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Volanen, S.-M., Lassander, M., Hankonen, N., Santalahti, P., Hintsanen, M., Simonsen, N., . . . Suominen, S. (2020). Healthy learning mind – Effectiveness of a mindfulness program on mental health compared to a relaxation program and teaching as usual in schools: A cluster-randomised controlled trial. Journal of Affective Disorders, 260, 660-669
Open this publication in new window or tab >>Healthy learning mind – Effectiveness of a mindfulness program on mental health compared to a relaxation program and teaching as usual in schools: A cluster-randomised controlled trial
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2020 (English)In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 260, p. 660-669Article in journal (Refereed) Published
Abstract [en]

Background: Mindfulness-Based Interventions (MBIs) have shown promising effects on mental health among children and adolescents, but high-quality studies examining the topic are lacking. The present study assessed the effects of MBI on mental health in school-setting in an extensive randomised controlled trial. Methods: Finnish school children and adolescents (N = 3519), aged 12–15 years (6th to 8th graders), from 56 schools were randomized into a 9 week MBI group, and control groups with a relaxation program or teaching as usual. The primary outcomes were resilience, socio-emotional functioning, and depressive symptoms at baseline, at completion of the programs at 9 weeks (T9), and at follow-up at 26 weeks (T26). Results: Overall, mindfulness did not show more beneficial effects on the primary outcomes compared to the controls except for resilience for which a positive intervention effect was found at T9 in all participants (β=1.18, SE 0.57, p = 0.04) as compared to the relaxation group. In addition, in gender and grade related analyses, MBI lowered depressive symptoms in girls at T26 (β=−0.49, SE 0.21, p = 0.02) and improved socio-emotional functioning at T9 (β=−1.37, SE 0.69, p = 0.049) and at T26 (β=−1.71, SE 0.73, p = 0.02) among 7th graders as compared to relaxation. Limitations: The inactive control group was smaller than the intervention and active control groups, reducing statistical power. Conclusions: A short 9-week MBI in school-setting provides slight benefits over a relaxation program and teaching as usual. Future research should investigate whether embedding regular mindfulness-based practice in curriculums could intensify the effects. 

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Mental health promotion, Mindfulness, Randomized controlled trial, School-based intervention
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-17756 (URN)10.1016/j.jad.2019.08.087 (DOI)000490428300083 ()31546105 (PubMedID)2-s2.0-85072510110 (Scopus ID)
Available from: 2019-10-04 Created: 2019-10-04 Last updated: 2019-10-31Bibliographically approved
Vuorio, T., Suominen, S., Kautiainen, H. & Korhonen, P. (2019). Determinants of sickness absence rate among Finnish municipal employees. Scandinavian Journal of Primary Health Care, 37(1), 3-9
Open this publication in new window or tab >>Determinants of sickness absence rate among Finnish municipal employees
2019 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 37, no 1, p. 3-9Article in journal (Refereed) Published
Abstract [en]

Objective: In addition to acute health problems, various aspects of health behavior, work-related and sociodemographic factors have been shown to influence the rate of sickness absence. The aim of this study was to concomitantly examine factors known to have an association with absenteeism. We hypothesized the prevalence of chronic diseases being the most important factor associated with sickness absence. Design: A cross-sectional study. Setting: Occupational health care in the region of Pori, Finland. Subjects: 671 municipal employees (89% females) with a mean age of 49 (SD 10) years. Information about the study subjects was gathered from medical records, by physical examination and questionnaires containing information about physical and mental health, health behavior, work-related and sociodemographic factors. The number of sickness absence days was obtained from the records of the city of Pori. Main outcome measures: The relationship of absenteeism rate with sociodemographic, health- and work-related risk factors. Results: In the multivariate analysis, the mean number of chronic diseases (IRR 1.24, 95% CI 1.13 to 1.36), work ability (IRR 0.83, 95% CI 0.76 to 0.91), and length of years in education (IRR 0.90, 95% CI 0.85 to 0.95) remained as independent factors associated with absenteeism. Conclusion: According to our results, chronic diseases, self-perceived work ability and length of years in education are the most important determinants of the rate of sickness absence. This implies that among working-aged people the treatment of chronic medical conditions is also worth prioritizing, not only to prevent complications, but also to avoid sickness absences. KEY POINTS Various sociodemographic, health- and work- related risk factors have been shown to influence sickness absence. The study aimed to find the most important determinants of absenteeism among several known risk factors in Finnish municipal employees. Chronic diseases, self-perceived work ability and education years remained as the most important determinants of sickness absence rates. Treatment of chronic medical conditions should be prioritized in order to reduce sickness absence rate. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
chronic disease, health behavior, occupational health care, sickness absence, sociodemographic factor, work ability, work-related factor
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-16630 (URN)10.1080/02813432.2019.1568710 (DOI)000463364700008 ()30689483 (PubMedID)2-s2.0-85060928514 (Scopus ID)
Available from: 2019-02-15 Created: 2019-02-15 Last updated: 2019-05-09
Ervasti, J., Airaksinen, J., Pentti, J., Vahtera, J., Suominen, S., Virtanen, M. & Kivimaki, M. (2019). Does increasing physical activity reduce the excess risk of work disability among overweight individuals?. Scandinavian Journal of Work, Environment and Health, 45(4), 376-385
Open this publication in new window or tab >>Does increasing physical activity reduce the excess risk of work disability among overweight individuals?
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2019 (English)In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 4, p. 376-385Article in journal (Refereed) Published
Abstract [en]

Objectives We examined the extent to which an increase in physical activity would reduce the excess risk of work disability among overweight and obese people (body mass index >= 25kg/m(2)).

Methods We used counterfactual modelling approaches to analyze longitudinal data from two Finnish prospective cohort studies (total N=38 744). Weight, height and physical activity were obtained from surveys and assessed twice and linked to electronic records of two indicators of long-term work disability (>= 90-day sickness absence and disability pension) for a 7-year follow-up after the latter survey. The models were adjusted for age, sex, socioeconomic status, smoking, and alcohol consumption.

Results The confounder-adjusted hazard ratio (HR) of long-term sickness absence for overweight compared to normal-weight participants was 1.43 [95% confidence interval (CI) 1.35-1.53]. An increase in physical activity among overweight compared to normal-weight individuals was estimated to reduce this HR to 1.40 (95% CI 1.31-1.48). In pseudo-trial analysis including only the persistently overweight, initially physically inactive participants, the HR for long-term sickness absence was 0.82 (95% CI 0.70-0.94) for individuals with increased physical activity compared to those who remained physically inactive. The results for disability pension as an outcome were similar.

Conclusions These findings suggest that the excess risk of work disability among overweight individuals would drop by 3-4% if they increased their average physical activity to the average level of normal-weight people. However, overweight individuals who are physically inactive would reduce their risk of work disability by about 20% by becoming physically active.

Place, publisher, year, edition, pages
Nordic Association of Occupational Safety and Health (NOROSH), 2019
Keywords
counterfactual analysis, mediation, normal weight; obesity, sickness absence, weight
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-17464 (URN)10.5271/sjweh.3799 (DOI)000473173000007 ()30640978 (PubMedID)
Available from: 2019-07-22 Created: 2019-07-22 Last updated: 2019-11-13
Koponen, A. M., Simonsen, N. & Suominen, S. (2019). How to promote fruits, vegetables, and berries intake among patients with type 2 diabetes in primary care?: A self-determination theory perspective. Health Psychology Open, 6(1)
Open this publication in new window or tab >>How to promote fruits, vegetables, and berries intake among patients with type 2 diabetes in primary care?: A self-determination theory perspective
2019 (English)In: Health Psychology Open, E-ISSN 2055-1029, Vol. 6, no 1Article in journal (Refereed) Published
Abstract [en]

The results of this study showed the importance of autonomous motivation for healthy eating. Autonomous motivation and female gender were the determinants most strongly associated with fruits, vegetables, and berries intake among patients with type 2 diabetes. Other determinants of fruits, vegetables, and berries intake were high education, high social support, high age, and a strong sense of coherence. Autonomous motivation and self-care competence mediated the effect of perceived autonomy support from a physician on fruits, vegetables, and berries intake. Thus, physicians can promote patients’ fruits, vegetables, and berries intake by supporting their autonomous motivation and self-care competence. The results are in line with self-determination theory.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
adherence, diabetes, diet, fruit and vegetable intake, self-determination theory
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-17320 (URN)10.1177/2055102919854977 (DOI)000471634900001 ()31218074 (PubMedID)2-s2.0-85067349786 (Scopus ID)
Available from: 2019-06-27 Created: 2019-06-27 Last updated: 2019-08-06Bibliographically approved
Magnusson Hanson, L. L., Rod, N. H., Vahtera, J., Peristera, P., Pentti, J., Rugulies, R., . . . Westerlund, H. (2019). Multicohort study of change in job strain, poor mental health and incident cardiometabolic disease. Occupational and Environmental Medicine, 76, 785-792
Open this publication in new window or tab >>Multicohort study of change in job strain, poor mental health and incident cardiometabolic disease
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2019 (English)In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 76, p. 785-792Article in journal (Refereed) Published
Abstract [en]

Objectives: Several recent large-scale studies have indicated a prospective association between job strain and coronary heart disease, stroke and diabetes. Job strain is also associated with poorer mental health, a risk factor for cardiometabolic disease. This study investigates the prospective relationships between change in job strain, poor mental health and cardiometabolic disease, and whether poor mental health is a potential mediator of the relationship between job strain and cardiometabolic disease. Methods: We used data from five cohort studies from Australia, Finland, Sweden and UK, including 47 757 men and women. Data on job strain across two measurements 1-5 years apart (time 1 (T1)-time 2 (T2)) were used to define increase or decrease in job strain. Poor mental health (symptoms in the top 25% of the distribution of the scales) at T2 was considered a potential mediator in relation to incident cardiometabolic disease, including cardiovascular disease and diabetes, following T2 for a mean of 5-18 years. Results: An increase in job strain was associated with poor mental health (HR 1.56, 95% CI 1.38 to 1.76), and a decrease in job strain was associated with lower risk in women (HR 0.70, 95% CI 0.60-0.84). However, no clear association was observed between poor mental health and incident cardiometabolic disease (HR 1.08, 95% CI 0.96-1.23), nor between increase (HR 1.01, 95% CI 0.90-1.14) and decrease (HR 1.08, 95% CI 0.96-1.22) in job strain and cardiometabolic disease. Conclusions: The results did not support that change in job strain is a risk factor for cardiometabolic disease and yielded no support for poor mental health as a mediator.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
cardiovascular, diabetes mellitus, mental health, meta-analysis, stress
National Category
Public Health, Global Health, Social Medicine and Epidemiology Occupational Health and Environmental Health General Practice
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-17718 (URN)10.1136/oemed-2018-105595 (DOI)31488605 (PubMedID)2-s2.0-85072081458 (Scopus ID)
Available from: 2019-09-23 Created: 2019-09-23 Last updated: 2019-11-11Bibliographically approved
Lagström, H., Halonen, J. I., Kawachi, I., Stenholm, S., Pentti, J., Suominen, S., . . . Vahtera, J. (2019). Neighborhood socioeconomic status and adherence to dietary recommendations among Finnish adults: A retrospective follow-up study. Health and Place, 55, 43-50
Open this publication in new window or tab >>Neighborhood socioeconomic status and adherence to dietary recommendations among Finnish adults: A retrospective follow-up study
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2019 (English)In: Health and Place, ISSN 1353-8292, E-ISSN 1873-2054, Vol. 55, p. 43-50Article in journal (Refereed) Published
Abstract [en]

Neighborhood socioeconomic status (SES) is associated with dietary habits among the residents, but few studies have examined this association separately among long-term residents and movers. We calculated cumulative neighborhood SES score weighted by residential time in each address over 6 years for non-movers (n = 7704) and movers (n = 8818) using national grid database. Increase in average neighborhood SES was associated with higher adherence to dietary recommendations in both groups. Among the movers, an upward trajectory from low to high neighborhood SES was also associated with better adherence. Our findings suggest high SES areas might offer healthier food environments than low SES areas.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
dietary habits, dietary recommendations, neighborhood socioeconomic status, adult, article, controlled study, diet, female, Finn (citizen), follow up, habit, human, major clinical study, male, neighborhood, resident, retrospective study, social status
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-16474 (URN)10.1016/j.healthplace.2018.10.007 (DOI)000456089600006 ()30470615 (PubMedID)2-s2.0-85056901266 (Scopus ID)
Available from: 2018-12-06 Created: 2018-12-06 Last updated: 2019-02-06Bibliographically approved
Kivimäki, M., Singh-Manoux, A., Pentti, J., Sabia, S., Nyberg, S. T., Alfredsson, L., . . . Jokela, M. (2019). Physical inactivity, cardiometabolic disease, and risk of dementia: an individual-participant meta-analysis. BMJ. British Medical Journal, 365, Article ID l1495.
Open this publication in new window or tab >>Physical inactivity, cardiometabolic disease, and risk of dementia: an individual-participant meta-analysis
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2019 (English)In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 365, article id l1495Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE To examine whether physical inactivity is a risk factor for dementia, with attention to the role of cardiometabolic disease in this association and reverse causation bias that arises from changes in physical activity in the preclinical (prodromal) phase of dementia. DESIGN Meta-analysis of 19 prospective observational cohort studies. DATA SOURCES The Individual-Participant-Data Meta-analysis in Working Populations Consortium, the Inter-University Consortium for Political and Social Research, and the UK Data Service, including a total of 19 of a potential 9741 studies. REVIEW METHOD The search strategy was designed to retrieve individual-participant data from prospective cohort studies. Exposure was physical inactivity; primary outcomes were incident all-cause dementia and Alzheimer's disease; and the secondary outcome was incident cardiometabolic disease (that is, diabetes, coronary heart disease, and stroke). Summary estimates were obtained using random effects meta-analysis. RESULTS Study population included 404 840 people (mean age 45.5 years, 57.7% women) who were initially free of dementia, had a measurement of physical inactivity at study entry, and were linked to electronic health records. In 6.0 million person-years at risk, we recorded 2044 incident cases of all-cause dementia. In studies with data on dementia subtype, the number of incident cases of Alzheimer's disease was 1602 in 5.2 million person-years. When measured < 10 years before dementia diagnosis (that is, the preclinical stage of dementia), physical inactivity was associated with increased incidence of all-cause dementia (hazard ratio 1.40, 95% confidence interval 1.23 to 1.71) and Alzheimer's disease (1.36, 1.12 to 1.65). When reverse causation was minimised by assessing physical activity >= 10 years before dementia onset, no difference in dementia risk between physically active and inactive participants was observed (hazard ratios 1.01 (0.89 to 1.14) and 0.96 (0.85 to 1.08) for the two outcomes). Physical inactivity was consistently associated with increased risk of incident diabetes (hazard ratio 1.42, 1.25 to 1.61), coronary heart disease (1.24, 1.13 to 1.36), and stroke (1.16, 1.05 to 1.27). Among people in whom cardiometabolic disease preceded dementia, physical inactivity was non-significantly associated with dementia (hazard ratio for physical activity assessed > 10 before dementia onset 1.30, 0.79 to 2.14). CONCLUSIONS In analyses that addressed bias due to reverse causation, physical inactivity was not associated with all-cause dementia or Alzheimer's disease, although an indication of excess dementia risk was observed in a subgroup of physically inactive individuals who developed cardiometabolic disease.

Place, publisher, year, edition, pages
ENGLAND: BMJ Publishing Group Ltd, 2019
Keywords
JOB STRAIN, PROPORTIONAL-HAZARDS, HEART-DISEASE, LIFE-STYLE, FOLLOW-UP, COHORT, TIME, MEN, ASSOCIATION, MORTALITY
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-16879 (URN)10.1136/bmj.l1495 (DOI)000465550000004 ()30995986 (PubMedID)2-s2.0-85064695071 (Scopus ID)
Available from: 2019-05-10 Created: 2019-05-10 Last updated: 2019-08-06Bibliographically approved
Varinen, A., Kosunen, E., Mattila, K., Suominen, S., Sillanmäki, L. & Sumanen, M. (2019). The association between bullying victimization in childhood and fibromyalgia: Data from the nationwide Finnish health and social support (HeSSup) study based on a sample of 64,797 individuals. Journal of Psychosomatic Research, 117, 48-53
Open this publication in new window or tab >>The association between bullying victimization in childhood and fibromyalgia: Data from the nationwide Finnish health and social support (HeSSup) study based on a sample of 64,797 individuals
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2019 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 117, p. 48-53Article in journal (Refereed) Published
Abstract [en]

Background: Fibromyalgia is a functional pain syndrome presenting with various psychological symptoms. Several studies have shown that adverse life events are associated with fibromyalgia. The aim of the current study is to explore the association between self-reported bullying victimization in childhood and self-reported fibromyalgia in adulthood. Methods: The basic study setting is cross-sectional - with focused use of retrospective data - derived from a large on-going postal follow up survey (sample N = 64,797) initiated in Finland in 1998. Only respondents having answered the questions on fibromyalgia in both follow ups in 2003 and 2012 were included (N = 11,924). Severity of bullying was divided into three groups starting from no bullying followed by minor and severe bullying. Covariates having shown statistically significant associations with fibromyalgia in cross tabulation using Pearson's chi-squared test were included in the final multiple logistic regression analyses. Results: In our study, 50.6% of the respondents reported victimization of minor and 19.6% of severe bullying in childhood. Participants reporting fibromyalgia in adulthood reported more bullying, and in females alone this association was statistically significant (p =.027). In multiple logistic regression analysis statistically significant associations between bullying victimization in childhood (reference: no bullying) and fibromyalgia were found: adjusted odds ratio (OR) for minor bullying was 1.35 (95% CI 1.09–1.67) and for severe bullying 1.58 (95% CI 1.21–2.06). However, in log-linear and logistic regression interaction models the association between bullying and fibromyalgia was not statistically significant when depression was included in the models. Conclusions: Our results suggest that peer bullying victimization might be associated with fibromyalgia. However, in logistic log linear and logistic interaction models there was no statistically significant association when depression was included. As a result, there is need for further, preferably prospective cohort studies. The findings also emphasize the importance of actions to prevent childhood bullying. 

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
childhood adversity, cross-sectional, fibromyalgia, peer bullying
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-16570 (URN)10.1016/j.jpsychores.2018.12.003 (DOI)000457669800008 ()2-s2.0-85059481710 (Scopus ID)
Available from: 2019-01-17 Created: 2019-01-17 Last updated: 2019-05-09Bibliographically approved
Kivimäki, M., Luukkonen, R., Batty, G. D., Ferrie, J. E., Pentti, J., Nyberg, S. T., . . . Jokela, M. (2018). Body mass index and risk of dementia: Analysis of individual-level data from 1.3 million individuals. Alzheimer's & Dementia, 14(5), 601-609
Open this publication in new window or tab >>Body mass index and risk of dementia: Analysis of individual-level data from 1.3 million individuals
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2018 (English)In: Alzheimer's & Dementia, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 14, no 5, p. 601-609Article in journal (Refereed) Published
Abstract [en]

Introduction: Higher midlife body mass index (BMI) is suggested to increase the risk of dementia, but weight loss during the preclinical dementia phase may mask such effects. Methods: We examined this hypothesis in 1,349,857 dementia-free participants from 39 cohort studies. BMI was assessed at baseline. Dementia was ascertained at follow-up using linkage to electronic health records (N = 6894). We assumed BMI is little affected by preclinical dementia when assessed decades before dementia onset and much affected when assessed nearer diagnosis. Results: Hazard ratios per 5-kg/m(2) increase in BMI for dementia were 0.71 (95% confidence interval = 0.66-0.77), 0.94 (0.89-0.99), and 1.16 (1.05-1.27) when BMI was assessed 10 years, 10-20 years, and >20 years before dementia diagnosis. Conclusions: The association between BMI and dementia is likely to be attributable to two different processes: a harmful effect of higher BMI, which is observable in long follow-up, and a reverse-causation effect that makes a higher BMI to appear protective when the follow-up is short. (C) 2017 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer's Association.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
body mass index, dementia, cohort study, bias, obesity
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-15589 (URN)10.1016/j.jalz.2017.09.016 (DOI)000432438800003 ()29169013 (PubMedID)2-s2.0-85036621583 (Scopus ID)
Available from: 2018-06-14 Created: 2018-06-14 Last updated: 2018-08-30Bibliographically approved
Virtanen, M., Ervasti, J., Head, J., Oksanen, T., Salo, P., Pentti, J., . . . Kivimäki, M. (2018). Lifestyle factors and risk of sickness absence from work: a multicohort study. Lancet Public Health, 3(11), E545-E554
Open this publication in new window or tab >>Lifestyle factors and risk of sickness absence from work: a multicohort study
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2018 (English)In: Lancet Public Health, ISSN 2468-2667, Vol. 3, no 11, p. E545-E554Article in journal (Refereed) Published
Abstract [en]

Background Lifestyle factors influence the risk of morbidity and mortality, but the extent to which they are associated with employees' absence from work due to illness is unclear. We examined the relative contributions of smoking, alcohol consumption, high body-mass index, and low physical activity to diagnosis-specific sickness absence. Methods We did a multicohort study with individual-level data of participants of four cohorts from the UK, France, and Finland. Participants' responses to a lifestyle survey were linked to records of sickness absence episodes, typically lasting longer than 9 days; for each diagnostic category, the outcome was the total number of sickness absence days per year. We estimated the associations between lifestyle factors and sickness absence by calculating rate ratios for the number of sickness absence days per year and combining cohort-specific estimates with meta-analysis. The criteria for assessing the evidence included the strength of association, consistency across cohorts, robustness to adjustments and multiple testing, and impact assessment by use of population attributable fractions (PAF), with both internal lifestyle factor prevalence estimates and those obtained from European populations (PAF external). Findings For 74 296 participants, during 446 478 person-years at risk, the most common diagnoses for sickness absence were musculoskeletal diseases (70.9 days per 10 person-years), depressive disorders (26.5 days per 10 person-years), and external causes (such as injuries and poisonings; 12.8 days per 10 person-years). Being overweight (rate ratio [adjusted for age, sex, socioeconomic status, and chronic disease at baseline] 1.30, 95% CI 1.21-1.40; PAF external 8.9%) and low physical activity (1.23, 1.14-1.34; 7.8%) were associated with absences due to musculoskeletal diseases; heavy episodic drinking (1.90, 1.41-2.56; 15.2%), smoking (1.70, 1.42-2.03; 11.8%), low physical activity (1.67, 1.42-1.96; 19.8%), and obesity (1.38, 1.11-1.71; 5.6%) were associated with absences due to depressive disorders; heavy episodic drinking (1.64, 1.33-2.03; 11.3%), obesity (1.48, 1.27-1.72; 6.6%), smoking (1.35, 1.20-1.53; 6.3%), and being overweight (1.20, 1.08-1.33; 6.2%) were associated with absences due to external causes; obesity (1.82, 1.40-2.36; 11.0%) and smoking (1.60, 1.30-1.98; 10.3%) were associated with absences due to circulatory diseases; low physical activity (1.37, 1.25-1.49; 12.0%) and smoking (1.27, 1.16-1.40; 4.9%) were associated with absences due to respiratory diseases; and obesity (1.67, 1.34-2.07; 9.7%) was associated with absences due to digestive diseases. Interpretation Lifestyle factors are associated with sickness absence due to several diseases, but observational data cannot determine the nature of these associations. Future studies should investigate the cost-effectiveness of lifestyle interventions aimed at reducing sickness absence and the use of information on lifestyle for identifying groups at risk. 

Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-16498 (URN)10.1016/S2468-2667(18)30201-9 (DOI)000451514600015 ()30409406 (PubMedID)2-s2.0-85056003586 (Scopus ID)
Available from: 2018-12-14 Created: 2018-12-14 Last updated: 2019-09-30Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0001-6648-603X

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