Effects of urbanization, economic development, and migration of workers on suicide mortality in Japan

The relationships between male or female age-adjusted suicide mortality and social life factors for all 47 Japanese prefectures in 1980, 1985 and 1990 were investigated by stepwise multiple regression analysis after classification of 20 social life indicators by factor analysis. During this period, Japan experienced the second economic crisis (the so-called secondary oil crisis) in 1980-1983 and economic prosperity (bubble economy) in 1986-1990. In all the three years, male suicide mortality was significantly related inversely to the urbanization and economic development factor, the result of which was consistent with the data in our previous study for the years 1970 and 1975. Similarly, the male mortality was positively related to the factor of migration of workers in the three years. No factor significantly related to female mortality for all the three years was found. It is suggested that (1) urbanization was a major determinant which prevented male suicide mortality during the past 20 years (1970-1990) in Japan; (2) migration of workers became an important factor for male suicide mortality during these 10 years; and (3) female suicide mortality was less vulnerable to social life factors for these 20 years than the male mortality.     

Racial, ethnic, and gender differences in smoking cessation associated with employment and joblessness through young adulthood in the US

The dynamics of labor force participation and joblessness during young adulthood influence access to social and material resources and shape exposure to different sources of psychosocial strain. Differences in these dynamics by race, ethnicity, and gender are related to changes in a behavioral determinant of poor health (tobacco use) for young adults aging into midlife. Using discrete-time hazards models, we estimate the relationship between labor force participation in the past year and smoking cessation for US adults (ages 14-21 years in 1979) followed in a population-representative sample until 1998 (i.e. the National Longitudinal Survey of Youth). We assess the unique role of racial, ethnic and gender differences in exposure, vulnerability, and reactivity to employment and joblessness by controlling for social and economic resources obtained through working and by controlling for early life factors that select individuals into certain labor force and smoking trajectories. There are three main findings: (1) joblessness is more strongly associated with persistent daily smoking among women than among men; (2) fewer social and economic resources for women out of the labor force compared to employed women explains their lower cessation rates; and (3) lower cessation among unemployed women compared to employed women can only partially be explained by these resources. These findings illustrate how differential access to work-related social and economic resources is an important mediator of poor health trajectories. Contextual factors such as social norms and psychosocial strains at work and at home may play a unique role among European American men and women in explaining gender differences in smoking.     

Does the work environment contribute to excess male mortality?

It is sometimes assumed that male jobs are on average more unhealthy than female jobs. The aim of the present study is to examine whether work-related factors contribute to excess male mortality. All Swedish deaths during 1970-80 and 1980-86 were analysed with Poisson regressions--for all individuals and for labour force participants--in order to estimate gender mortality rate ratios for all causes, circulatory diseases and external causes. Results for all men and women, as well as results restricted to those in full-time employment, revealed that no work-related factors contribute to excess male mortality. For the period 1980-86, a more detailed analysis was performed, and work environment exposures were aggregated from a secondary data source. In accordance with previous studies, it was found that men experience unhealthier physical work environments than women and that women experience unhealthier psychosocial work environments than men. Among labour force participants, men's greater exposure to hazardous work contributed to men's excess of external causes of death. This finding however, applied only to part-time workers. In conclusion, when factors such as women's greater likelihood of having a low socioeconomic status, their poor psychosocial work environment (low levels of work control and workplace social support), and the fact that women working full-time are more likely than men to be unmarried, were taken into account, the work environment did not appear to contribute to excess male mortality. It is suggested that the lack of reduction in excess male mortality during the 1970 s could be a consequence of the following: women commonly took jobs with low mortality rates; the rapid increase in the numbers of Swedish women in paid employment probably lowered their mortality; other social, behavioural and bio-genetical factors are more important than work in determining excess male mortality. Causality considerations are also discussed.     

Suicide in Italy during a time of economic recession: some recent data related to age and gender based on a nationwide register study

Previous research reported that economic crises may have important implications for increasing suicide rates. We investigated official data on completed suicide in Italy during the recent economic crisis as related to age and gender. Data were extracted from the Italian Mortality Database. The trend in suicide rates from 1980 to 2010 (the most recent year available) was analysed by joinpoint regression analysis. Rate ratios were calculated to compare suicide rates before and after the present economic crisis. Suicide rates for men 25–64 years of age (those involved in the labour force) started to increase in 2008 after a period of a statistically significant decrease from 1994 to 2007 and their suicide rate was 12% higher in 2010 compared with that in 2006. In contrast, suicide rates declined for women of all ages and for men younger than 25 and older than 65 years of age. After 2007, there was a noticeable increase in suicide rates among Italian men involved in the labour force.     

Suicidality and Sexual Orientation: Differences Between Men and Women in a General Population-Based Sample From The Netherlands

Homosexuality has been shown to be associated with suicidality and mental disorders. It is unclear whether homosexuality is related to suicidality, independently of mental disorders. This study assessed differences in lifetime symptoms of suicidality (death ideation, death wishes, suicide contemplation, and deliberate self-harm) between homosexual and heterosexual men and women, controlling for lifetime psychiatric morbidity. Interaction effects of age and the role of perceived discrimination were also examined. Data were collected on a representative sample of the Dutch population aged 18–64 years. Classification as heterosexual or homosexual was based upon reported sexual behavior in the preceding year. Of those sexually active, 2.8% of 2,878 men and 1.4% of 3,120 women had had same-sex partners. Homosexual men differed from their heterosexual counterparts on all four suicide symptoms (OR ranging from 2.58 to 10.23, with higher ORs for more severe symptoms), and on the sum total of the four symptoms; homosexual women only differed from heterosexual women on suicide contemplation (OR=2.12). Controlling for psychiatric morbidity decreased the ORs, but among men all associations were still significant; the significance for suicide contemplation among women disappeared. Younger homosexuals were not at lower risk for suicidality than older homosexuals in comparison with their heterosexual counterparts. Among homosexual men, perceived discrimination was associated with suicidality. This study suggests that even in a country with a comparatively tolerant climate regarding homosexuality, homosexual men were at much higher risk for suicidality than heterosexual men. This relationship could not only be attributed to their higher psychiatric morbidity. In women, there was no such clear relationship.     

Mortality differentials in men and women in the southeastern region, Brazil--1960, 1970 and 1980]

Male and female mortality rates in the city of Rio de Janeiro in 1960, 1970 and 1980 are studied with a view to analysing the different risks to which men and women are subject by age group. Mortality differentials by sex and cause were studied by means of male/female mortality ratios, relative and absolute differences among rates, and standardized rates. An analysis of differentials by selected groups of cause for 1980 was undertaken. Male mortality rates were higher than the female rates in all age groups in the three years studied, with an increase of the male/female mortality ratio for the 15-34 age group over this period. The excess of male death was mainly due to the increase of deaths from violent causes among young men, a dramatic circumstance that can hardly be changed by "technical" procedures. As regards deaths from other causes, biological determinants and the different risks for men and women should be considered in order better to understand this situation.     

The organization of the health care provider's practice influenced patient participation in research: a multilevel analysis

ObjectiveTo analyze the participation of the patients in a survey about prevention, according to their own medical (hypertension and inclusion during house call) and social (occupational class and birthplace) characteristics and characteristics related to the organization of their physicians' practice.Study Design and SettingFifty-nine randomly recruited physicians from the Paris metropolitan area enrolled every consecutive patient seen during a 2-week period. Actual patient participation (responding to the telephonic questionnaire) was analyzed with a logistic mixed model separately for male and female patients.ResultsThe participation rate among 4,106 eligible patients was 66.7% and varied among physicians (from 48.7% to 80.8% for the 10th and 90th percentiles of the distribution). Participation was better for higher occupational classes, patients included during office visits, men with hypertension, and women born in France. After controlling for all patient characteristics, participation was best if the physician saw at least some patients by appointment [odds ratio (OR), 2.12; 95% confidence interval (CI): 1.12, 4.01 for men and OR, 3.38; 95% CI: 1.72, 6.63 for women). This characteristic explained 14% of the variability between physicians for participation by men and 28% of that by women.ConclusionCluster studies should take the characteristics of the health care providers into account in their design, particularly their practice organization.     

The projected supply of registered nurses, 1990

The number of employed registered nurses (RNs) in the United States stood at an all-time high of 1.3 million in 1980. This paper, using life table techniques, develops a population base of all living graduates from data on graduations from basic nursing education programs between 1928 and 1980, and estimates that there are some 1.9 million graduates now living. The number of graduates is projected to rise to some 2.4 million by the end of 1990, of whom 1.7 million will be active in the profession. Factors taken into account include recent increases in admissions, which rose from 79,000 in 1970 to 112,000 in 1980; the extent to which older women are entering the profession; the rapid growth of 2-year associate degree programs, which now account for half of all admissions; and increased labor force participation, with 68 percent of all living graduates in the labor force in 1980, compared to 60 percent in 1970. It is projected that the movement to advanced education among RNs will continue so that, by 1990, the proportion with baccalaureate or higher degrees will have risen from 29 to 36 percent of the employed RNs. By 1990 the largest number of active RNs will be in their 30s. Graduates with diplomas will have a median age of 45; those with associate degrees, 35; and those with baccalaureate or higher degrees, 32 years.     

Ischaemic heart disease among livestock and agricultural workers

Aims: To compare the occurrence of ischaemic heart disease (IHD) among male and female livestock and agricultural workers with gainfully employed men and women in Sweden.

Methods: Male and female livestock and agricultural workers were identified in the Swedish National Censuses of 1970 and 1990 and were followed until the end of 1995. The IHD mortality among the livestock and agricultural workers was compared with that of gainfully employed men and women. Information of smoking habits was gathered from a previous national survey.

Results: Male as well as female livestock workers had slightly higher standardised mortality ratios (SMR) regarding IHD compared with all gainfully employed men and women in Sweden. The SMR for male workers was 1.06 (95% CI 0.95 to 1.18). The SMR for female workers was 1.10 (95% CI 0.98 to 1.23). Agricultural workers had lower SMRs. Adjustments for smoking habits would further increase the SMRs by about 9% in male workers and about 5% in female workers.

Conclusion: The present data suggest a slightly increased risk for IHD among both male and female livestock workers, which may be the result of organic dust exposure.

     

Socioeconomic differences in suicide mortality by sex in Finland in 1971-2000: a register-based study of trends, levels, and life expectancy differences

AIM: Suicide is a common cause of death in many Western countries and it has been predicted to become even more common worldwide. The authors analysed socioeconomic differences and trends in Finnish suicide mortality, and assessed the relevance to public health by calculating socioeconomic differences in years of life expectancy lost attributable to suicide. DATA AND METHODS: Census records were used, linked with the death records of men and women aged 25 years and over in 1971-2000 in Finland. RESULTS: Suicide among male and female manual workers was 2.3 and 1.3 times higher respectively than among upper non-manual workers. The differences were largest among those in their thirties. Because of the decline in suicide among upper non-manual workers and a slower decrease or even an increase among other socioeconomic groups, the relative mortality differences increased somewhat during 1970-90, then decreased in the 1990s but remained higher than in the 1970s. In 1991-2000 the suicide-related life expectancy gap between the upper non-manual and manual male workers was 0.6 years, and this difference contributed 10% to the total difference in years of life expectancy lost between these socioeconomic groups. CONCLUSION: Large and persistent socioeconomic differences were found in suicide mortality and suicide was an important component of the socioeconomic difference in total mortality. Reducing these differences could significantly improve equity in health and reduce the burden of excess mortality.     

Non-Hodgkin's lymphoma and occupation in Denmark.

An analysis was made of the occurrence in Denmark of non-Hodgkin's lymphoma among men and women by socioeconomic group and detailed occupation, using a linkage between cancer registry data on incidence (1970-1980) and census data on industry and occupation (1970). No socioeconomic gradient in the risk for non-Hodgkin's lymphoma was found. Significantly increased relative risks were found in a number of detailed occupational groups including female physicians, female family workers in retail trade and transport; and male fitters, and gold, silver, and electroplate workers in metal industry. Also male cowmen experienced a significantly increased risk, whereas the risk was not increased for farming in general. Tabulations of clusters of detailed occupational groups suggested that groups with potential exposure to infections and chemical agents may experience an increased risk for NHL.     

Facteurs professionnels en lien avec le suicide au sein des salariés affiliés à la Mutualité sociale agricole (MSA) et en activité entre 2007 et 2013

BackgroundWork and related exposures may play a role in suicide and there has been evidence in the literature that some occupational factors may be associated with suicide. The identification of occupational risk factors of suicide mortality among employees affiliated to the French special agricultural social security scheme (MSA), an understudied population, appears important. The objective of this study was to identify the occupational factors associated with suicide mortality among French employees from the MSA working between 2007 and 2013.MethodsThe study population included all the employees affiliated to the MSA working between 1st January 2007 and 31st December 2013, i.e. 1,699,929 men and 1,201,017 women. The studied occupational factors included: economic activity, skill level, and work contract. Survival analyses (Cox models) stratified on gender were performed using age as time scale and region and year of contract as adjustment variables.ResultsAmong men, the factors associated with an elevated suicide risk were: economic activities of forestry, agriculture and related activities, and manufacture of food products and beverages (e.g. meat, wine), low-skilled level and working in the regions of Brittany, Burgundy Franche-Comté, Pays de la Loire, Normandy, Grand Est and Centre-Val-de-Loire. No association was observed among women.ConclusionThese results suggest that economic activity and low-skilled level may be associated with suicide among men affiliated to the MSA and may contribute to the implementation of prevention interventions. Further studies are needed to confirm and better understand these associations.     

Availability of Child Care in Rural Communities: Implications for Workforce Recruitment and Retention

The objective of this study was to identify differences in child care availability by rural–urban location for all counties in Wisconsin, and describe implications for recruitment and retention of health care workforce. We used data on licensed child care slots for young children (age <5), socio-demographic characteristics, women’s and men’s labor force participation, and household structure for all counties in Wisconsin in 2013 (n = 72). Data came from KIDS COUNT, County Health Rankings, and the American Community Survey. We used t tests to analyze bivariate differences in child care availability and community characteristics by metropolitan, micropolitan, and non-core rural location. We then used ordinary least squares regression to analyze the relationship between geographic location and child care slots, adjusting for labor force participation and household structure. Rural counties had significantly fewer licensed child care slots per child than metropolitan and micropolitan counties. These counties also had, on average, higher rates of poverty and higher unemployment than micropolitan and metropolitan counties. The association between geographic location and child care availability remained, even after adjusting for household structure and labor force participation. The number of hours men worked and the percentage of men not working were both negatively associated with available child care slots, whereas there was not a significant relationship between women’s labor force participation and child care availability. Rural areas face health care workforce shortages. Recruitment strategies to overcome shortages must move beyond individual-level incentives to focus on community context and family support, including availability of child care in rural counties.     

Effect of domestic and occupational roles on morbidity and mortality

This study examines the effect of labor force participation, occupational status and domestic roles on morbidity and mortality among women and men over a 15-year period. The main research questions address the long-term effects of multiple roles. Does the combination of domestic and work roles result in adverse health effects, or provide some health advantage? The study population was randomly selected from among members of a large HMO and were part of a household interview conducted in 1970-71. Medical records for the two years prior to the interview and for 15 years after the interview for the cohort members are linked with the survey data. The findings show that for women there is some longevity advantage in paid employment. Overall, the combination of employment and domestic roles apparently poses no health threat to women, and may provide some advantage. Multiple roles are unrelated to mortality and morbidity outcomes among men.     

Effects of socioeconomic factors on suicide from 1980 through 1999 in Osaka Prefecture,Japan

Suicide rate in Japan surged in 1998. Although the standardized mortality ratios (SMRs) of suicide in Osaka Prefecture, Japan had been mostly lower than the national SMRs of suicide between 1980 and 1997, they surpassed the increased national SMR of suicide in 1998 and 1999. We investigated whether the suicide rates for 1980-97 and the recent increased suicide rates in Osaka Prefecture were associated with socioeconomic factors. Time-series regression analyses of the suicide rate and socioeconomic factors were performed on respective data for five sub-areas in Osaka Prefecture. The suicide rates of young people and middle-aged men were more strongly associated with the job application and divorce rates for 1980-99 than for 1980-97. Some relations between the suicide rate and public assistance rate were found. The suicide rate was negatively associated with the marriage rate in some areas. The suicide rate of elderly women was strongly associated with the number of persons per household. The notable relation was found between the suicide rate of middle-aged men and the job application rate for 1980-99. The inverse relation between the suicide rate of elderly women and the number of persons per household was noteworthy.     

Men’s hopes,fears and challenges in engagement in perinatal health and the prevention of mother-to-child transmission of HIV in rural Kenya

Abstract

Male involvement in antenatal care has been shown to improve health outcomes for women and infants. However, little is known about how best to encourage male partners to support essential perinatal health activities. We explored men’s perceptions of facilitators and barriers to involvement in antenatal care and HIV prevention including fears, hopes and challenges. Forty in-depth interviews were conducted with the male partners of HIV-positive and HIV-negative pregnant women in southwest Kenya. Most male partners believed engaging in pregnancy health-related activities was beneficial for keeping families healthy. However, thematic analysis revealed several obstacles that hindered participation. Poor couple relationship dynamics seemed negatively to influence male engagement. Some men were apprehensive that clinic staff might force them to test for HIV and disclose the results; if HIV-positive, men feared being labelled as ‘victimisers’ in situations of serodiscordancy, and described fears of abandonment by their wives. Some men avoided accompanying their wives, citing local culture as rationale for avoiding the ‘effeminate’ act of antenatal care attendance. Amidst these obstacles, some men chose to use their partners’ HIV status as proxy for their own. Findings suggest that improving male engagement in essential maternal and child health-related activities will require addressing both structural and interpersonal barriers.     

Suicides and pesticides in Sri Lanka.

Sri Lanka has one of the highest rates of suicide in the world (29 per 100,000 population in 1980). Suicides are especially frequent among young adults, both male and female. Compared to the US, the suicide rate for males ages 15 to 24 years in Sri Lanka is nearly four times greater; the female rate nearly 13 times greater. The most common mode of suicide is ingestion of liquid pesticides.     

Explaining differential rates of mortality decline for Swedish men and women: a time-series analysis, 1945–1992

The aim of this study is to identify social factors that could be related to differential rates of mortality decline for men and women in Sweden. The annual changes in fifteen indicators and their relationship with changes in absolute excess male mortality were analyzed by means of time series analysis for the period 1945–1992.Economic growth seems to have been more beneficial for women's survival than for that of men. A few labor market indicators (unemployment rate and the wage ratio men/women) may have had some influence on changes in excess male mortality as well. Consumption factors, such as alcohol consumption and cigarette consumption, have been important for changes in excess male mortality. Changes in excess male mortality have been particularly pronounced among 65–74 year olds, due to rapidly improved female survival in these age groups.I discuss the finding that there seem to be connections between, on the one hand, changes in general social factors such as economic growth and labor market factors, and perhaps urbanization and alcohol and cigarette consumption on the other. I therefore suggest that gender-specific consumer behavior, seen as an outcome of gender-specific norm systems, is one mechanism which links changes in general social factors to changes in excess male mortality.