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Solovieva S, de Wind A, Undem K, Dudel C, Mehlum IS, van den Heuvel SG, Robroek SJW, Leinonen T. Socioeconomic differences in working life expectancy: a scoping review. BMC Public Health 2024; 24:735. [PMID: 38454363 PMCID: PMC10921693 DOI: 10.1186/s12889-024-18229-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/28/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND In the last decade, interest in working life expectancy (WLE) and socioeconomic differences in WLE has grown considerably. However, a comprehensive overview of the socioeconomic differences in WLE is lacking. The aim of this review is to systematically map the research literature to improve the insight on differences in WLE and healthy WLE (HWLE) by education, occupational class and income while using different ways of measuring and estimating WLE and to define future research needs. METHODS A systematic search was carried out in Web of Science, PubMed and EMBASE and complemented by relevant publications derived through screening of reference lists of the identified publications and expert knowledge. Reports on differences in WLE or HWLE by education, occupational class or income, published until November 2022, were included. Information on socioeconomic differences in WLE and HWLE was synthesized in absolute and relative terms. RESULTS A total of 26 reports from 21 studies on educational and occupational class differences in WLE or HWLE were included. No reports on income differences were found. On average, WLE in persons with low education is 30% (men) and 27% (women) shorter than in those with high education. The corresponding numbers for occupational class difference were 21% (men) and 27% (women). Low-educated persons were expected to lose more working years due to unemployment and disability retirement than high-educated persons. CONCLUSIONS The identified socioeconomic inequalities are highly relevant for policy makers and pose serious challenges for equitable pension policies. Many policy interventions aimed at increasing the length of working life follow a one-size-fits-all approach which does not take these inequalities into account. More research is needed on socioeconomic differences in HWLE and potential influences of income on working life duration.
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Affiliation(s)
- Svetlana Solovieva
- Finnish Institute of Occupational Health, P.O. Box 40, Työterveyslaitos, Helsinki, 00032, Finland.
| | - Astrid de Wind
- Amsterdam UMC location University of Amsterdam, Public and Occupational Health, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Societal Participation and Health, Amsterdam, The Netherlands
| | - Karina Undem
- National Institute of Occupational Health, Oslo, Norway
| | - Christian Dudel
- Max Planck Institute for Demographic Research, Rostock, Germany
- Federal Institute for Population Research, Wiesbaden, Germany
- Max Planck - University of Helsinki Center for Social Inequalities in Population Health, Rostock, Germany
- Max Planck - University of Helsinki Center for Social Inequalities in Population Health, Helsinki, Finland
| | - Ingrid S Mehlum
- National Institute of Occupational Health, Oslo, Norway
- Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospitals, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Taina Leinonen
- Finnish Institute of Occupational Health, P.O. Box 40, Työterveyslaitos, Helsinki, 00032, Finland
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Haider W, Salonen L. Disability pension and sociodemographic & work-related risk factors among 2.3 million migrants and natives in Finland (2011-2019): a prospective population study. BMC Public Health 2023; 23:1977. [PMID: 37821921 PMCID: PMC10568789 DOI: 10.1186/s12889-023-16880-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Increasing employment and immigration have been proposed as possible solutions to tackle the problem of the labour force shortage in aging societies. Ensuring sufficient health and work ability among migrants is a key factor in increasing and maintaining their employment. Many studies have found higher disability pension (DP) rates among migrants compared to natives but such studies lack in determining the risk of DP by occupational class and industrial sector. This study explores the risk of DP and the contribution of sociodemographic and work-related factors between migrants and natives in Finland. METHODS Full-population panel data obtained from the administrative registers of Statistics Finland were used to study 2.3 million individuals aged 25-60 years in 2010. We calculated hazard ratios (HR) and their 95% confidence intervals (CI) to estimate the risk of having a DP in 2011-2019 using Cox proportional hazard models adjusting for different sociodemographic and work-related factors. RESULTS Compared to natives, migrants had a lower risk of a DP (HR 0.58, 95% CI 0.53-0.63). We found great variation between countries of origin, where compared to natives, migrants from refugee-exporting countries (HR 1.37, 95% CI 1.22-1.53) and other non-European countries (HR 1.30; CI 1.18-1.43) had a higher risk of DP, but migrants from other countries did not differ or had a slightly lower risk of DP than natives. The associations between sociodemographic factors and the risk of DP were very similar between natives and migrants. CONCLUSION Migrants had a lower risk of a DP than natives except for migrants from outside Europe. The associations between different sociodemographic and work-related factors and the risk of DP were similar between natives and migrants and did not completely explain the differences in the risk of DP.
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Affiliation(s)
| | - Laura Salonen
- Finnish Institute of Occupational Health & University of Turku, Turku, Finland
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Nakazawa S, Fukai K, Furuya Y, Hoshi K, Kojimahara N, Toyota A, Korenaga M, Tatemichi M. Occupational class and risk of hepatitis B and C viral infections: A case-control study-based data from a nationwide hospital group in Japan. J Infect Public Health 2022; 15:1415-1426. [PMID: 36395666 DOI: 10.1016/j.jiph.2022.11.005] [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: 09/02/2022] [Revised: 10/26/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Occupational class, a proxy for socio-economic status, is a known factor for health disparities. However, no study has reported the association between occupational class and the risk of viral hepatitis B and C (HBV/HCV) infections. We investigated the effects of occupational class on the prevalence of HBV/HCV infections. METHODS This is an unmatched hospital-based case-control study that included 12,101 patients who were diagnosed with HBV infection (ICD-10, B16.0, B16.1, B16.2, B16.9, B17.0, B18.0, B18.1) or HCV infection (ICD-10, B17.1, B18.2) and 698,168 controls (those with non-HBV/HCV-related diseases) aged ≥ 20 years who were initially hospitalized between 2005 and 2019. Patients were categorized according to occupational class (blue-collar, service, professional, and manager) and industrial sector (blue-collar, service, and white-collar). Managers in the blue-collar industry were set as the reference group, and the odds ratios (ORs) for the risk of HBV and HCV infections were calculated. RESULTS Occupational class was significantly associated with only HCV infection risk. Professionals in all industrial sectors showed the lowest risk for HCV (OR (95% confidence intervals [CIs]) = 0.69 [0.58-0.82] in the blue-collar industry, 0.52 [0.38-0.73] in the service industry, and 0.60 [0.52-0.70] in the white-collar industry). Further, after adjusting for sex, age, and region of admitting hospital, all occupational classes in the white-collar industry showed lower risks of HCV than those in the other industries (ORs= 0.58 [0.47-0.71] in blue-collar workers, 0.74 [0.64-0.84] in service workers, 0.60 [0.52-0.70] in professionals, and 0.81 [0.64-1.02] in managers in white-collar industry). CONCLUSIONS Occupational class was closely associated with HCV infection risk only. Considering that blue-collar workers in the white-collar industry also showed a low risk, adequate measures should be taken against hepatitis, possibly because of the screening tests and cure implemented in that population.
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Affiliation(s)
- Shoko Nakazawa
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Kota Fukai
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan.
| | - Yuko Furuya
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Keika Hoshi
- Center for Public Health Informatics, National Institute of Public Health, Wako, Japan; Department of Hygiene, School of Medicine, Kitasato University, Sagamihara, Japan
| | - Noriko Kojimahara
- Department of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Akihiro Toyota
- Chugoku Rosai Hospital Research Center for the Promotion of Health and Employment Support, Japan Organization of Occupational Health and Safety, Hiroshima, Japan
| | - Masaaki Korenaga
- Hepatitis Information Centre, Research Centre for Hepatitis and Immunology, National Centre for Global Health and Medicine, Ichikawa, Japan
| | - Masayuki Tatemichi
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan
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Björkenstam E, Helgesson M, Gustafsson K, Virtanen M, Hanson LLM, Mittendorfer-Rutz E. Sickness absence due to common mental disorders in young employees in Sweden: are there differences in occupational class and employment sector? Soc Psychiatry Psychiatr Epidemiol 2022; 57:1097-106. [PMID: 34386867 DOI: 10.1007/s00127-021-02152-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 07/30/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND A large proportion of sickness absence (SA) in young adults is due to common mental disorders (CMDs). Still studies on CMD-related SA in young workers are lacking, especially studies for those employed in the private sector. The current study investigated the associations between sector of employment, occupational class and SA due to CMDs. In addition, associations between type of employment branch and SA due CMDs within each sector were examined. METHODS This population-based longitudinal cohort study included 663,583 employees, 19-29 years, residing in Sweden in 2009. Employment sector (i.e., private/public) and occupational class (non-manual/manual workers) were measured in 2009. Risk estimates of SA due to CMDs, between 2010 and 2016, were calculated as Hazard Ratios (HR) with 95% confidence intervals (CI), using Cox regression analysis. RESULTS Sector of employment was associated with SA due to CMDs, such that public sector workers had an elevated risk when compared with private sector employees (adjusted HR: 1.31 (95% CI 1.29-1.33). Moreover, manual workers had a slightly elevated risk for SA due to CMDs compared to non-manual workers. Within the private sector, in both manual and non-manual workers, those employed in education and health and social services evidenced the highest rates and risks of SA due to CMDs. CONCLUSION Sector of employment and occupational class play a role in SA due to CMDs in young employees. These findings should be considered when identifying high-risk groups for SA in the young working population.
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Björkenstam E, Helgesson M, Mittendorfer-Rutz E. Childhood adversity and common mental disorders in young employees in Sweden: is the association affected by early adulthood occupational class? Soc Psychiatry Psychiatr Epidemiol 2021; 56:237-246. [PMID: 32405790 PMCID: PMC7870617 DOI: 10.1007/s00127-020-01874-0] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 05/02/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Childhood adversities are associated with an elevated risk for common mental disorders (CMDs). Whether the strength of the association also holds for young employees is unclear. Given the increase in CMD rates in young adults over the past decade, identification of risk factors has important implications for future public health interventions. The current study aimed to investigate the effects of childhood adversities on CMDs. Additionally, the role of occupational class (non-manual/manual workers) in the relationship was examined. METHODS This population-based longitudinal cohort study included 544,003 employees, 19-29 years, residing in Sweden in 2009. Adversities included parental death, parental mental and somatic disorders, parental separation or single-parent household, household public assistance and residential instability. Estimates of risk of CMDs, measured as prescription of antidepressants and/or psychiatric care with a clinical diagnosis of CMDs, between 2010 and 2016 were calculated as relative risks (RR) with 95% confidence intervals (CI), using a modified Poisson regression analysis. Occupational class (non-manual/manual workers) was explored as a potential moderator. RESULTS In both manual and non-manual workers, childhood adversities were associated with an elevated risk of subsequent CMDs. The risk was moderated by occupational class, i.e., especially pronounced risk was found in manual workers who had experienced cumulative adversity (adjusted RR 1.76, 95% CI 1.70-1.83) when compared to non-manual workers with no adversity. Among the adversities examined, having had a parent treated for a mental disorder, having grown up in a household living on public assistance or having experienced residential instability were the strongest predictors of CMDs. CONCLUSION Our findings suggest that, among young employees, manual workers with a history of multiple childhood adversities are especially vulnerable to subsequent CMDs.
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Affiliation(s)
- Emma Björkenstam
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
- Department of Community Health Sciences, Fielding School of Public Health and California Center for Population Research, University of California Los Angeles, Los Angeles, CA, USA.
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.
| | - Magnus Helgesson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Ellenor Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
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Salonen L, Blomgren J, Laaksonen M. From long-term sickness absence to disability retirement: diagnostic and occupational class differences within the working-age Finnish population. BMC Public Health 2020; 20:1078. [PMID: 32641015 PMCID: PMC7346453 DOI: 10.1186/s12889-020-09158-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 06/22/2020] [Indexed: 11/10/2022] Open
Abstract
Background It is well documented that sickness absence is strongly associated with disability retirement. A long-term sickness absence (LTSA) in particular increases the risk of disability retirement, but little is known about the variation of this risk across diagnostic causes. Further, as occupational classes differ in their diagnostic profiles, it is likely that the role of diagnosis in the pathway from LTSA to disability retirement varies between occupational classes. We examined how LTSA of different diagnostic causes predicts all-cause disability retirement and disability retirement due to the same diagnostic group or due to some other diagnostic group than that which caused the LTSA spell in different occupational classes. Methods Cox proportional hazards models were used to analyse a 70% random sample of all employed Finns aged 25–62 Finns in 2006 (N = 1,458,288). Disability retirement was followed from 2007 to 2014. The risk of disability retirement was compared between occupational classes with at least one LTSA spell due to musculoskeletal diseases, mental disorders, respiratory diseases, or circulatory diseases and those who had no LTSA spells due to these diagnostic groups during 2005. Results Those who had LTSA due to musculoskeletal diseases or mental disorders transferred more often to disability retirement due to same diagnostic group, whereas those who had LTSA due to respiratory or circulatory diseases transferred more often to disability retirement due to some other diagnostic group. The largest occupational class differences in all-cause disability retirement were found among those with LTSA due to mental disorders. For men, the hazard ratios (HR) varied from HR 5.70 (95% confidence interval (CI) 5.00–6.52) in upper non-manual employees to 2.70 (95% CI 2.50–2.92) in manual workers. For women, the corresponding HRs were 3.74 (95% CI 3.37–4.14) in upper non-manual employees and 2.32 (95% 2.17–2.50) in manual workers. Conclusions The association between LTSA and disability retirement varies between diagnostic groups, and the strength of this association further depends on the person’s occupational class and gender.
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Affiliation(s)
- Laura Salonen
- Department of Social Research, University of Turku, Turku, Finland.
| | - Jenni Blomgren
- The Social Insurance Institution of Finland, Helsinki, Finland
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Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo 113-8602, Japan
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Pekkala J, Blomgren J, Pietiläinen O, Lahelma E, Rahkonen O. Occupational class differences in diagnostic-specific sickness absence: a register-based study in the Finnish population, 2005-2014. BMC Public Health 2017; 17:670. [PMID: 28830389 PMCID: PMC5568169 DOI: 10.1186/s12889-017-4674-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 08/08/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Musculoskeletal diseases and mental disorders are major causes of long-term sickness absence in Western countries. Although sickness absence is generally more common in lower occupational classes, little is known about class differences in diagnostic-specific absence over time. Focusing on Finland during 2005-2014, we therefore set out to examine the magnitude of and changes in absolute and relative occupational class differences in long-term sickness absence due to major diagnostic causes. METHODS A 70-per-cent random sample of Finns aged 25-64 linked to register data on medically certified sickness absence (of over 10 working days) in 2005-2014 was retrieved from the Social Insurance Institution of Finland. Information on occupational class was obtained from Statistics Finland and linked to the data. The study focused on female (n = 658,148-694,142) and male (n = 604,715-642,922) upper and lower non-manual employees and manual workers. The age-standardised prevalence, the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) were calculated for each study year to facilitate examination of the class differences. RESULTS The prevalence of each diagnostic cause of sickness absence declined during the study period, the most common causes being musculoskeletal diseases, mental disorders and injuries. The prevalence of other causes under scrutiny was less than 1 % annually. By far the largest absolute and relative differences were in musculoskeletal diseases among both women and men. Moreover, the absolute differences in both genders (p < 0.0001) and the relative differences in men (p < 0.0001) narrowed over time as the prevalence declined most among manual workers. Both genders showed modest and stable occupational class differences in mental disorders. In the case of injuries, no major changes occurred in absolute differences but relative differences narrowed over time in men (p < 0.0001) due to a strong decline in prevalence among manual workers. Class differences in the other studied diagnostic causes under scrutiny appeared negligible. CONCLUSIONS By far the largest occupational class differences in long-term sickness absence concerned musculoskeletal diseases, followed by injuries. The results highlight potential targets for preventive measures aimed at reducing sickness absence and narrowing class differences in the future.
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Affiliation(s)
- Johanna Pekkala
- Department of Public Health, University of Helsinki, P.O. Box 20 (Tukholmankatu 8B), 00014 Helsinki, Finland
| | - Jenni Blomgren
- The Social Insurance Institution of Finland, P.O. Box 450, (Nordenskiöldinkatu 12), FIN-00056 KELA, Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, P.O. Box 20 (Tukholmankatu 8B), 00014 Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, P.O. Box 20 (Tukholmankatu 8B), 00014 Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, P.O. Box 20 (Tukholmankatu 8B), 00014 Helsinki, Finland
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