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Functioning will be an increasingly important issue in Finland over the coming decades as the proportion of the population aged 65 and older is growing significantly. However, the associations between changes in physical activity and subsequent health functioning are poorly understood. The aim of this study was to examine how changes in physical activity relate to concurrent and prospective levels of health functioning. Cohort data from the Helsinki Health Study were used. Phase 1 ( n = 8960, response rate 67%, 80% women) was conducted among 40- to 60-year-old employees of the City of Helsinki in 2000-2002, phase 2 in 2007 ( n = 7332, response rate 83%), and phase 3 in 2012 ( n = 6814, response rate 79%). Linear mixed models were used as the main statistical method. Increasing physical activity was associated with higher concurrent and prospective levels of physical health functioning, whereas decreasing activity was associated with lower levels of physical health functioning. The associations were stronger with physical than with mental health functioning. Promoting physical activity among aging people may help to maintain their level of health functioning. [ABSTRACT FROM AUTHOR]

Aims: Socioeconomic inequalities in both disability retirement and mortality are large. The aim of this study was to examine socioeconomic differences in cause-specific mortality after disability retirement due to different diseases. Methods: We used administrative register data from various sources linked together by Statistics Finland and included an 11% sample of the Finnish population between the years 1987 and 2007. The data also include an 80% oversample of the deceased during the follow-up. The study included men and women aged 30-64 years at baseline and those who turned 30 during the follow-up. We used Cox regression analysis to examine socioeconomic differences in mortality after disability retirement. Results: Socioeconomic differences in mortality after disability retirement were smaller than in the population in general. However, manual workers had a higher risk of mortality than upper non-manual employees after disability retirement due to mental disorders and cardiovascular diseases, and among men also diseases of the nervous system. After all-cause disability retirement, manual workers ran a higher risk of cardiovascular and alcohol-related death. However, among men who retired due to mental disorders or cardiovascular diseases, differences in social class were found for all causes of death examined. For women, an opposite socioeconomic gradient in mortality after disability retirement from neoplasms was found. Conclusions: The disability retirement process leads to smaller socioeconomic differences in mortality compared with those generally found in the population. This suggests that the disability retirement system is likely to accurately identify chronic health problems with regard to socioeconomic status. [ABSTRACT FROM PUBLISHER]

Objectives Common mental disorders are prevalent among employees and may cause work disability. We aimed to examine the association between common mental disorders and disability retirement, with an emphasis on the severity of disorders and diagnostic causes for retirement. Methods Our data were derived from the Helsinki Health Study cohort on the staff of the City of Helsinki, Finland. The baseline mail surveys were made in 2000-2002 among employees reaching ages 40, 45, 50, 55 and 60 in each year (n=8960, response rate 67%, 80% women). Disability retirement events from national registers (n=628) were followed up by the end of 2010 and linked to the baseline data. After exclusions, the number of participants was 6525. Common mental disorders were measured by the General Health Questionnaire 12-item version (GHQ-12). Covariates at baseline included sociodemographic, work-related and health-related factors. Hazard ratios (HR) and 95% CIs were calculated using Cox proportional hazards models. Results Common mental disorders showed a graded association with disability retirement. For disability retirement due to any diagnostic cause, the fully adjusted HR for the GHQ-12 score 7-12 was 2.16, 95% CI 1.63 to 2.85. For disability retirement due to mental disorders the corresponding HR was 7.46, 95% CI 4.46 to 12.49. For disability retirement due to musculoskeletal diseases, the association was weaker and did not survive all adjustments. Conclusions Common mental disorders are an important antecedent of disability retirement in general and due to mental disorders in particular. Successful measures against common mental disorders may prevent disability retirement due to mental disorders. [ABSTRACT FROM AUTHOR]

Purpose: Research on the association between family-to-work and work-to-family conflicts and sleep problems is sparse and mostly cross-sectional. We examined these associations prospectively in three occupational cohorts. Methods: Data were derived from the Finnish Helsinki Health Study ( n = 3,881), the British Whitehall II Study ( n = 3,998), and the Japanese Civil Servants Study ( n = 1,834). Sleep problems were assessed using the Jenkins sleep questionnaire in the Finnish and British cohorts and the Pittsburgh Sleep Quality Index in the Japanese cohort. Family-to-work and work-to-family conflicts measured whether family life interfered with work or vice versa. Age, baseline sleep problems, job strain, and self-rated health were adjusted for in logistic regression analyses. Results: Adjusted for age and baseline sleep, strong family-to-work conflicts were associated with subsequent sleep problems among Finnish women (OR, 1.33 (95 % CI, 1.02-1.73)) and Japanese employees of both sexes (OR, 7.61 (95 % CI, 1.01-57.2) for women; OR, 1.97 (95 % CI, 1.06-3.66) for men). Strong work-to-family conflicts were associated with subsequent sleep problems in British, Finnish, and Japanese women (OR, 2.36 (95 % CI, 1.42-3.93), 1.62 (95 % CI, 1.20-2.18), and 5.35 (95 % CI, 1.00-28.55), respectively) adjusted for age and baseline sleep problems. In men, this association was seen only in the British cohort (OR, 2.02 (95 % CI, 1.42-2.88)). Adjustments for job strain and self-rated health produced no significant attenuation of these associations. Conclusion: Family-to-work and work-to-family conflicts predicted subsequent sleep problems among the majority of employees in three occupational cohorts. [ABSTRACT FROM AUTHOR]

Objective To study the associations of sociodemographic factors, working conditions, lifestyle and previous pain in the spine with new onset chronic neck pain ( NP). Methods The participants were municipal employees free of chronic NP at baseline, aged 40, 45, 50, 55 or 60 years ( n = 5277, 80% women). Self-reported data on occupational class, working conditions, body mass index, smoking, exercise, mental well-being, sleep problems, NP and low back pain ( LBP) were obtained from baseline questionnaire surveys in 2000-2002. The question on chronic NP was repeated in a follow-up in 2007. Logistic regression analysis was used. Results The incidence of chronic NP was 15% in women and 9% in men. In multivariable analysis among women, acute NP [odds ratio ( OR) 3.8, 95% confidence interval ( CI) 2.9-5.1], chronic LBP (1.6, 1.2-2.2), reporting current workplace bullying ( OR 1.6, 95% CI 1.1-2.4), earlier bullying at the present workplace (1.6, 1.2-2.0), and earlier bullying in another workplace (1.8, 1.3-2.4), frequent sleep problems (1.5, 1.2-2.0), overweight (1.2, 1.0-1.5), and obesity (1.4, 1.1-1.8) predicted chronic NP at follow-up. Men with acute NP (2.3, 1.4-3.8), chronic LBP (2.3, 1.2-4.3), manual occupational class (1.8, 1.1-3.1) and high work-related emotional exhaustion (1.9, 1.1-3.3) at baseline had an increased risk of new onset chronic NP. Conclusions We found potentially modifiable predictors of chronic NP among employees: workplace bullying, sleep problems, and high body mass index in women, and work-related emotional exhaustion in men. In both genders, previous acute NP and chronic LBP were predictive of chronic NP. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To study the effects of occupational class, physical and psychosocial working conditions, health behaviours, and pain in the low back and the neck on sciatic pain among middle-aged employees. METHODS: The participants were municipal employees without previous sciatica, aged 40, 45, 50, 55, and 60years at baseline (n=5261, 80% women). Sciatica was defined as low back pain radiating to the calf or the foot. Data on occupational class, physical and psychosocial working conditions, body mass index, smoking, leisure-time physical activity, neck pain, local low back pain, and sciatica were obtained from baseline questionnaire surveys in 2000-2002. The question on sciatica was repeated in a follow-up survey in 2007. Logistic regression analysis was used. RESULTS: In women, manual occupational class (OR 1.3; 95% CI 1.0-1.6 compared with managers/professionals), overweight (1.3; 1.1-1.5), obesity (1.4; 1.1-1.7), smoking (1.5; 1.2-1.7), low leisure-time physical activity (1.3; 1.0-1.7), previous acute (1.5; 1.3-1.7) and chronic (1.5; 1.1-2.0) local low back pain, and acute (1.20; 1.0-1.4) and chronic (1.5;1.2-1.9) neck pain predicted the onset of sciatica in a multivariable model. In men, semi-professionals (1.5; 1.1-2.1) and manual workers (2.0; 1.4-2.8) had an increased risk compared with managers/professionals; also acute (1.5; 1.2-2.0) and chronic (2.1; 1.2-3.9) local low back pain predicted sciatica. CONCLUSIONS: Manual occupational class in both genders and semi-professional occupations in men, unhealthy behaviours and previous pain both in the neck and the lower back predicted sciatica, while physical and psychosocial working conditions had no independent effect. [ABSTRACT FROM AUTHOR]

Objective:To examine the associations between sleep problems and major weight gain during a 5- to 7-year follow-up among middle-aged women and men.Methods:The Helsinki Health Study prospective cohort baseline survey data from 2000 to 2002 (n=8960, response rate 67%) among 40- to 60-year-old municipal employees and follow-up survey data from 2007 (n=7332, response rate 83%) were used. Logistic regression analysis was used to examine the association between the four-item Jenkins Sleep Questionnaire and major weight gain of 5 kg or more over a 5- to 7-year follow-up.Results:Half of the participants reported at least occasional sleep problems, whereas 13% of women and 17% of men reported no such problems at baseline. The frequency of sleep problems varied by item. Frequent sleep problems were reported by 20% of women and 17% of men. Major weight gain was reported by 25% of women and 24% of men. Trouble falling asleep (odds ratio (OR) 1.65; 95% confidence interval (CI) 1.22, 2.22), waking up several times per night (OR 1.49; 95% CI 1.22, 1.81) and trouble staying asleep (OR 1.41; 95% CI 1.13, 1.75) were associated with major weight gain during the follow-up in women but not in men. In contrast, waking up tired was unassociated with weight gain. The summary measure of the four items was also associated with weight gain in women. Adjusting for baseline body mass index, physical health, health behaviour, marital status, education, work arrangements and sleep duration had only minor effects on the above associations. Adjusting for common mental disorders at baseline, the associations were attenuated but remained for trouble falling asleep, waking up several times per night and trouble staying asleep. Occasional sleep problems were also associated with weight gain.Conclusion:Sleep problems likely contribute to weight gain. To prevent major weight gain and obesity, sleep problems need to be taken into account. [ABSTRACT FROM AUTHOR]

Objectives Low socioeconomic position is consistently associated with higher rates of sickness absence. We aimed to examine whether working conditions, health-related behaviours and family-related factors explain occupational class differences in medically certified sickness absence. Methods The study included 5470 women and 1464 men employees of the City of Helsinki, surveyed in 2000-2002. These data were prospectively linked to sickness absence records until the end of 2005, providing a mean follow-up time of 3.9 years. Poisson regression was used to examine the occurrence of medically certified sickness absence episodes lasting 4 days or more. Results Medically certified sickness absence was roughly three times more common among manual workers than among managers and professionals in both women and men. Physical working conditions were the strongest explanatory factors for occupational class differences in sickness absence, followed by smoking and relative weight. Work arrangements and family-related factors had very small effects only. The effects of psychosocial working conditions were heterogeneous: job control narrowed occupational class differences in sickness absence while mental strain and job demands tended to widened them. Overall, the findings were quite similar in women and men. Conclusions Physical working conditions provided strongest explanations for occupational class differences in sickness absence. Smoking and relative weight, which are well-known determinants of health, also explained part of the excess sickness absence in lower occupational classes. Applying tailored work arrangements to employees on sick leave, reducing physically heavy working conditions and promoting healthy behaviours provide potential routes to narrow occupational class differences in sickness absence. [ABSTRACT FROM AUTHOR]

BACKGROUND: Work-family conflicts are associated with poor health. However, work-family conflicts and health behaviors have been little studied. PURPOSE: This study examined the associations of conflicts between paid work and family life with unhealthy behaviors among British, Finnish, and Japanese employees. METHOD: Data were derived from postal questionnaire surveys among 40 to 60 years old employees from three cohorts, the British Whitehall II Study (n = 3,397), the Finnish Helsinki Health Study (n = 4,958), and the Japanese Civil Servants Study (n = 2,901). Outcomes were current smoking, heavy drinking, physical inactivity, and unhealthy food habits. Work-family conflicts were measured with eight items. Age, marital status, and occupational class were adjusted for in logistic regression analyses. RESULTS: Work-family conflicts had few and inconsistent associations with unhealthy behaviors in all three cohorts. In the Finnish cohort, strong work-family conflicts were associated with current smoking among men. Women with strong conflicts had more often unhealthy food habits and were more often heavy drinkers than women with weaker conflicts. Likewise, British women with strong work-family conflicts were more often heavy drinkers. CONCLUSION: Although work-family conflicts were fairly prevalent in the examined cohorts, these conflicts had but few associations with the studied key health behaviors. [ABSTRACT FROM AUTHOR]

Work–family conflicts are associated with poor health. However, work–family conflicts and health behaviors have been little studied. This study examined the associations of conflicts between paid work and family life with unhealthy behaviors among British, Finnish, and Japanese employees. Data were derived from postal questionnaire surveys among 40 to 60 years old employees from three cohorts, the British Whitehall II Study ( n = 3,397), the Finnish Helsinki Health Study ( n = 4,958), and the Japanese Civil Servants Study ( n = 2,901). Outcomes were current smoking, heavy drinking, physical inactivity, and unhealthy food habits. Work–family conflicts were measured with eight items. Age, marital status, and occupational class were adjusted for in logistic regression analyses. Work–family conflicts had few and inconsistent associations with unhealthy behaviors in all three cohorts. In the Finnish cohort, strong work–family conflicts were associated with current smoking among men. Women with strong conflicts had more often unhealthy food habits and were more often heavy drinkers than women with weaker conflicts. Likewise, British women with strong work–family conflicts were more often heavy drinkers. Although work–family conflicts were fairly prevalent in the examined cohorts, these conflicts had but few associations with the studied key health behaviors. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine whether the volume and intensity of physical activity are associated with subsequent sickness absence spells of different lengths, and how much of these associations can be explained by socioeconomic position, body mass index (BMI) and physical health functioning. Baseline data were collected by questionnaire surveys in 2000–2002 among 40–60-year-old employees of Helsinki City ( n=6465, 79% women). Sickness absence data were derived from the employer's registers (mean follow-up time 3.9 years). Associations of physical activity with shorter (≤14 days) and longer (>14 days) sickness absence spells were examined, using Poisson's regression analysis. The volume of physical activity was weakly and somewhat inconsistently associated with sickness absence. However, men and women who were vigorously active systematically had reduced risk of sickness absence, whereas the same volume of moderately intensive physical activity did not reduce the risk of sickness absence. Adjusting for BMI and in particular physical health functioning attenuated these associations, after which the associations lost statistical significance. The results suggest that vigorous physical activity is associated with sickness absence and may contribute to better work ability. [ABSTRACT FROM AUTHOR]

This study examined whether the association of household income with fresh fruit and vegetable consumption varies by the level of education. Data were derived from mail surveys carried out during 2000–2002 among 40- to 60-year-old employees of the City of Helsinki (n=8960, response rate 67%). Education was categorized into three levels, and the household income was divided into quartiles weighted by household size. The outcome was consumption of fresh fruit and vegetables at least twice a day (58% among women and 33% among men). Beta-binomial regression analysis was used. Among women, higher income resulted in equally higher consumption of fruit and vegetables at all educational levels, that is, similar among those with low, intermediate and high education. Among men, the pattern was otherwise similar; however, men with intermediate education differed from those with low education. We conclude that the absolute cost of healthy food is likely to have a role across all income groups. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objectives: To study the effects of pain on sickness absence, taking into account physical and psychosocial work load and socio-economic position. Methods: Data consisted of City of Helsinki personnel register data on sickness absence and a cross-sectional questionnaire survey which was carried out among employees of the City of Helsinki who reached the age of 40, 45, 50, 55 or 60 years during the years 2000-2002 (n = 8960, response rate 67%). Data sets were combined for those who gave permission for such linkage (78%). The main statistical method was negative binomial regression analysis. Results: The burden of pain on sickness absence was dependent on the duration of absence: the longer the duration, the higher the burden. Self-certified absence was equally predicted by acute and chronic pain, but medically certified absence was more clearly predicted by chronic pain. Adjustments for a range of work load factors and socio-economic position showed that pain was a relatively independent determinant of subsequent sickness absence, but in particular physical work load and socio-economic position explained a small proportion of the association. Overall, pain accounted for 13% of self- certified absence among women and 8% among men. Corresponding figures were 23% and 25% for medically certified 4-4-day sickness absence and 37% and 30% for absence of over 2 weeks. Conclusions: The burden of pain on medically certified sickness absence is considerable. Prevention of pain problems is vital for reducing sickness absence rates. [ABSTRACT FROM AUTHOR]

BACKGROUND: To further increase our understanding of socio-economic health inequalities, we need studies considering multiple socio-economic circumstances and comparing different cultural contexts. This study compared the associations of past and present socio-economic circumstances with physical functioning between employees from Finland and Britain. METHODS: Cross-sectional survey data from the Helsinki Health Study (n = 5866) and the Whitehall II Study (n = 3052) were used. Participants were white-collar public sector employees aged 45-60 years. Physical functioning was measured with the SF-36 physical component summary. The socio-economic indicators were parental and own education, childhood and current economic difficulties, occupational class, income, housing tenure. RESULTS: Childhood and current economic difficulties were independently associated with physical functioning in both cohorts, although in London women childhood difficulties did not reach statistical significance. Own education was independently associated with physical functioning in Helsinki. Occupational class showed associations with physical functioning in both cohorts. These were mainly attenuated by education and income, but in London women there was a strong independent association. The association of income with physical functioning was attenuated by education (Helsinki) and occupational class (London). Parental education and housing tenure showed no consistent associations. CONCLUSIONS: Past and present economic difficulties were independently associated with physical functioning. The conventional socio-economic indicators showed less consistent associations which were partly mediated through other indicators and modified by the national context. The associations that varied according to the indicators and between the cohorts highlight the importance of considering the multiplicity of socio-economic circumstances and comparing different cultural contexts in further studies. [ABSTRACT FROM AUTHOR]

Objectives: To examine gender differences in sickness absence spells of various lengths and to explain these differences by health status, working conditions and family-related factors. Methods: The study included 5470 female and 1464 male employees of the City of Helsinki surveyed at baseline in 2000-2. These survey data were linked to the employer's sickness absence records until the end of 2005, providing a mean follow-up time of 3.9 years. Explanations for gender differences in self-certified (1-3 days) and medically confirmed absence spells of various lengths (4 days or more, more than 2 weeks, and more than 60 days) were examined using Poisson regression. Results: Women had 46% higher risk for self-certified sickness absence than men. In medically confirmed spells there was 34% female excess which gradually weakened with lengthening absence, and no differences were observed in spells longer than 60 days. Adjusting for physical functioning and self-reported diagnosed diseases clearly attenuated gender differences in sickness absence spells shorter than two weeks and fully explained them in longer absence spells. Physical work demands explained female excess in medically confirmed absence spells of all lengths, as did work fatigue in spells longer than two weeks. Psychosocial working conditions and family-related factors did not affect the gender differences. Physical health problems, physical work demands and work fatigue were somewhat more prevalent in women than in men, but their impact on sickness absence was similar in both genders. Conclusions: The overall gender differences in sickness absence are due to relatively short absence spells being more common among women. In longer sickness absence spells the female excess is mainly explained by heavier burden of ill-health and to a lesser extent by higher physical work demands among women. The authors found no support for greater vulnerability to health- and work-related problems among women as reasons for sickness absence. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study examined whether living in rented housing is associated with increased all-cause and cause-specific mortality, and whether the association between home ownership and mortality can be explained by household income, occupational class, and educational level. METHODS: A random sample including every seventh Finn aged 40-80 years at the end of 1997 (N = 308 291) was derived from the population register of Finland. The sample was followed up for mortality until the end of 2003 during which time there were 22,721 deaths. RESULTS: The hazard ratio for all-cause mortality among renters compared with owner-occupiers was 2.06 (95% CI 1.98 to 2.14) in men and 1.73 (1.65 to 1.81) in women. Adjusting for household income, occupational class, and educational level attenuated the excess mortality among renters by 30% in men and 19% in women. The effect of income was larger among the under 65 year olds than those aged 65 years or over. Excess mortality among renters was particularly high for alcohol-related diseases, respiratory diseases, lung cancer, as well as endocrine, metabolic and nutritional diseases, and infections. CONCLUSIONS: Renters had higher mortality than owner-occupiers even after adjusting for household income, occupational class, and educational level. Home ownership may indicate material living standards and cumulative wealth that cannot sufficiently be captured by conventional socioeconomic indicators. Analysing home ownership may thus increase understanding of the factors producing inequalities in health. [ABSTRACT FROM AUTHOR]

Background: This study examined whether living in rented housing is associated with increased all-cause and cause-specific mortality, and whether the association between home ownership and mortality can be explained by household income, occupational class, and educational level. Methods: A random sample including every seventh Finn aged 40-80 years at the end of 1997 (N = 308 291) was derived from the population register of Finland. The sample was followed up for mortality until the end of 2003 during which time there were 22721 deaths. Results: The hazard ratio for all-cause mortality among renters compared with owner-occupiers was 2.06 (95% Cl 1.98 to 2.14) in men and 1.73 (1.65 to 1.81) in women. Adjusting for household income, occupational class, and educational level attenuated the excess mortality among renters by 30% in men and 19% in women. The effect of income was larger among the under 65 year olds than those aged 65 years or over. Excess mortality among renters was particularly high for alcohol-related diseases, respiratory diseases, lung cancer, as well as endocrine, metabolic and nutritional diseases, and infections. Conclusions: Renters had higher mortality than owner- occupiers even after adjusting for household income, occupational class, and educational level. Home ownership may indicate material living standards and cumulative wealth that cannot sufficiently be captured by conventional socioeconomic indicators. Analysing home ownership may thus increase understanding of the factors producing inequalities in health. [ABSTRACT FROM AUTHOR]

A strong sense of coherence (SOC) is found to be associated with good mental health. This study investigated (1) whether negative life events affect level of SOC, (2) whether initial level of SOC modifies the effect of negative life events on SOC, and (3) whether stability of SOC differs between genders. The data were derived from the 15-year Health and Social Support study ( N= 17,271). Ordinary linear regression analysis was used. Negative life events decreased the level of SOC among both genders irrespective of the timing of the event. The more recent the life event, the lower the SOC. A strong SOC in 1998 did not protect SOC from declining during follow-up. Specific gender differences were not discovered. SOC was related to negative changes in people's environment. Initially strong SOC was not more stable than initially mediocre or weak SOC. Men and women reacted quite similarly to negative life events. [ABSTRACT FROM AUTHOR]

Objective:To examine associations between seven indicators of socio-economic circumstances and healthy food habits, while taking into account assumed temporal order between these socio-economic indicators.Design and setting:Data were derived from cross-sectional postal questionnaires in 2000–2002. Socio-economic circumstances were assessed by parental education, childhood economic difficulties, own education, occupational class, household income, home ownership and current economic difficulties. Healthy food habits were measured by an index consisting of consumption of fresh vegetables, fruit or berries, rye bread, fish and choosing vegetable fats on bread and oil in cooking. Sequential logistic regression models were used, adjusting for age and marital status.Participants:Employees of the City of Helsinki, Finland (n=8960, aged 40–60 years).Results:Healthy food habits were reported by 28% of women and by 17% of men. Own education, occupational class, household income, home ownership and current economic difficulties were associated with healthy food habits. These associations were attenuated but mainly remained after mutual adjustments for the socio-economic indicators. Among women, a pathway was found suggesting that part of the effects of education on food habits were mediated through occupational class.Conclusions:Employees in higher and lower socio-economic positions differ in their food habits, and those in lower positions and economically disadvantaged are less likely to report healthy food habits. Health promotion programmes and food policies should encourage healthier food choices among those in lower socio-economic positions and among those with economic difficulties in particular.Sponsorship:Academy of Finland.European Journal of Clinical Nutrition (2007) 61, 701–710; doi:10.1038/sj.ejcn.1602583; published online 20 December 2006 [ABSTRACT FROM AUTHOR]

We identified policies that may be effective in reducing smoking among socioeconomically disadvantaged groups, and examined trends in their level of application between 1985 and 2000 in six western-European countries (Sweden, Finland, the United Kingdom, the Netherlands, Germany, and Spain). We located studies from literature searches in major databases, and acquired policy data from international data banks and questionnaires distributed to tobacco policy organisations/researchers. Advertising bans, smoking bans in workplaces, removing barriers to smoking cessation therapies, and increasing the cost of cigarettes have the potential to reduce socioeconomic inequalities in smoking. Between 1985 and 2000, tobacco control policies in most countries have become more targeted to decrease the smoking behaviour of low-socioeconomic groups. Despite this, many national tobacco-control strategies in western-European countries still fall short of a comprehensive policy approach to addressing smoking inequalities.Journal of Public Health Policy (2007) 28, 261–280. doi:10.1057/palgrave.jphp.3200132 [ABSTRACT FROM AUTHOR]

Objective: This study examines the relationship between family-work conflicts with food habits and physical activity, and whether the relationship is dependent on family structure and work-related factors.Design and Setting: Cross-sectional postal surveys were carried out in 2001 and 2002 among employees of the City of Helsinki, Finland, aged 40-60 years (n = 5346, response rate 66%; for women 70% and for men 60%). Dependent variables in logistic regression analyses were nationally recommended food habits and physical activity. Independent variables were work-family conflicts and family-work conflicts. Covariates included age, marital status, number of children, occupational class, working hours, time travelling to work, and physical and mental work load.Results: Women reporting strong work-family conflicts were more likely to follow recommended food habits (odds ratio (OR) and 95% confidence intervals 1.49 (1.19-1.86)), but this relationship weakened when adjusting for work-related factors (OR 1.20 (0.93-1.55)). Women and men with strong family-work conflicts were less likely to report recommended food habits after adjusting for family structure and work-related factors (women OR 0.75 (0.61-0.92), men OR 0.57 (0.34-0.96)). Women and men with strong work-family conflicts were less likely to follow the recommended amount of physical activity (women OR 0.76 (0.60-0.96), men OR 0.54 (0.34-0.87)). Additionally, women with strong family-work conflicts were less likely to follow the recommended amount of physical activity (OR 0.77 (0.63-0.94)). Adjusting for family and work-related factors did not affect these associations.Conclusions: Conflicts between paid work and family life are likely to constitute barriers for a physically active lifestyle and possibly also for healthy food habits. Improving the balance between work and family may provide a route for promoting health-related behaviours. [ABSTRACT FROM AUTHOR]

Work-family conflicts are common, but their effects on health are not well known. The aim of this study was to examine the associations between work-family conflicts and self-rated health among middle-aged municipal employees. In addition, the effect of social background factors on the association between work-family conflicts and self-rated health were examined. The data were based on cross-sectional postal surveys, which were carried out in 2001 and 2002, among female and male employees of the city of Helsinki, Finland. The participants were aged 40-60, and the response rate for women was 69%, and for men 60%. In the final analysis, 3,443 women and 875 men were included. For men and woman alike, work-to-family and family-to-work conflicts were associated with poor self-rated health. The association remained after adjusting for sociodemographic and socioeconomic factors. This study shows that a better balance between family life and work outside the home would probably have a health promoting effect. [ABSTRACT FROM AUTHOR]

Background: Despite similar living conditions among the Finnish-speaking majority and the Swedish-speaking minority in Finland, the latter is a more advantaged group e.g. in terms of socioeconomic status and health. This study investigated (1) the level of sense of coherence (SOC), (2) the structure of generalized resistance resources (GRRs), and (3) associations of GRRs with SOC among Finnish- and Swedish-speaking Finns. Methods: The data derived from the Health and Social Support (HeSSup) Study. The sample comprised 22,937 Finnish men and women aged 20-54, including an additional sample from the Swedish-speaking population (n = 2,967). The response rate was 40%. Ordinary regression analysis was used. Results: Swedish-speaking women scored 0.9 (p = 0.005) and men 0.6 (p = 0.05) points higher on SOC scale compared with Finnish-speaking respondents. The minor difference in the SOC level between the language groups was explained by Finnish speakers' worse psychosocial living conditions in childhood and working conditions in adulthood. Only one interaction was found: parents' divorce during childhood was associated with a significant decrease of SOC scores only for Finnish speakers. Otherwise the same GRRs had similar effects on both Finnish- and Swedish-speaking men's and women's SOC. Conclusion: The only key difference between Finnish- and Swedish-speaking Finns concerned the unequal distribution of GRRs. An increase in GRRs among Finnish speakers would probably strengthen their SOC. However, the slightly stronger level of SOC among Swedish-speaking compared with Finnish-speaking Finns is unlikely to explain the possible differences in well-being between the two language groups. [ABSTRACT FROM AUTHOR]

AIMS: To investigate time trends in the smoking prevalence and the sociodemographic and psychosocial background of smoking in the Baltic countries in comparison with Finland during 1994-2002. METHODS: Differences in daily smoking according to age, education, urbanization, and psychological distress in the Baltic countries and Finland were studied using postal surveys in 1994, 1996, 1998, 2000, and 2002 among adults (20-64 years old) in Estonia (n = 6,271), Latvia (n = 6,106), Lithuania (n = 9,824), and Finland (n = 15,764). RESULTS: In 1994, 1996, 1998, 2000, and 2002 the prevalence of smoking in Estonia, Latvia, Lithuania, and Finland was 47%, 54%, 46%, and 29% among men, and 21%, 19%, 11%, and 19% among women, respectively. Smoking increased among Lithuanian women from 6% in 1994 to 13% in 2002, but decreased among Estonian men and women. Smoking was generally more common among younger individuals, the less educated, and people with distress in all four countries. The odds ratios for smoking for those with low education compared with those with high education were 2.18 (1.69-2.81), 3.32 (2.55-4.31), 2.20 (1.79-2.70) and 2.80 (2.40-3.27) in men, and 1.90 (1.42-2.52). 3.09 (2.28-4.18), 0.86 (0.59-1.26), and 3.00 (2.53-3.55) in women, in Estonia, Latvia, Lithuania, and Finland, respectively. There were indications of increasing educational differences in Latvian men. Smoking was less common among rural women in all countries except Estonia. CONCLUSIONS: Estonia, Latvia, and Finland show characteristics of the 'mature' phase of a smoking epidemic, and smoking may not increase in these countries. In Lithuanian women smoking may increase. Smoking may be increasingly unequally distributed in the future in all the studied countries. [ABSTRACT FROM AUTHOR]

Objective: To examine the associations of mental health functioning (SF-36) and work and family related psychosocial factors with intentions to retire early. Methods: Cross sectional survey data (n = 5037) from the Helsinki Health Study occupational cohort in 2001 and 2002 were used. Intentions to retire early were inquired with a question: ‘Have you considered retiring before normal retirement age?’ Mental health functioning was measured by the Short Form 36 (SF-36) mental component summary (MCS). Work and family related psychosocial factors included job demands and job control, procedural and relational justice, conflicts between work and family, and social network size. Multinomial regression models were used to analyse the data. Results: Poor mental health functioning, unfavourable psychosocial working conditions, and conflicts between work and family were individually related to intentions to retire early. After adjustments far all work and family related factors the odds ratio for low mental health functioning was halved (from OR = 6.05 to 3.67), but nevertheless the association between poor mental health functioning and strong intentions to retire early remained strong. Conclusions: These findings highlight not only the importance of low mental health and unfavourable working conditions but also the simultaneous impact of conflicts between work and family to employees' intentions to retire early. [ABSTRACT FROM AUTHOR]

AIMS: To examine the associations of mental health functioning with intentions to retire early among ageing municipal employees. METHODS: Cross-sectional survey data (n = 7,765) from the Helsinki Health Study in 2000, 2001, and 2002 were used. Intentions to retire early were sought with a question: 'Have you considered retiring before normal retirement age?' The dependent variable was divided into three categories: 1 = no intentions to retire early; 2 = weak intentions; 3 = strong intentions. Mental health functioning was measured by the Short Form 36 (SF-36) mental component summary (MCS). Other variables included age, sex, physical health functioning (SF-36), limiting longstanding illness, socioeconomic status, and spouse's employment status. Multinomial regression analysis was used to examine the association of mental health functioning with intentions to retire early. RESULTS: Employees with the poorest mental health functioning were much more likely to report strong intentions to retire early (OR 6.09, 95% CI 4.97-7.47) than those with the best mental health functioning. Adjustments for physical health, socioeconomic status, and spouse's employment status did not substantially affect this association. CONCLUSIONS: The findings highlight the importance of mental health for intentions to retire early. Strategies aimed at keeping people at work for longer should emphasize the importance of mental well-being and the prevention of poor mental health. More evidence is needed on why mental problems among ageing baby-boomer employees are giving rise to increasing social consequences, although the overall prevalence of mental problems has not increased. [ABSTRACT FROM AUTHOR]

BACKGROUND: The aim of the study was to investigate (1) how much of the association between health and social class is accounted by psychosocial working conditions, and (2) whether health is related to working conditions after controlling for social class. METHODS: The data derive from the surveys of the Helsinki health study, collected in 2000, 2001, and 2002 from 40-60 year old employees working for the City of Helsinki (n=8970, response rate 67%). The study measured occupation based social class and Karasek's demand-control model. The health outcomes were self rated health as less than good and limiting longstanding illness. Age adjusted prevalence percentages and fitted logistic regression models were calculated. RESULTS: The individual effects of social class and psychosocial working conditions on self rated health and limiting longstanding illness were strong among both men and women. The relation between social class and both health outcomes considerably attenuated when job control was controlled for, but was reinforced when controlling for job demands. Controlling for both job control and job demands attenuated the relation between social class and self rated health and limiting longstanding illness among women, however, was reinforced among men. CONCLUSIONS: A substantial part of the relation between social class and health could be attributed to job control, however, job demands reinforced the relation. Although the effect of social class is mediated by psychosocial working conditions, both social class and working conditions were related to health after mutual adjustments. [ABSTRACT FROM AUTHOR]

Aims: The Nordic countries have relatively equal employment participation between men and women, but some differences between countries exist in labour market participation. The aim was to examine the association between employment status and health among women and men in Denmark, Finland, Norway, and Sweden, and analyse whether this association is modified by marital status and parental status. Methods: The data come from nationally representative cross‐sectional surveys carried out in Denmark ( n = 2,209), Finland ( n = 4,604), Norway ( n = 1,844) and Sweden ( n = 5,360) in 1994–95. Women and men aged 25–49 were included. Employment status was categorized into full‐time employed, part‐time employed, unemployed, and housewives among women and into employed and unemployed among men. Health was measured by perceived health and limiting longstanding illness. Logistic regression analysis was used, adjusting for age and education. Marital status and parental status were analysed as modifying factors. Results: The non‐employed were more likely to report perceived health as below good and limiting longstanding illness than the employed among both women and men. The association between employment status and perceived health remained unchanged when marital status and parental status were adjusted for among all men and Finnish women, but the association was slightly strengthened among Danish and Swedish women, with the housewives becoming more likely to report ill health than employed women. The association between employment status and limiting longstanding illness was slightly strengthened among women, and slightly weakened among Norwegian men when marital and parental status were adjusted for. Conclusions: Non‐employment was associated with poorer health in all countries, although there are differences in the employment patterns between the countries. Among women marital status and parental status showed a modest or no influence on the association between employment status and health. Among men there was no such influence. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To study the associations between psychosocial working conditions and weight gain. DESIGN, SUBJECTS AND MEASUREMENTS: Data from postal questionnaires (response rate 67%) sent to 40- to 60-y-old women (n = 7093) and men (n =1799) employed by the City of Helsinki in 2000-2002 were analysed. Weight gain during the previous 12 months was the outcome variable in logistic regression analyses. Independent variables included Karasek's job demands and job control, work fatigue, working overtime, work-related mental strain, social support and the work-home interface. The final models were adjusted for age, education, marital status, physical strain and body mass index. RESULTS: In the previous 12 months, 25% of women and 19% of men reported weight gain. Work fatigue and working overtime were associated with weight gain in both sexes. Women who were dissatisfied with combining paid work and family life were more likely to have gained weight. Men with low job demands were less likely to have gained weight. All of these associations were independent of each other. CONCLUSIONS: Few work-related factors were associated with weight gain. However, our study suggests that work fatigue and working overtime are potential risk factors for weight gain. These findings need to be confirmed in prospective studies. [ABSTRACT FROM AUTHOR]

Objective: To examine whether trends in smoking behaviour in Western Europe between 1985 and 2000 differed by education group. Design: Data of smoking behaviour and education level were obtained from national cross sectional surveys conducted between 1985 and 2000 (a period characterised by intense tobacco control policies) and analysed for countries combined and each country separately. Annual trends in smoking prevalence and the quantity of cigarettes consumed by smokers were summarised for each education level. Education inequalities in smoking were examined at four time points. Setting: Data were obtained from nine European countries: Norway, Sweden, Denmark, Finland, the United Kingdom, the Netherlands, Germany, Italy, and Spain. Participants: 451 386 non-institutionalised men and women 25-79 years old. Main outcome measures: Smoking status, daily quantity of cigarettes consumed by smokers. Results: Combined country analyses showed greater declines in smoking and tobacco consumption among tertiary educated men and women compared with their less educated counterparts. in country specific analyses, elementary educated British men and women, and elementary educated Italian men showed greater declines in smoking than their more educated counterparts. Among Swedish, Finnish, Danish, German, Italian, and Spanish women, greater declines were seen among more educated groups. Conclusions: Widening education inequalities in smoking related diseases may be seen in several European countries in the future. More insight into effective strategies specifically targeting the smoking behaviour of low educated groups may be gained from examining the tobacco control policies of the UK and Italy over this period. [ABSTRACT FROM AUTHOR]

Aims: To test whether (1) physically demanding work is less frequent for older than younger employees, and whether (2) the association of physically demanding work with decline of physical functioning is stronger for older employees than their younger counterparts. The gender differences in these associations were examined. Methods: Subjects of the study were 40-60 year old employees of the City of Helsinki. Data (n = 5802) were collected with mail questionnaires in 2000 and 2001. Functioning was measured with the Role Limitations due to Physical Health Problems scale of the SF36 health questionnaire. Logistic regression models were used to analyse the data. Results: There was a linear trend of less physically demanding work in older than in younger age groups. This trend was more marked for men than women. Age and physically demanding work were associated with poor functioning. In women the association of physically demanding work with poor functioning tended to be stronger for older than for younger age groups, while the opposite was observed in men. Conclusions: Results suggest that physically demanding work causes more ailments in women of high age than men. It is possible that less men than women are still employed in physically demanding occupations at high age, even though direct evidence of exit from physically demanding work cannot be obtained from cross-sectional data. In these data the physically demanding occupations for men and women were largely different. High physical workload among women working in social and health care is likely to contribute to the gender differences. [ABSTRACT FROM AUTHOR]

Study objective: To compare the age pattern of educational health inequalities in four Nordic countries in the mid-1980s and the mid-1990s.Design: Cross sectional interview surveys at two points of time.Setting: Data on self reported limiting longstanding illness, and perceived health were collected from Denmark, Finland, Norway, and Sweden in 1986/87 and in 1994/95.Participants: Representative samples of the non-institutionalised population at 15 years or older. Analyses were restricted to respondents aged between 25 and 75 (n= 23 325 men and 24 184 women). Response rates varied from 73% to 87%.Main results: The age adjusted prevalence of limiting longstanding illness in Finland was 10% higher in men and 6% higher in women than in other Nordic countries in 1986/87 but the gap narrowed by 1994/95. Educational health inequalities were largest in Norway. In 1986/87 the odds ratio (OR) for limiting longstanding illness was 11.25 (95% CI 8.66 to 14.62) among men and 8.23 (95% CI 6.60 to 10.27) among women in the oldest age group (65-74 years old) in Finland when the youngest age group (25-34 years old) was used as the reference category (OR=1.00). The age pattern in Finland was steeper than in Sweden (OR=5.02, 95% CI 3.97 to 6.34 in men and 5.29, 95% CI 4.18 to 6.71 in women) or Norway (OR=6.32, 95% CI 4.06 to 9.84 and 5.45, 95% CI 3.81 to 7.82, respectively). In 1994/95 relative health improved in the oldest age group in Finland (OR=5.80, 95% CI 4.33 to 7.78 in men and 5.94, 95% CI 4.52 to 7.79 in women) and in Norway (OR=4.55, 95% CI 3.01 to 6.88 and 3.96, 95% CI 2.70 to 5.81, respectively) but remained stable in Sweden. The study compared health differences by age in different educational categories and found that in Finland in 1986/87 the health in the oldest age group was poorer for secondary (OR=10.59, 95% CI 5.96 to 18.82) or basic educated (OR=9.76, 95% CI 6.66 to 14.30) men than for men with higher education (OR=5.15, 95% CI 2.59 to 10.22). The difference was not found among women or in other Nordic countries and it diminished among men in Finland in 1994/95. The results of perceived health were broadly similar to the above results of limiting longstanding illness.Conclusion: The results suggest that compared with other Nordic countries the comparatively poorer health in Finland is partly attributable to a cohort effect. This may be associated with the lower standard of living in Finland that lasted until the mid-1950s. The cohort effect is also likely to contribute to educational health inequalities among older Finnish men. The results suggest that not only current social policies but also past economic circumstances are likely to affect the overall health status as well as health inequalities. [ABSTRACT FROM AUTHOR]

STUDY OBJECTIVE: To assess the relation between self rated health and mortality over a period of 23 years, taking into account medical history, cardiovascular risk factors, and education at the beginning of the follow up. DESIGN: A cohort of random population samples. The baseline studies included a self administered questionnaire and a health examination. Mortality data were collected from the national mortality register using personal identification numbers. SETTING: The provinces of North Karelia and Kuopio in eastern Finland. PARTICIPANTS: Random samples of working age people (n=21 302) from the population register. MAIN RESULTS: For self rated health, the age adjusted poor to good relative risk for all cause mortality was 2.36 (95% confidence intervals 2.10, 2.64) for men and 1.90 (1.63, 2.22) for women, and for cardiovascular mortality 2.29 (1.96, 2.68) for men and 2.34 (1.84, 2.96) for women. Adjusted for selected potentially fatal diseases from the subjects' medical histories, cardiovascular disease risk factors, and education, the corresponding relative risks for all cause mortality were 1.66 (1.47, 1.88) for men and 1.50 (1.26, 1.78) for women, and for cardiovascular mortality 1.54 (1.29, 1.82) for men and 1.63 (1.26, 2.10) for women. The association between self rated health and mortality attributable to external causes was fairly strong. CONCLUSIONS: Poor self rated health is a strong predictor of mortality, and the association is only partly explained by medical history, cardiovascular disease risk factors, and education. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This study examined the change in heritability of adult body height across birth cohorts in Finland. METHODS: In 1981, cross-sectional questionnaires were completed by 10,968 twin pairs born before 1958. The effect of genetic factors was estimated via genetic modeling. RESULTS: Heritability increased from the cohort born before 1929 (0.76, 95% confidence interval [CI] = 0.65, 0.88 in men; 0.66, 95% CI = 0.55, 0.77 in women) to that born in 1947 through 1957 (0.81, 95% CI = 0.73, 0.87 in men; 0.82, 95% CI = 0.75, 0.89 in women). CONCLUSIONS: Heritability of height increased across Finnish birth cohorts born in the first half of this century and leveled off after World War II. Environmental factors, compared with genetic factors, appear to be more important among women than men. [ABSTRACT FROM AUTHOR]

Study Objective: To study the socio-demographic determinants of body-height and the bearing of these determinants on the association between body-height and health among Finnish adults.Data and Method: Cross-sectional population survey including questions on social background, body-height and health, and retrospective questions on childhood living conditions. The data derive from a representative Survey on Living Conditions collected by Statistics Finland in 1994. The response rate was 73%. Male and female respondents > or =20 years were included in the analysis (N = 8212). Statistical methods include regression analysis and logistic regression analysis.Results: Body-height was strongly associated with year of birth, region, childhood living conditions and education among adult men and women. Body-height was also associated with limiting long-standing illness and perceived health as below good. Tall men had the best health and short men the poorest health. Among women the association of body-height with health differed from men, as tall women showed high levels of limiting long-standing illness, notably musculo-skeletal diseases. Adjusting for the background variables weakened but did not abolish the association between poor health and short stature among men and women.Conclusions: Short stature is associated with poor health among Finnish men and women. A non-linear association among women was found for musculo-skeletal diseases. The studied social background factors explained only little of the association between body-height and health. [ABSTRACT FROM AUTHOR]

Background: Although an inverse relationship between socioeconomic status and body mass index (BMI) is well documented, broad population studies focusing on the association between BMI and various forms of disadvantage such as unemployment, low income or social isolation are rare.Methods: A nationwide, representative sample of 25-64-year-old Finnish subjects (n = 6016) was classified according to their BMI into four groups: 'thin' (BMI < 20), 'normal' (BMI 20-24.9), 'overweight' (BMI 25-29.9) and 'obese' (BMI > or = 30). Multivariable analyses using logistic regression were conducted with this BMI-grouping as an independent variable to predict social and economic disadvantage, controlling simultaneously for age, educational attainment, region of residence, and limiting long-standing illness.Results: In women, overweight was associated with current unemployment and obesity with long-term unemployment as well as absence of close friends outside the family circle. Both overweight and obesity were associated with low individual earnings. Obese women were also most likely to have low household disposable and individual incomes; a similar pattern was seen among thin women. A small subgroup of thin men were socially and economically disadvantaged with all our indicators whereas excess body weight was not problematic for men.Conclusions: Deviant body weight is associated with social and economic disadvantage in a gender-specific and partly curvilinear way. In particular, obese women face multiple social and economic disadvantage. [ABSTRACT FROM AUTHOR]

Background: The study examines whether self-rated health forms a continuum from poor through average to good health in terms of two groups of health-related variables.Methods: The data come from the 1994 Finnish Survey on Living Conditions, a representative sample of Finnish men and women aged 25 years or older (n = 7290). Logistic regression analysis was used with two dependent variables: (1) average versus good/excellent self-rated health and (2) poor versus good/excellent self-rated health. Two groups of independent variables were used: (1) risk factors and (2) ill-health indicators. Separate analyses were made for men and women controlling for sociodemographic background variables.Results: Of the risk factors, BMI and physical exercise were associated both with average and poor self-rated health whereas frequency of drinking was only associated with poor health. All used indicators of ill health were strongly associated with average as well as poor self-rated health. With the exception of BMI, the associations of both risk factors and ill health were stronger with poor than with average health.Conclusions: The study suggests that self-rated health forms a continuum from poor to good health when risk factors and indicators of ill health are considered, and that there are only minor differences in the continuity of self-rated health between men and women. [ABSTRACT FROM AUTHOR]

To assess whether there are variations between 11 Western European countries with respect to the size of differences in self reported morbidity between people with high and low educational levels. National representative data on morbidity by educational level were obtained from health interview surveys, level of living surveys or other similar surveys carried out between 1985 and 1993. Four morbidity indicators were included and a considerable effort was made to maximise the comparability of these indicators. A standardised scheme of educational levels was applied to each survey. The study included men and women aged 25 to 69 years. The size of morbidity differences was measured by means of the regression based Relative Index of Inequality. The size of inequalities in health was found to vary between countries. In general, there was a tendency for inequalities to be relatively large in Sweden, Norway, and Denmark and to be relatively small in Spain, Switzerland, and West Germany. Intermediate positions were observed for Finland, Great Britain, France, and Italy. The position of the Netherlands strongly varied according to sex: relatively large inequalities were found for men whereas relatively small inequalities were found for women. The relative position of some countries, for example, West Germany, varied according to the morbidity indicator. Because of a number of unresolved problems with the precision and the international comparability of the data, the margins of uncertainty for the inequality estimates are somewhat wide. However, these problems are unlikely to explain the overall pattern. It is remarkable that health inequalities are not necessarily smaller in countries with more egalitarian policies such as the Netherlands and the Scandinavian countries. Possible explanations are discussed. [ABSTRACT FROM AUTHOR]

Background: High job strain has been linked with cardiovascular outcomes. This study aimed to examine whether job strain is associated with angina pectoris symptoms among British and Finnish non-manual employees. Methods: Postal questionnaire survey data among 40-60-year-old employees of the British Whitehall II Study (n=4551, 27% women) and the Finnish Helsinki Health Study (n=7605, 83% women) cohort were analysed. Angina pectoris symptoms were the outcome in logistic regression analysis. Karasek's job strain was examined. Models were adjusted first for age, second for occupational class and finally for smoking, heavy drinking, physical inactivity, unhealthy food habits and obesity. Results: Angina pectoris symptoms were reported by 5% of women and 3% of men in Britain, and by 6% of women and 4% of men in Finland. High job strain was associated with angina pectoris symptoms among men in Britain (OR 2.08; CI 95% 1.07 to 4.02) and women in Finland (OR 1.90; CI 95% 1.36 to 2.63) independent of age, occupational class, and behavioural risk factors. However, similar associations between job strain and angina pectoris symptoms were not observed among men in Finland or women in Britain. Conclusion: The results yielded partial support for the association between job strain and angina pectoris symptoms across national contexts. [ABSTRACT FROM AUTHOR]

Objectives: To compare associations of health-related behaviours with self-certified and medically confirmed sickness absence, and to examine whether these associations can be explained by psychosocial and physical working conditions and occupational social class. Methods: The study included 5470 female and 1464 male employees of the City of Helsinki surveyed in 2000??"2002. These data were linked to sickness absence records until the end of 2005, providing a mean follow-up time of 3.9 years. Poisson regression analysis was used to examine associations of smoking, alcohol use, physical activity, dietary habits and relative weight (body mass index) with self-certified (1-3 days) and medically confirmed (≥4 days) absence spells. Population attributable fractions (PAFs) were calculated to quantify the sickness absence burden related to the behaviours. Results: Smoking and high relative weight were most strongly associated with sickness absence, while the associations of other studied health-related behaviours were weaker. The associations were stronger for medically confirmed sickness absence spells for which heavy smoking and obesity more than doubled the risk of sickness absence in men and nearly doubled it in women. Adjusting for psychosocial working conditions had little or no effect on the associations. Physical working conditions and social class somewhat attenuated the associations, especially for smoking and relative weight. In self-certified sickness absence the PAF for smoking (16.4 in men, 10.3 in women) was largest, while in medically confirmed absence relative weight had the largest PAF (23.5 in men, 15.0 in women). Conclusions: Health-related behaviours, smoking and high relative weight in particular, were associated with subsequent sickness absence independently of psychosocial and physical working conditions and social class. Decreasing smoking and relative weight is likely to provide important gains in work ability and reduce sickness absence. [ABSTRACT FROM AUTHOR]

Socioeconomic inequalities in health are well established but few studies have used a comprehensive approach and examined these inequalities by several socioeconomic indicators simultaneously. The main objective of this study is to examine socioeconomic inequalities in self rated health by indicators ranging from childhood socioeconomic environment to adult socioeconomic status and material resources. The data derived from the Helsinki Health Study baseline surveys in 2000-2002. Respondents to postal surveys were middle aged employees of the City of Helsinki. Associations between seven socioeconomic indicators and self rated health were examined by fitting a series of logistic regression models.

STUDY OBJECTIVE: To examine the associations of individual and household income with various health behaviours, before and after adjusting for educational attainment and occupational social class. DESIGN AND SETTING: Data from 19 982 respondents to nationwide health behaviour surveys from 1993 to 1999 (response rate 70%) were linked with socioeconomic information from population registers. MEASUREMENTS: The income measures were total individual income liable to taxation and household's monthly disposable income. Health behaviours included smoking, alcohol use, leisure time physical activity, use of vegetables, use of saturated fat on bread, and being overweight. Main results: In men, smoking and infrequent vegetable use were more common among those with lower individual and household income. However, adjusting for education and occupational class removed most of the differences. Use of saturated fat on bread increased with decreasing individual income, before and after the adjustments. In women, smoking, infrequent vegetable use and being overweight were more common among those with lower income, but the differences by both income measures were largely removed by the adjustments. Women with higher income more often also were high alcohol users and had less physical activity, in particular when income was measured by the respondents' individual income. CONCLUSIONS: Adjusting for education and occupation largely removed income differences in health behaviours, but for some behaviours some independent effect remained. The results suggest that income does not only reflect the available material resources, but works as a general socioeconomic indicator that is associated with health behaviours in much the same way as other socioeconomic indicators. [ABSTRACT FROM AUTHOR]