European Journal of Public Health最新文献

Many European countries have increased retirement ages to address the challenge of population ageing. However, job strain which is the combination of high job demands and low job control may be an obstacle to extending the working lives of older workers. Job strain is associated with poor health and early work exit among older workers, but less is known about whether job strain impacts working life expectancy (WLE)-an increasingly employed summary measure capturing the length of working lives. This study aims to fill this gap in the literature. The sample included n = 13 225 individuals aged 50 years or older at baseline providing 53 004 persons-observations from the Swedish Longitudinal Occupational Survey of Health in 2008 through 2020. We used continuous time multi-state Markov models to assess the average number of years people may be expected to work beyond age 50 years by job strain, and stratified by sex, occupational class, and level of education. Job strain was associated with a significantly shorter WLE (by about 6 months to a year) among those who experienced job strain compared to those who did not experience job strain. Our findings suggest that job strain may play a role in shortening the working lives of older people. The findings further suggest that if older workers are to remain in the labor market for longer periods, this may require improvements of psychosocial working conditions.

To reduce the spread of COVID-19, schools closed and moved to remote learning in many countries and municipalities. At the time of this study, Switzerland maintained the position that schools should be prioritized to remain open. The state of knowledge regarding the challenges that school staff encountered during the pandemic was limited. The aim of this study was to qualitatively explore the impact of COVID-19 and related measures in Switzerland on the professional life of school staff in terms of challenges, strategies, and benefits. Data were collected between November 2021 and March 2022. We conducted interviews with 47 participants working in nurseries, kindergartens, primary, middle, special, and after-schools across Switzerland. The majority were women and part of the teaching staff. Most had received at least one dose of the COVID-19 vaccine. Participants reported various challenges such as isolation, loneliness, and 'dryness' of work, pedagogical alienation and deontological distress, privacy loss, and confusion regarding health measures. They also cited different strategies, namely resuming simple activities, finding the right degree of transgression, recreating normality with children, and continuous adaptation. Finally, they identified some benefits, i.e. improvements in education regarding hygiene standards, greater acceptance of illness and death as a normal part of life, recognition of the privilege of being able to attend school in-person, and valorization of cultural diversity. We highlight the importance of listening to staff's concerns, enacted strategies, and perceived benefits and taking them into account when developing appropriate and effective public health and communication efforts.

Occupational accidents have emerged as a global concern, necessitating a comprehensive examination of their determinants and associated costs. This review aims to summarize, synthesize, and organize the factors and cost drivers of occupational accidents, exploring whether there is a gender perspective. Adhering to PRISMA guidelines, we performed a narrative synthesis to systematically review relevant literature. A systematic search was conducted in the electronic databases PubMed, Web of Science, and Scopus. Two researchers screened all records to eliminate any duplicates, and they selected the articles for full review. A third researcher was consulted to resolve discrepancies and reach a consensus. The analysis of 15 studies revealed diverse perspectives; in terms of determinants, studies on organizational aspects and the theory of human error were grouped together, while in cost drivers, the human capital model and willingness to pay were the most frequently used. Gender, meanwhile, is identified as a determinant variable for accident rate. Additionally, limitations such as data underestimation were noted in the existing literature. The review highlights the need for empirical studies capable of addressing both determinants and cost drivers. It also provides guidelines for researchers to design studies that are more comparable across different contexts, including the gender debate.

Physical activity (PA) has a positive effect on risk factors related to cardiometabolic health yet amount of PA and time of onset is unclear. Therefore, we investigated the relationship of PA estimates and cardiometabolic risk factors in a large healthy population of an understudied age group of young adults using a standard gravity-based method on body adiposity and risk markers. In 856 (532 women, 324 men, 32-35 years) subjects we evaluated the association of PA and cardiometabolic risk factors in early adulthood. PA was measured using accelerometers for a period of two weeks. Step counts were divided into light (LPA), moderate (MPA), and vigorous (VPA) intensity classes. Income of the household was 63 446 ± 46 899€ and 57.5% had higher education. Total daily step numbers were 11962.5 ± 5163.2, LPA 5459.6 ± 2986.6, MPA 5932 ± 3404.6, and VPA 572.3 ± 668. Higher total PA volume was associated with lower weight, BMI, % body fat, smaller visceral fat area (VFA) and waist circumference, lower total cholesterol, LDL, and reflection coefficient of the pulse wave. LPA correlated with weight, BMI, waist circumference, total cholesterol, LDL, and central pulse pressure (cPP). Percent body fat (%BF), VFA, total cholesterol, LDL, reflection coefficient, heart minute index, and heart minute volume were significantly associated with MPA and VPA intensity PA volume. Lower PA in early adulthood correlates with increased cardiometabolic risk markers which should be translated into specific recommendations to thrive for a healthier lifestyle to delay and decrease their onset.

It is still unclear how changes in alcohol control policies may have contributed to changes in overall levels of alcohol-attributed harm between and within the Nordic countries. We modified and applied the Bridging the Gap (BtG)-scale to measure the restrictiveness of a set of alcohol control policies for each Nordic country and each year between 1990 and 2019. Alcohol-attributed harm was measured as total and sex-specific alcohol-attributed disease burden by age-standardized years of life losts (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) per 100 000 population from the Global Burden of Disease Study (GBD). Longitudinal cross-country comparisons with random effects regression analysis were employed to explore associations, within and across countries, differentiated by sex and the time to first effect. Overall, alcohol-attributed YLLs, YLDs, and DALYs decreased over the study period in all countries, except in Iceland. The burden was lower in those countries with restrictive national policies, apart from Finland, and higher in Denmark which had the least restrictive policies. Changes in restrictiveness were negatively associated with DALYs for causes with a longer time to effect, although this effect was stronger for males and varied between countries. The low alcohol attributed disease burden in Sweden, Norway, and Iceland, compared to Denmark, points towards the success of upholding lower levels of harm with strict alcohol policies. However, sex, location and cause-specific associations indicate that the role of formal alcohol policies is highly context dependent and that other factors might influence harm as well.

Cancers represent the primary cause of mortality among people living with HIV (PLWH). However, comprehensive nationwide data regarding cancer incidence remains limited. Our objective was to evaluate the incidence rates of cancers, particularly those associated with human papillomavirus (HPV), within a nationwide study cohort. Using data from the Estonian Health Insurance Fund and the National Cancer Registry from 2004 to 2021, we calculated standardized incidence ratios (SIRs) for various cancer types among PLWH to compare to the general population with special emphases on HPV-associated cancers. A total of 7011 individuals (65.7% men) diagnosed with HIV were identified. HPV-associated cancers accounted for 21.4% of all incident cancer cases among PLWH. SIRs for HPV-associated cancers were 3.7 [95% confidence interval (CI) 2.2-6.2] among men living with HIV (MLWH) and 5.7 (95% CI 4.0-7.9) among women living with HIV (WLWH). In MLWH, the highest SIRs were for penile 12.5 (95% CI 4.0-38.7), followed by oropharyngeal 3.6 (95% CI 1.7-7.6) and anal-rectal cancers 2.7 (95% CI 1.1-6.4) in comparison to the general population. In WLWH, an increased incidence of cervical (SIR = 5.8, 95% CI 3.9-8.5), oropharyngeal (SIR = 6.1, 95% CI 1.5-24.3), and anal-rectal (SIR = 3.6, 95% CI 1.2-11.2) cancers was observed. A significantly increased risk of AIDS-defining and non-AIDS-defining cancers is reported. We demonstrate a substantially heightened risk of HPV-associated cancers among PLWH compared to the general population, underscoring the imperative for intensified screening and scaled-up vaccination along with improvement in adherence to antiretroviral therapy.

The aim of this paper was to study ethnic and socioeconomic (SEP) factors' association with provision and participation in a type 2 diabetes disease-management program. In 2016-21, 3464 persons were referred to type 2 diabetes management in Copenhagen municipality. Personalized plans included a mix of activities; program consultations, dietary education, telephone conversations, patient education, and physical training. We estimated the association between education, income, civic status, employment, and country of origin with the number of booked and participated activities using Poisson regression models. A total of 55 394 program sessions were scheduled. Small differences in booked dietary education, program consultations, telephone conversations, and patient education were seen between SEP groupings. In situations where groups with lower SEP had booked more sessions (e.g. unemployed bookings of dietary education), these were predominantly translated into equal or more participated sessions among persons with high SEP. Regarding physical training, considerably more booked and participated sessions were delivered to women with lower SEP and ethnic minorities. This study is unique, in the sense that it is the first of its kind to analyze data on diabetes-management programs, systematically collected by primary healthcare workers. Our results suggest that specific elements of the program together with a higher number of booked sessions promoted vulnerable women to participate in more physical training sessions. In closing, these findings have the potential to provide motivation and ideas for policymakers and health professionals in how to design equitable type 2 diabetes management activities.

Unemployment has been associated with increased risk of cardiovascular disease (CVD) and all-cause mortality. However, factors behind this association remain unsettled. A primary care CVD prevention programme was conducted in two Finnish towns in 2005-07. Of the participants (n = 4450), a cohort of apparently healthy CVD risk subjects belonging to the labour force (n = 1487) was identified. Baseline depressive symptoms were assessed by Beck's Depression Inventory. Data on employment status and mortality were obtained from official statistics. The effect of employment status and depressive symptoms on all-cause mortality after a median follow-up of 15 years was estimated in models adjusted for age, sex, body mass index, non-high-density lipoprotein cholesterol, physical activity, alcohol use, current smoking, glucose metabolism, and hypertension. In comparison to employed non-depressive subjects, fully adjusted hazard ratio (HR) for all-cause mortality was 3.53 (1.90-6.57) in unemployed subjects with increased depressive symptoms, 1.26 (0.68-2.34) in unemployed non-depressive subjects, and 1.09 (0.63-1.90) in employed depressive subjects. Factors independently associated with mortality were unemployment with increased depressive symptoms [HR 3.56 (95% CI 1.92-6.61)], screen-detected diabetes [HR 2.71 (95% CI 1.59-4.63)], current smoking [HR 1.77 (95% CI 1.19-2.65)], and higher age [HR 1.10 (95% CI 1.05-1.15)]. Unemployment in itself was not associated with all-cause mortality. If unemployment was accompanied with increased depressive symptoms, risk of death was significantly elevated.