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Eero Lahelma - One of the best experts on this subject based on the ideXlab platform.

  • interrelationships between education occupational social class and income as determinants of disability retirement
    Scandinavian Journal of Public Health, 2012
    Co-Authors: Taina Leinonen, Pekka Martikainen, Eero Lahelma
    Abstract:

    AIMS: The association between a low Socioeconomic position and disability retirement is established in the literature, but the interrelationships between various subdomains of Socioeconomic position are poorly understood. We examined the independent and interdependent effects of education, social class, and income on disability retirement. METHODS: Using nationally representative register data we followed up over 260,000 Finns aged 30-63 at the end of 1995 for disability retirement from 1996 to 2004. Cox regression analysis was used to calculate hazard ratios (HR) and relative indices of inequality (RII). RESULTS: Each Socioeconomic Indicator had a linear negative association with disability retirement. The Socioeconomic gradients were stronger in the younger age groups. The effect of education was largely mediated through succeeding social class. Social class was largely explained by preceding education, but was only moderately mediated through income. Income was largely explained by education, and even further by social class. The independent effects of education, social class, and income on disability retirement as measured by the RII were 1.74 (95% CI 1.60-1.90), 1.95 (1.78-2.15), and 1.35 (1.25-1.47) for men and 1.76 (1.61-1.92), 2.14 (1.95-2.34), and 1.14 (1.05-1.24) for women. CONCLUSIONS: The effects of Socioeconomic position on disability retirement may not be fully captured if the pathways between the various subdomains are disregarded. Our results suggest that efforts to delay and prevent disability retirement should focus on lifestyle and cognitive factors associated with education, as well as on factors associated with social class such as working conditions and power resources. Language: en

  • Socioeconomic position and self rated health the contribution of childhood Socioeconomic circumstances adult Socioeconomic status and material resources
    American Journal of Public Health, 2005
    Co-Authors: Mikko Laaksonen, Ossi Rahkonen, Pekka Martikainen, Eero Lahelma
    Abstract:

    OBJECTIVES: We examined Socioeconomic inequalities in self-rated health by analyzing Indicators of childhood Socioeconomic circumstances, adult Socioeconomic position, and current material resources. METHODS: We collected data on middle-aged adults employed by the City of Helsinki (n=8970; 67% response rate). Associations between 7 Socioeconomic Indicators and health self-ratings of less than "good" were examined with sequential logistic regression models. RESULTS: After adjustment for age, each Socioeconomic Indicator was inversely associated with self-rated health. Childhood economic difficulties, but not parental education, were associated with health independently of all other Socioeconomic Indicators. The associations of respondents' own education and occupational class with health remained when adjusted for other Socioeconomic Indicators. Home ownership and economic difficulties, but not household income, were the material Indicators associated with health after full adjustment. CONCLUSIONS: Own education and occupational class showed consistent associations with health, but the association with income disappeared after adjustment for other Socioeconomic Indicators. The effect of parental education on health was mediated by the respondent's own education. Both childhood and adulthood economic difficulties showed clear associations with health and with conventional Socioeconomic Indicators.

  • Socioeconomic status and smoking
    European Journal of Public Health, 2005
    Co-Authors: Mikko Laaksonen, Ossi Rahkonen, Sakari Karvonen, Eero Lahelma
    Abstract:

    Background and aims: Socioeconomic differences in smoking have been well established. While previous studies have mostly relied on one Socioeconomic Indicator at a time, this study examined Socioeconomic differences in smoking by using several Indicators that reflect different dimensions of Socioeconomic position. Data and methods: Data derive from Helsinki Health Study baseline surveys conducted among the employees of the City of Helsinki in 2000 and 2001. The data include 6243 respondents aged 40–60 years (response rate 68%). Six Socioeconomic Indicators were used: education, occupational status, household income per consumption unit, housing tenure, economic difficulties and economic satisfaction. Their associations with current smoking were examined by fitting sequential logistic regression models. Results: All Socioeconomic Indicators were strongly associated with smoking among both men and women. When the Indicators were examined simultaneously their associations with smoking attenuated, especially when education and occupational status were considered together, and when income and housing tenure were introduced into the models already containing education and occupational status. After mutual adjustment for all Socioeconomic Indicators, housing tenure and economic satisfaction remained associated with smoking in men. In women, all Indicators except income and economic difficulties were inversely associated with smoking after adjustments. Conclusions: Smoking was associated with structural, material as well as perceived dimensions of Socioeconomic disadvantage. Attempts to reduce smoking among the Socioeconomically disadvantaged need to target several dimensions of Socioeconomic position.

  • pathways between Socioeconomic determinants of health
    Journal of Epidemiology and Community Health, 2004
    Co-Authors: Eero Lahelma, Mikko Laaksonen, Pekka Martikainen, Akseli Aittomaki
    Abstract:

    Study objective: Many previous studies on Socioeconomic inequalities in health have neglected the causal interdependencies between different Socioeconomic Indicators. This study examines the pathways between three Socioeconomic determinants of ill health. Design, setting, and participants: Cross sectional survey data from the Helsinki health study in 2000 and 2001 were used. Each year employees of the City of Helsinki, reaching 40, 45, 50, 55, and 60 years received a mailed questionnaire. Altogether 6243 employees responded (80% women, response rate 68%). Socioeconomic Indicators were education, occupational class, and household income. Health Indicators were limiting longstanding illness and self rated health. Inequality indices were calculated based on logistic regression analysis. Main results: Each Socioeconomic Indicator showed a clear gradient with health. Among women half of inequalities in limiting longstanding illness by education were mediated through occupational class and household income. Inequalities by occupational class were largely explained by education. A small part of inequalities for income were explained by education and occupational class. For self rated health the pathways were broadly similar. Among men most of the inequalities in limiting longstanding illness by education were mediated through occupational class and income. Part of occupational class inequalities were explained by education. Two thirds of inequalities by income were explained by education and occupational class. Conclusions: Parts of the effects of each Socioeconomic Indicator on health are either explained by or mediated through other Socioeconomic Indicators. Analyses of the predictive power of Socioeconomic Indicators on health run the risk of being fruitless, if interrelations between various Indicators are neglected.

Thomas M Gill - One of the best experts on this subject based on the ideXlab platform.

  • Socioeconomic differences in the benefits of structured physical activity compared with health education on the prevention of major mobility disability in older adults the life study
    Journal of Epidemiology and Community Health, 2016
    Co-Authors: David Bann, Haiying Chen, Chris Bonell, Nancy W Glynn, Roger A Fielding, Todd M Manini, Abby C King, Marco Pahor, Shannon L Mihalko, Thomas M Gill
    Abstract:

    Background Evidence is lacking on whether health-benefiting community-based interventions differ in their effectiveness according to Socioeconomic characteristics. We evaluated whether the benefit of a structured physical activity intervention on reducing mobility disability in older adults differs by education or income. Methods The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicentre, randomised trial that compared a structured physical activity programme with a health education programme on the incidence of mobility disability among at-risk community-living older adults (aged 70–89 years; average follow-up of 2.6 years). Education (≤ high school (0–12 years), college (13–17 years) or postgraduate) and annual household income were self-reported ( Results The effect of reducing the incidence of mobility disability was larger for those with postgraduate education (0.72, 0.51 to 1.03; N=411) compared with lower education (high school or less (0.93, 0.70 to 1.24; N=536). However, the education group×intervention interaction term was not statistically significant (p=0.54). Findings were in the same direction yet less pronounced when household income was used as the Socioeconomic Indicator. Conclusions In the largest and longest running trial of physical activity amongst at-risk older adults, intervention effect sizes were largest among those with higher education or income, yet tests of statistical interactions were non-significant, likely due to inadequate power. Trial registration number NCT01072500.

  • Socioeconomic differences in the benefits of structured physical activity compared with health education on the prevention of major mobility disability in older adults the life study
    Journal of Epidemiology and Community Health, 2016
    Co-Authors: David A, Roger A Fielding, Todd M Manini, Abby C King, Shannon L Mihalko, Haiying Che, Chris Onell, Nancy W Gly, Marco Paho, Thomas M Gill
    Abstract:

    BACKGROUND: Evidence is lacking on whether health-benefiting community-based interventions differ in their effectiveness according to Socioeconomic characteristics. We evaluated whether the benefit of a structured physical activity intervention on reducing mobility disability in older adults differs by education or income. METHODS: The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicentre, randomised trial that compared a structured physical activity programme with a health education programme on the incidence of mobility disability among at-risk community-living older adults (aged 70-89 years; average follow-up of 2.6 years). Education (≤ high school (0-12 years), college (13-17 years) or postgraduate) and annual household income were self-reported (<$24 999, $25 000 to $49 999 and ≥$50 000). The risk of disability (objectively defined as loss of ability to walk 400 m) was compared between the 2 treatment groups using Cox regression, separately by Socioeconomic group. Socioeconomic group×intervention interaction terms were tested. RESULTS: The effect of reducing the incidence of mobility disability was larger for those with postgraduate education (0.72, 0.51 to 1.03; N=411) compared with lower education (high school or less (0.93, 0.70 to 1.24; N=536). However, the education group×intervention interaction term was not statistically significant (p=0.54). Findings were in the same direction yet less pronounced when household income was used as the Socioeconomic Indicator. CONCLUSIONS: In the largest and longest running trial of physical activity amongst at-risk older adults, intervention effect sizes were largest among those with higher education or income, yet tests of statistical interactions were non-significant, likely due to inadequate power. TRIAL REGISTRATION NUMBER: NCT01072500.

Mikko Laaksonen - One of the best experts on this subject based on the ideXlab platform.

  • Socioeconomic position and self rated health the contribution of childhood Socioeconomic circumstances adult Socioeconomic status and material resources
    American Journal of Public Health, 2005
    Co-Authors: Mikko Laaksonen, Ossi Rahkonen, Pekka Martikainen, Eero Lahelma
    Abstract:

    OBJECTIVES: We examined Socioeconomic inequalities in self-rated health by analyzing Indicators of childhood Socioeconomic circumstances, adult Socioeconomic position, and current material resources. METHODS: We collected data on middle-aged adults employed by the City of Helsinki (n=8970; 67% response rate). Associations between 7 Socioeconomic Indicators and health self-ratings of less than "good" were examined with sequential logistic regression models. RESULTS: After adjustment for age, each Socioeconomic Indicator was inversely associated with self-rated health. Childhood economic difficulties, but not parental education, were associated with health independently of all other Socioeconomic Indicators. The associations of respondents' own education and occupational class with health remained when adjusted for other Socioeconomic Indicators. Home ownership and economic difficulties, but not household income, were the material Indicators associated with health after full adjustment. CONCLUSIONS: Own education and occupational class showed consistent associations with health, but the association with income disappeared after adjustment for other Socioeconomic Indicators. The effect of parental education on health was mediated by the respondent's own education. Both childhood and adulthood economic difficulties showed clear associations with health and with conventional Socioeconomic Indicators.

  • Socioeconomic status and smoking
    European Journal of Public Health, 2005
    Co-Authors: Mikko Laaksonen, Ossi Rahkonen, Sakari Karvonen, Eero Lahelma
    Abstract:

    Background and aims: Socioeconomic differences in smoking have been well established. While previous studies have mostly relied on one Socioeconomic Indicator at a time, this study examined Socioeconomic differences in smoking by using several Indicators that reflect different dimensions of Socioeconomic position. Data and methods: Data derive from Helsinki Health Study baseline surveys conducted among the employees of the City of Helsinki in 2000 and 2001. The data include 6243 respondents aged 40–60 years (response rate 68%). Six Socioeconomic Indicators were used: education, occupational status, household income per consumption unit, housing tenure, economic difficulties and economic satisfaction. Their associations with current smoking were examined by fitting sequential logistic regression models. Results: All Socioeconomic Indicators were strongly associated with smoking among both men and women. When the Indicators were examined simultaneously their associations with smoking attenuated, especially when education and occupational status were considered together, and when income and housing tenure were introduced into the models already containing education and occupational status. After mutual adjustment for all Socioeconomic Indicators, housing tenure and economic satisfaction remained associated with smoking in men. In women, all Indicators except income and economic difficulties were inversely associated with smoking after adjustments. Conclusions: Smoking was associated with structural, material as well as perceived dimensions of Socioeconomic disadvantage. Attempts to reduce smoking among the Socioeconomically disadvantaged need to target several dimensions of Socioeconomic position.

  • pathways between Socioeconomic determinants of health
    Journal of Epidemiology and Community Health, 2004
    Co-Authors: Eero Lahelma, Mikko Laaksonen, Pekka Martikainen, Akseli Aittomaki
    Abstract:

    Study objective: Many previous studies on Socioeconomic inequalities in health have neglected the causal interdependencies between different Socioeconomic Indicators. This study examines the pathways between three Socioeconomic determinants of ill health. Design, setting, and participants: Cross sectional survey data from the Helsinki health study in 2000 and 2001 were used. Each year employees of the City of Helsinki, reaching 40, 45, 50, 55, and 60 years received a mailed questionnaire. Altogether 6243 employees responded (80% women, response rate 68%). Socioeconomic Indicators were education, occupational class, and household income. Health Indicators were limiting longstanding illness and self rated health. Inequality indices were calculated based on logistic regression analysis. Main results: Each Socioeconomic Indicator showed a clear gradient with health. Among women half of inequalities in limiting longstanding illness by education were mediated through occupational class and household income. Inequalities by occupational class were largely explained by education. A small part of inequalities for income were explained by education and occupational class. For self rated health the pathways were broadly similar. Among men most of the inequalities in limiting longstanding illness by education were mediated through occupational class and income. Part of occupational class inequalities were explained by education. Two thirds of inequalities by income were explained by education and occupational class. Conclusions: Parts of the effects of each Socioeconomic Indicator on health are either explained by or mediated through other Socioeconomic Indicators. Analyses of the predictive power of Socioeconomic Indicators on health run the risk of being fruitless, if interrelations between various Indicators are neglected.

George C Patton - One of the best experts on this subject based on the ideXlab platform.

  • economic development and the nutritional status of chinese school aged children and adolescents from 1995 to 2014 an analysis of five successive national surveys
    The Lancet Diabetes & Endocrinology, 2019
    Co-Authors: Yanhui Dong, Catherine Jan, Bin Dong, Zhiyong Zou, Yide Yang, Yi Song, Susan M Sawyer, George C Patton
    Abstract:

    Summary Background Socioeconomic development is widely regarded as contributing to improved nutrition in children. We aimed to assess the association between Socioeconomic Indicators and child and adolescent nutritional status, and the differences in this association between urban and rural areas. Methods We extracted data from the 1995, 2000, 2005, 2010, and 2014 cycles of the Chinese National Survey on Students' Constitution and Health. We analysed these data for three nutritional outcomes—stunting, thinness, and overweight and obesity—in children and adolescents aged between 7 and 18 years, as defined by WHO standards and classifications. We included three Socioeconomic Indicators—gross domestic product (GDP) per capita, Engel coefficient (the proportion of household income spent on food), and urbanisation ratio—at both national and subnational levels for each survey year. We used logistic regression models to estimate the association between Socioeconomic Indicators and child nutritional status, and used prevalence odds ratios (ORs) to assess the urban–rural disparity for nutritional status over time. We also used generalised additive models to evaluate differences in associations between Socioeconomic and nutritional status between urban and rural areas. Findings We included 1 054 602 participants (204 932 in 1995; 209 167 in 2000; 225 213 in 2005; 208 136 in 2010; 207 154 in 2014) with complete records on age, sex, nationality, height, and weight in the final analyses, and the final dataset contained 29 provinces (Hong Kong, Macau, Taiwan, Chongqing, and Tibet were excluded) with complete Socioeconomic Indicator information and student nutritional status information. From 1995 to 2014, the mean stunting prevalence in Chinese children and adolescents decreased from 8·1% (95% CI 8·0–8·2) to 2·4% (2·4–2·5), and the mean thinness prevalence declined from 7·5% (7·4–7·6) to 4·1% (4·0–4·2). Overweight and obesity mean prevalence increased from 5·3% (5·2–5·4) to 20·5% (20·4–20·7). We observed an inverse association between Socioeconomic Indicators and mean stunting and thinness prevalence, and found a positive association between Socioeconomic Indicators and overweight and obesity prevalence. The urban–rural disparity in nutritional status gradually diminished, with the prevalence ORs approaching equivalence over time. More rapid improvement of Socioeconomic Indicators was associated with changed nutritional status in children and adolescents, but with differences across urban and rural settings. The association between Socioeconomic status and overweight and obesity was stronger in rural than in urban areas. Improvements (reductions) in the Engel coefficient were accompanied by a greater reduction of stunting and thinness in rural than in urban areas. Interpretation Although Socioeconomic development has been accompanied by continued improvements in stunting and thinness, a marked increase has occurred in overweight and obesity in Chinese children and adolescents, particularly in rural areas. There is a pressing need for policy actions to extend beyond an emphasis on economic growth alone, and to focus on promotion of healthy diets and physical activity. Funding National Natural Science Foundation, The Research Special Fund for Public Welfare Industry of Health of the Ministry of Health of China, and China Scholarship Council.

Steven T Case - One of the best experts on this subject based on the ideXlab platform.