| 1. |
- Almroth, Melody, 1989-, et al.
(författare)
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The role of working conditions in educational differences in all-cause and ischemic heart disease mortality among Swedish men
- 2024
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Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 50:4, s. 300-309
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Tidskriftsartikel (refereegranskat)abstract
- Objectives This study aims to investigate the extent to which low job control and heavy physical workload in middle age explain educational differences in all-cause and ischemic heart disease (IHD) mortality while accounting for important confounding factors.Methods The study is based on a register-linked cohort of men who were conscripted into the Swedish military at around the age of 18 in 1969/1970 and were alive and registered in Sweden in 2005 (N=46 565). Cox proportional hazards regression models were built to estimate educational differences in all-cause and IHD mortality and the extent to which this was explained by physical workload and job control around age 55 by calculating the reduction in hazard ratio (HR) after adjustments. Indicators of health, health behavior, and other factors measured during conscription were accounted for.Results We found a clear educational gradient for all-cause and IHD mortality (HR 2.07 and 2.47, respectively, for the lowest compared to the highest education level). A substantial part was explained by the differential distribution of the confounding factors. However, work-related factors, especially high physical workload, also played important explanatory roles.Conclusion Even after accounting for earlier life factors, low job control and especially high physical workload seem to be important mechanistic factors in explaining educational inequalities in all-cause and IHD mortality. It is therefore important to find ways to reduce physical workload and increase job control in order to decrease inequalities in mortality.
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| 2. |
- Almroth, Melody, 1989-, et al.
(författare)
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Labour market exit routes in high- and low-educated older workers before and after social insurance and retirement policy reforms in Sweden
- 2024
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Ingår i: Ageing & Society. - 0144-686X .- 1469-1779.
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Tidskriftsartikel (refereegranskat)abstract
- Few previous studies have investigated how socioeconomic differences in labour market exit have changed after restrictions in social insurance policies. The aim of this register-based study is to investigate how early labour market exit pathways among older men and women with different levels of education changed after major restrictive social insurance and retirement policy reforms in Sweden. Cohort 1 (pre-reform) consisted of individuals who were 60 or 61 years old in 2005 (N = 186,145) and Cohort 2 (post-reform) consisted of individuals who were 60 or 61 years old in 2012 (N = 176,216). Educational differences in four labour market exit pathways were investigated using Cox proportional hazards regression; the exit pathways were disability pension, early old-age pension with and without income respectively, and no income for two consecutive years. As expected, exits through disability pension were rarer in Cohort 2. Lower education was also more strongly associated with disability pension in Cohort 2. Parallel to this, lower education showed a stronger association with both early old-age pension types in Cohort 2. Additionally, a tendency towards a relatively higher likelihood of earning no income was seen among the less educated. Increases in inequalities tended to be greater for women. Our results indicate that educational inequalities in labour market exit have grown significantly after restrictions in social insurance and changes in retirement policies, which can have negative financial repercussions for those already in a vulnerable position. These results indicate that careful analyses of effects on disparities are needed before making major changes in welfare systems.
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| 3. |
- Falkstedt, Daniel, et al.
(författare)
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Job demands and job control and their associations with disability pension—a register-based cohort study of middle-aged and older Swedish workers
- 2023
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Ingår i: International Archives of Occupational and Environmental Health. - 0340-0131 .- 1432-1246. ; 96:8, s. 1137-1147
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Job demands and control at work and their combination, job strain, have been studied in relation to risk of disability pension (DP) previously. In the present study, based on registry data, we aimed to deepen the knowledge by analyzing major disease groups among the DPs, dose–response shape of the associations, and potential confounding effects of physical workload.Methods Approximately 1.8 million workers aged 44 or older and living in Sweden in 2005 were followed up for 16 years, up to a maximum of 65 years of age. We linked mean values of job demands and job control, estimated in a job-exposure matrice (JEM) by gender, to individuals through their occupational titles in 2005. These values were categorized by rank order, and, for the construction of job-strain quadrants, we used a median cut-off. Associations with DP were estimated in Cox proportional-hazards models.Results In models accounting for covariates including physical workload, low levels of job control were associated with higher risk of DP among both men and women. This association was most clear for DP with a psychiatric diagnosis, although a dose–response shape was found only among the men. High levels of job demands were associated with decreased risk of DP across diagnoses among men, but the same association varied from weak to non-existing among women. The high- and passive job-strain quadrants both showed increased risk of DP with a psychiatric diagnosis.Conclusion The results suggest that, at the occupational level, low job control, but not high job demands, contributes to an increased incidence of DP, particularly regarding DP with a psychiatric diagnosis.
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| 4. |
- Hernando-Rodriguez, Julio C., et al.
(författare)
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Unequal access? Use of sickness absence benefits by precariously employed workers with common mental disorders : a register-based cohort study in Sweden
- 2023
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Ingår i: BMJ Open. - 2044-6055. ; 13:7
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Tidskriftsartikel (refereegranskat)abstract
- Objective This study compares the use of sickness absence benefits (SABs) due to a common mental disorder (CMD) between precariously employed and non-precariously employed workers with CMDs. DesignRegister-based cohort study. Participants The study included 78 215 Swedish workers aged 27-61 who experienced CMDs in 2017, indicated by a new treatment with selective serotonin reuptake inhibitors (SSRIs). Excluded were those who emigrated or immigrated, were self-employed, had an annual employment-based income <100 Swedish Krona, had >90 days of unemployment per year, had student status, had SABs due to CMDs during the exposure measurement (2016) and the two previous years, had an SSRI prescription 1 year or less before the start of the SSRI prescription in 2017, had packs of >100 pills of SSRI medication, had a disability pension before 2017, were not entitled to SABs due to CMDs in 2016, and had no information about the exposure. Outcome The first incidence of SABs due to CMDs in 2017. Results The use of SABs due to a CMD was slightly lower among precariously employed workers compared with those in standard employment (adjusted OR [aOR] 0.92, 95% CI 0.81 to 1.05). Particularly, women with three consecutive years in precarious employment had reduced SABs use (aOR 0.48, 95% CI 0.26 to 0.89), while men in precarious employment showed weaker evidence of association. Those in standard employment with high income also showed a lower use of SABs (aOR 0.74, 95% CI 0.67 to 0.81). Low unionisation and both low and high-income levels were associated with lower use of SABs, particularly among women. ConclusionsThe study indicates that workers with CMDs in precarious employment may use SABs to a lower extent. Accordingly, there is a need for (1) guaranteeing access to SABs for people in precarious employment and/or (2) reducing involuntary forms of presenteeism.
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| 5. |
- Pan, Kuan-Yu, et al.
(författare)
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Trajectories of psychosocial working conditions and all-cause and cause-specific mortality : a Swedish register-based cohort study
- 2023
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Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 49:7, s. 496-505
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Tidskriftsartikel (refereegranskat)abstract
- Objectives While psychosocial working conditions have been associated with morbidity, their associations with mortality, especially cause-specific mortality, have been less studied. Additionally, few studies considered the time-varying aspect of exposures. We aimed to examine trajectories of job demand–control status in relation to all-cause and cause-specific mortality, including cardiovascular diseases (CVD), suicide, and alcohol-related mortality.Methods The study population consisted of around 4.5 million individuals aged 16-60 years in Sweden in 2005. Job control and demands were respectively measured using job exposure matrices (JEM). Trajectories of job control and demands throughout 2005–2009 were identified using group-based trajectory modelling, and job demand–control categories were subsequently classified. Deaths in 2010–2019 were recorded in the national cause of death register. Cox regression models were used.Results A total of 116 242 individuals died in 2010–2019. For both job control and demands, we identified four trajectories, which were parallel to each other and represented four levels of exposures. Low control and passive jobs were associated with higher all-cause, CVD, and suicide mortality among both men and women. High strain jobs were associated with higher all-cause and CVD mortality among men, while low control, passive jobs, and high strain jobs were associated with higher alcohol-related mortality among women.Conclusions The trajectories identified may suggest stable levels of job control and demands over time. Poor psychosocial working conditions are related to all-cause and cause-specific mortality, and these patterns vary to some extent between men and women.
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