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Childhood adversity, adult socioeconomic status and risk of work disability: a prospective cohort study.

Halonen, JI; Kivimäki, M; Vahtera, J; Pentti, J; Virtanen, M; Ervasti, J; Oksanen, T; (2017) Childhood adversity, adult socioeconomic status and risk of work disability: a prospective cohort study. Occup Environ Med , 74 pp. 659-666. 10.1136/oemed-2017-104319. Green open access

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Abstract

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.

Type: Article
Title: Childhood adversity, adult socioeconomic status and risk of work disability: a prospective cohort study.
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/oemed-2017-104319
Publisher version: http://dx.doi.org/10.1136/oemed-2017-104319
Language: English
Additional information: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Keywords: Childhood adversity, cohort study, life course, socioeconomic status, work disability
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: http://discovery.ucl.ac.uk/id/eprint/1569681
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