each healthy behaviour was individually associated with a reduced mortality risk, non-smoking having the strongest and healthy diet the weakest association. The combined association showed that those without any of the healthy behaviours (HR 2.8, 95% CI 1.51-5.29) and those with only one healthy behaviour (HR 1.89, 95% CI 1.04-3.43) had a higher mortality risk than those with four healthy behaviours. Instead, those with at least two healthy behaviours were not at an increased risk of mortality.
Conclusions
A low number of healthy behaviours predicted mortality among middle-aged employees. Efforts should be made to promote multiple healthy behaviours among the middle-aged to enhance health and prevent premature mortality.
Key messages
Almost one third of the respondents had no or only one healthy behaviour. A low number of healthy behaviours was associated with an increased risk of mortality.
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Affiliation(s)
- J Lahti
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - E Mauramo
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - E Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - T Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - J Salmela
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - A Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
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11
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Salonsalmi A, Lallukka T, Lahelma E, Pietiläinen O, Rahkonen O. Childhood adversities and chronic pain among midlife employees. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Chronic pain is common among employees. Childhood adversities are known determinants of adult health but their association with chronic pain in adulthood is largely unknown. We aimed to examine the associations between childhood adversities and chronic pain among midlife employees.
Methods
Data on seven childhood adversities and chronic pain (pain having lasted at least 3 months) were derived from the baseline survey of the Helsinki Health Study collected in 2000 to 2002 among 40 to 60-year-old employees of the City of Helsinki in Finland. The study included 8140 employees of whom 80% were women. The analyses were made by logistic regression and the results are presented as odds ratios (OR) and their 95% confidence intervals (CI). Age, gender, father’s education, own education, marital status, working conditions, sleep problems and common mental disorders were included as covariates.
Results
Economic difficulties in the childhood family (OR 1.60, 95% CI 1.41-1.81), childhood illness (1.74, 1.45-2.08), parental divorce (1.26, 1.07-1.48), parental alcohol problems (1.34, 1.18-1.52) and bullying in school or among peers (1.59, 1.37-1.89) were associated with an increased odds of chronic pain in midlife. Adjusting for father’s education, own education and marital status did not contribute to the associations. Working conditions, sleep problems and common mental disorders slightly attenuated the associations between childhood adversities and chronic pain.
Conclusions
Childhood adversities associate to chronic pain in midlife. The results suggest that promoting well-being among children might lead to less pain decades after childhood.
Key messages
Childhood adversities are associated with chronic pain in adulthood. Considering well-being among children might lead to less pain decades after childhood.
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Affiliation(s)
- A Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - T Lallukka
- Finnish Institute of Occupational Health, Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - E Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
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12
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Mauramo E, Salmela J, Kanerva N, Lahelma E, Lallukka T, Pietiläinen O, Rahkonen O, Salonsalmi A, Lahti J. Joint associations of fruit and vegetable consumption and physical activity with mortality risk. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Fruit and vegetable consumption (FVC) and leisure-time physical activity (LTPA) are associated with better health outcomes but less is known about their joint associations with the risk of mortality. We examined the joint associations of FVC and LTPA with premature mortality among midlife and ageing municipal employees, adjusting for key covariates.
Methods
Survey data collected in 2000–2002 among 40–60-year-old employees of the City of Helsinki, Finland, were linked with complete register data on mortality from Statistics Finland (4961 women, 1373 men; response rate 67%; written consent for register linkages 74%). FVC was dichotomised into daily or non-daily, and LTPA into high (>14 MET-hours/week including vigorous exercise) or low. Covariates included age, sex, marital status, socioeconomic position, binge drinking, smoking and self-rated health. Cox regression models were fitted. The follow-up continued until the event of death or the end of 2015.
Results
A total of 281 deaths occurred during the follow-up. The mortality rate was 7.1% in men and 3.7% in women. A gender interaction was found, showing differing associations for women and men. Men with both daily FVC and high LTPA had the lowest mortality risk (HR 0.19, 95% CI 0.06-0.63) after adjusting for covariates. Men with high LTPA and non-daily FVC also had a lower mortality risk (HR 0.51, 95% CI 0.29-0.90) compared to those with non-daily FVC and low LTPA. Women with daily FVC and high LTPA had a lower mortality risk initially, but after adjusting for covariates no statistically significant associations were observed.
Conclusions
The joint associations of FVC and LTPA with premature mortality differed between women and men. This could be related to gender differences in e.g. the causes of death, and further studies are needed to clarify this. Increasing FVC and LTPA might prevent premature mortality among men.
Key messages
Fruit and vegetable consumption jointly with physical activity decreased the risk of premature mortality among men only. Further studies are needed to clarify the gender difference which could be related to for example death causes.
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Affiliation(s)
- E Mauramo
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - J Salmela
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - N Kanerva
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - E Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - T Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - A Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - J Lahti
- Department of Public Health, University of Helsinki, Helsinki, Finland
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13
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Blomgren J, Jäppinen S, Pekkala J, Rahkonen O. Socioeconomic differences in paid sickness allowances in Finland. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Receipt of sickness allowance (SA), which in the Finnish benefit system functions as compensation for loss of income due to over 10-days-long sickness absence, is more prevalent in lower socioeconomic groups. As SA is an earnings-related benefit and higher occupational classes have on average higher previous income, their share of SA expenditure must be higher than their share of SA days would suggest. However, the allocation of SA costs to different socioeconomic groups is not known. The aim of this study was to compare occupational classes in terms of their shares of total paid SA days and SA benefit costs.
Methods
We used register data covering the total working-age (16-64) employed population of Finland at the end of 2016 (N = 2.2 million), with linked data on paid sickness allowances during 2017. Yearly accumulated sickness allowance days and allowance costs, paid by the Social Insurance Institution of Finland, were calculated for upper and lower non-manual employees, manual workers and self-employed persons.
Results
Of the total yearly SA days of the employed population, 13% were paid to upper non-manual employees, 40% to lower non-manual employees, 37% to manual workers and 10% to the self-employed (the respective shares of these occupational classes of the employed population were 23%, 36%, 30% and 11 %). The average gross allowance was 77€ per day among upper non-manuals and between 54€ and 60€ in the other groups. Accordingly, upper non-manuals accounted for a larger share of the SA costs compared to their share of SA days: the proportions of costs were 16%, 39%, 36% and 9% in each occupational class, respectively.
Conclusions
The results show that as the average amount of daily sickness allowance is distributed in an opposite manner compared to the prevalence and length of sickness allowance spells, socioeconomic differences in sickness allowance costs are smaller than differences in the prevalence of sickness allowance.
Key messages
Upper non-manual employees have a lower prevalence of sickness absence and shorter spells than other occupational groups. Because of higher earnings-related sickness allowance among upper non-manual employees, their share of sickness allowance costs is higher than their share of sickness allowance days.
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Affiliation(s)
- J Blomgren
- Research Unit, The Social Insurance Institution of Finland, Helsinki, Finland
| | - S Jäppinen
- Research Unit, The Social Insurance Institution of Finland, Helsinki, Finland
| | - J Pekkala
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
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14
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Neupane S, Lallukka T, Pietiläinen O, Rahkonen O, Leino-Arjas P. Trajectories of musculoskeletal pain among midlife employees. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
We examined the developmental trajectories of multisite musculoskeletal pain to acquire the developmental patterns of musculoskeletal pain among midlife municipal employees and whether pain trajectories associate with common mental disorders or behaviors.
Methods
Middle-aged (44 to 67 years) municipal employees from the city of Helsinki were studied. The baseline survey was conducted in 2000-02 (N = 8960) and two follow-up surveys in 2007 (N = 7332) and 2012 (N = 6809). Repeated measurement of musculoskeletal pain in four anatomical sites was obtained. Trajectories of number of pain sites (0-4) were modeled using latent class growth analysis (n = 6527). Common mental disorders were measured using the General Health Questionnaire 12-item version (GHQ-12). Information on behavior factors, morbidity, and the socioeconomic position was obtained from the questionnaire survey. Associations of baseline factors with pain trajectories were assessed by multinomial logistic regression.
Results
We found four distinct trajectories of the number of pain sites: high (15%), increasing (24%), decreasing (20%) and low (41%). In multivariable multinomial regression model high, increasing and decreasing trajectories were strongly associated with higher odds with both medium and high common mental disorders. However, the magnitude of the association was much higher for high vs. low trajectory group due to medium (OR 3.70, 95% CI 2.81-4.89) and high (OR 5.37, 95% 4.36-6.61) common mental disorders. Mean score of common mental disorders was also highest for high trajectory group. High, increasing and decreasing trajectory group were also associated with poor behavior, having one or more musculoskeletal comorbidities and low socioeconomic position.
Conclusions
Multisite musculoskeletal pain remain persistent among midlife employees and those high trajectories of musculoskeletal pain are associated with common mental disorders, behavior, and musculoskeletal comorbidities.
Key messages
Four distinct trajectories of number of pain sites was identified among midlife municipal employees. High common mental disorders and poor behavior, as well as low socioeconomic position and musculoskeletal comorbidities were strongly associated with pain trajectories.
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Affiliation(s)
- S Neupane
- Unit of Health Sciences, Tampere University, Tampere, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - T Lallukka
- Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - P Leino-Arjas
- Finnish Institute of Occupational Health, Helsinki, Finland
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15
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Lallukka T, Kronholm E, Pekkala J, Jäppinen S, Blomgren J, Pietiläinen O, Lahelma E, Rahkonen O. Work participation trajectories in 1098748 Finns: determinants and the incidence of sickness absence. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Early exit from paid employment is a notable public health and societal challenge. Previous research has largely focused on the relationships among variables instead of the relationships among individuals with different work participation history. Person-oriented methods enable to identify latent groups of individuals who are likely to follow similar development in their work participation over time. We thus aimed to identify work participation trajectories during early and midlife careers and their social determinants. A further aim was to determine the cumulative incidence of sickness absence due to key diagnostic groups, mental disorders and musculoskeletal diseases within the trajectories.
Methods
Young (25-38 years at baseline, n = 495663) and midlife (39-52 years at baseline, n = 603085) Finnish people, working in 2004, were followed up through 2013, with registers of the Social Insurance Institution, and the Statistics Finland. The registers provided data for the outcome (work participation) and its determinants and sickness absence. Latent class growth analysis was used to identify trajectories.
Results
Three distinctive trajectories were identified: temporary exit, permanent exit, and continuously employed people. As compared to the other trajectories, those belonging to the permanent exit trajectory were more likely men, manual workers and had a lower income. The cumulative incidence of sickness absence due to mental disorders was highest in the permanent exit trajectory group. For musculoskeletal diseases, the cumulative incidence of sickness absence increased in the permanent exit trajectory mainly in the older age groups.
Conclusions
Distinct group-based trajectories of early work exit can be identified in a representative cohort of initially employed people. Focusing on the determinants of premature exit and early intervention to tackle increasing sickness absence may promote work participation particularly in the most vulnerable groups.
Key messages
Distinct trajectories of premature exit from paid employment can be identified in a nationally representative cohort of initially employed people from Finland. Focusing on the determinants and reasons of premature long-term labor market exit may help promote work participation particularly in the most vulnerable groups.
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Affiliation(s)
- T Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - E Kronholm
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - J Pekkala
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - S Jäppinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
- The Social Insurance Institution of Finland (Kela), Helsinki, Finland
| | - J Blomgren
- The Social Insurance Institution of Finland (Kela), Helsinki, Finland
| | - O Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - E Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
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16
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Lahelma E, Pietiläinen O, Pentala-Nikulainen O, Helakorpi S, Rahkonen O. Monitoring inequalities in self-rated health over 36 years among Finnish women and men. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Health inequalities across countries and populations are well established, 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 adult Finns, considering individual covariates and macro-economic fluctuations.
Methods
Data were derived from representative annual surveys in 1979-2014 among men and women and covered ages 25-64. Nine periods were used (n = 8870-14235). Our health outcome was less-than-good self-rated health and our socioeconomic indicator was completed years of education as a continuous variable. Nine time-variant sociodemographic and health-related covariates were included. Educational inequalities in self-rated health were examined by relative index of inequality (RII) and slope index of inequality (SII).
Results
Linear trends suggested stable overall development in both relative and absolute health equalities during 36 years. Period specific analyses showed that among men relative and absolute inequalities narrowed immediately after economic recession in Finland in 1993-94, and among women, inequalities narrowed during global financial crisis in 2008-09. Adjusting for covariates reduced the magnitude of inequalities throughout the nine periods, but affected little the period specific patterning of health inequalities.
Conclusions
Educational inequalities in self-rated health persisted 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 calls for powerful measures to tackle health inequalities, such as preventing unhealthy behaviours, obesity and unemployment in particular among the lower educated.
Key messages
Health inequalities have persisted in Finland over 36 years, with unhealthy behaviors and unemployment affecting their magnitude. Health inequalities narrowed during economic recessions, but widened soon back to pre-recession level.
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Affiliation(s)
- E Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - S Helakorpi
- National Institute for Health and Welfare, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
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17
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Salonsalmi A, Pietiläinen O, Lahelma E, Rahkonen O. Childhood conditions and midlife disability retirement due to mental disorders. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - E Lahelma
- University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- University of Helsinki, Helsinki, Finland
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18
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Kronholm E, Marshall N, Mänty M, Lahti J, Lahelma E, Rahkonen O, Lallukka T. Sleep, functioning and premature exit from labour market: repeated measures latent class analysis. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E Kronholm
- Finnish Institute of Occupational Health, Turku, Finland
| | | | - M Mänty
- Laurea University of Applied Sciences, Vantaa, Finland
- University of Helsinki, Helsinki, Finland
| | - J Lahti
- University of Helsinki, Helsinki, Finland
| | - E Lahelma
- University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- University of Helsinki, Helsinki, Finland
| | - T Lallukka
- Finnish Institute of Occupational Health, Turku, Finland
- University of Helsinki, Helsinki, Finland
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19
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Holstila A, Lahti J, Salonsalmi A, Lahelma E, Rahkonen O. Changes in alcohol drinking before and after the statutory retirement: a longitudinal cohort study. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Holstila
- Department of Public Health, Helsinki, Finland
| | - J Lahti
- Department of Public Health, Helsinki, Finland
| | | | - E Lahelma
- Department of Public Health, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, Helsinki, Finland
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20
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Svärd A, Pipping H, Lahti J, Mänty M, Rahkonen O, Lahelma E, Lallukka T. Joint association of overweight and common mental disorders with disability retirement in Finland. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | - M Mänty
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Laurea University of Applied Sciences, Vantaa, Finland
| | - O Rahkonen
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - E Lahelma
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - T Lallukka
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
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21
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Pietiläinen O, Roos E, Roos T, Rahkonen O, Heikkinen S, Seppä K, Ryynänen H, Pietkäniemi J. Interactions of smoking, alcohol use, overweight and physical inactivity as predictors of cancer. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- O Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - E Roos
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - T Roos
- Department of Computer Science, University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - K Seppä
- Finnish Cancer Registry, Helsinki, Finland
| | - H Ryynänen
- Finnish Cancer Registry, Helsinki, Finland
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22
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Uusitalo L, Erkkola M, Lintonen T, Rahkonen O, Nevalainen J. What’s in a shopping basket? Alcohol and grocery purchases among Finnish loyalty-card holders. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L Uusitalo
- University of Helsinki, Helsinki, Finland
| | - M Erkkola
- University of Helsinki, Helsinki, Finland
| | - T Lintonen
- University of Tampere, The Finnish Foundation for Alcohol Studies, Tampere, Finland
| | - O Rahkonen
- University of Helsinki, Helsinki, Finland
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23
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Pekkala J, Suur-Uski J, Blomgren J, Pietiläinen O, Rahkonen O, Mänty M. Sickness absence due to breast cancer by occupational class among Finnish women during 2005–2013. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J Pekkala
- University of Helsinki, Helsinki, Finland
| | | | - J Blomgren
- The Social Insurance Institution of Finland, Helsinki, Finland
| | | | - O Rahkonen
- University of Helsinki, Helsinki, Finland
| | - M Mänty
- University of Helsinki, Helsinki, Finland
- Laurea University of Applied Sciences, Vantaa, Finland
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24
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Lahti J, Kanerva N, Haaramo P, Pietiläinen O, Lahelma E, Rahkonen O, Mänty M. Healthy behaviours and health functioning: a follow-up study among middle-aged employees. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J Lahti
- University of Helsinki, Helsinki, Finland
| | - N Kanerva
- University of Helsinki, Helsinki, Finland
| | - P Haaramo
- National Institute for Health and Welfare, Helsinki, Finland
| | | | - E Lahelma
- University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- University of Helsinki, Helsinki, Finland
| | - M Mänty
- University of Helsinki, Helsinki, Finland
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25
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Jäppinen S, Blomgren J, Pekkala J, Pietiläinen O, Lahelma E, Rahkonen O. Gender differences in diagnosis-specific sickness absence in middle-aged Finnish working population. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Jäppinen
- University of Helsinki, Helsinki, Finland
| | - J Blomgren
- The Social Insurance Institution of Finland, Helsinki, Finland
| | - J Pekkala
- University of Helsinki, Helsinki, Finland
| | | | - E Lahelma
- University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- University of Helsinki, Helsinki, Finland
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26
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Pekkala J, Rahkonen O, Pietiläinen O, Lahelma E, Blomgren J. Sickness absence due to musculoskeletal diagnoses by occupational class in Finland: a register study. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Pekkala
- University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- University of Helsinki, Helsinki, Finland
| | | | - E Lahelma
- University of Helsinki, Helsinki, Finland
| | - J Blomgren
- The Social Insurance Institution of Finland, Helsinki, Finland
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27
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Lahti J, Mänty M, Roos E, Rahkonen O, Lahelma E, Lallukka T, Svärd A. Weight gain and subsequent diagnosis-specific sickness absence: A register-linked follow-up study. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Lahti
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - M Mänty
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - E Roos
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - E Lahelma
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - T Lallukka
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - A Svärd
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Lallukka T, Lahelma E, Rahkonen O, Mauramo E. Common mental disorders and sickness absence: a register-linkage study among Finnish employees. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Lallukka
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - E Lahelma
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - E Mauramo
- Department of Public Health, University of Helsinki, Helsinki, Finland
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29
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Lahelma E, Pietiläinen O, Rahkonen O, Chandola T, Hyde M, Lallukka T. Occupational class trajectories in physical health functioning among ageing female employees. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw169.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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30
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Sumanen H, Pietiläinen O, Lahelma E, Rahkonen O. Short sickness absence spells and long mental sickness absence in 10-year follow-up. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw175.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Pekkala J, Blomgren J, Pietiläinen O, Lahelma E, Rahkonen O. Occupational class differences in sickness absence: a register study of 2.3 million Finns, 1995-2013. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw165.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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32
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Piha K, Lahelma E, Rahkonen O. Socio-economic position, surgical operations, and disability pension due to musculoskeletal disease. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw172.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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33
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Lahti J, Holstila A, Lahelma E, Mänty M, Rahkonen O. Changes in educational differences in leisure-time physical activity – A 12 year follow-up study. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw170.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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34
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Salonsalmi A, Rahkonen O, Lahelma E, Lahti J. Drinking habits and subsequent antidepressant medication among middle-aged employees. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw172.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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35
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Holstila A, Mänty M, Rahkonen O, Lahelma E, Lahti J. Changes in leisure-time physical activity and physical and mental health functioning: a follow-up study. Scand J Med Sci Sports 2016; 27:1785-1792. [DOI: 10.1111/sms.12758] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2016] [Indexed: 12/23/2022]
Affiliation(s)
- A. Holstila
- Department of Public Health; University of Helsinki; Helsinki Finland
| | - M. Mänty
- Department of Public Health; University of Helsinki; Helsinki Finland
| | - O. Rahkonen
- Department of Public Health; University of Helsinki; Helsinki Finland
| | - E. Lahelma
- Department of Public Health; University of Helsinki; Helsinki Finland
| | - J. Lahti
- Department of Public Health; University of Helsinki; Helsinki Finland
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Sumanen H, Rahkonen O, Pietiläinen O, Lahelma E, Roos E, Lahti J. Educational differences in disability retirement among young employees. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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37
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Lahti J, Lahelma E, Rahkonen O. Changes in physical activity and subsequent mental disorders among aging Finnish employees 2000–2012. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv174.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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38
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Lahelma E, Pietiläinen O, Rahkonen O, Lahti J, Lallukka T. Common mental disorders and cause-specific mortality among ageing employees. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv171.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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39
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Svärd A, Lahti J, Mänty M, Roos E, Rahkonen O, Lahelma E, Lallukka T. Weight gain and subsequent physical and mental health functioning: a follow-up study among employees. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv172.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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40
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Lallukka T, Podlipskytė A, Sivertsen B, Andruskienė J, Varoneckas G, Lahelma E, Ursin R, Tell GS, Rahkonen O. Insomnia and mortality: a register-linked study among Finnish, Norwegian and Lithuanian women and men. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv168.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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41
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Piha K, Lahelma E, Rahkonen O. Attending to health check-ups and medically certified sickness absence in 10 year follow-up. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv173.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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42
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Holstila A, Mänt M, Rahkonen O, Lahelma E, Lahti J. Changes in physical activity and subsequent changes in health related functioning. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv173.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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43
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Mänty M, Kouvonen A, Lallukka T, Lahti J, Lahelma E, Rahkonen O. Changes in working conditions and physical functioning in ageing employees in Finland. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv167.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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44
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Kaikkonen R, Härkänen T, Rahkonen O, Gould R, Koskinen S. Explaining socioeconomic inequalities in work-ability during the three decades. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv167.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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45
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Lallukka T, Pietiläinen O, Partonen T, Rahkonen O, Lahelma E. Psychotropic medication and mortality: a register-based study among Finnish women and men 1995–2013. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv174.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
OBJECTIVES Common mental disorders are prevalent among employees and may cause work disability. We aimed to examine the association between common mental disorders and disability retirement, with an emphasis on the severity of disorders and diagnostic causes for retirement. METHODS Our data were derived from the Helsinki Health Study cohort on the staff of the City of Helsinki, Finland. The baseline mail surveys were made in 2000-2002 among employees reaching ages 40, 45, 50, 55 and 60 in each year (n=8960, response rate 67%, 80% women). Disability retirement events from national registers (n=628) were followed up by the end of 2010 and linked to the baseline data. After exclusions, the number of participants was 6525. Common mental disorders were measured by the General Health Questionnaire 12-item version (GHQ-12). Covariates at baseline included sociodemographic, work-related and health-related factors. Hazard ratios (HR) and 95% CIs were calculated using Cox proportional hazards models. RESULTS Common mental disorders showed a graded association with disability retirement. For disability retirement due to any diagnostic cause, the fully adjusted HR for the GHQ-12 score 7-12 was 2.16, 95% CI 1.63 to 2.85. For disability retirement due to mental disorders the corresponding HR was 7.46, 95% CI 4.46 to 12.49. For disability retirement due to musculoskeletal diseases, the association was weaker and did not survive all adjustments. CONCLUSIONS Common mental disorders are an important antecedent of disability retirement in general and due to mental disorders in particular. Successful measures against common mental disorders may prevent disability retirement due to mental disorders.
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Affiliation(s)
- E Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - T Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland Finnish Institute of Occupational Health, Helsinki, Finland
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Lahelma E, Pietiläinen O, Ferrie J, Kivimäki M, Lahti J, Marmot M, Rahkonen O, Sekine M, Shipley M, Tatsuse T, Lallukka T. Changes over time in social class differences in smoking among employee cohorts from Britain, Finland and Japan. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku163.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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48
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Holstila A, Lahti J, Rahkonen O, Lahelma E. Changes in physical activity and subsequent long-term sickness absence. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku166.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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49
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Lahti J, Holstila AL, Lahelma E, Rahkonen O. Changes in leisure-time physical activity and subsequent disability retirement. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku166.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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50
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Salonsalmi A, Rahkonen O, Lahelma E, Laaksonen M. Working conditions and subsequent drinking habits. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku164.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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