A1 Refereed original research article in a scientific journal
Childhood adversity, adult socioeconomic status and risk of work disability: a prospective cohort study
Authors: Jaana I Halonen, Mika Kivimäki, Jussi Vahtera, Jaana Pentti, Marianna Virtanen, Jenni Ervasti, Tuula Oksanen, Tea Lallukka
Publisher: BMJ PUBLISHING GROUP
Publication year: 2017
Journal: Occupational and Environmental Medicine
Journal name in source: OCCUPATIONAL AND ENVIRONMENTAL MEDICINE
Journal acronym: OCCUP ENVIRON MED
Volume: 74
Issue: 9
First page : 659
Last page: 666
Number of pages: 8
ISSN: 1351-0711
DOI: https://doi.org/10.1136/oemed-2017-104319
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/26735081
Objectives To examine the combined effects of childhood adversities and low adult socioeconomic status (SES) on the risk of future work disability.Methods Included were 34 384 employed Finnish Public Sector study participants who responded to questions about childhood adversities (none vs any adversity, eg, parental divorce or financial difficulties) in 2008, and whose adult SES in 2008 was available. We categorised exposure into four groups: neither (reference), childhood adversity only, low SES only or both. Participants were followed from 2009 until the first period of register-based work disability (sickness absence >9 days or disability pension) due to any cause, musculoskeletal or mental disorders; retirement; death or end of follow-up (December 2011). We ran Cox proportional hazard models adjusted for behavioural, health-related and work-related covariates, and calculated synergy indices for the combined effects.Results When compared with those with neither exposure, HR for work disability from any cause was increased among participants with childhood adversity, with low SES, and those with both exposures. The highest hazard was observed in those with both exposures: HR 2.53, 95% CI 2.29 to 2.79 for musculoskeletal disability, 1.55, 95% CI 1.36 to 1.78 for disability due to mental disorders and 1.29, 95% CI 1.20 to 1.39 for disability due to other reasons. The synergy indices did not indicate synergistic effects.Conclusions These findings indicate that childhood psychosocial adversity and low adult SES are additive risk factors for work disability.
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