Work Stress as a Risk Factor for Cardiovascular Disease

The role of psychosocial work stress as a risk factor for chronic disease has been the subject of considerable debate. Many researchers argue in support of a causal connection while others remain skeptical and have argued that the effect on specific health conditions is either negligible or confounded. This review of evidence from over 600,000 men and women from 27 cohort studies in Europe, the USA and Japan suggests that work stressors, such as job strain and long working hours, are associated with a moderately elevated risk of incident coronary heart disease and stroke. The excess risk for exposed individuals is 10-40 % compared with those free of such stressors. Differences between men and women, younger versus older employees and workers from different socioeconomic backgrounds appear to be small, indicating that the association is robust. Meta-analyses of a wider range of health outcomes show additionally an association between work stress and type 2 diabetes, though not with common cancers or chronic obstructive pulmonary disease, suggesting outcome specificity. Few studies have addressed whether mitigation of work stressors would reduce the risk of cardiovascular disease. In view of the limited interventional evidence on benefits, harms and cost-effectiveness, definitive recommendations have not been made (e.g. by the US Preventive Services Taskforce) for the primary prevention of cardiovascular disease via workplace stress reduction. Nevertheless, governments are already launching healthy workplace campaigns, and preventing excessive work stress is a legal obligation in several countries. Promoting awareness of the link between stress and health among both employers and workers is an important component of workplace health promotion

Economic uncertainty and suicide in the United States

Previous studies have found an association between recessions and increased rates of suicide. In the present study we widened the focus to examine the association between economic uncertainty and suicides. We used monthly suicide data from the US at the State level from 2000 to 2017 and combined them with the monthly economic uncertainty index. We followed a panel data econometric approach to study the association between economic uncertainty and suicide, controlling for unemployment and other indicators. Economic uncertainty is positively associated with suicide when controlling for unemployment [coeff: 8.026; 95% CI: 3.692–12.360] or for a wider range of economic and demographic characteristics [coeff: 7.478; 95% CI: 3.333–11.623]. An increase in the uncertainty index by one percent is associated with an additional 11–24.4 additional monthly suicides in the US. Economic uncertainty is likely to act as a trigger, which underlines the impulsive nature of some suicides. This highlights the importance of providing access to suicide prevention interventions (e.g. hotlines) during periods of economic uncertainty

Psychosocial and material pathways in the relation between income and health: a response to Lynch et al

Summary points: Economic and social circumstances affect health through the physiological effects of their emotional and social meanings and the direct effects of material circumstances. Material conditions do not adequately explain health inequalities in rich countries. The relation between smaller inequalities in income and better population health reflects increased psychosocial wellbeing. In rich countries wellbeing is more closely related to relative income than absolute income. Social dominance, inequality, autonomy, and the quality of social relations have an impact on psychosocial wellbeing and are among the most powerful explanations for the pattern of population health in rich countries

Social epidemiology

Social epidemiology is the branch of epidemiology concerned with understanding how social and economic characteristics influence states of health in populations. There has been a resurgence recently in interest among epidemiologists about the roles that social and economic factors play in determining health, leading to valuable synergies with the social sciences. The determinants of health commonly studied in social epidemiology include absolute poverty, income inequality, as well as race and discrimination. Recently, social epidemiologists have been at the forefront of conceptual developments within the discipline that view the determinants of health at different levels of social organization. © 2008 Copyright © 2008 Elsevier Inc. All rights reserved

Study protocol: SWING – social capital and well-being in neighborhoods in Ghent

Background: Investing in social capital has been put forth as a potential lever for policy action to tackle health inequity. Notwithstanding, empirical evidence that supports social capital's role in the existence of health inequity is limited and inconclusive. Furthermore, social capital literature experiences important challenges with regard to (1) the level on which social capital is measured and analyzed; (2) the measurement of the concept in line with its multidimensional nature; and (3) the cross-cultural validity of social capital measurements. The Social capital and Well-being In Neighborhoods in Ghent (SWING) study is designed to meet these challenges. The collected data can be used to investigate the distribution of health problems and the association between social capital, health and well-being, both at the individual and at the neighborhood level. The main goals of the SWING study are (1) to develop a coherent multilevel dataset of indicators on individual and neighborhood social capital and well-being that contains independent indicators of neighborhood social capital at a low level of aggregation and (2) to measure social capital as a multidimensional concept. The current article describes the background and design of the SWING study. Methods/Design: The SWING study started in 2011 and data were collected in three cross-sectional waves: the first in 2011, the second in 2012, and the third in 2013. Data collection took place in 142 neighborhoods (census tract level) in the city of Ghent (Flanders, Belgium). Multiple methods of data collection were used within each wave, including: (1) a standardized questionnaire, largely administered face-to-face interviews for neighborhood inhabitants (N = 2,730); (2) face-to-face interviews with key informants using a standardized questionnaire (N = 2,531); and (3) an observation checklist completed by the interviewers (N = 2,730 in total). The gathered data are complemented by data available within administrative data services. Discussion: The opportunities and ambitions of the SWING study are discussed, together with the limitations of the database

Toward the next generation of research into small area effects on health : a synthesis of multilevel investigations published since July 1998.

To map out area effects on health research, this study had the following aims: (1) to inventory multilevel investigations of area effects on self rated health, cardiovascular diseases and risk factors, and mortality among adults; (2) to describe and critically discuss methodological approaches employed and results observed; and (3) to formulate selected recommendations for advancing the study of area effects on health. Overall, 86 studies were inventoried. Although several innovative methodological approaches and analytical designs were found, small areas are most often operationalised using administrative and statistical spatial units. Most studies used indicators of area socioeconomic status derived from censuses, and few provided information on the validity and reliability of measures of exposures. A consistent finding was that a significant portion of the variation in health is associated with area context independently of individual characteristics. Area effects on health, although significant in most studies, often depend on the health outcome studied, the measure of area exposure used, and the spatial scale at which associations are examined

Workplace exposure to passive smoking and risk of cardiovascular disease: summary of epidemiologic studies.

We reviewed the published epidemiologic studies addressing the relationship between workplace exposure to environmental tobacco smoke (ETS) and cardiovascular disease risk in three case-control studies and three cohort studies. Although the point estimates of risk for cardiovascular disease exceeded 1.0 in five of six studies, none of the relative risks was statistically significant because of the small number of cardiovascular end points occurring in individual studies. In common with most epidemiologic investigations of the health risks of ETS, none of the workplace studies included independent biochemical validation of ETS exposure. In contrast to the evidence on increased cardiovascular disease risk from exposure to spousal ETS, studies of ETS exposure in the workplace are still sparse and inconclusive. Conversely, there is no biologically plausible reason to believe that the hazards of ETS exposure that have been demonstrated in the home should not also apply to the workplace

The association of shift work and coronary heart disease risk factors among male factory workers in Kota Bharu, Kelantan

Shift work is one of the work hour systems in which a relay of employees extends the period of production beyond the conventional 8-hour working day. It has been found to be associated with various health problems and there is concern that shift workers are at higher risk to develop risk factors for coronary heart disease (CHD). The study was undertaken to examine relationships between shift work and CHD risk factors, namely hypertension, dyslipidaemia (either hypercholesterolaemia, hyper-low density lipoprotein-cholesterolaemia, hypo-high density lipoprotein-cholesterolaemia or hypertriglyceridaemia), high body mass index (BMI), hyperglycemia and physical inactivity among male factory workers in a factory in Kota Bharu, Kelantan. METHODS: This study was a contrived cross-sectional study of 76 shift and 72 day workers from one ofthe factories in Kota Bharu, Kelantan. Data was collected through a questionnaire on psychosocial and life-style factors, anthropometric and blood pressure measurement, fasting blood sugar and fasting lipid proJiles analyses. RESULTS: The prevalence of hypertension, hypercholesterolaemia, hypertriglyceridaemia and high body mass index (BMO were significantly higher among shift workers compared to day workers. There was no difference in the prevalence of hyperg[ycemia, hypo-high-density lipoprotein-cholesterolaemia, hyper-high-density lipoprotein-cholesterolaemia and physical inactivity. When the shiji workers were compared with the day workers, the aajusted odds ratio (OR) for hypertension, high BMI andphysical inactivity were 9.1 (95% CI 1.4-56.8), 2.9 (95% CI 1.3-6.1) and 7.7 (95% CI 2.1-27.5) respectively. There was neither association of shift work with dyslipidaemia, nor with hyperglycemia. CONCLUSIONS: There were positive association between shiji work and hypertension, high BMI andphysical inactivity which denotes a higher risk of CHD risk factors among shift workers compared to day workers