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) study (N=5,854) were used to examine trajectories of self-rated health. Adjusting for age, sex, socioeconomic position, and marital status, we study 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 of change in self-rated health. 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 self-rated health 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

Bi-directional associations between gender-based harassment at work, psychological treatment and depressive symptoms

IntroductionThe objective of this study was to investigate the bi-directional associations between experienced and witnessed gender-based harassment (GBH) on the one hand, and depressive symptoms and psychological treatment on the other, in an occupational setting. GBH are behaviors that derogate, demean, or humiliate an individual based on his or her gender.MethodsThe analyses were based on data from the Swedish Longitudinal Occupational Survey of Health at 2018 (T1) and 2020 (T2), including 6,679 working participants (60.3% women) with a majority in the age range of 45–64. Using cross-lagged structural equational models, we analyzed experienced and witnessed GBH in relation to depressive symptoms and having received psychological treatment (talked to a counselor or psychological professional) over time.ResultsOur results showed that neither experienced nor witnessed GBH was prospectively associated with depressive symptoms or psychological treatment over two years. Both higher levels of depressive symptoms (β = 0.002, p ≤ 0.001) and having received psychological treatment (β = 0.013, p = 0.027) weakly predicted experiences of GBH over time. Having received psychological treatment was furthermore weakly associated with witnessed GBH (β = 0.019, p = 0.012).DiscussionIn conclusion, the hypothesized associations between exposure to GBH and mental health outcomes were not statistically significant, while a weak reverse association was noted. More research addressing bidirectional associations between GBH and mental health outcomes are needed

Multicohort study of change in job strain, poor mental health and incident cardiometabolic disease

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.Peer reviewe

Interactional justice at work is related to sickness absence: a study using repeated measures in the Swedish working population

Background: Research has shown that perceived unfairness contributes to higher rates of sickness absence. While shorter, but more frequent periods of sickness absence might be a possibility for the individual to get relief from high strain, long-term sickness absence might be a sign of more serious health problems. The Uncertainty Management Model suggests that justice is particularly important in times of uncertainty, e.g. perceived job insecurity. The present study investigated the association between interpersonal and informational justice at work with long and frequent sickness absence respectively, under conditions of job insecurity. Methods: Data were derived from the 2010, 2012, and 2014 biennial waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH). The final analytic sample consisted of 19,493 individuals. We applied repeated measures regression analyses through generalized estimating equations (GEE), a method for longitudinal data that simultaneously analyses variables at different time points. We calculated risk of long and frequent sickness absence, respectively in relation to interpersonal and informational justice taking perceptions of job insecurity into account. Results: We found informational and interpersonal justice to be associated with risk of long and frequent sickness absence independently of job insecurity and demographic variables. Results from autoregressive GEE provided some support for a causal relationship between justice perceptions and sickness absence. Contrary to expectations, we found no interaction between justice and job insecurity. Conclusions: Our results underline the need for fair and just treatment of employees irrespective of perceived job insecurity in order to keep the workforce healthy and to minimize lost work days due to sickness absence

Ανάπτυξη στατιστικής μεθοδολογίας για την προσέγγιση δημογραφικών φαινομένων

The main objective of this work is to develop statistical methodology for estimating patterns of demographic phenomena. The main topics are briefly described below. Several techniques have been proposed in the literature for graduating mortality data. An innovative topic for graduating mortality data is the use of kernel regression estimators. In this work we provide an analytical evaluation of the alternative kernel estimators as tools for graduating mortality data. In order to evaluate the efficiency and accuracy of kernel techniques for graduation purposes, we apply these to several empirical data sets and compare the results with those of classical graduation techniques. The interesting finding is that the Gasser-Muller estimator proves more adequate compared to other kernel-type regression estimators. The study of sex mortality differences is a topic that has been widely studied. Particular emphasis is given to the causes that provoke these differences as well as the evolution of the sex mortality gap through time. The gap between the mortality patterns of the two sexes significantly varies through ages exhibiting a pattern that became typical since the middle of the 20th century. This pattern consists of two humps, the first around age 20 and the second around age 60. However the literature lacks a model that captures this pattern. Therefore in this work a parametric model is developed for estimating the age-specific pattern of sex mortality differences over the whole age range. This model is useful for many purposes. In fact, such a model, eliminating the random variations of empirical data can serve for simplifying comparisons of the mortality patterns between sexes. Moreover, capturing the pattern into a limited set of parameter values, it can simplify comparisons of the shape and the severity of the mortality deviations of the two sexes, through space and time.In order to evaluate the performance of such a parametric representation, we fit the model to a variety of empirical data sets. The results suggest that a widening of the sex mortality differential is reflected through time. In addition in recent years, the modes of the two humps tend to move to higher ages, except of some Baltic and East-European countries. It is of course interesting to further investigate the reasons for which this sex mortality widening occurs in recent years.Furthermore, a parametric model is developed in order to graduate the age-specific patterns of fertility and nuptiality. Considering fertility, it is known that the age-specific fertility pattern has a typical shape common in all human populations through years. In recent years, a distorted fertility pattern is observed for the UK, the USA and Ireland characterised by a second hump at earlier ages. As expected, the existing models are unable to estimate the new shape of the fertility pattern and therefore the use of more appropriate representations is required. The model proposed here is able to capture both the old and the new distorted fertility pattern. In this work, this model is utilised for estimating the age-specific fertility pattern the age-specific parity rates of several European populations. The results reveal that the patterns of early-age fertility, previously confined to a few mostly English-speaking countries, are now more widely distributed in Europe. Another finding is that for countries with enhanced early-age fertility the pattern of first births also exhibits a strongly intense hump in younger ages and even stronger than the pattern of total fertility. Furthermore the fertility pattern of the USA when differentiated by the ethnicity of the mother is quite heterogeneous. These facts provide a strong evidence of heterogeneity in the female populations associated not only to the marital status, race and birth order but also to the educational level, social and economic status as well as the religiosity of the mothers. The model proposed is also adequate for estimating the age-specific pattern of nuptiality. To evaluate its adequacy, comparisons with existing models are provided, for several populations through time. The results indicate that these models generally show deviations between the empirical and estimated rates at the tails of the first-marriage distribution for the majority of populations. This might be an indication of heterogeneity in these populations and therefore, as shown here, mixture modes are more adequate for fitting the nuptiality pattern of modern populations.Σκοπός της εργασίας αυτής είναι η ανάπτυξη στατιστικής μεθοδολογίας για την προσέγγιση δημογραφικών φαινομένων. Στη συνέχεια περιγράφεται συνοπτικά η μεθοδολογία που παρουσιάζεται στην εργασία αυτή. Στη βιβλιογραφία έχουν αναπτυχθεί πολλές τεχνικές για την εξομάλυνση των ειδικών κατά ηλικία δεδομένων θνησιμότητας. Το πρώτο κεφάλαιο της εργασίας αυτής επικεντρώνεται στη χρήση διαφόρων εκτιμητών kernel. Προκειμένου να αξιολογηθεί η αποτελεσματικότητα των διάφορων εναλλακτικών εκτιμητών kernel, αυτοί εφαρμόζονται σε εμπειρικά δεδομένα διαφόρων χωρών και τα αποτελέσματά τους συγκρίνονται με αυτά που προκύπτουν από την εφαρμογή των πλέον επιτυχημένων στη βιβλιογραφία παραμετρικών μοντέλων. Τα κύρια συμπεράσματα είναι ότι ο εκτιμητής Gasser-Muller αποδεικνύεται αποτελεσματικότερος σε σχέση με τους υπόλοιπους εκτιμητές kernel και εξομαλύνει τα δεδομένα θνησιμότητας σε όλο το ηλιακό εύρος. Τα αποτελέσματά του είναι ισοδύναμα με τα αντίστοιχα των παραμετρικών μοντέλων. Η μελέτη των διαφορών θνησιμότητας μεταξύ των φύλων είναι ένα θέμα που έχει ευρέως μελετηθεί στη βιβλιογραφία. Ιδιαίτερη έμφαση δίνεται στις αιτίες που προκαλούν τις διαφορές στη θνησιμότητα των δύο φύλων καθώς και στη διαχρονική εξέλιξη των διαφορών αυτών. Η καμπύλη που εκφράζει τις διαφορές θνησιμότητας μεταξύ των δύο φύλων έχει επίσης μια τυπική μορφή στο δεύτερο μισό του εικοστού αιώνα, που χαρακτηρίζεται από δύο κορυφές κοντά στις ηλικίες των 20 και 60 ετών αντίστοιχα. Εν τούτοις στη βιβλιογραφία δεν έχει παρουσιαστεί κάποιο μοντέλο που εκτιμά αυτή τη καμπύλη. Στην εργασία αυτή αναπτύσσεται ένα παραμετρικό μοντέλο για την εκτίμηση της ειδικής κατά ηλικία καμπύλης των διαφορών θνησιμότητας μεταξύ των δύο φύλων. Το μοντέλο αυτό μπορεί να είναι χρήσιμο για διάφορους σκοπούς, αφού εξαλείφοντας τη τυχαία μεταβλητότητα των εμπειρικών δεδομένων, απλουστεύει τη σύγκριση των καμπυλών θνησιμότητας μεταξύ των δύο φύλων. Επιπλέον, βασισμένο στην εκτίμηση συγκεκριμένων παραμέτρων, απλουστεύει τις συγκρίσεις καμπυλών θνησιμότητας διαχρονικά αλλά και μεταξύ διαφορετικών πληθυσμών. Το μοντέλο που προτείνεται στην εργασία αυτή εφαρμόζεται σε μια ευρεία γκάμα εμπειρικών συνόλων δεδομένων με σκοπό την αξιολόγησή του. Τα αποτελέσματα δείχνουν ότι οι διαφορές θνησιμότητας μεταξύ ανδρών και γυναικών διευρύνονται στην περίοδο 1960-2000. Επίσης στα πρόσφατα χρόνια, παρατηρείται μία τάση των δύο κορυφών της καμπύλης να μετατοπίζονται σε μεγαλύτερες ηλικίες εκτός από κάποιες Βαλτικές χώρες καθώς και χώρες της Ανατολικής Ευρώπης. Τα αποτελέσματα αυτά αποτελούν το κίνητρο για περαιτέρω έρευνα σχετικά με τις αιτίες που συμβάλλουν στην εντατικοποίηση της απόκλισης μεταξύ της θνησιμότητας ανδρών και γυναικών. Στη συνέχεια αναπτύσσεται και αξιολογείται ένα παραμετρικό μοντέλο για την περιγραφή τόσο της ειδικής κατά ηλικία καμπύλης γεννητικότητας και όσο και της ειδικής κατά ηλικία καμπύλης γαμηλιότητας. Είναι γνωστό ότι η ειδική κατά ηλικία καμπύλη γεννητικότητας έχει μια συγκεκριμένη μορφή διαχρονικά για όλους τους ανθρώπινους πληθυσμούς. Τα τελευταία χρόνια, μία διαφορετική μορφή της καμπύλης γεννητικότητας παρατηρείται ειδικότερα σε δεδομένα της Μεγάλης Βρετανίας, ΗΠΑ και Ιρλανδίας, που χαρακτηρίζεται από την ύπαρξη μιας δεύτερης κορυφής στις νεότερες ηλικίες. Επιπλέον για τις χώρες αυτές, το ίδιο φαινόμενο χαρακτηρίζει και την καμπύλη των γεννήσεων του πρώτου παιδιού. Κατά συνέπεια, σε αυτές τις περιπτώσεις, τα υπάρχοντα μοντέλα είναι ανεπαρκή για την περιγραφή των αντίστοιχων καμπυλών. Το μοντέλο που προτείνεται αποδεικνύεται επαρκές για την περιγραφή τόσο της παλαιάς όσο και της νέας μορφής της κατά ηλικία καμπύλης γεννητικότητας καθώς και καμπύλης των πρώτων γεννήσεων. Από τη παρούσα μελέτη προκύπτει ότι η νέα μορφή της καμπύλης γεννητικότητας χαρακτηρίζει εκτός από την Αγγλία, ΗΠΑ και Ιρλανδία και άλλες Ευρωπαϊκές χώρες. Επίσης από την ανάλυση προκύπτει, ότι σε αυτές τις χώρες η καμπύλη των πρώτων γεννήσεων χαρακτηρίζεται από τη νέα μορφή, υποδεικνύοντας μεγάλη ανομοιογένεια στους πληθυσμούς αυτούς. Στην περίπτωση της Αμερικής η μορφή της καμπύλης γεννητικότητας βάσει της καταγωγής των μητέρων δείχνει ότι υπάρχει μεγάλη ανομοιογένεια στον πληθυσμό ως προς την ηλικία. Υπάρχει ένδειξη ότι η ανομοιογένεια σε αυτούς τους πληθυσμούς σχετίζεται όχι μόνο με τη γαμηλιότητα ή την καταγωγή των γυναικών αυτών, αλλά και με το εκπαιδευτικό, κοινωνικό και οικονομικό επίπεδο καθώς και τη θρησκεία.Το μοντέλο που προτείνεται εδώ, προτείνεται ακόμα για την περιγραφή της ειδικής κατά ηλικία καμπύλης γαμηλιότητας. Για την αξιολόγησή του, γίνεται μια συγκριτική μελέτη των αποτελεσμάτων που δίνει το μοντέλο αυτό με εκείνα που έχουν προηγούμενα παρουσιαστεί στη βιβλιογραφία, σε διάφορα σύνολα δεδομένων διαφόρων χωρών, αντρικών και γυναικείων πληθυσμών, διαχρονικά. Τα αποτελέσματα της ανάλυσης δείχνουν ότι αυτά τα μοντέλα έχουν κάποιες αποκλίσεις μεταξύ των εμπειρικών και εκτιμώμενων τιμών, κυρίως στις ουρές της κατανομής γαμηλιότητας για τους περισσότερους πληθυσμούς που εξετάσθηκαν. Αυτό μπορεί να αποτελεί ένδειξη της ύπαρξης μεγάλης ανομοιογένειας στους πληθυσμούς αυτούς ως προς την ηλικία γαμηλιότητας ενώ τα σύνθετα μοντέλα είναι πιο χρήσιμα για την εκτίμηση της μορφής της καμπύλης γαμηλιότητας σε σύγχρονους πληθυσμούς

The role of managerial leadership in sickness absence in health and social care : antecedent or moderator in the association between psychosocial working conditions and register-based sickness absence? A longitudinal study based on a swedish cohort

Background The prevalence of sickness absence is particularly high among employees in health and social care, where psychosocial work stressors are pertinent. Managerial leadership is known to affect sickness absence rates, but the role leadership plays in relation to sickness absence is not fully understood; that is, whether poor leadership (i) is associated with sickness absence directly, (ii) is associated with sickness absence indirectly through the establishment of poor psychosocial working conditions, or (iii) whether good leadership rather has a buffering role in the association between work stressors and sickness absence. Methods Four biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH, 2010–2016, N=2333) were used. Autoregressive cross-lagged analyses within a multilevel structural equation modelling (MSEM) framework were conducted to test hypotheses i)–iii), targeting managerial leadership, register-based sickness absence and psychosocial work stressors (high psychological demands, poor decision authority and exposure to workplace violence). Results A direct association was found between poor leadership and sickness absence two years later, but no associations were found between leadership and the psychosocial work stressors. Finally, only in cases of poor leadership was there a statistically significant association between workplace violence and sickness absence. Conclusions Poor managerial leadership may increase the risk of sickness absence among health and social care workers in two ways: first, directly and, second, by increasing the link between workplace violence and sickness absence

Does Exposure to High Job Demands, Low Decision Authority, or Workplace Violence Mediate the Association between Employment in the Health and Social Care Industry and Register-Based Sickness Absence? : A Longitudinal Study of a Swedish Cohort

Background: The aim of this paper was to investigate if job demands, decision authority, and workplace violence mediate the association between employment in the health and social care industry and register-based sickness absence. Methods: Participants from the Swedish Longitudinal Occupational Survey of Health who responded to questionnaires in 2006-2016 (n = 3951) were included. Multilevel autoregressive cross-lagged mediation models were fitted to the data. Employment in the health and social care industry at one time point was used as the predictor variable and register-based sickness absence >14 days as the outcome variable. Self-reported levels of job demands, decision authority, and exposure to workplace violence from the first time point were used as mediating variables. Results: The direct path between employment in the health and social care industry and sickness absence >14 days was, while adjusting for the reverse path, 0.032, p = 0.002. The indirect effect mediated by low decision authority was 0.002, p = 0.006 and the one mediated by exposure to workplace violence was 0.008, p = 0.002. High job demands were not found to mediate the association. Conclusion: Workplace violence and low decision authority may, to a small extent, mediate the association between employment in the health and social care industry and sickness absence