Paraskevi Peristera

Does job promotion affect men’s and women’s health differently? Dynamic panel models with fixed effects

Background Higher occupational status has consistently been shown to be associated with better health, but few studies have to date examined if an upward change in occupational status is associated with a positive change in health. Furthermore, very little is known about whether this association differs by sex. Methods Data were derived from four waves (2008-14) of the Swedish Longitudinal Occupational Survey of Health (SLOSH), a follow-up study of a nationally representative sample of the Swedish working population. The present study comprises 1410 men and 1926 women. A dynamic panel model with fixed effects was used to analyse the lagged association between job promotion on the one hand and self-rated health (SRH) and symptoms of depression on the other. This method allowed controlling for unobserved time-invariant confounders and determining the direction of causality between the variables. Multigroup comparisons were performed to investigate differences between the sexes. Results The results showed that job promotion was associated with decreased subsequent SRH and increased symptoms of depression among both men and women. Women reported a larger relative worsening of self-rated health following a job promotion than men and men reported a larger relative worsening of depression symptoms. There was limited evidence that SRH and symptoms of depression were associated with subsequent job promotion. Conclusions The present study indicates that a job promotion could lead to decreased SRH and increased symptoms of depression in a 2-4-year perspective. Associations appear to differ for women and men.

The influence of and change in procedural justice on self-rated health trajectories: Swedish Longitudinal Occupational Survey of Health results

OBJECTIVES Procedural justice perceptions are shown to be associated with minor psychiatric disorders, long sickness absence spells, and poor self-rated health, but previous studies have rarely considered how changes in procedural justice influence changes in health. METHODS Data from four consecutive biennial waves of the Swedish Longitudinal Survey of Health (SLOSH) (N=5854) were used to examine trajectories of self-rated health. Adjusting for age, sex, socioeconomic position, and marital status, we studied the predictive power of change in procedural justice perceptions using individual growth curve models within a multilevel framework. RESULTS The results show that self-rated health trajectories slowly decline over time. The rate of change was influenced by age and sex, with older people and women showing a slower rate. After adjusting for age, sex, socioeconomic position, and marital status, procedural justice was significantly associated with self-rated health. Also, improvements in procedural justice were associated with improvements in self-rated health. Additionally, a reverse relationship with and change in self-rated health predicting procedural justice was found. CONCLUSIONS Our findings support the idea that procedural justice at work is a crucial aspect of the psychosocial work environment and that changes towards more procedural justice could influence self-rated health positively. The reciprocal association of procedural justice and self-rated health warrants further research.

Longitudinal Mediation Modeling of Unhealthy Behaviors as Mediators between Workplace Demands/Support and Depressive Symptoms

Lifestyle has been regarded as a key pathway through which adverse psychosocial working characteristics can give rise to long-term health problems. The purpose of this study was to estimate the indirect/mediated effect of health behaviors in the longitudinal work characteristics-depression relationship. The analyses were based on the Swedish Longitudinal Occupational Survey of Health, including 3706 working participants with repeat survey measures on four occasions (2008, 2010, 2012 and 2014). Psychosocial work characteristics including demands and social support were analyzed in relation to depressive symptoms. Autoregressive longitudinal mediation models using structural equation modeling were used to estimate the intermediate effects of unhealthy behaviors including current smoking, excessive alcohol consumption, unhealthy diet and physical inactivity. Both workplace demands and social support were related to later depressive symptoms. In bivariate models we found no significant paths from workplace demands to health behaviors, but two out of three significant time-specific paths from workplace support to excessive drinking and from excessive drinking to depressive symptoms. Social support was also associated with subsequent unhealthy diet, and one path from unhealthy diet to depressive symptoms was found. However, despite indications of certain longitudinal relationships between psychosocial working conditions and health behaviors as well as between health behaviors and depressive symptoms, no significant intermediate effects were found (p>0.05). We conclude that changes in unhealthy behaviors over a period of two years are unlikely to act as strong intermediaries in the longitudinal relationship between job demands and depressive symptoms and between social support and depressive symptoms.

Socio-economic predictors of depressive symptoms around old age retirement in Swedish women and men

ABSTRACT Objectives: To estimate trajectories of depression around old age retirement in Swedish women and men and examine if socio-economic status predicted the trajectories Methods: The analytic sample comprised 907 women and 806 men from the Swedish Longitudinal Occupational Survey of Health. B-spline smoothers and group-based trajectory modelling were used to identify groups of individuals with similar trajectories of depressive symptoms around retirement. Multinomial regression analyses were conducted to investigate if socio-economic factors were associated with odds of belonging to trajectory groups with higher depression scores. Results: Four depressive symptoms trajectories were identified in both genders, all showing similar symptom levels across the retirement transition. Low levels of depressive symptoms were observed in the three largest groups. In the last trajectory group among women (2.5%) depression scores were moderate to severe and among men (3.3%) depression scores were persistent moderate. Higher educational level and lower subjectively rated social status were associated with higher odds of belonging to trajectory groups with higher levels of depressive symptoms in both genders. Conclusion: Retirement transition was not associated with symptoms of depression. Higher educational level and lower subjective social status may predict higher depressive symptom levels the years around old age retirement.

Temporal Relationships between Job Strain and Low-Back Pain

Objectives Psychosocial working conditions are suggested risk factors for low-back pain, but it is unclear whether these associations are causal. The present study examined whether there are lagged and bidirectional associations between job strain and low-back pain and further controlled for unmeasured time-invariant confounding. Methods The study was based on four biennial waves of data from the Swedish Longitudinal Occupational Survey of Health (SLOSH), including 3084 men and women. Cross-lagged analyses using structural equation modeling (SEM) were conducted on job strain, a combination of high job demands and low control, and any as well as low-back pain severity (how much any problems affected the respondents life). Analogous SEM (dynamic panel) models with fixed effects were also fitted to remove confounding from time-invariant factors (such as non-observed individual and environmental factors, eg, genetics, childhood conditions, personality). Results The SEM models indicated bidirectional associations between job strain and any back pain over a 2-year time lag (β=0.21 and 0.19, P<0.05), when adjusting for a range of covariates. Job strain was also associated with an increase in low-back pain severity and vice versa. However, the SEM models with fixed-effects showed no statistically significant lagged relationships between job strain and any or low-back pain severity (β=-0.05 and β=0.00, respectively). Conclusions This study suggests that associations between job strain and low-back pain with a lag of years may be due to residual confounding by time invariant characteristics. Further studies are, however, needed to elucidate short-term relationships.

0058 Accuracy of a single item on mentally tiring work as proxy measure of job demands and efforts in the gazel cohort

Objective Comparing the accuracy of single item about mentally tiring work against validated scales, Demand-Control (DC) and the Effort Reward Imbalance (ERI). Methods We analysed data from the Gazel cohort, where a question about mentally tiring work was administered simultaneously with the DC (in 1997 and 1999) and ERI (in 1998) scales. Correlation and accuracy were studied comparing this single question (8 categories, and recoded into 2 or categories) with DC and ERI scales (without and with recoding into 2 categories based on usual threshold), using sensitivity, specificity, predictive values, and likelihood ratio. Results For the years considered, 5706 (1998) to 11 304 (1997) workers had responded to the questionnaires. The demand and effort dimensions were moderately correlated with the mentally tiring work question showing a good sensitivity (>0.8), and a negative likelihood ratio (<0.33), with a possible dose-response-relationship. Specificity and positive likelihood ratio were low (respectively <0.5 and<2). Job control, Job strain and ERI were not captured by mentally tiring work, and reward only partly. Conclusion Though a single question does not replace validated scales as the DC and the ERI scales, these results indicate that it would be possible to use simple measures in questionnaires and non-specialised cohorts for screening purpose.

A parametric model for estimating nuptiality patterns in modern populations

Nuptiality is a phenomenon closely related to fertility. The age-specific marriage distribution has a typical shape common in all human populations. In order to estimate this pattern, alternative parametric models have been proposed. However recent evidence suggests that mixture models are required to estimate nuptiality patterns. In this paper, a flexible parametric model is proposed in three versions, appropriate to describe the age pattern of first marriage rates. For evaluation purposes the models as well as the alternative existing models are fitted to a variety of empirical datasets.

Stuck at a workplace: What’s work control, demands and learning got to do with it? A longitudinal multilevel study on Swedish permanent employees in situations of ‘workplace locked-in’

Abstract Whilst health consequences of being locked-in at the workplace have been documented in several research studies, it is largely unknown how work characteristics and their changes over time relate to risks for becoming locked-in at a certain workplace. Accordingly, this paper studied how perceived control, learning opportunities and quantitative demands at work associate with workplace-locked-in (WPLI). The study included permanent employees who participated in the Swedish Longitudinal Occupational Survey of Health (SLOSH) study in wave 3 through 5 (n = 2918 individuals; n = 7460 observations). Results from multi-level analysis show that there was significant individual variation in WPLI changes over time, even though on average, WPLI decreased slightly. Differences in work characteristics between individuals (L2) and across time (L1) associated significantly with WPLI: higher levels of job control and learning opportunities related to lower odds ratios for WPLI, whereas higher quantitative job demands associated with higher odds ratios of WPLI. Moreover, differences in quantitative job demands, number of job changes and educational achievements explained the individual variations of WPLI developments over time. The result shows that WPLI can – to some extent – be prevented or reduced through good work design, and implications for HR managers and organizations are discussed.

Paid and unpaid working hours among Swedish men and women in relation to depressive symptom trajectories: results from four waves of the Swedish Longitudinal Occupational Survey of Health

Background Long working hours and unpaid work are possible risk factors for depressive symptoms. However, little is known about how working hours influence the course of depressive symptoms. This study examined the influence of paid, unpaid working hours and total working hours on depressive symptoms trajectories. Methods The study was based on data from four waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH 2008–2014). We applied group-based trajectory modelling in order to identify trajectories of depressive symptoms and studied paid and unpaid working hours and total working hours as risk factors. Results Six trajectory groups were identified with symptoms: ‘very low stable’, ‘low stable’, ‘doubtful increasing’, ‘high decreasing’, ‘mild decreasing’ and ‘high stable’. More time spent on unpaid work was associated with the ‘low stable’ (OR 1.16, 95% CI 1.04 to 1.30) and the ‘high stable (OR 1.40, 95% CI 1.18 to 1.65) symptom trajectories compared with being in the ‘very low stable’ symptom group. In addition, more total working hours was associated with a higher probability of having ‘high decreasing’ (OR 1.30, 95% CI 1.14 to 1.48) and ‘high stable’ (OR 1.22, 95% CI 1.01 to 1.47) symptoms, when adjusting for sex, age, civil status and socioeconomic status. The results, however, differed somewhat for men and women. More unpaid working hours was more clearly associated with higher symptom trajectories among women. More total working hours was associated with ‘high stable’ symptoms among women only. Conclusions This study supported heterogeneous individual patterns of depressive symptoms over time among the Swedish working population. The results also indicate that a higher burden of unpaid work and longer total working hours, which indicate a double burden from paid and unpaid work, may be associated with higher depressive symptom trajectories, especially among women.

Does work-personal life interference predict turnover among male and female managers, and do depressive symptoms mediate the association? A longitudinal study based on a Swedish cohort

BackgroundIn the present study we used a longitudinal design to examine if work-personal life interference predicted managerial turnover, if depressive symptoms mediated the association, and if the relationships differed by gender.MethodsData were drawn from four waves (2010, 2012, 2014 and 2016) of the Swedish Longitudinal Occupational Survey of Health (SLOSH), a cohort of the Swedish working population. Participants who in any wave reported to have a managerial or other leading position were included (n = 717 men and 741 women). Autoregressive longitudinal mediation models within a multilevel structural equation modelling (MSEM) framework, in which repeated measures (level 1) were nested within individuals (level 2), were fitted to data. First, bivariate autoregressive and cross-lagged paths between the variables were fitted in gender stratified models. Secondly, a full gender stratified mediation model was built to estimate if the association between work-personal life interference and turnover was mediated through depressive symptoms. Gender differences in cross-lagged paths were estimated with multiple-group analysis. All analyses were adjusted for age, education, labour market sector, civil status and children living at home, and conducted in MPLUS 7.ResultsIn both genders there were significant paths between work-personal life interference and turnover. Depressive symptoms were, however, not found to mediate in the relationship between work-personal life interference and turnover. The models differed significantly between genders.ConclusionsEstablishing organisational prerequisites for good work-personal life balance among managers may be a means to retain both male and female managerial talent.