PubMed Health⌕ Search

Biomedical subjects

E Lahelma

Publications and source records attributed to E Lahelma.

At least 19 recordsLinked to original sources
PubMed2006

Multiple socio-economic circumstances and healthy food habits.

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.

Adult↗
PubMed2006

Associations of SF-36 mental health functioning and work and family related factors with intentions to retire early among employees.

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 for 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.

Adult↗
PubMed2006

Children's use of general practitioner services in the five Nordic countries.

OBJECTIVE: To compare socioeconomic, sociodemographic, and living area differences in children's use of GP services in five Nordic countries from the 1980s to the 1990s and to analyse trends during the period. DESIGN: Cross sectional population surveys using random samples comprising 3000 children aged 2-17 years were conducted in 1984 and 1996 in five Nordic countries. Time trends in use of GP services were studied in each country by age, sex, parents' highest level of education, and living area. SETTING: Five Nordic countries, Denmark, Finland, Iceland, Norway, and Sweden in 1984 and 1996. PARTICIPANTS: A total sample of 15 000 children aged 2-17 years. Altogether 3000 children were selected at random from the national population registers of the national bureaus of statistics in each country. MAIN OUTCOME: Health services utilisation on the basis of responses to a questionnaire item asking whether the parents had consulted a GP with regard to their children's health during the previous three months. MAIN RESULTS: The prevalence of children's utilisation of GP services varied from 14% in 1984 in Sweden to 28% in 1996 in Iceland. A clear time trend towards increasing utilisation of GP services (p<0.05) was found in all countries except in Denmark. Odds ratios for time trends (1984 = 1.00) varied from 1.22 (1.02 to 1.46) in Sweden to 1.92 (1.62 to 2.30) in Norway. After adjusting for independent variables, a statistically borderline significant declining utilisation trend (OR = 0.85 (0.70 to 1.03)) was found for Denmark. CONCLUSION: Children's use of GP services has increased significantly in four of the five Nordic countries.

Adolescent↗
PubMed2005

Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries.

BACKGROUND: Few studies have compared socioeconomic inequalities in the prevalence of both fatal and non-fatal diseases. This paper aims to give the first international overview for several common chronic diseases. METHODS: Micro-level data were pooled from non-standardized national health surveys conducted in eight European countries in the 1990s. Surveys ranged in size from 3700 to 41 200 participants. The prevalence of 17 chronic disease groups were analysed in relation to education. Standardized prevalence rates and age-adjusted odds ratios (ORs) were calculated. RESULTS: Most diseases showed higher prevalence among the lower education group. Stroke, diseases of the nervous system, diabetes, and arthritis displayed relatively large inequalities (OR > 1.50). No socioeconomic differences were evident for cancer, kidney diseases, and skin diseases. Allergy was more common in the higher education group. Relative socioeconomic differences were often smaller among the 60-79 age group as compared with the 25-59 age group. Cancer was more prevalent among the lower educated in the 25-59 age group, but among the higher educated in the 60-79 age group. For diabetes, hypertension, and heart disease, socioeconomic differences were larger among women as compared with men. Inequalities in heart disease were larger in northern European countries as compared with southern European countries. CONCLUSION: There are large variations between chronic diseases in the size and pattern of socioeconomic differences in their prevalence. The large inequalities that are found for some specific fatal diseases (e.g. stroke) and non-fatal diseases (e.g. arthritis) require special attention in equity-oriented research and policies.

Adult↗
PubMed2005

Psychosocial working conditions and weight gain among employees.

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.

Adult↗
PubMed2005

The association of employment status and family status with health among women and men in four Nordic countries.

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.

Adult↗
PubMed2005

Trends in smoking behaviour between 1985 and 2000 in nine European countries by education.

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.

Adult↗
PubMed2005

Gender differences in the association of age with physical workload and functioning.

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.

Activities of Daily Living↗
PubMed2004

Pathways between socioeconomic determinants of health.

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.

Adult↗
PubMed2003

Income and health behaviours. Evidence from monitoring surveys among Finnish adults.

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.

Adolescent↗
PubMed2002

Health inequalities by education and age in four Nordic countries, 1986 and 1994.

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.

Adolescent↗
PubMed2001

[Small changes in health differences in the Nordic countries during the 1980s and 1990s].

The study examined changes over time in health inequality in Denmark, Finland, Norway and Sweden. Data derive from comparable interview surveys carried out in 1986/87 and 1994/95. Limiting long-standing illness and perceived ill health were analysed regarding age, gender; educational attainment, and employment status. Age adjusted prevalence rates were calculated. Changes in differences in health were found in education and employment status groups. There was little or no change in the prevalence of ill health during the time period studied. Despite social and economic changes differences in health remained broadly stable in the examined countries.

Age Factors↗
PubMed2001

Transitions of employment status among suicide attempters during a severe economic recession.

Previous studies have shown a positive association between unemployment and attempted suicide. This study investigated transitions of employment status among suicide attempters during the severe economic recession. The main research question was whether inequality in the labour market also prevails among as selected a population as suicide attempters. The material consisted of 2495 persons who attempted suicide during 1989-1994 in Helsinki, Finland. Logistic regression analysis and survival analysis were used. Unemployment rates among suicide attempters were higher than in the general population, male rates being higher than female rates throughout the recession. There were significant changes in the employment status of the entire attempted suicide population from 1989 to 1994, especially in terms of the transition from employment to unemployment. Gender, age and education level predicted exit from the labour market. Among suicide attempters young middle-aged men with low education had the highest risk of unemployment.

Adolescent↗
PubMed2001

Body height, birth cohort and social background in Finland and Sweden.

BACKGROUND: Poor childhood living conditions are associated with short stature. Before the Second World War Finland had much lower living standards than Sweden, but this gap had largely disappeared by the 1970s. Body height differences were examined by birth cohort, economic difficulties in childhood and adult socioeconomic position in Finland and Sweden. METHODS: Two nationally representative data sets were used (n = 7,300 in Finland and n = 4,551 in Sweden). Three indicators of social background were included, i.e. economic difficulties in childhood, education and occupational class. The methods used were direct age-standardisation, index of dissimilarity and regression analysis. RESULTS: In the cohort born in 1920-1929 body height was taller in Sweden (175.8 cm among men and 163.7 cm among women) than in Finland (173.9 and 161.2 cm respectively). Body height by birth cohort increased faster in Finland, with the result that, in the cohort born in 1960-1969, the gap between the countries had narrowed to 0.8 cm among men and 0.3 cm among women. Body height differences by social background were larger in Finland than in Sweden. Socioeconomic body height differences have remained largely stable over the birth cohorts in both countries. CONCLUSIONS: The results suggest that differential economic development is partly seen in the narrowing of body height differences between Finland and Sweden. However, socioeconomic differences in body height have remained largely similar over the birth cohorts studied and between Finland and Sweden.

Adolescent↗
PubMed2001

Educational differences in lung cancer mortality in male smokers.

BACKGROUND: To assess the extent of lung cancer mortality differentials by education while adjusting for exposure to tobacco smoke and asbestos based on survey questions. METHODS: Alpha-Tocopherol, Beta Carotene Cancer Prevention (ATBC) Study of 50-69-year-old Finnish male smokers enrolled 1985-1988. These analyses are based on the placebo group and the alpha-tocopherol supplementation group, altogether 14 011 men, with full information on tobacco smoking. Mortality follow-up was to the end of April 1993 and it was based on the complete death certificate register of the Statistics Finland. RESULTS: Lung cancer mortality of basic-educated men was 32% (rate ratio [RR] = 1.32; 95% CI : 0.93-1.87) higher than that of better-educated men in the ATBC Study. The excess is practically unchanged when additional adjustment was made for age at initiation, duration of smoking, current smoking at baseline and at first follow-up, smoke inhalation, occupational exposure to asbestos and interactions between asbestos exposure and all smoking variables. This excess mortality was about 40% of the similar excess observed in the general population of men of similar age. CONCLUSIONS: Educational differences in lung cancer mortality in the total Finnish population are likely to be mainly caused by differences in exposure, particularly to active smoking. Further understanding of the determinants and consequences of socioeconomic differences in smoking behaviour are of major scientific and public health importance.

Aged↗
PubMed2001

Food insecurity is associated with past and present economic disadvantage and body mass index.

Fears and experiences of food restriction influence eating behavior but the association between past and present economic disadvantage, food insecurity and body size is poorly understood. Therefore, we examined these associations in a nationwide, representative sample of 25- to 64-y-old Finnish men and women (n = 6506). The respondents were classified by their body mass index (BMI) into four groups: thin, normal, overweight and obese. Economic disadvantage was assessed by three indicators including low household income, unemployment during past 5 y and long-term economic problems in childhood. Food insecurity was assessed by five separate items concerning economic fears and experiences related to sufficient supply of food during the past 12 mo, and a combined scale in which those with affirmative responses to four to five items were classified as hungry. Multivariable logistic regression analyses were conducted using both the BMI grouping and indicators of economic disadvantage as independent variables to predict food insecurity, controlling simultaneously for age, educational attainment and sex. The results showed that low household income, recent unemployment and economic problems in childhood were all predictors of food insecurity. Thin people were most likely to be hungry and showed most food insecurity in five separate items. In addition, obese people reported more buying cheaper food due to economic problems and fears or experiences of running out of money to buy food than did normal weight subjects. In conclusion, both past and present economic disadvantage is associated with various aspects of food insecurity. The association between food insecurity and BMI is curvilinear.

Adult↗