Documents Gadeyne, Sylvie 3 results

"Background
Reducing socioeconomic inequalities in mortality, a key public health objective may be supported by a careful monitoring and assessment of the contributions of specific causes of death to the global inequality.
Methods
The 1991 and 2001 Belgian censuses were linked with cause-of-death data, each yielding a study population of over 5 million individuals aged 25–64, followed up for 5?years. Age-standardised mortality rates (ASMR) were computed by educational level (EL) and cause. Inequalities were measured through rate differences (RDs), rate ratios (RRs) and population attributable fractions (PAFs). We analysed changes in educational inequalities between the 1990s and the 2000s, and decomposed the PAF into the main causes of death.
Results
All-cause and avoidable ASMR decreased in all ELs and both sexes. Lung cancer, ischaemic heart disease (IHD), chronic obstructive pulmonary disease (COPD) and suicide in men, and IHD, stroke, lung cancer and COPD in women had the highest impact on population mortality. RDs decreased in men but increased in women. RRs and PAFs increased in both sexes, albeit more in women. In men, the impact of lung cancer and COPD inequalities on population mortality decreased while that of suicide and IHD increased. In women, the impact of all causes except IHD increased.
Conclusion
Absolute inequalities decreased in men while increasing in women; relative inequalities increased in both sexes. The PAFs decomposition revealed that targeting mortality inequalities from lung cancer, IHD, COPD in both sexes, suicide in men and stroke in women would have the largest impact at population level."

"Objectives
Evidence is growing that non-standard employment is associated with adverse health. However, little is known about the relationship between different non-standard employment arrangements and subsequent all-cause and cause-specific mortality. Using population-wide data, the present study investigated this link.
Methods
Data was derived from the 2001 Belgian census and a 13-year-long follow-up. The analyses comprised 1 454 033 healthy and disability-free employees aged 30–59 years at baseline. Cox regressions were fitted to analyze the mortality risks of those in non-standard employment forms (temporary agency, seasonal, fixed-term, causal work and employment program) compared to permanent employees.
Results
Several groups of workers in non-standard employment arrangements in 2001 exhibited a higher mortality risk relative to permanent employees during the follow-up after adjusting for socio-economic and work-related factors. This was especially the case among men. The relative mortality disadvantage was particularly elevated for male temporary agency workers. External causes of death played an important role in this association.
Conclusions
A mortality gradient between the core and outer periphery of the Belgian labor market has been observed. This study also shows that the excess risk of death, previously attributed to non-permanent employment as a whole, hides inequalities between specific forms of non-standard work (eg, temporary agency, seasonal, fixed-term employment).

"Objectives
An individual's quality of employment over time has been highlighted as a potential determinant of mental health. With mental ill-health greatly contributing to work incapacities and disabilities in Belgium, the present study aims to explore whether mental health, as indicated by registered mental health-related disability, is structured along the lines of employment quality, whereby employment quality is assessed over time as part of individuals' labour market trajectories.
Methods
Using administrative data from the Belgian Crossroads Bank for Social Security over 16 quarters between 2006 and 2009, transitions between waged jobs of varying quality (based on dimensions of income, working time, employment stability and multiple jobholding), self-employment, and unemployment are considered among individuals in the labour force aged 30–40 at baseline (n = 41,065 women and 45,667 men). With Multichannel Sequence Analysis and clustering, we constructed ideal types of employment trajectories. Fitting Cox regressions, we then evaluated individuals' hazard of experiencing a disability from a mental disorder between 2010 and 2016.
Results
Our analysis highlights various gender-specific trajectories. Among both genders, individuals exposed to near-constant unemployment over the initial 4 years showed the highest hazard of subsequent mental health-related disability compared to a group characterised by stable full-time employment, single jobholding, and above-median income. Trajectories involving a higher probability of subsidised and non-standard employment and (potential) spells of unemployment and lower relative income were also strong predictors of cause-specific disabilities. Health selection and confounding might, however, be contributing factors.
Conclusions
Our study shows a gradient of mental disorders resulting in a disability along trajectory types. Our findings highlight the predictive power of labour market trajectories and their employment quality for subsequent mental disorder-related disability. Future research should examine the mechanisms, including selection effects in this association."