| 1. |
- Agahi, Neda, et al.
(author)
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Heavy alcohol consumption before and after negative life events in late mid-life : longitudinal latent trajectory analyses
- 2022
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In: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 76:4, s. 360-366
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Journal article (peer-reviewed)abstract
- Background People who experience negative life events report more heavy alcohol consumption compared with people without these experiences, but little is known about patterns of change within this group. This study aims to identify trajectories of heavy alcohol consumption before and after experiencing either divorce, or severe illness or death in the family. Furthermore, the aim is to examine characteristics of individuals belonging to each trajectory.Methods Longitudinal study of public sector employees from the Finnish Retirement and Aging Study with up to 5 years of annual follow-ups (n=6783; eligible sample n=1393). Divorce and severe illness or death in the family represented negative life events. Heavy alcohol consumption was categorised as >14 units/week.Results Based on latent trajectory analysis, three trajectories of heavy drinking were identified both for divorce and for severe illness or death in the family: ‘No heavy drinking’ (82% illness/death, 75% divorce), ‘Constant heavy drinking’ (10% illness/death, 13% divorce) and ‘Decreasing heavy drinking’ (7% illness/death, 12% divorce). Constant heavy drinkers surrounding illness or death in the family were more likely to be men, report depression and anxiety and to smoke than those with no heavy drinking. Constant heavy drinkers surrounding divorce were also more likely to be men and to report depression compared with those with no heavy drinking.Conclusions Most older workers who experience divorce or severe illness or death in the family have stable drinking patterns regarding heavy alcohol consumption, that is, most do not initiate or stop heavy drinking.
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| 2. |
- Blodgett, Joanna M., et al.
(author)
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Device-measured physical activity and cardiometabolic health : the Prospective Physical Activity, Sitting, and Sleep (ProPASS) consortium
- 2023
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In: European Heart Journal. - 0195-668X .- 1522-9645.
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Journal article (peer-reviewed)abstract
- Background and Aims: Physical inactivity, sedentary behaviour (SB), and inadequate sleep are key behavioural risk factors of cardiometabolic diseases. Each behaviour is mainly considered in isolation, despite clear behavioural and biological interdependencies. The aim of this study was to investigate associations of five-part movement compositions with adiposity and cardiometabolic biomarkers.Methods: Cross-sectional data from six studies (n = 15 253 participants; five countries) from the Prospective Physical Activity, Sitting and Sleep consortium were analysed. Device-measured time spent in sleep, SB, standing, light-intensity physical activity (LIPA), and moderate-vigorous physical activity (MVPA) made up the composition. Outcomes included body mass index (BMI), waist circumference, HDL cholesterol, total:HDL cholesterol ratio, triglycerides, and glycated haemoglobin (HbA1c). Compositional linear regression examined associations between compositions and outcomes, including modelling time reallocation between behaviours.Results: The average daily composition of the sample (age: 53.7 ± 9.7 years; 54.7% female) was 7.7 h sleeping, 10.4 h sedentary, 3.1 h standing, 1.5 h LIPA, and 1.3 h MVPA. A greater MVPA proportion and smaller SB proportion were associated with better outcomes. Reallocating time from SB, standing, LIPA, or sleep into MVPA resulted in better scores across all outcomes. For example, replacing 30 min of SB, sleep, standing, or LIPA with MVPA was associated with −0.63 (95% confidence interval −0.48, −0.79), −0.43 (−0.25, −0.59), −0.40 (−0.25, −0.56), and −0.15 (0.05, −0.34) kg/m2 lower BMI, respectively. Greater relative standing time was beneficial, whereas sleep had a detrimental association when replacing LIPA/MVPA and positive association when replacing SB. The minimal displacement of any behaviour into MVPA for improved cardiometabolic health ranged from 3.8 (HbA1c) to 12.7 (triglycerides) min/day.Conclusions: Compositional data analyses revealed a distinct hierarchy of behaviours. Moderate-vigorous physical activity demonstrated the strongest, most time-efficient protective associations with cardiometabolic outcomes. Theoretical benefits from reallocating SB into sleep, standing, or LIPA required substantial changes in daily activity.
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| 3. |
- Clark, Alice, et al.
(author)
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Workplace discrimination as risk factor for long-term sickness absence : Longitudinal analyses of onset and changes in workplace adversity
- 2021
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 16:8
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Journal article (peer-reviewed)abstract
- Workplace discrimination may affect the health of the exposed employees, but it is not known whether workplace discrimination is also associated with an increased risk of long-term sickness absence. The aim of this study was to examine the longitudinal associations of changes in and onset of workplace discrimination with the risk of long-term sickness absence. Data on workplace discrimination were obtained from 29,597 employees participating in survey waves 2004, 2006, 2008 and/or 2010 of the Finnish Public Sector Study. Four-year changes in long-term sickness absence (>= 10 days of medically certified absence with a mental or non-mental diagnosis) were assessed. This covered successive study waves in analyses of onset of workplace discrimination as well as fixed effect analyses of change in workplace discrimination (concurrent i.e. during the exposure year and 1-year lagged i.e. within one year following exposure), by using each employee as his/her own control. The risk of long-term sickness absence due to mental disorders was greater for employees with vs. without onset of workplace discrimination throughout the 4-year period, reaching a peak at the year when the onset of discrimination was reported (adjusted risk ratio 2.13; 95% confidence interval (CI) 1.80-2.52). The fixed effects analyses showed that workplace discrimination was associated with higher odds of concurrent, but not 1-year lagged, long-term sickness absence due to mental disorders (adjusted odds ratio 1.61; 95% CI 1.33-1.96 and adjusted odds ratio 1.02; 95% CI 0.83-1.25, respectively). Long-term sickness absence due to non-mental conditions was not associated with workplace discrimination. In conclusion, these findings suggest that workplace discrimination is associated with an elevated risk of long-term sickness absence due to mental disorders. Supporting an acute effect, the excess risk was confined to the year when workplace discrimination occurred.
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| 4. |
- Fröberg, Andreas, 1985, et al.
(author)
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Changes in Accelerometer-Measured Physical Activity and Sedentary Time Across Retirement Transition as a Predictor of Self-Rated Health
- 2024
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In: Journal of Physical Activity and Health. - 1543-3080.
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Journal article (peer-reviewed)abstract
- Background: Retirement transition has shown to associate with changes in physical activity (PA) and self-rated health (SRH), but their interrelationship is less studied. The aim was to investigate changes in accelerometer measured total PA, moderate-to-vigorous PA (MVPA) and sedentary time across retirement transition as a predictor of self-rated health. Methods: Data from the Swedish Retirement Study and the Finnish Retirement and Aging study was harmonized and pooled. Data from three waves (about 12 months apart) was included: one pre-retirement (wave 1) and two post-retirement follow-ups (wave 2-3). Totally 245 participants (27% men) were included. Thigh-worn accelerometers were used to collect data for PA variables (wave 1-2), and SRH was obtained from the questionnaire (wave 1-3). Results: Between wave 1 and 2, total PA decreased with 11 (CI:-22;-1) minutes per day, MVPA was stable (0 [CI:-3;3] min), and sedentary time decreased non-significantly with 9 (CI:-20;1) minutes. SRH changed between all three waves (all, p<0.001). At pre-retirement, 10 more minutes of MVPA was associated with greater odds of better SRH when adjusting for accelerometer wear-time, cohort, sex and age, and occupational status (OR:1.11 (95%CI:1.02-1.22)). This association was no longer statistically significant when additionally adjusting for marital status, BMI, and smoking. No significant associations were observed between changes in the PA variables during retirement transition, and SRH at post-retirement follow-ups. Conclusion: This study showed a cross-sectional association between MVPA and greater odds of reporting better SRH before retirement. No longitudinal associations were observed between changes in the PA variables from before to after retirement and later change in SRH
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| 5. |
- Halonen, Jaana I., et al.
(author)
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Commuting time to work and behaviour-related health : a fixed-effect analysis
- 2020
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In: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 77:2, s. 77-83
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Journal article (peer-reviewed)abstract
- Objectives: Long commuting times are linked to poor health outcomes, but the evidence is mainly cross-sectional. We examined longitudinal within-individual associations between commuting time and behaviour-related health.Methods: Data were from the Swedish Longitudinal Occupational Survey of Health study. We selected workers who responded to a minimum of two surveys conducted every other year between 2008 and 2018. We included all study waves with self-reported commuting time (ie, the exposure, 1–5, 6–10, 11–15 or ≥15 hours/week), body mass index (based on weight and height), physical (in)activity, smoking, alcohol use and sleep problems (ie, the outcomes) (Nindividuals=20 376, Nobservations=46 169). We used conditional logistic regression for fixed effects analyses that controls for time-varying confounders by design. Analyses were stratified by working hours: normal (30–40 hours/week) or longer than normal (>40 hours/week) and adjusted for time dependent covariates: age, marital status, occupational position, presence of children, chronic disease, depressive symptoms, job strain and shift work.Results: Those working >40 hours/week had higher odds of physical inactivity (OR 1.25, 95% CI 1.03 to 1.51) and sleep problems (OR 1.16, 95% CI 1.00 to 1.35) when they were commuting >5 hours/week than when they were commuting 1–5 hours/week. Among women working normal hours, longer commuting time associated with lower odds of problem drinking.Conclusion: Our findings suggest that lengthy commuting time increases the risk of physical inactivity and sleep problems if individuals have longer than normal weekly working hours. Effects of work arrangements that decrease commuting time should be examined in relation to health behaviours.
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| 6. |
- Halonen, Jaana, et al.
(author)
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Psychotropic medication before and after disability retirement by pre-retirement perceived work-related stress
- 2020
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In: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 30:1, s. 158-163
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Journal article (peer-reviewed)abstract
- Background: Retirement has been associated with improved mental health, but it is unclear how much this is due to the removal of work-related stressors. We examined rates of psychotropic medication use before and after the transition to disability retirement due to mental, musculoskeletal and other causes by pre-retirement levels of perceived work stress (effort-reward imbalance, ERI). Methods: Register-based date and diagnosis of disability retirement of 2766 participants of the Finnish Public Sector study cohort were linked to survey data on ERI, socialand health-related covariates, and to national records on prescribed reimbursed psychotropic medication, measured as defined daily doses (DDDs). Follow-up for DDDs was 2–5 years before and after disability retirement. We assessed differences in the levels of DDDs before and after retirement among those with high vs. low level of pre-retirement ERI with repeated measures regression. Results: Those with high (vs. low) levels of ERI used slightly more psychotropic medication before disability retirement due to mental disorders [rate ratio (RR) 1.14, 95% confidence intervals (CI) 0.94–1.37], but after retirement this difference attenuated (RR 0.94, 95% CI 0.80–1.10, P for interaction 0.02). Such a change was not observed for the other causes of disability retirement. Conclusions: The level of psychotropic medication use over the transition to disability retirement due to mental, but not musculoskeletal or other, causes was modified by pre-retirement perceived work-related stress. This suggests that among people retiring due to mental disorders those who had stressful jobs benefit from retirement more than those with low levels of work-related stress.
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| 7. |
- Head, Jenny, et al.
(author)
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Socioeconomic differences in healthy and disease-free life expectancy between ages 50 and 75 : a multi-cohort study
- 2019
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In: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 29:2, s. 267-272
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Journal article (peer-reviewed)abstract
- Background: There are striking socioeconomic differences in life expectancy, but less is known about inequalities in healthy life expectancy and disease-free life expectancy. We estimated socioeconomic differences in health expectancies in four studies in England, Finland, France and Sweden. Methods: We estimated socioeconomic differences in health expectancies using data drawn from repeated waves of the four cohorts for two indicators: (i) self-rated health and (ii) chronic diseases (cardiovascular, cancer, respiratory and diabetes). Socioeconomic position was measured by occupational position. Multistate life table models were used to estimate healthy and chronic disease-free life expectancy from ages 50 to 75. Results: In all cohorts, we found inequalities in healthy life expectancy according to socioeconomic position. In England, both women and men in the higher positions could expect 82-83% of their life between ages 50 and 75 to be in good health compared to 68% for those in lower positions. The figures were 75% compared to 47-50% for Finland; 85-87% compared to 77-79% for France and 80-83% compared to 72-75% for Sweden. Those in higher occupational positions could expect more years in good health (2.1-6.8 years) and without chronic diseases (0.5-2.3 years) from ages 50 to 75. Conclusion: There are inequalities in healthy life expectancy between ages 50 and 75 according to occupational position. These results suggest that reducing socioeconomic inequalities would make an important contribution to extending healthy life expectancy and disease-free life expectancy.
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| 8. |
- Kivimäki, Mika, et al.
(author)
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Association between socioeconomic status and the development of mental and physical health conditions in adulthood : a multi-cohort study
- 2020
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In: The Lancet Public Health. - : Elsevier. - 2468-2667. ; 5:3, s. e140-e149
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Journal article (peer-reviewed)abstract
- Background: Socioeconomic disadvantage is a risk factor for many diseases. We characterised cascades of these conditions by using a data-driven approach to examine the association between socioeconomic status and temporal sequences in the development of 56 common diseases and health conditions. Methods: In this multi-cohort study, we used data from two Finnish prospective cohort studies: the Health and Social Support study and the Finnish Public Sector study. Our pooled prospective primary analysis data comprised 109 246 Finnish adults aged 17–77 years at study entry. We captured socioeconomic status using area deprivation and education at baseline (1998–2013). Participants were followed up for health conditions diagnosed according to the WHO International Classification of Diseases until 2016 using linkage to national health records. We tested the generalisability of our findings with an independent UK cohort study—the Whitehall II study (9838 people, baseline in 1997, follow-up to 2017)—using a further socioeconomic status indicator, occupational position. Findings: During 1 110 831 person-years at risk, we recorded 245 573 hospitalisations in the Finnish cohorts; the corresponding numbers in the UK study were 60 946 hospitalisations in 186 572 person-years. Across the three socioeconomic position indicators and after adjustment for lifestyle factors, compared with more advantaged groups, low socioeconomic status was associated with increased risk for 18 (32·1%) of the 56 conditions. 16 diseases formed a cascade of inter-related health conditions with a hazard ratio greater than 5. This sequence began with psychiatric disorders, substance abuse, and self-harm, which were associated with later liver and renal diseases, ischaemic heart disease, cerebral infarction, chronic obstructive bronchitis, lung cancer, and dementia. Interpretation: Our findings highlight the importance of mental health and behavioural problems in setting in motion the development of a range of socioeconomically patterned physical illnesses. Policy and health-care practice addressing psychological health issues in social context and early in the life course could be effective strategies for reducing health inequalities. Funding: UK Medical Research Council, US National Institute on Aging, NordForsk, British Heart Foundation, Academy of Finland, and Helsinki Institute of Life Science.
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| 9. |
- Kivimäki, Mika, et al.
(author)
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Climate Change, Summer Temperature, and Heat-Related Mortality in Finland : Multicohort Study with Projections for a Sustainable vs. Fossil-Fueled Future to 2050
- 2023
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In: Journal of Environmental Health Perspectives. - : EHP Publishing. - 0091-6765 .- 1552-9924. ; 131:12, s. 1270201-1-1270201-16
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Journal article (peer-reviewed)abstract
- BACKGROUND: Climate change scenarios illustrate various pathways in terms of global warming ranging from "sustainable development" (Shared Socioeconomic Pathway SSP1-1.9), the best-case scenario, to 'fossil-fueled development' (SSP5-8.5), the worst-case scenario. OBJECTIVES: We examined the extent to which increase in daily average urban summer temperature is associated with future cause-specific mortality and projected heat-related mortality burden for the current warming trend and these two scenarios. METHODS: We did an observational cohort study of 363,754 participants living in six cities in Finland. Using residential addresses, participants were linked to daily temperature records and electronic death records from national registries during summers (1 May to 30 September) 2000 to 2018. For each day of observation, heat index (average daily air temperature weighted by humidity) for the preceding 7 d was calculated for participants' residential area using a geographic grid at a spatial resolution of formula presented . We examined associations of the summer heat index with risk of death by cause for all participants adjusting for a wide range of individual-level covariates and in subsidiary analyses using case-crossover design, computed the related period population attributable fraction (PAF), and projected change in PAF from summers 2000-2018 compared with those in 2030-2050. RESULTS: During a cohort total exposure period of 582,111,979 summer days (3,880,746 person-summers), we recorded 4,094 deaths, including 949 from cardiovascular disease. The multivariable-adjusted rate ratio (RR) for high (formula presented ) vs. reference (formula presented ) heat index was 1.70 (95% CI: 1.28, 2.27) for cardiovascular mortality, but it did not reach statistical significance for noncardiovascular deaths, formula presented (95% CI: 0.96, 1.36), a finding replicated in case-crossover analysis. According to projections for 2030-2050, PAF of summertime cardiovascular mortality attributable to high heat will be 4.4% (1.8%-7.3%) under the sustainable development scenario, but 7.6% (3.2%-12.3%) under the fossil-fueled development scenario. In the six cities, the estimated annual number of summertime heat-related cardiovascular deaths under the two scenarios will be 174 and 298 for a total population of 1,759,468 people. DISCUSSION: The increase in average urban summer temperature will raise heat-related cardiovascular mortality burden. The estimated magnitude of this burden is formula presented times greater if future climate change is driven by fossil fuels rather than sustainable development. https://doi.org/10.1289/EHP12080.
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| 10. |
- Kivimäki, Mika, et al.
(author)
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Modifications to residential neighbourhood characteristics and risk of 79 common health conditions : a prospective cohort study
- 2021
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In: The Lancet Public Health. - : Elsevier. - 2468-2667. ; 6:6, s. e396-e407
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Journal article (peer-reviewed)abstract
- BACKGROUND: Observational studies have identified a link between unfavourable neighbourhood characteristics and increased risk of morbidity, but it is unclear whether changes in neighbourhoods affect future disease risk. We used a data-driven approach to assess the impact of neighbourhood modification on 79 health outcomes.METHODS: In this prospective cohort study, we used pooled, individual-level data from two Finnish cohort studies: the Health and Social Support study and the Finnish Public Sector study. Neighbourhood characteristics (mean educational level, median income, and employment rate of residents, and neighbourhood green space) and individual lifestyle factors of community-dwelling individuals were assessed at baseline (at different waves starting between 1998 and 2013). We repeated assessment of neighbourhood characteristics and lifestyle factors approximately 5 years from each baseline assessment, after which follow-up began for health conditions diagnosed according to the WHO International Classification of Diseases for 79 common health conditions using linkage to electronic health records. We used Cox proportional hazard regression models to compute adjusted hazard ratios (HRs) of incident disease associated with neighbourhood characteristics and changes in neighbourhood characteristics over time and logistic regression analysis to compute adjusted odds of association between changes in neighbourhood characteristics and individual lifestyle factors.FINDINGS: 114 786 individuals (87 012 [75·8%] women; mean age 44·4 years [SD 11·1]) had complete data and were included in this cohort study. During 1·17 million person-years at risk, we recorded 164 368 new-onset health conditions and 3438 deaths. Favourable changes in neighbourhood characteristics were associated with reduced risk of all-cause mortality and incidence of 19 specific health conditions. Unfavourable changes were correspondingly associated with increased risk of mortality and 27 specific health conditions. Among participants who did not move residence during the observation period, relative to individuals who continually lived in disadvantaged neighbourhoods, those who experienced favourable modifications in neighbourhood characteristics had a lower risk of future diabetes (HR 0·84, 95% CI 0·75-0·93), stroke (0·49, 0·29-0·83), skin disease (0·72, 0·53-0·97), and osteoarthritis (0·87, 0·77-0·99). Living in a neighbourhood with improving characteristics was also associated with improvements in individual-level health-related lifestyle factors. Among participants who lived in advantaged residential environments at baseline, unfavourable changes in neighbourhood characteristics were associated with an increased risk of diabetes, stroke, skin disease, and osteoarthritis compared with individuals who lived in advantaged neighbourhoods throughout the study period.INTERPRETATION: Favourable modifications to residential neighbourhoods showed robust, longitudinal associations with a range of improvements in health outcomes, including improved health behaviours and reduced risk of cardiometabolic, infectious, and orthopaedic conditions.FUNDING: UK Medical Research Council, US National Institute on Aging, NordForsk, and Academy of Finland.
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