Documents Ferrie, Jane E. 11 results

"Objective The main aims of this longitudinal study were to (i) examine associations between changes in economic difficulties and health functioning among middle-aged employees and (ii) assess whether the associations remained after considering conventional domains of socioeconomic position. The associations were tested in two European welfare state occupational cohorts to strengthen the evidence base and improve generalizability. Methods Data came from two cohorts: the Finnish Helsinki Health Study (baseline 2000–2002, follow-up 2007, N=6328) and the British Whitehall II Study (baseline 1997–1999, follow-up 2003–2004, N=4350). Responses to the survey item “finding it hard to afford adequate food and clothes and pay bills” repeated at baseline and follow-up were used to examine persistent, increasing, and decreasing economic difficulties. Poor physical and mental health functioning were denoted as being in the lowest quartile of the Short Form 36 physical and mental component summary. Logistic regression analyses were adjusted for sex, age, childhood economic difficulties, household income at baseline and follow-up, employment status at follow-up, and baseline health functioning. Results We observed strong sex- and age-adjusted associations between increasing [odds ratio (OR) range 1.69–2.96] and persistent (OR range 2.54–3.21) economic difficulties and poorer physical and mental health functioning in both British and Finnish occupational cohorts. These associations remained after full adjustments. Those reporting decreasing difficulties over follow-up also had poorer functioning (OR range 1.30–1.61) compared to those who did not have difficulties at baseline, possibly reflecting residual effects of economic difficulties at baseline. Conclusion Changes in economic difficulties are associated with poorer physical and mental health functioning independent of income, employment status, and baseline health functioning.'

"Moves towards a more flexible labor market have focused research attention on the health effects of downsizing, temporary employment, and job insecurity. Most published research documents adverse effects on health, although null findings and direct associations have been observed. There is evidence that major downsizing is associated with poor mental health, medically certified sickness absence, and poor physical health, including cardiovascular disease mortality, among the survivors of downsizing. Recent research suggests that repeated exposure to personnel expansion also predicts sickness absence and hospitalization. There is strong evidence that job insecurity adversely affects psychological health and also evidence of increases in poor self-reported physical health, workplace injuries and accidents, sickness absence, and health service use. However, evidence of a link with disease and premature death remains limited. While temporary workers are initially selected for good health, they generally have poorer mental and physical health, including increased premature mortality, in the long term. "

"OBJECTIVES
To study the association between organisational downsizing and subsequent musculoskeletal problems in employees and to determine the association with changes in psychosocial and behavioural risk factors.
METHODS
Participants were 764 municipal employees working in Raisio, Finland before and after an organisational downsizing carried out between 1991 and 1993. The outcome measures were self reports of severity and sites of musculoskeletal pain at the end of 1993 and medically certified musculoskeletal sickness absence for 1993–5. The contribution of changes in psychosocial work characteristics and health related behaviour between the 1990 and 1993 surveys was assessed by adjustment.
RESULTS
After adjustment for age, sex, and income, the odds ratio (OR) for severe musculoskeletal pain between major and minor downsizing and the corresponding rate ratios for musculoskeletal sickness absence were 2.59 (95% confidence interval (95% CI) 1.5 to 4.5) and 5.50 (3.6 to 7.6), respectively. Differences between the mean number of sites of pain after major and minor downsizing was 0.99 (0.4 to 1.6). The largest contribution from changes in work characteristics and health related behaviour to the association between downsizing and musculoskeletal problems was from increases in physical demands, particularly in women and low income employees. Additional contributory factors were reduction of skill discretion (relative to musculoskeletal pain) and job insecurity. The results were little different when analyses were confined to initially healthy participants.
CONCLUSIONS
Downsizing is a risk factor for musculoskeletal problems among those who remain in employment. Much of this risk is attributable to increased physical demands, but adverse changes in other psychosocial factors may also play a part."

"Background Little is known about the role that work-related factors play in the decline of cognitive function. This study examined the association between perceived organisational justice and cognitive function among middle-aged men and women. Methods Perceived organisational justice was measured at phases 1 (1985–8) and 2 (1989–90) of the Whitehall II study when the participants were 35–55?years old. Assessment of cognitive function at the screening clinic at phases 5 (1997–9) and 7 (2003–4) included the following tests in the screening clinic: memory, inductive reasoning (Alice Heim 4), vocabulary (Mill Hill), and verbal fluency (phonemic and semantic). Mean exposure to lower organisational justice at phases 1 and 2 in relation to cognitive function at phases 5 and 7 were analysed using linear regression analyses. The final sample included 4531 men and women. Results Lower mean levels of justice at phases 1 and 2 were associated with worse cognitive function in terms of memory, inductive reasoning, vocabulary and verbal fluency at both phases 5 and 7. These associations were independent of covariates, such as age, occupational grade, behavioural risks, depression, hypertension and job strain. Conclusions This study suggests an association between perceived organisational justice and cognitive function. Further studies are needed to examine whether interventions designed to improve organisational justice would affect employees' cognition function favourably."

"Background Father's occupational position, education and height have all been used to examine the effects of adverse early life socioeconomic circumstances on health, but it remains unknown whether they predict mortality equally well.Methods We used pooled data on 18?393 men and 7060 women from the Whitehall II and GAZEL cohorts to examine associations between early life socioeconomic circumstances and all-cause and cause-specific mortality.Results During the 20-y follow-up period, 1487 participants died. Education had a monotonic association with all mortality outcomes; the age, sex and cohort-adjusted HR for the lowest versus the highest educational group was 1.45 (95% CI 1.24 to 1.69) for all-cause mortality. There was evidence of a U-shaped association between height and all-cause, cancer and cardiovascular mortality robust to adjustment for the other indicators (HR 1.41, 95% CI 1.03 to 1.93 for those shorter than average and HR 1.36, 95% CI 0.98 to 1.88 for those taller than average for cardiovascular mortality). Greater all-cause and cancer mortality was observed in participants whose father's occupational position was manual rather than non-manual (HR 1.11, 95% CI 1.00 to 1.23 for all-cause mortality), but the risks were attenuated after adjusting for education and height.Conclusions The association between early life socioeconomic circumstances and mortality depends on the socioeconomic indicator used and the cause of death examined. Height is not a straightforward measure of early life socioeconomic circumstances as taller people do not have a health advantage for all mortality outcomes."

"The objective was to examine whether downsizing, the reduction of personnel in organisations, is a predictor of increased sickness absence and mortality among employees.
Major downsizing was associated with an increase in sickness absence (P for trend <0.001) in permanent employees but not in temporary employees. The extent of downsizing was also associated with cardiovascular deaths (P for trend <0.01) but not with deaths from other causes. Cardiovascular mortality was 2.0 (95% confidence interval 1.0 to 3.9) times higher after major downsizing than after no downsizing. Splitting the follow up period into two halves showed a 5.1 (1.4 to 19.3) times increase in cardiovascular mortality for major downsizing during the first four years after downsizing. The corresponding hazard ratio was 1.4 (0.6 to 3.1) during the second half of follow up.
Organisational downsizing may increase sickness absence and the risk of death from cardiovascular disease in employees who keep their jobs."

"Background: In addition to conventional indicators of socioeconomic position, material conditions such as economic difficulties are associated with mental health. However, there has been little investigation of these associations. This study aims to examine the association of current economic difficulties with common mental disorders (CMD) and the contribution of social and behavioural factors to this association in two cohorts of Finnish and British white-collar employees. Methods: Comparable survey data from the Finnish Helsinki Health Study and the British Whitehall II Study were used. CMD were measured with the GHQ-12. Inequality indices from logistic regression analysis were used to examine the association between current economic difficulties and CMD, and the contribution of other past and present socioeconomic circumstances, health behaviours, living arrangements and work-family conflicts to this association. Inequality indices show the average change in ill health for each step up in the level of economic difficulties. Analyses were conducted separately for men and women.Results: Clear associations between current economic difficulties and CMD were found. Adjusting for work-family conflicts attenuated the associations. Adjusting for indicators of past and present socioeconomic circumstances, health behaviours and living arrangements had generally negligible effects. The results were very similar among both sexes in the two cohorts. Conclusions: Conflicts between work and family contribute to the association between economic difficulties and CMD in both Finland and Britain. Supporting people to cope not only with everyday economic difficulties but also with work-family conflicts may be important for reducing inequalities in mental health."

"This study examined the association between long working hours and cognitive function in middle age. Data were collected in 1997-1999 (baseline) and 2002-2004 (follow-up) from a prospective study of 2,214 British civil servants who were in full-time employment at baseline and had data on cognitive tests and covariates. A battery of cognitive tests (short-term memory, Alice Heim 4-I, Mill Hill vocabulary, phonemic fluency, and semantic fluency) were measured at baseline and at follow-up. Compared with working 40 hours per week at most, working more than 55 hours per week was associated with lower scores in the vocabulary test at both baseline and follow-up. Long working hours also predicted decline in performance on the reasoning test (Alice Heim 4-I). Similar results were obtained by using working hours as a continuous variable; the associations between working hours and cognitive function were robust to adjustments for several potential confounding factors including age, sex, marital status, education, occupation, income, physical diseases, psychosocial factors, sleep disturbances, and health risk behaviors. This study shows that long working hours may have a negative effect on cognitive performance in middle age."

"Background Previous studies show that sickness absence predicts health, but it is unclear whether this association is persistent over time and whether specific diseases underlie long-term associations. The aim of this study was to investigate overall and diagnosis-specific sickness absences as predictors of sustained suboptimal health. Methods Prospective occupational cohort study of 15,320 employees (73% men) aged 37-51. Sickness absence records in 1990-1992, including 13 diagnostic categories, were examined in relation to self-rated health measured annually for the years 1993-2006. Results 3385 employees (22%) had >30 days of sickness absence and 5564 (36%) 1-30 days during the 3-year exposure window. Repeated-measures logistic regression analysis adjusted for age, sex, occupational status and chronic diseases show that employees with >30 absence days, compared with those with no absences, had 2.14 (95% CI 2.00 to 2.29) times higher odds for suboptimal health over the 14 years of follow-up. Retirement did not dilute this association. Nine sickness absence diagnostic categories, such as diseases of the nervous, circulatory, metabolic, musculoskeletal, sensory and gastrointestinal systems, cancer, mental disorders and external causes, independently predicted increased risk of sustained suboptimal health.Conclusions There is a remarkably persistent association between sickness absence and future long-term self-rated health status for the majority of diagnostic categories for sickness absence. This suggests that the association between sickness absence and health is ubiquitous and not driven by a limited number of rare and severe diseases."

"Objective: To explore the underlying mechanisms between organisational downsizing and deterioration of health of employees. Design: Longitudinal cohort study. Data were assembled from before downsizing (time 1); during major downsizing affecting some job categories (time 2); and after downsizing (time 3). Contributions of changes in work, support, and health related behaviours between time 1 and time 2 to the relation between downsizing and sickness absence at time 3 were assessed by multilevel modelling. Mean length of follow up was 4.9 years. Setting: Raisio, a town in Finland. Subjects: 764 municipal employees who remained in employment after downsizing. Main outcome measures: Records of absences from work from all causes with medical certificate. Results: Downsizing was associated with negative changes in work, impaired support from spouse, and increased prevalence of smoking. Sickness absence rate from all causes was 2.17 (95% confidence interval 1.54 to 3.07) times higher after major downsizing than after minor downsizing. Adjustment for changes in work (for instance, physical demands, job control, and job insecurity) diminished the relation between downsizing and sickness absence by 49% Adjustments for impaired social support or increased smoking did not alter the relation between downsizing and sickness absence. The findings were unaffected by sex and income."