Biomedical subjects

Pekka Martikainen

Publications and source records attributed to Pekka Martikainen.

At least 19 recordsLinked to original sources

PubMed2025

The impact of polygenic score and socioeconomic status in predicting risk for 19 complex diseases.

Both socioeconomic circumstances and genetic predisposition shape disease risk, yet their joint contribution across diseases has not been systematically examined. We studied 19 high-burden diseases in 743,194 participants (729,928 European; 13,266 non-European ancestry) from FinnGen, the UK Biobank, and Generation Scotland. Higher educational attainment was associated with lower risk of most conditions, but with higher risk of most common cancers. These associations were largely independent of disease-specific polygenic scores (PGSs). For seven out of 19 diseases, PGSs showed stronger effects among individuals with high education. Joint inclusion of education and PGSs modestly improved prediction for 14 and 10 out of 19 diseases in FinnGen and the UK Biobank, respectively. PGS associations were consistent across ancestries, whereas education effects were less stable; results using an alternative socioeconomic measure were directionally similar but smaller. Our findings highlight the distinct and partly interacting contributions of socioeconomic and genetic factors to disease risk.

Journal Article↗

PubMed2006

The contribution of musculoskeletal disorders and physical workload to socioeconomic inequalities in health.

OBJECTIVES: The objective of the study was to examine whether the association of physical workload with musculoskeletal disorders might explain occupational social class inequalities in self-rated health. METHODS: Participants of the study were 40-60 years old employees of the City of Helsinki. The data (n = 3740) were derived from several sources, including mail survey designed by the researchers and health check-ups carried out by occupational health care. Prevalence data and logistic regression were used in the analyses. RESULTS: An occupational class gradient was found for musculoskeletal disorders. The gradient in musculoskeletal disorders was largely explained by physical demands at work in both genders. The contribution of physical demands to occupational class gradient in self-rated health was considerable in women, but smaller in men. The contribution of musculoskeletal disorder to the occupational class gradient in self-rated health was weak for both genders. CONCLUSION: Physical workload is likely to considerably contribute to inequalities in health. Mediation of this effect through musculoskeletal disorder to generic health, however, could not be demonstrated. Different mechanisms are likely to cause inequalities in different health outcomes.

Adult↗

PubMed2006

Multiple measures of socioeconomic circumstances and common mental disorders.

While serious mental disorders typically show socioeconomic differences similar to physical illness-that is, that lower positions imply poorer health-differences for common mental disorders have been inconsistent. We aim to clarify the associations and pathways between measures of socioeconomic circumstances and common mental disorders by simultaneously analysing several past and present socioeconomic measures. The data were derived from middle-aged women and men employed by the City of Helsinki. Cross-sectional surveys were conducted in 2000-2002 among employees who, during each year, reached 40, 45, 50, 55 or 60 years of age. The pooled data include 8970 respondents (80% women; response rate 67%). Common mental disorders were measured by GHQ-12 and the SF-36 mental component summary. Seven socioeconomic measures were included: parental education, childhood economic difficulties, own education, occupational class, household income, home ownership, and current economic difficulties. Logistic regression analysis was used to examine associations between the socioeconomic circumstances and common mental disorders. Past and present economic difficulties were strongly associated with common mental disorders, whereas conventional past and present socioeconomic status measures showed weak or slightly reverse associations. Adjusting for age and gradually for each socioeconomic measure did not affect the main findings, which were very similar for women and men, as well as for both measures of common mental disorders. While the associations of conventional socioeconomic status measures with common mental disorders were weak and inconsistent, our results highlight the importance of past and present economic difficulties to these disorders.

Adult↗

PubMed2006

Incidence and prognostic implications of stable angina pectoris among women and men.

CONTEXT: Stable angina pectoris in women has often been considered a "soft" diagnosis, with less-severe prognostic implications than in men, but large-scale population studies are lacking. OBJECTIVE: To determine sex differences in the incidence and prognosis of stable angina in a large ambulatory population. DESIGN: Prospective cohort study using linked national registers. SETTING: All municipal primary health care centers, hospital outpatient clinics, occupational health care services, and the private sector in Finland. PARTICIPANTS: Among ambulatory patients aged 45 to 89 years who had no history of coronary disease, we defined new cases of "nitrate angina" based on nitrate prescription (56,441 women and 34,885 men) or "test-positive angina" based on abnormal invasive or noninvasive test results (11,391 women and 15,806 men). Potentially eligible patients were evaluated between January 1, 1996, and December 31, 1998. Follow-up ended in December 2001. MAIN OUTCOME MEASURES: Coronary mortality at 4 years (n = 7906 deaths) and fatal and nonfatal myocardial infarction at 1 year (n = 3129 events). RESULTS: The age-standardized annual incidence per 100 population of all cases of angina was 2.03 in men and 1.89 in women, with a sex ratio of 1.07 (95% confidence interval [CI], 1.06-1.09). At every age, nitrate angina in women and men was associated with a similar increase in risk of coronary mortality relative to the general population. Women with test-positive angina who were younger than 75 years had higher coronary-standardized mortality ratios than men; for example, among those aged 55 to 64 years, it was 4.69 (95% CI, 3.60-6.11) in women compared with 2.40 (95% CI, 2.11-2.73) in men (P<.001 for interaction). There was a strong, graded relationship between amount of nitrates used and event rates; women using higher doses of nitrates had prognoses comparable with those of men. Among patients with diabetes and test-positive angina, age-standardized coronary event rates were 9.9 per 100 person-years in women vs 9.3 in men (P = .69), and the fully adjusted male-female sex ratio was 1.07 (95% CI, 0.81-1.41). CONCLUSIONS: Women have a similarly high incidence of stable angina compared with men. Furthermore, stable angina in women is associated with increased coronary mortality relative to women in the general population and, among easily identifiable clinical subgroups, has similarly high absolute rates of prognostic outcomes compared with men.

Age Distribution↗

PubMed2006

Socioeconomic inequalities in physical and mental functioning of Japanese civil servants: explanations from work and family characteristics.

Poor physical and mental functioning is more common among people of low socioeconomic status (SES) and those with disadvantaged work and family characteristics. This study aims to clarify whether the SES inequalities in functioning can be explained by the SES differences in work and family characteristics. The subjects were 3787 male and female civil servants, aged 20-65, working in a local government on the west coast of Japan. Logistic regression analysis was performed to examine (1) whether there were employment-grade (SES) differences in poor physical and mental functioning as measured by the Short Form 36 (SF-36) and (2) whether these SES differences were explained by work and family characteristics. In general, low control at work, high demands, low social support, short and long work hours, shift work, being unmarried, high family-to-work conflict and high work-to-family conflict were independently associated with poor physical and mental functioning in both men and women. In men, the age-adjusted odds ratio (OR) of low-grade employees for poor physical functioning was 1.93 (95% confidence interval: 1.38-2.69) in comparison to high-grade employees. The grade difference was mildly attenuated, when adjusted for work and family characteristics (OR = 1.72)(1.20-2.47). The age-adjusted OR of the low-grade employees for poor mental functioning was 1.88 (1.29-2.74). The grade difference was attenuated and no longer significant when adjusted for work and family characteristics (OR = 1.51)(0.99-2.31). Among women, there were no significant grade-differences in poor physical and mental functioning. Although longitudinal research is necessary to clarify the causal nature of these associations, improvements in SES differences in work and family characteristics may be important for reducing SES inequalities in physical and mental functioning among Japanese men. The different patterns of SES inequalities in health between men and women deserve further research.

Adult↗

PubMed2006

Smoking and SF-36 health functioning.

OBJECTIVE: To examine the association between smoking and general health as measured by the Short-Form Health Survey (SF-36) questionnaire. METHODS: Data derived are from three cross-sectional surveys conducted in 2000, 2001 and 2002. Respondents to the postal surveys were middle-aged employees of the City of Helsinki (1799 men and 7171 women, response rate 67%). Smoking status was divided into current heavy and moderate smokers, ex-smokers and never smokers. Health status was measured by the eight SF-36 subscales and the physical and mental component summaries. RESULTS: On the physical subscales, current smokers reported poorer health than non-smokers on general health and physical functioning in men. On the mental subscales, current smokers had consistently poorer health than non-smokers. However, often only heavy smokers differed from non-smokers. No differences were found between ex-smokers and never smokers on any subscale or the component summaries of the SF-36. CONCLUSIONS: Differences between smoking categories were found on some physical and all mental subscales of the SF-36. The differences were slightly larger among men. As heavy smokers more often report limitations with daily activities as well as loss of well-being, these impairments potentially provide valuable incentives for non-smoking to be used in health education messages and interventions.

Activities of Daily Living↗

PubMed2006

Neighbourhood inequalities in health and health-related behaviour: results of selective migration?

We hypothesised that neighbourhood inequalities in health and health-related behaviour are due to selective migration between neighbourhoods. Ten-year follow-up data of 25-74-year-old participants in a Dutch city (Eindhoven) showed an increased probability of both upward and downward migration in 25-34-year-old participants, and in single and divorced participants. Women and those highly educated showed an increased probability of upward migration from the most deprived neighbourhoods; lower educated showed an increased probability of moving downwards. Adjusted for these factors, health and health-related behaviour were weakly associated with migration. Over 10 years of follow-up, selective migration will hardly contribute to neighbourhood inequalities in health and health-related behaviour.

Adult↗

PubMed2006

Mental health functioning (SF-36) and intentions to retire early among ageing municipal employees: the Helsinki Health Study.

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.

Adult↗

PubMed2006

Work and family characteristics as determinants of socioeconomic and sex inequalities in sleep: The Japanese Civil Servants Study.

STUDY OBJECTIVE: To clarify whether socioeconomic and sex inequalities in poor sleep quality are explained by socioeconomic and sex differences in work and family characteristics. DESIGN: A cross-sectional study. PARTICIPANTS: Three thousand five hundred fifty-six employees (2397 men and 1159 women) aged 20 to 65 years in local government in Japan. MEASUREMENTS: Respondents completed a self-administered questionnaire that asked about sleep quality, as measured by the Pittsburgh Sleep Quality Index; work characteristics, as measured by the job-demand-control-support model, work hours, and shift work; and family characteristics, such as family structure and family-work conflicts. RESULTS: Lower control at work, higher work demands, lower social support, shorter and longer working hours, shift work, being single, higher family-to-work conflict, and higher work-to-family conflict were independently associated with poorer sleep quality in both men and women. In men, the age-adjusted odds ratio (OR) of low-grade employees for poor sleep quality was 1.64 (95% confidence interval: 1.14-2.36) in comparison with high-grade employees. The difference in sleep was attenuated when work and family characteristics were adjusted for (OR=1.25 [0.84-1.86]). Among women, there was no significant grade difference in sleep. Women tended to have poorer sleep quality than men (the age-adjusted OR=1.75 [1.49-2.06]). The sex difference was attenuated and no longer significant when adjustments were made for work and family characteristics (OR=1.04 [0.85-1.27]). CONCLUSIONS: The results of this study suggest that work and family characteristics may be important for reducing socioeconomic and sex inequalities in sleep. Sex differences in the pattern of socioeconomic inequalities in sleep deserve further research.

Adult↗

PubMed2006

Job control, job demands, or social class? The impact of working conditions on the relation between social class and health.

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.

Adult↗

PubMed2006

Influence of change in psychosocial work characteristics on sickness absence: The Whitehall II Study.

OBJECTIVES: To study the influence of change in self perceived psychosocial work characteristics on subsequent rates of sickness absence. METHODS: Prospective cohort study of British civil service employees. Job control, job demands, and work social supports were measured in 1985/88 and in 1991/93. Analyses included 3817 British civil servants with sickness absence records at baseline (1985-89) and for two follow up periods, early (1994-95) and later follow up (1996-98). RESULTS: Change in work characteristics predicted subsequent incidence of long spells of sickness absence (>7 days) in the early follow up period after adjustment for covariates including baseline work characteristics, health status, and sickness absence. Adjusted rate ratios were 1.23 (95% CI 1.03 to 1.46) for decreased compared with stable decision latitude; 1.17 (95% CI 1.01 to 1.36) for increased compared with stable job demands and 0.79 (95% CI 0.67 to 0.93) for increased compared with stable work social support. These associations were also seen in a sub-sample who did not change employment grade. In the later follow up period, associations between work change and long spells of sickness absence were similar for decision latitude, less pronounced for job demands, and no longer apparent for social supports. Changes in work characteristics were not associated with subsequent short spells of sickness absence (<or=7 days). CONCLUSIONS: Adverse changes in the psychosocial work environment may lead to increased rates of sickness absence. These findings suggest that workplace interventions to improve psychosocial working conditions may reduce levels of sickness absence.

Absenteeism↗

PubMed2006

What does self rated health measure? Results from the British Whitehall II and French Gazel cohort studies.

OBJECTIVES: To investigate the determinants of self rated health (SRH) in men and women in the British Whitehall II study and the French Gazel cohort study. METHODS: The cross sectional analyses reported in this paper use data from wave 1 of the Whitehall II study (1985-88) and wave 2 of the Gazel study (1990). Determinants were either self reported or obtained through medical screening and employer's records. The Whitehall II study is based on 20 civil service departments located in London. The Gazel study is based on employees of France's national gas and electricity company (EDF-GDF). SRH data were available on 6889 men and 3403 women in Whitehall II and 13 008 men and 4688 women in Gazel. RESULTS: Correlation analysis was used to identify determinants of SRH from 35 measures in Whitehall II and 33 in Gazel. Stepwise multiple regressions identified five determinants (symptom score, sickness absence, longstanding illness, minor psychiatric morbidity, number of recurring health problems) in Whitehall II, explaining 34.7% of the variance in SRH. In Gazel, four measures (physical tiredness, number of health problems in the past year, physical mobility, number of prescription drugs used) explained 41.4% of the variance in SRH. CONCLUSION: Measures of mental and physical health status contribute most to the SRH construct. The part played by age, early life factors, family history, sociodemographic variables, psychosocial factors, and health behaviours in these two occupational cohorts is modest.

Adult↗

PubMed2006

Living arrangements and mental health in Finland.

BACKGROUND: Non-married persons are known to have poor mental health compared with married persons. Health differences between marital status groups may largely arise from corresponding differences in interpersonal social bonds. However, official marital status mirrors the social reality of persons to a decreasing extent, and living arrangements may be a better measure of social bonds. Little is known about mental health in different living arrangement groups. This study aims to establish the extent and determinants of mental health differences by living arrangement in terms of psychological distress (GHQ) and DSM-IV psychiatric disorders (CIDI). METHODS: Data were used from the nationally representative cross sectional health 2000 survey, conducted in 2000-1 in Finland. Altogether 4685 participants (80%) aged 30-64 years were included in these analyses; comprehensive information was available on measures of mental health and living arrangements. Living arrangements were measured as follows: married, cohabiting, living with other(s) than a partner, and living alone. RESULTS: Compared with the married, persons living alone and those living with other(s) than a partner were approximately twice as likely to have anxiety or depressive disorders. Cohabiters did not differ from the married. In men, psychological distress was similarly associated with living arrangements. Unemployment, lack of social support, and alcohol consumption attenuated the excess psychological distress and psychiatric morbidity of persons living alone and of those living with other(s) than a partner by about 10%-50% each. CONCLUSIONS: Living arrangements are strongly associated with mental health, particularly among men. Information on living arrangements, social support, unemployment, and alcohol use may facilitate early stage recognition of poor mental health in primary health care.

Adult↗

PubMed2006

Pain and health related functioning among employees.

STUDY OBJECTIVE: Although employees report high rates of pain, little is known about the effects of pain on health related functioning among them. This study examined the effects of pain on employees' health related functioning by bodily locations of pain, number of painful locations, and whether pain was acute or chronic. DESIGN: Cross sectional questionnaire survey. Data on pain and health related functioning as measured with the eight subscales of the short form 36 health survey (SF-36) were obtained in the years 2001 and 2002. SETTING: Municipal employees of the City of Helsinki, Finland. PARTICIPANTS: All employees who reached the age of 40, 45, 50, 55, and 60 years during each study year. Response rate was 66% (n = 5829). MAIN RESULTS: Compared with those reporting no pain, those with pain had considerably poorer functioning on all SF-36 subscales. The lowest scores for health related functioning were seen in the physical domain of health, whereas the mental domain was less affected. The association of pain with functioning was practically independent of the bodily location of pain. Whether pain was acute or chronic had only a modest effect on functioning. Widest variation in functioning was found by the number of painful locations. CONCLUSIONS: Among employees pain complaints, irrespective of the location, are associated with a decreased level of functioning. The number of painful locations is likely to be the most useful measure to identify employees with a high risk of poor functioning.

Activities of Daily Living↗

PubMed2006

Work-family conflicts and self-rated health among middle-aged municipal employees in Finland.

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.

Adult↗

PubMed2005

Explaining social inequalities in health by sleep: the Japanese civil servants study.

BACKGROUND: Individuals of low socioeconomic status (SES) are likely to have poor sleep and poor health. This study aims to evaluate whether and how much of the socioeconomic differences in health are explained by sleep. METHODS: The subjects were 3684 (2471 males and 1213 females) employees aged 20-65 working in local government in Japan. A questionnaire survey was conducted in January 2003. Analysis of covariance (ANCOVA) was performed to examine the association of employment-grade with sleep, measured by the Pittsburgh Sleep Quality Index (PSQI), and with health, measured by the Physical and Mental Component Summary Scales (PCS and MCS) of the Short Form-36 (SF-36). RESULTS: In men, higher grade employees had better sleep and better health. The age-adjusted difference between the highest and the lowest grade employees was 1.9 points (95% confidence interval = 1.0-3.0) in the PCS and 3.4 points (1.8-4.9) in the MCS. The grade difference in health reduced to 1.5 points (0.5-2.5) in the PCS (21.1% reduction) and 2.0 points (0.6-3.4) in the MCS (41.2% reduction), when the PSQI global score was adjusted for. The grade differences in sleep quality contributed more to the health inequalities than sleep quantity. Among women, no significant grade differences were observed in the PSQI global score. The grade differences in the PCS and MCS were weaker and less consistent than those of men, and the differences hardly changed when the PSQI global score was adjusted for. CONCLUSION: Sleep quality may mediate the relationship between SES and physical and, in particular, mental health in men.

Adult↗

PubMed2005

Associations of psychosocial working conditions with self-rated general health and mental health among municipal employees.

OBJECTIVES: To examine associations of job demands and job control, procedural and relational organizational fairness, and physical work load with self-rated general health and mental health. In addition, the effect of occupational class on these associations is examined. METHODS: The data were derived from the Helsinki Health Study baseline surveys in 2001-2002. Respondents to cross-sectional postal surveys were middle-aged employees of the City of Helsinki (n=5.829, response rate 67%). Associations of job demands and job control, organizational fairness and physical work load with less than good self-rated health and poor GHQ-12 mental health were examined. RESULTS: Those with the poorest working conditions two to three times more, often reported poor general and mental health than those with the best working conditions. Adjustment for occupational class weakened the associations of low job control and physical work load with general health by one fifth, but even more strengthened that of high job demands. Adjustment for occupational class clearly strengthened the associations of job control and physical work load with mental health in men. Mutual adjustment for all working conditions notably weakened their associations with both health measures, except those of job control in men. All working conditions except relational organizational fairness remained independently associated with general and mental health. CONCLUSIONS: All studied working conditions were strongly associated with both general and mental health but the associations weakened after mutual adjustments. Of the two organizational fairness measures, procedural fairness remained independently associated with both health outcomes. Adjustment for occupational class had essentially different effects on the associations of different working conditions and different health outcomes.

Adult↗

PubMed2005

Occupational class inequalities across key domains of health: results from the Helsinki Health Study.

BACKGROUND: Studies comparing socioeconomic inequalities in health using several health indicators are scarce. Therefore, this study aims to compare the shape and magnitude of occupational class inequalities across key domains of health, i.e. the subjective, functional and medical domains. Additionally, we examine whether physical or mental workload will affect these inequalities, and whether these effects are specific to particular health indicators. METHODS: 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. 6243 employees responded (80% women, response rate 68%). The socioeconomic indicator was occupational social class. Nine health indicators were included: self-rated health, pain or ache, GHQ-12 mental well-being, limiting long-standing illness, SF-36 physical and mental health functioning, Rose angina symptoms, circulatory diseases and mental problems. Prevalence percentages, odds ratios and inequality indices from logistic regression analysis were calculated. RESULTS: Occupational class inequalities were found for self-rated health, pain or ache, limiting long-standing illness, physical health functioning, angina symptoms, and circulatory diseases. Physical or mental workload did not account for these inequalities. Inequalities were non-existent or slightly reversed for GHQ-12 mental well-being, SF-36 mental health functioning and mental problems. CONCLUSION: Expected occupational class inequalities in health among both women and men were found for global and physical health but not for mental health. The observed inequalities could not be attributed to physical or mental workload.

Adult↗