Psychosocial work conditions, unemployment and health locus of control: a population-based study

AIMS: To investigate the association between psychosocial work conditions, unemployment and lack of belief in the possibility of influencing one's own health. Design/setting/participants/measurements: The 2000 public health survey in Scania is a cross-sectional postal questionnaire study with a 59% participation rate. In total, 5180 persons aged 18-64 years who belonged to the workforce and the unemployed were included in this study. Logistic regression models were used to investigate the associations between psychosocial factors at work and unemployment, and lack of belief in the possibility of influencing one's own health (external locus of control). Psychosocial conditions at work were defined according to the Karasek-Theorell demand-control/decision latitudes into relaxed, active, passive, and job strain categories. The multivariate analyses included age, country of birth, education, economic stress, and social participation. RESULTS: In total, 26.6% of all men and 26.9% of all women lack an internal locus of control. The passive, job strain and unemployed categories have significantly higher odds ratios of lack of internal locus of control, as compared to the relaxed reference category. No such significant differences are observed for the active category. These patterns remain in the multivariate models, with the exception of the passive and unemployed categories among men, in which the significant differences disappear. CONCLUSIONS: Psychosocial work conditions and unemployment may affect health locus of control. The control dimension in the Karasek-Theorell model seems to be of greatest importance.     

Psychosocial work conditions, unemployment, and leisure-time physical activity: a population-based study

OBJECTIVE: To investigate the association between psychosocial work conditions and unemployment, and low leisure-time physical activity. DESIGN/SETTING/PARTICIPANTS/MEASUREMENTS: The 2000 public health survey in Scania is a cross-sectional postal questionnaire study with a 59% participation rate. A total of 5,180 persons aged 18-64 years who belonged to the workforce and the unemployed were included in this study. Logistic regression models were used to investigate the associations between psychosocial factors at work and unemployment, and low leisure-time physical activity. Psychosocial conditions at work were defined according to the Karasek-Theorell demand-control/decision latitudes into relaxed, active, passive, and job strain categories. The multivariate analyses included age, country of birth, education, economic stress, and social participation. RESULTS: In total, 16.1% of men and 14.8% of women had low leisure-time physical activity. The job strain (high demands/low control) and unemployed categories had significantly higher odds ratios of low leisure-time physical activity among both men and women compared with the relaxed (low demands/high control) reference category. However, the significant differences between the job strain, the unemployed, and the relaxed categories disappeared in the multivariate models. CONCLUSIONS: Respondents with job strain or unemployment have significantly higher odds ratios of low leisure-time physical activity than the relaxed category. However, after adjustments for education in particular the differences disappear. Nevertheless, the results suggest that the association between psychosocial work conditions, which are often dependent on education, and leisure-time physical activity may be interesting to study in more detail.     

Social capital, anticipated ethnic discrimination and self-reported psychological health: a population-based study

This study investigates the association between anticipated ethnic discrimination and self-reported psychological health, taking generalized trust in other people into consideration. The 2004 Public Health Survey in Skåne, Sweden, is a cross-sectional postal questionnaire study including a total of 27,757 respondents aged 18–80 with a 59% response rate. Multivariate analyses of anticipated discrimination and self-reported psychological health were performed using logistic regressions in order to investigate the importance of possible confounders (age, country of origin, education and horizontal trust). Poor psychological health was reported by 13.0% of men and 18.9% of women, and 44.8% and 44.7%, respectively, reported that 50% or more of employers would discriminate according to race, colour of skin, religion, or cultural background. Respondents in younger age groups, born abroad, with high education, low trust and high levels of self-reported anticipated discrimination, had significantly higher levels of poor self-reported psychological health. There was a significant association between anticipated discrimination and low horizontal trust. After multiple adjustments for age, country of origin and education, the addition of trust in the model reduced the odds ratio of poor self-reported psychological health in the “most employers” category from 1.8 (1.4–2.1) to 1.5 (1.3–1.9) among men and from 2.2 (1.8–2.6) to 1.8 (1.5–2.2) among women. Generalized trust in other people may be a confounder of the association between anticipated discrimination and poor psychological health. Anticipated discrimination may have effects on the mental health of not only the affected minorities, but also on the mental health of the general population.     

Social capital,political trust and self-reported psychological health: A population-based study

This study investigates the association between political trust (an aspect of institutional trust) in the Riksdag (the national parliament in Sweden) and self-reported psychological health, taking generalized (horizontal) trust in other people into account. The 2004 public health survey in Skåne in Southern Sweden is a cross-sectional postal questionnaire study that was answered by 27,757 respondents aged 18–80 yielding a 59% response rate. A logistic regression model was used to investigate the associations between political trust and self-reported psychological health adjusting for possible confounders (age, country of origin, education, economic stress and generalized trust in other people i.e. horizontal trust). We found that 13.0% of the men and 18.9% of the women reported poor psychological health. A total of 17.3% and 11.6% of the male and female respondents, respectively, reported that they had no trust at all in the national parliament, and another 38.2% and 36.2%, respectively, reported that their political trust was not particularly high. Respondents in younger age groups, born abroad, with high education, high levels of economic stress, low horizontal trust and low political trust had significantly higher levels of self-reported poor psychological health. There was a significant association between low political trust and low horizontal trust. After adjustments for age, country of origin, education and economic stress, the inclusion of horizontal trust reduced the odds ratios of self-reported poor psychological health in the “no political trust at all” category compared to the “very high political trust” category from 1.6 to 1.4 among men and from 1.7 to 1.4 among women. It is concluded that low political trust in the Riksdag seems to be significantly and positively associated with poor mental health.     

Individual and contextual determinants of self-reported poor psychological health: a population-based multilevel analysis in southern Sweden

OBJECTIVE: To investigate the influence of contextual and individual factors on self-reported psychological health. DESIGN/SETTING/PARTICIPANTS/MEASUREMENTS: The 2000 public health survey in Scania is a cross-sectional postal questionnaire study with a 59% participation rate. A total of 13,715 persons aged 18-80 answered the questionnaire. A multilevel logistic regression model, with individuals at the first level and municipalities/city quarters at the second, was performed. The effect (intra-class correlation, cross-level modification, and odds ratios) of individual and municipality/city quarter factors on self-reported psychological health was analysed. RESULTS: The crude variance between municipalities/city quarters was small but significant. It was particularly affected and lowered by individual civil status, country of origin, economic stress, and social participation. The inclusion of all individual factors age, sex, civil status, country of origin, education, economic stress, and social participation lowered the between municipality variance to not-significant levels, which is the reason why no contextual variables were included in the calculations. CONCLUSIONS: The results of this study suggest that poor self-reported psychological health is affected mainly by individual characteristics of the population and not by contextual factors at the municipality/city quarter level.     

Aging and self-reported hearing loss: a population-based study

The aim of this study was to estimate the prevalence of self-reported hearing loss among elderly people in S?o Paulo, Brazil, according to socio-demographic characteristics and to identify associated factors. Data were from the S?o Paulo Health Survey (ISA-Capital 2003), and the subgroup of elderly (n = 872) was analyzed. The χ(2) test was used to verify the association between self-reported hearing loss and socio-demographic characteristics. The statistical analyses used Poisson regression. Prevalence of self-reported hearing loss in the elderly was 11.2%, and was higher in men (PR = 1.86; 95%CI: 1.19-2.92). There was an important lack of knowledge among the elderly regarding the causes of their hearing loss (42.5%). Among the sample, 25.5% reported difficulties in leisure-time activities and 11.4% needed help in routine activities, while 63.3% required no assistance due to their impairment. The high prevalence of self-reported hearing loss in the elderly, especially in men, highlights the importance of this public health problem. Population aging is a new reality, placing increasing demands on healthcare professionals and government.     

A cross-sectional study of self-reported work conditions and psychiatric health in native Swedes and immigrants

Several studies have demonstrated that immigrants in Scandinaviancountries are more affected by psychosocial disabilities thanthe native-born population. The aim of the study was to evaluatethe possible impact of work-related stressors on psychiatrichealth in immigrants compared to native Swedes. The study includeda cluster selected cohort of 1,040 men born in 1944 (participationratio=79.9%), living in Gothenburg, Sweden. Of these, 182 (18.0%)were immigrants, defined as being born outside Sweden. Informationon work conditions and psychiatric health were obtained by self-administeredquestionnaires. Employment in native Swedes showed inverse associationsto frequent use of anxiolytics [relative risk (RR)=0.2; 95%confidence interval (Cl)=0.067ndash;0.4], frequent use of hypnotics(RR=0.1; Cl=0.02–0.2) and use of antidepressants (RR=0.3;Cl=0.2–0.5). None of the employed immigrants used anxiolyticsor hypnotics frequently. Swedes seemed to display a number ofpsychiatric ill-health factors related to working conditions.These factors included frequent use of hypnotics, frequent insomnia,use of antidepressants, a high degree of melancholy, and wererelated to shift work, dissatisfaction with current work andmanagement and a low degree of influence on work situation,often related to a high degree of stress at work and a frequentdesire to change type of work. These associations were not seenin immigrants, apart from the risk of frequent insomnia (RR=4.7;Cl=1.2–18.3) and dissatisfaction with colleagues (RR=10.4;Cl=2.27ndash;48.8) when working in shift. With a few exceptions,non-optimal working environment was associated with a low degreeof life satisfaction in both groups. It was hypothesized thatoptimal working conditions are important for maintaining psychiatrichealth, and that immigrants, when employed, seem less affectedby impaired working conditions than native Swedes.     

Psychosocial work conditions, social participation and social capital: a causal pathway investigated in a longitudinal study

Social capital is often claimed to be promoted by stable social structures such as low migration rates between neighbourhoods and social networks that remain stable over time. However, stable social structures may also inhibit the formation of social capital in the form of social networks and social participation. One example is psychosocial conditions at work, which may be determined by characteristics such as demand and control in the work situation. The study examines the active workforce subpopulation within the Swedish Malm? Shoulder Neck Study. A total of 7836 individuals aged 45-69 years, were interviewed at baseline between 1992 and 1994, and at a 1-year follow-up. Four groups of baseline psychosocial work conditions categories defined by the Karasek-Theorell model (jobstrain, passive, active, relaxed) were analysed according to 13 different social participation items during the past year reported at the 1-year follow-up. Odds ratios and 95% confidence intervals with the jobstrain group as a reference were estimated. A multivariate logistic regression model was used to assess differences in different aspects of social participation between the four psychosocial work conditions groups. The results show that the respondents within the active category in particular but also the relaxed category, have significantly higher participation in many of the 13 social participation items, even after multivariate adjustments. The results strongly suggest that psychosocial work conditions may be an important determinant of social capital measured as social participation, a finding of immediate public health relevance because of the well known positive association between social participation and health-related behaviours.     

Sickness absence and self-reported health a population-based study of 43,600 individuals in central Sweden

Background  

Sickness absence is very high in Sweden. The reasons for this phenomenon are not well known. The aim of this study was to investigate the association between degree of self-reported sickness absence and health. The hypothesis was that individuals with long-term sickness absence would report more symptoms and lower self-rated health. Another hypothesis was that women are more likely to self-rate psychiatric diagnoses compared to men, who are more likely to self-rate musculoskeletal diagnoses.     

Psychosocial conditions on and off the job and psychological ill health: depressive symptoms,impaired psychological wellbeing,heavy consumption of alcohol

Background: Psychiatric epidemiology has revealed a number of associations between gender, socioeconomic status, and psychiatric disorders.

Aims: To examine psychosocial conditions on and off the job in relation to psychological ill health.

Methods: Longitudinal design with 24 year follow up of employed persons (190 women, 177 men). Interview and questionnaire data on work and leisure conditions were collected in 1969 and 1993. Risk analyses were performed in relation to three outcomes in 1993: depression within the preceding 12 months, impaired psychological wellbeing, and heavy alcohol use.

Results: Thirteen per cent of the women and 11% of the men showed symptoms of depression, 21% and 22% had impaired psychological wellbeing, and 7% and 15% respectively were heavy alcohol users. Dissatisfaction with the quality (women) or quantity (men) of social contacts 24 years earlier was a significant risk factor for depression. Dissatisfaction with the quality of social contacts was also associated with impaired psychological wellbeing (among women), and dissatisfaction with leisure time activities was associated with heavy alcohol use (among men). Frequent overtime work 24 years earlier was associated with heavy alcohol use among women. Cross sectional analyses also showed associations between psychological ill health and some work related factors (mentally demanding work and lack of job pride).

Conclusions: Perceived inadequacies in social contacts, and practical obstacles to social relationships are viewed as risk factors for depression. In this longitudinal study, work related factors, including mental demands and time pressure, do not appear sufficiently associated with psychological ill health.

     

Marital status,social capital,material conditions and self-rated health: A population-based study

AimsAssociations between marital status and self-rated health were investigated, adjusting for material conditions and trust (social capital).MethodsThe 2004 public-health survey in Skåne is a cross-sectional study. A total of 27,757 persons aged 18–80 years answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model was used to investigate associations between marital status and self-rated health, adjusting for economic problems and trust.ResultsThe prevalence of poor self-rated health was 28.7% among men and 33.2% among women. Older respondents, respondents born abroad, with medium/low education, low emotional support, low instrumental support, economic problems, low trust, never married and divorced had significantly higher odds ratios of poor self-rated health than their respective reference group. Low trust was significantly higher among the divorced and unmarried compared to the married/cohabitating. Adjustment for economic problems but not for trust reduced the odds ratios of poor self-rated health among the divorced, which became not significant among men.ConclusionsNever married and the divorced have significantly higher age-adjusted odds ratios of poor self-rated health than the married/cohabitating group. Economic problems but not trust seem to affect the association between marital status and poor self-rated health.     

Validity of self-reported health plan information in a population-based health survey.

OBJECTIVE: To validate information on private health insurance coverage in a population-based study. METHODS: Respondents to the Massachusetts Behavioral Risk Factor Surveillance System were asked the name of their health plan company (affiliation) and specific brand of insurance (product), the duration in which they belonged to the plan, and demographic and health-related data. Information on plan affiliation and product was used to classify individuals on type of coverage. At the end of the survey, respondents with health insurance were asked to retrieve their health plan cards, and to read detailed information from the cards. Self-reported data were compared with information from the cards. RESULTS: Self-reported information on health plan affiliation agreed with plan cards for 93 percent of individuals, while agreement was 79 percent for health plan product. Among health maintenance organization (HMO) participants, 93 percent correctly reported being in an HMO (sensitivity), whereas 76 percent of respondents in a non-HMO plan correctly self-reported (specificity). Individuals with higher levels of income, those with a primary care doctor, and those in a health plan for at least 1 year had higher agreement. Higher validity was associated with poor physical health and recent cancer screening. CONCLUSIONS: Self-reported data on health plan affiliation and product have good validity in a population-based sample of adults. While agreement differs according to specific respondent characteristics, these differences do not appear substantial.     

Effects of de-industrialization on unemployment, re-employment, and work conditions in a manufacturing workforce

Background  

The purpose of this study was to investigate the impact of a 20-year process of de-industrialization in the British Columbia (BC) sawmill industry on labour force trajectories, unemployment history, and physical and psychosocial work conditions as these are important determinants of health in workforces.     

Association between self-reported hearing impairment and diabetes: a Brazilian population-based study

Background

Some studies have already explored the relationship between diabetes and hearing loss; however, this relationship has still not been well established, especially due to methodological limitations related to lack of control for confounders. The aim of this study was to analyze the association between self-reported hearing impairment and diabetes among adults in Brazil, controlling for sociodemographic and occupational exposure to ototoxic agents.

Methods

This is a cross-sectional study based on data collected by the National Health Survey of 2013 in Brazil. A total of 60,202 individuals aged≥18 years were interviewed. Crude and adjusted prevalence ratios were calculated using the Poisson regression model with robust estimation of the variance. All analyzes were performed considering the appropriated weights imposed by the complex sample design.

Results

Hearing loss prevalence was 2.56% (95%CI: 2.34–2.79). It was higher in males, older age groups, white and individuals with lower levels of schooling. Diabetes was positively and significantly associated with hearing loss in the crude analysis (PR_crude?=?2.92; 95%CI: 2.75–3.11) and also in the analysis adjusted for gender, age, skin color, schooling, smoking, alcohol consumption and occupational exposure (PR_adj?=?1.46; 95%CI: 1.32–1.61).

Conclusions

The present results suggest that individuals with diabetes have higher prevalence of hearing impairment. There is the need of longitudinal studies to investigate if diabetes is a risk factor to hearing impairment.

     

Women,international migration and self-reported health. A population-based study of women of reproductive age

Although our knowledge of the relationship between migration and health in women is increasing, we still have a limited knowledge of the migration and health of women of reproductive age. A cross-sectional analysis of a simple random sample of 10,661 women aged 20-49 in Sweden in 1980-1985 and 9585 such women in 1992-1997 was carried out to assess their health. The risk factors for self-reported, poor health and psychosomatic complaints for female refugees and women from Finland, Southern Europe, Western countries and Sweden were examined. Country of birth was a significant risk factor for poor self-reported health and psychosomatic complaints, with women from Southern Europe, female refugees and Finnish women being at higher risk in this respect than Swedish women. The increased risk remained significant after adjustment for demographic and socio-economic factors. Swedish-born women, female refugees, and Finnish women reported poorer health and had more psychosomatic complaints (not Finns) in the 1990s than in the 1980s.