Health, lifestyle and employment beyond state-pension age.

BACKGROUND: The factors influencing one's choice to retire vary, with financial and health considerations being some of the main factors impacting or associated with people's timing of retirement. The aim of the study is to investigate the differences in current health and health-related behaviours, such as smoking, drinking and exercising, between people who kept on working beyond state-pension age and those who retired before or at state-pension age. METHODS: Data from six waves (2003, 2008-2012) of the Scottish Health Survey (SHeS) are used. Descriptive analyses were used to characterise the population. Multivariate logistic regression was undertaken to analyse the relationship between retirement groups and gender, age, deprivation, marital status, housing tenure, general health, longstanding illness, cigarette smoking status, amount of exercise and mental health, using Stata. RESULTS: Reporting poor self-rated health or having a long-standing illness was associated with increased odds of retiring before state pension age (SPA) in groups with a medium deprivation profile in almost all the survey years. For the least deprived there was little evidence of an association between poor health and extended-working-life, while significant associations were observed for the most deprived. An increasing trend was observed for both genders in the number of people extending their working life. Similar associations between reporting poorer self-rated health and extended working lives were observed for men and women. Distinct gender differences were observed for the associations with reporting poor mental health and no exercise. In the adjusted models, both were significantly associated with retiring at or before SPA in almost every year for women, whereas no significant associations were observed (except in 1 year) for men. CONCLUSIONS: This study shows an increasing trend in the number of people extending their working lives and demonstrates significant associations between health and lifestyle behaviours and employment status past SPA. The results suggest that good health - both physically and mentally - along with either a need or a want to stay in employment could be important reasons for continuing to work beyond SPA.

Changing gender roles and attitudes and their implications for well-being around the new millennium.

PURPOSE: Given evidence that gender role attitudes (GRAs) and actual gender roles impact on well-being, we examine associations between GRAs, three roles (marital status, household chore division, couple employment) and psychological distress in working-age men and women. We investigate time-trends reflecting broader social and economic changes, by focusing on three age groups at two dates. METHODS: We used British Household Panel Survey data from 20- to 64-year-olds in heterosexual couple households in 1991 (N = 5,302) and 2007 (N = 6,621). We examined: levels of traditional GRAs according to gender, age, date, household and employment roles; associations which GRAs and roles had with psychological distress (measured via the GHQ-12); whether psychological distress increased when GRAs conflicted with actual roles; and whether any of these associations differed according to gender, age or date. RESULTS: Gender traditionalism was lower among women, younger people, those participating in 2007 and in 'less traditional' relationships and households. Psychological distress was higher among those with more traditional GRAs and, particularly among men, for those not employed, and there was some evidence of different patterns of association according to age-group. There was limited evidence, among women only, of increased psychological distress when GRAs and actual roles conflicted and/or reductions when GRAs and roles agreed, particularly in respect of household chores and paid employment. CONCLUSIONS: Although some aspects of gender roles and attitudes (traditionalism and paid employment) are associated with well-being, others (marital status and household chores), and attitude-role consistency, may have little impact on the well-being of contemporary UK adults.

Cardiovascular disease and air pollution in Scotland: no association or insufficient data and study design?

BACKGROUND: Coronary heart disease and stroke are leading causes of mortality and ill health in Scotland, and clear associations have been found in previous studies between air pollution and cardiovascular disease. This study aimed to use routinely available data to examine whether there is any evidence of an association between short-term exposure to particulate matter (measured as PM10, particles less than 10 micrograms per cubic metre) and hospital admissions due to cardiovascular disease, in the two largest cities in Scotland during the years 2000 to 2006. METHODS: The study utilised an ecological time series design, and the analysis was based on overdispersed Poisson log-linear models. RESULTS: No consistent associations were found between PM10 concentrations and cardiovascular hospital admissions in either of the cities studied, as all of the estimated relative risks were close to one, and all but one of the associated 95% confidence intervals contained the null risk of one. CONCLUSIONS: This study suggests that in small cities, where air quality is relatively good, then either PM10 concentrations have no effect on cardiovascular ill health, or that the routinely available data and the corresponding study design are not sufficient to detect an association.

Evaluating sickness absence duration by musculoskeletal and mental health issues: a retrospective cohort study of Scottish healthcare workers.

OBJECTIVES: Sickness absence (SA) among healthcare workers is associated with occupational and non-occupational risk factors and impacts employee health, healthcare delivery and patient health. At the same time, healthcare is one of the employment sectors with the highest rates of work-related ill health in the UK. Musculoskeletal (MSK) and mental health (MH) issues are leading causes of SA, but there is a lack of research on how certain MSK/MH conditions impact on SA duration. The study aim is to determine differences in SA duration by MH and MSK disorders in healthcare employees. METHODS: Survival analyses were used to estimate SA duration due to MSK and MH problems over 6 years, and Cox's proportional hazards models to determine the HRs of returning to work, using a bespoke Scottish health board database with over 53 000 SA events. SA duration and time to return-to-work (RTW) were estimated for employees by age, gender, job and health conditions. RESULTS: MSK and MH conditions accounted for 27% and 6% of all SA events and 23.7% and 19.5% of all days lost, respectively. Average SA duration was 43.5 days for MSK and 53.9 days for MH conditions. For MSK conditions, employees with low back or neck pain had the fastest RTW (median P50: 7 days), whereas employees absent due to depression took the longest (P50: 54 days). The most influential sociodemographic variables affecting RTW were age, gender and job category. CONCLUSIONS: Using a unique and rich database, we found significant differences in SA duration by presenting condition in healthcare workers. MH conditions, and depression specifically, accounted for the most working days' absence. Significant variations in duration were also observed for MSK conditions. Our findings can inform public health practitioners and healthcare managers of the most significant factors impacting MSK-related and MH-related SA to develop and implement tailored and targeted workplace interventions.

Positive associations between consumerism and tobacco and alcohol use in early adolescence: cross-sectional study.

BACKGROUND: There is concern about the negative impact of modern consumer culture on young people's mental health, but very few studies have investigated associations with substance use. In those which have, positive associations have been attributed to attempts to satisfy the unmet needs of more materialistic individuals. OBJECTIVES: This study examines associations between different dimensions of consumerism and tobacco and alcohol use among Scottish early adolescents. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: 2937 (92% of those eligible) secondary school pupils (ages 12-14) completed questionnaires in examination conditions. Analyses were restricted to those with complete data on all relevant variables (N=2736 smoking; N=2737 drinking). MEASURES: Dependent variables comprised ever smoking and current drinking. Measures of consumerism comprised number of 'premium' (range 0-7) and 'standard' (range 0-5) material possessions and three Consumer Involvement subscales, 'dissatisfaction', 'consumer orientation' and 'brand awareness' (each range 3-12). Analyses also included school-year group and family affluence. RESULTS: Ever smoking and current drinking were both more prevalent among adolescents with more 'premium' and 'standard' material possessions, greater consumer 'dissatisfaction' and 'brand awareness' (mutually adjusted analyses including school-year group and family affluence). The strongest relationships occurred for 'brand awareness': for each unit increase in 'brand awareness' the ORs (95% CI) of ever smoking were 1.17 (1.08 to 1.26) and 1.23 (1.14 to 1.33) in males and females, respectively; and those for drinking were 1.15 (1.08 to 1.23) and 1.21 (1.13 to 1.30). 'Brand awareness' had an equal or stronger relationship with both smoking and drinking than did family affluence. CONCLUSIONS: These results suggest aassociations between consumerism and both smoking and drinking might arise because adolescent identities incorporate both consumerism and substance use, or be the result of promotion (indirectly in the case of tobacco) linking consumerist or aspirational lifestyles with these behaviours.

Association of life course socioeconomic disadvantage with future problem drinking and heavy drinking: gender differentials in the west of Scotland.

OBJECTIVE: To examine gender differentials in the association between life course socioeconomic disadvantage and the risk of exceeding internationally recognised weekly and daily guidelines for 'sensible' alcohol consumption and problem drinking. METHODS: A population-representative cohort study of 1,218 men and women from the west of Scotland, UK was conducted. Data on life course socioeconomic position were collected in 1987/1988 (at around 35 years of age). Alcohol consumption patterns (detailed 7-day recall) and problem drinking (CAGE questionnaire) were ascertained in 1990/1992. RESULTS: There was evidence of marked gender divergence in the socioeconomic position-alcohol intake/problem gradients. Typically, disadvantage in men conferred an increased risk of exceeding 'sensible' guidelines for weekly consumption (for own education and adult social class) and having alcohol problems (for employment status, income, adult social class and car ownership). In contrast, a reverse gradient was evident in women where adverse social status was generally associated with a reduced prevalence of these outcomes. CONCLUSION: Investigators should consider more carefully socioeconomic patterning of alcohol intake, and possibly other health-related behaviours, separately in men and women.