Fagerlund, P.

Kaartinen, S.

Lallukka, T.

Rahkonen, O.

Shiri, R.

Suur-Uski, J.

English

PubMed

Helsingin yliopiston digitaalinen arkisto

https://helda.helsinki.fiPain and mental health - separate and joint associations withsickness absence among young employeesFagerlund, P.2022-10-25Fagerlund , P , Shiri , R , Suur-Uski , J , Kaartinen , S , Rahkonen , O & Lallukka , T 2022 , 'Pain and mental health - separate and joint associations with sickness absence amongyoung employees ' , European Journal of Public Health , vol. 32 , no. Suppl. 3 , ckac129.31 . https://doi.org/10.1093/eurpub/ckac129.310http://hdl.handle.net/10138/356044https://doi.org/10.1093/eurpub/ckac129.310cc_bypublishedVersionDownloaded from Helda, University of Helsinki institutional repository.This is an electronic reprint of the original article.This reprint may differ from the original in pagination and typographic detail.Please cite the original version.5.H. Round table: Health care systems, healthservice provision, and equity in healthAbstract citation ID: ckac129.309Organised by: EUPHA-HSR, EUPHA-EPIChair persons: Johan Hansen (EUPHA-HSR), Stefania Boccia (EUPHA-EPI)Contact: p.groenewegen@nivel.nlThe starting point for this round table is the observation thatthe research areas of health systems, health services andpopulation health are usually seen as separate academicspecialisations. This hampers the potential for getting insightsinto the role of health care systems and service provision in thedevelopment of population health and health inequalities, andof policies to reduce inequalities. As a result of the differentmix of disciplines, with different approaches, different researchand publication cultures, and different funding sources healthsystems research, health services research and populationhealth research have tended to grow apart and to ignore theresults from the other areas. In this round table session we willdiscuss the ways health care systems and health serviceprovision influence inequalities in health. This implies lookingat different levels of analysis. Health care systems andinequalities in population health refer to the macro level,and both are influenced by the same political and societalcontext. Health inequalities are also (and more strongly)influenced by structures and processes at macro level outsidethe health care system and service provision. Health serviceprofessionals form the intermediate level; their actual servicedelivery takes place at the micro level where health careprofessionals and users meet. Health care professionals andusers of services bring their own attitudes, beliefs and resourcesthat influence their interaction and consequent outcomes.Both meso and micro level are influenced by structures andinstitutions, in society in general as well as in the design of thehealth care system. The results of the interactions betweenhealth care professionals and users are (e.g.) decisions whetheror not to use certain types of care, with consequences for thehealth and functional abilities of users. These decisions andtheir consequences are patterned by socio-economic charac-teristics of care users. These aggregate into patterns ofinequality at the macro level. Over time, the influence ofhealth care on population health has increased. The respon-sibility of health care for upstream causes of health inequalitiescan be strengthened through deliberate policies. With the(long-term) change of morbidity from infectious disease tochronic disease, prevention is often moving to programmes tosupport people in changing their lifestyle. This in itself exposesthe relationships between health care and health inequalities, asthose interventions that require a contribution from indivi-duals tend to increase inequalities since those lacking resourceswill find it harder to participate. In this round table we presenta proposal to integrate the three fields of research. We invitespecialists from each of these fields and the audience of theround table to react to our proposal. The aim of this roundtable is to promote cross-disciplinary collaboration. The twoorganizing EUPHA sections cover the three areas of research infocus.Key messages: The same political and societal context influences the healthsystem, service provision and many of the social determi-nants of population health. The potential to address health inequalities through healthcare may have increased, and requires specific attention tointegration of social care and different parts of health care.Speakers/Panellists:Peter GroenewegenNIVEL, Utrecht, NetherlandsIlmo KeskimäkiFinnish Institute for Health and Welfare, Helsinki, FinlandAlastair LeylandUniversity of Glasgow, Glasgow, UKEllen NolteLSHTM, London, UK5.J. Pitch presentations: Occupational health andsickness absenceAbstract citation ID: ckac129.310Pain and mental health - separate and jointassociations with sickness absence among youngemployeesPi FagerlundP Fagerlund1, R Shiri2, J Suur-Uski1, S Kaartinen1,3, O Rahkonen1,T Lallukka11Department of Public Health, University of Helsinki, Helsinki, Finland2Finnish Institute of Occupational Health, Helsinki, Finland3Department of Physical and Rehabilitation Medicine, Helsinki UniversityHospital, Hyvinkää, FinlandContact: pi.fagerlund@helsinki.fiBackground:Both pain and mental illness associate with work disability.However, few studies have examined the association ofconcurrent pain and mental distress with sickness absence(SA). We examined separate and joint associations of chronicpain, multisite pain, and mental distress with total and long-term all-cause SA among young and midlife municipalemployees.Methods:As part of the Young Helsinki Health study, baseline data werecollected in 2017 from 19-39-year-old employees of the City ofHelsinki, Finland. Chronic (3 months) pain, multisite (2body sites) pain and mental distress (RAND-36 emotionalwellbeing subscale below median) were reported by 3911respondents. Register data on total (>1 day) and long-term((>11 workdays) SA for the following year were obtained fromthe employer and the Social Insurance Institute of Finland withrespondents’ informed consent. Negative binomial regressionanalyses were performed with sociodemographic, socioeco-nomic, and health-related factors as confounders. Theinteraction of gender was examined.iii126 European Journal of Public Health, Volume 32 Supplement 3, 2022Downloaded from https://academic.oup.com/eurpub/article/32/Supplement_3/ckac129.310/6766351 by University of Helsinki and HU Central Hospital user on 10 March 2023Results:Chronic pain, multisite pain, and mental distress wereassociated with total SA. Chronic multisite pain was associatedwith long-term SA (rate ratio [RR] 2.51, 95% CI 1.17-5.42),and chronic pain (RR 5.04, 95% CI 2.14-11.87) and multisitepain (RR 4.88, 95% CI 2.30-10.33) with long-term SA amongthose with mental distress. For women, there was a synergisticinteraction of multisite pain to the association with total SA(synergy index 1.80, 95% CI 1.27-2.54).Conclusions:Chronic and multisite pain associate with SA among youngand midlife employees. The associations are generally strongeramong women and particularly among those with concurrentmental distress. Interventional studies are needed to confirm ifearly symptom recognition and support could reduce sicknessabsence.Key messages: Chronic pain and pain at multiple body sites associate withsickness absence among young and midlife employees,particularly among women and those with concurrentmental distress. Interventional studies are needed to confirm if sicknessabsence could be reduced by early recognizing pain andmental distress among employees and providing preventiveand therapeutic services.Abstract citation ID: ckac129.311Clustering of unhealthy behaviours and subsequentsickness absence among Finnish municipal employeesJatta SalmelaJ Salmela1, J Lahti1, N Kanerva2, O Rahkonen1, A Kouvonen3,4,T Lallukka11Department of Public Health, University of Helsinki, Helsinki, Finland2Department of Food and Nutrition, University of Helsinki, Helsinki, Finland3Faculty of Social Sciences, University of Helsinki, Helsinki, Finland4Centre for Public Health, Queen’s University Belfast, Belfast, UKContact: jatta.salmela@helsinki.fiBackground:Unhealthy behaviours are associated with increased sicknessabsence (SA), but few studies have explored these associationsusing person-oriented approach. We aimed to identify latentclasses of unhealthy behaviours among female and maleemployees and examined their associations with subsequentSA.Methods:Health behaviours (leisure-time physical activity, sedentarybehaviour, fruit and vegetable [F&V] consumption, sleep,binge drinking, and use of tobacco products) were derivedfrom the Helsinki Health Study questionnaire survey, collectedin 2017 among 19-39-year-old employees of the City ofHelsinki, Finland. The questionnaire data were linked toemployer’s SA register. Latent class analysis was used toidentify underlying profiles of unhealthy behaviours andnegative binomial regression was used to examine theirassociations with subsequent SA (7 days, >7 days, and alllengths) among 3228 women and 771 men. The mean follow-up time was 2.1 years.Results:Among women, we identified 3 latent classes: 1) healthybehaviours (81% of women), 2) binge drinking and tobaccouse (12%), and 3) inadequate F&V consumption andinsufficient sleep (7%). Classes 2 and 3 showed increasedrates for subsequent SA compared to class 1, regardless of thelength of SA spells (age-adjusted rate ratios [RR] 1.37-1.42 and1.35-1.64, respectively). Among men, we identified 3 latentclasses: 1) healthy behaviours (51% of men), 2) binge drinkingand tobacco use (19%), and 3) inadequate F&V consumption,binge drinking and tobacco use (30%). While classes 1 and 2were not different in terms of subsequent SA, class 3 hadincreased rates of subsequent, particularly short-term SA (RR1.24, 95% CI 1.03-1.48).Conclusions:Preventive actions should consider simultaneously severalunhealthy behaviours while aiming to reduce employees’ SA.These actions might benefit from regarding potential genderdifferences in the clustering of unhealthy behaviours and theirassociations with SA.Key messages: Preventive actions to reduce sickness absence shouldconsider clustering of unhealthy behaviours amongemployees. Potential gender differences need to be regarded in theseactions.Abstract citation ID: ckac129.312Work after cancer-sickness absence. Barriers andfacilitators from survivors’ perspectiveAmaya AyalaA Ayala1,2,3, L Serra4, D Rodriguez-Arjona5, FG Benavides1,2,31Centre for Research in Occupational Health, Universitat Pompeu Fabra,Barcelona, Spain2CIBER of Epidemiology and Public Health, Carlos III Health Institute,Madrid, Spain3IMIM – Parc Salut Mar, Barcelona, Spain4GRECS, Universitat de Girona, Girona, Spain5Fundación Memora, Barcelona, SpainContact: amaya.ayala@upf.eduPeople who have suffered from cancer find it difficult to returnto work after a sickness absence (SA). Previous evidenceindicates that people who survive a cancer have a higher riskthan general population of leaving the labor market prema-turely or being unemployed due to sequelae of both treatmentand disease. Our objective is to identify barriers and facilitatorsassociated with the return and permanence in the workplace ofsalaried workers after a SA due to cancer in Catalonia. Theresearch used a descriptive qualitative approach with socio-constructivist perspective. A theoretical sampling was carriedout until saturation. Three discussion groups (7 people/group)were conducted with people who had suffered a SA due tocancer in Catalonia. The sessions were held virtually and wererecorded, transcribed verbatim, and analyzed using thematicanalysis and mixed coding with Atlas.ti. Most of the peoplehad returned to work after SA or were looking for a job thatwas suitable for their health status. Among the barriers toreincorporation to their job detected: (1) coping with the sameworkload they had before the SA, (2) sequelae associated withcancer treatment that affected their ability to work (stress, lowability to concentrate, chronic fatigue, mobility limitations),(3) having jobs with a high physical load, (4) expectations ofcolleagues and bosses. Among the facilitating factors: (1)sessions with psycho-oncologists, (2) availability of holidays toadapt their return after SA, (3) teleworking, and (4) jobadaptation. Regarding proposals to improve this process, themost outstanding were the implementation of policies thatallow a gradual return to work adjusted to the people whowant to adhere to it and generalize the possibility of doingpsycho-oncological therapy. End of SA after cancer is a keymoment for people who go through it, they suffer manydifficulties during the process that could be prevented withmeasures such as a gradual return to work.Key messages: Workers who suffer a SA due to cancer face difficulties ontheir return to work. Initiatives of adaptation and gradual reincorporation to theworkplace could improve return to work process after a SAdue to cancer.15th European Public Health Conference 2022 iii127Downloaded from https://academic.oup.com/eurpub/article/32/Supplement_3/ckac129.310/6766351 by University of Helsinki and HU Central Hospital user on 10 March 2023

Pain and mental health - separate and joint associations with sickness absence among young employees

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Pain and mental health - separate and joint associations with sickness absence among young employees

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