Anne Linna - Academia.edu (original) (raw)

Papers by Anne Linna

Research paper thumbnail of Perceived organizational justice as a predictor of long-term sickness absence due to diagnosed mental disorders: Results from the prospective longitudinal Finnish Public Sector Study

WOS, Sep 6, 2013

Organizational justice perceptions have been suggested to be associated with symptoms of mental h... more Organizational justice perceptions have been suggested to be associated with symptoms of mental health but the nature of the association is unknown due to reporting bias (measurement error related to response style and reversed causality). In this study, we used prospective design and long-term (>9 days) sickness absence with psychiatric diagnosis as the outcome measure. Participants were 21 221 Finnish public sector employees (the participation rate at baseline in 2000e2002 68%), who responded to repeated surveys of procedural and interactional justice in 2000e2004 along with register data on sickness absence with a diagnosis of depression or anxiety disorders (822 cases). Results from logistic regression analyses showed that a one-unit increase in self-reported and work-unit level co-worker assessed interactional justice was associated with a 25e32% lower odds of sickness absence due to anxiety disorders. These associations were robust to adjustments for a variety of potential individuallevel confounders including chronic disease (adjusted OR for self-reported interactional justice 0.77, 95% CI 0.65e0.91) and were replicated using co-worker assessed justice. Only weak evidence of reversed causality was found. The results suggest that low organizational justice is a risk factor for sickness absence due to anxiety disorders.

Research paper thumbnail of Sleep disturbances as a predictor of long term sickness absence due to depression

Research paper thumbnail of Organisational downsizing as a predictor of disability pension: the 10-town prospective cohort study

Journal of Epidemiology and Community Health, Mar 1, 2005

Research paper thumbnail of Alcohol and coronary heart disease risk-is there an unknown confounder?

Research paper thumbnail of Sex Differences in Health Effects of Family Death or Illness: Are Women More Vulnerable Than Men?

Psychosomatic Medicine, Mar 1, 2006

To study sex differences in health after stressful life events in the family. We examined the ass... more To study sex differences in health after stressful life events in the family. We examined the association between a serious event (death or severe illness of spouse, death or severe illness of other family member, death of close relative) and health among 6,095 male and 21,217 female public sector employees in Finland by repeated measures Poisson regression analysis with the generalized estimating equations method. The longitudinal data comprised self-reports of 3,556 events and their timing in 2000 or 2001, monthly sickness absences between 1997 and 2003, and psychiatric morbidity and suboptimal health 0 to 3 months, 4 to 6 months, or 7 to 12 months after the event. Adjustments were made for age, education, and marital status. Exposure to stressful events was associated with a greater increase in sickness absence and a longer recovery period among women than among men. For the women, death or illness in the family was also associated with self-reported health problems irrespective of the time lag between the event and the measurement of health, whereas for the men, this association was found only in the first months after the event. Our findings suggest that women are more vulnerable than men in the aftermath of a death or illness in their extended family.

Research paper thumbnail of Organizational justice, sickness absence and employee age

Journal of Managerial Psychology, Nov 4, 2013

ABSTRACT Purpose – The aim of this paper is to study age-related differences in how perceptions o... more ABSTRACT Purpose – The aim of this paper is to study age-related differences in how perceptions of two forms of organizational justice, i.e. procedural and interactional justice, are related to short (i.e. non-certified) spells and long (i.e. medically certified) spells of sickness absence. Design/methodology/approach – The authors conducted a study on a large sample of Finnish public sector employees (n=37,324), in which they matched employees' 2004 survey data with their records-based sick absences in 2005 and 2006. Findings – The results suggest that age moderates the association between perceptions of procedural justice and long sickness absences after controlling for gender, tenure, occupational group, work unit, job demands and health behaviors. When older employees experienced a high level of procedural justice, they were 12 percent less likely to miss work due to medically certified illnesses. Overall, older employees were less likely to take short, non-certified sickness absences from work. Finally, the results suggest that high-quality relationships with supervisors can prevent both short and long spells of sickness absence at all ages Originality/value – The study contributes to the literature on age-related differences in the effects of psychosocial workplace conditions (organizational justice) on employee behavior (absenteeism).

Research paper thumbnail of daily working hours matter? subsequent sickness absence: does control over Long hours in paid and domestic work and

Research paper thumbnail of studypension: the 10-town prospective cohort Organisational downsizing as a predictor of

Research paper thumbnail of absence: the 10-town study job strain and effort-reward imbalance on sickness Employee worktime control moderates the effects of

Research paper thumbnail of Work Schedule Control Measure

Research paper thumbnail of Alcohol and coronary heart disease risk—is there an unknown confounder?

Addiction, 2005

ABSTRACTAims To evaluate whether confounding by several known or suspected coronary heart diseas... more ABSTRACTAims To evaluate whether confounding by several known or suspected coronary heart disease risk factors are likely to explain the lower coronary heart disease risk among light alcohol drinkers compared with never‐drinkers.Design A population‐based cross‐sectional study.Methods Hypertension, body mass index (BMI), diabetes, depression, sleep disturbances, smoking, physical activity, life satisfaction, psychological distress, trait anxiety, independent and dependent life events, length of working hours, job control, job strain and effort–reward imbalance were compared between never‐drinkers and light drinkers (<70 g of alcohol per week). Data on 41 099 participants (6222 men, 34 877 women) were derived from two ongoing cohort studies, the ‘10‐Town Study’ and ‘Finnish Hospital Personnel Study’, in Finland in 2000–02.Results Of the 16 comparisons under study, seven showed significant differences between never‐drinkers and light drinkers. Five of the differences favoured ne...

Research paper thumbnail of prospective cohort study Low organisational justice and heavy drinking: a

Objectives: To investigate whether low perceived organisational injustice predicts heavy drinking... more Objectives: To investigate whether low perceived organisational injustice predicts heavy drinking among employees. Methods: Data from a prospective occupational cohort study, the 10-Town Study, on 15 290 Finnish public sector local government employees nested in 2432 work units, were used. Non-drinkers were excluded. Procedural, interactional and total organisational justice, heavy drinking (>210 g of absolute alcohol per week) and other psychosocial factors were determined by means of questionnaire in 2000-2001 (phase 1) and 2004 (phase 2). Multilevel logistic regression analyses taking into account the hierarchical structure of the data were conducted and adjustments were made for sex, age, socioeconomic status, marital status, baseline heavy drinking, psychological distress and other psychosocial risk factors such as job strain and effort/reward imbalance. Results: After adjustments, participants who reported low procedural justice at phase 1 were approximately 1.2 times more likely to be heavy drinkers at phase 2 compared with their counterparts reporting high justice. Low perceived justice in interpersonal treatment and low perceived total organisational justice were associated with increased prevalence of heavy drinking only in the model adjusted for sociodemographics. Conclusions: This is the first longitudinal study to show that low procedural justice is weakly associated with an increased likelihood of heavy drinking. Main messages c Organisational justice is associated with employee health, but mechanisms underlying this association remain unclear. c There was a weak association between low procedural justice at baseline and an increased likelihood of heavy drinking at follow-up in a large sample of Finnish public sector employees. Policy implications Unfair managerial procedures might slightly increase risk of heavy drinking among employees.

Research paper thumbnail of Linna Elovainio Van den Bos Kivimäki Pentti Vahtera (2012, Int J HRM), 4-year longitudinal study of performance appraisal interviews and org justice

Research paper thumbnail of Työ ja ihminen

Research paper thumbnail of Job strain and leisure-time physical activity in female and male public sector employees

Research paper thumbnail of Effort-reward imbalance at work and the co-occurrence of lifestyle risk factors: cross-sectional survey in a sample of 36,127 public sector employees

Background: In occupational life, a mismatch between high expenditure of effort and receiving few... more Background: In occupational life, a mismatch between high expenditure of effort and receiving few rewards may promote the co-occurrence of lifestyle risk factors, however, there is insufficient evidence to support or refute this hypothesis. The aim of this study is to examine the extent to which the dimensions of the Effort-Reward Imbalance (ERI) model-effort, rewards and ERI-are associated with the co-occurrence of lifestyle risk factors. Methods: Based on data from the Finnish Public Sector Study, cross-sectional analyses were performed for 28,894 women and 7233 men. ERI was conceptualized as a ratio of effort and rewards. To control for individual differences in response styles, such as a personal disposition to answer negatively to questionnaires, occupational and organizational-level ecological ERI scores were constructed in addition to individual-level ERI scores. Risk factors included current smoking, heavy drinking, body mass index ≥25 kg/m 2 , and physical inactivity. Multinomial logistic regression models were used to estimate the likelihood of having one risk factor, two risk factors, and three or four risk factors. The associations between ERI and single risk factors were explored using binary logistic regression models. Results: After adjustment for age, socioeconomic position, marital status, and type of job contract, women and men with high ecological ERI were 40% more likely to have simultaneously ≥3 lifestyle risk factors (vs. 0 risk factors) compared with their counterparts with low ERI. When examined separately, both low ecological effort and low ecological rewards were also associated with an elevated prevalence of risk factor co-occurrence. The results obtained with the individual-level scores were in the same direction. The associations of ecological ERI with single risk factors were generally less marked than the associations with the co-occurrence of risk factors. Conclusion: This study suggests that a high ratio of occupational efforts relative to rewards may be associated with an elevated risk of having multiple lifestyle risk factors. However, an unexpected association between low effort and a higher likelihood of risk factor co-occurrence as well as the absence of data on overcommitment (and thereby a lack of full test of the ERI model) warrant caution in regard to the extent to which the entire ERI model is supported by our evidence.

Research paper thumbnail of Sex differences in health effects of family death or illness: are women more vulnerable than men?

To study sex differences in health after stressful life events in the family. We examined the ass... more To study sex differences in health after stressful life events in the family. We examined the association between a serious event (death or severe illness of spouse, death or severe illness of other family member, death of close relative) and health among 6,095 male and 21,217 female public sector employees in Finland by repeated measures Poisson regression analysis with the generalized estimating equations method. The longitudinal data comprised self-reports of 3,556 events and their timing in 2000 or 2001, monthly sickness absences between 1997 and 2003, and psychiatric morbidity and suboptimal health 0 to 3 months, 4 to 6 months, or 7 to 12 months after the event. Adjustments were made for age, education, and marital status. Exposure to stressful events was associated with a greater increase in sickness absence and a longer recovery period among women than among men. For the women, death or illness in the family was also associated with self-reported health problems irrespective of the time lag between the event and the measurement of health, whereas for the men, this association was found only in the first months after the event. Our findings suggest that women are more vulnerable than men in the aftermath of a death or illness in their extended family.

Research paper thumbnail of Effort/reward imbalance and sedentary lifestyle: an observational study in a large occupational cohort

To investigate the association between effort/reward imbalance (ERI) at work and sedentary lifest... more To investigate the association between effort/reward imbalance (ERI) at work and sedentary lifestyle. Methods: Cross sectional data from the ongoing Finnish Public Sector Study related to 30 433 women and 7718 men aged 17-64 were used (n = 35 918 after exclusion of participants with missing values in covariates). From the responses to a questionnaire, an aggregated mean score for ERI in a work unit was assigned to each participant. The outcome was sedentary lifestyle defined as ,2.00 metabolic equivalent task (MET) hours/day. Logistic regression with generalised estimating equations was used as an analysis method to include both individual and work unit level predictors in the models. Adjustments were made for age, marital status, occupational status, job contract, smoking, and heavy drinking. Results: Twenty five per cent of women and 27% of men had a sedentary lifestyle. High individual level ERI was associated with a higher likelihood of sedentary lifestyle both among women (odds ratio (OR) = 1.08, 95% CI 1.01 to 1.16) and men (OR = 1.17, 95% CI 1.02 to 1.33). These associations were not explained by relevant confounders and they were also independent of work unit level job strain measured as a ratio of job demands and control. Conclusions: A mismatch between high occupational effort spent and low reward received in turn seems to be associated with an increased risk of sedentary lifestyle, although this association is relatively weak.

Research paper thumbnail of Average household income, crime, and smoking behaviour in a local area: the Finnish 10-Town study

Social environments, like neighbourhoods, are increasingly recognised as determinants of health. ... more Social environments, like neighbourhoods, are increasingly recognised as determinants of health. While several studies have reported an association of low neighbourhood socio-economic status with morbidity, mortality and health risk behaviour, little is known of the health effects of neighbourhood crime rates. Using the ongoing 10-Town study in Finland, we examined the relations of average household income and crime rate measured at the local area level, with smoking status and intensity by linking census data of local area characteristics from 181 postal zip codes to survey responses to smoking behaviour in a cohort of 23,008 municipal employees. Gender-stratified multilevel analyses adjusted for age and individual occupational status revealed an association between low local area income rate and current smoking. High local area crime rate was also associated with current smoking. Both local area characteristics were strongly associated with smoking intensity. Among ever-smokers, being an ex-smoker was less likely among residents in areas with low average household income and a high crime rate. In the fully adjusted model, the association between local area income and smoking behaviour among women was substantially explained by the area-level crime rate. This study extends our knowledge of potential pathways through which social environmental factors may affect health.

Research paper thumbnail of Organizational justice in primary-care health centers and glycemic control in patients with type 2 diabetes

Organizational justice has been put forward as a measure of leadership quality that is associated... more Organizational justice has been put forward as a measure of leadership quality that is associated with better health among employees. We extended that idea to test whether perceived organizational justice among health care providers might be positively associated with glycemic control among their diabetic patients. Eighteen primary-care health centers (HCs) in Finland. Type 2 diabetes patients (n=8954) and HC staff (n=422). : Mean of 1 year&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s measurements of glycated hemoglobin [≥ 7.0 (the least optimal); 6.5-6.9; 6.0-6.4; and 4.5-5.9 (the most optimal)], health-center psychosocial work characteristics (staff-reported procedural justice and relational justice, effort-reward imbalance, and work-unit team climate), and individual-level and work-unit-level covariates. Perceptions of higher levels of procedural justice among staff were associated with more optimal glycated hemoglobin levels among patients (cumulative odds ratio per 1-U increase in justice=1.54, 95% confidence interval, 1.08-2.18) after adjustment for patient-level and unit-level covariates. Relational justice, effort-reward imbalance, and work-unit team climate were not associated with glycemic control. The quality of leadership at HCs, as indicated by staff perceptions of procedural justice, may play a role in achieving good glycemic control among type 2 diabetes patients.

Research paper thumbnail of Perceived organizational justice as a predictor of long-term sickness absence due to diagnosed mental disorders: Results from the prospective longitudinal Finnish Public Sector Study

WOS, Sep 6, 2013

Organizational justice perceptions have been suggested to be associated with symptoms of mental h... more Organizational justice perceptions have been suggested to be associated with symptoms of mental health but the nature of the association is unknown due to reporting bias (measurement error related to response style and reversed causality). In this study, we used prospective design and long-term (>9 days) sickness absence with psychiatric diagnosis as the outcome measure. Participants were 21 221 Finnish public sector employees (the participation rate at baseline in 2000e2002 68%), who responded to repeated surveys of procedural and interactional justice in 2000e2004 along with register data on sickness absence with a diagnosis of depression or anxiety disorders (822 cases). Results from logistic regression analyses showed that a one-unit increase in self-reported and work-unit level co-worker assessed interactional justice was associated with a 25e32% lower odds of sickness absence due to anxiety disorders. These associations were robust to adjustments for a variety of potential individuallevel confounders including chronic disease (adjusted OR for self-reported interactional justice 0.77, 95% CI 0.65e0.91) and were replicated using co-worker assessed justice. Only weak evidence of reversed causality was found. The results suggest that low organizational justice is a risk factor for sickness absence due to anxiety disorders.

Research paper thumbnail of Sleep disturbances as a predictor of long term sickness absence due to depression

Research paper thumbnail of Organisational downsizing as a predictor of disability pension: the 10-town prospective cohort study

Journal of Epidemiology and Community Health, Mar 1, 2005

Research paper thumbnail of Alcohol and coronary heart disease risk-is there an unknown confounder?

Research paper thumbnail of Sex Differences in Health Effects of Family Death or Illness: Are Women More Vulnerable Than Men?

Psychosomatic Medicine, Mar 1, 2006

To study sex differences in health after stressful life events in the family. We examined the ass... more To study sex differences in health after stressful life events in the family. We examined the association between a serious event (death or severe illness of spouse, death or severe illness of other family member, death of close relative) and health among 6,095 male and 21,217 female public sector employees in Finland by repeated measures Poisson regression analysis with the generalized estimating equations method. The longitudinal data comprised self-reports of 3,556 events and their timing in 2000 or 2001, monthly sickness absences between 1997 and 2003, and psychiatric morbidity and suboptimal health 0 to 3 months, 4 to 6 months, or 7 to 12 months after the event. Adjustments were made for age, education, and marital status. Exposure to stressful events was associated with a greater increase in sickness absence and a longer recovery period among women than among men. For the women, death or illness in the family was also associated with self-reported health problems irrespective of the time lag between the event and the measurement of health, whereas for the men, this association was found only in the first months after the event. Our findings suggest that women are more vulnerable than men in the aftermath of a death or illness in their extended family.

Research paper thumbnail of Organizational justice, sickness absence and employee age

Journal of Managerial Psychology, Nov 4, 2013

ABSTRACT Purpose – The aim of this paper is to study age-related differences in how perceptions o... more ABSTRACT Purpose – The aim of this paper is to study age-related differences in how perceptions of two forms of organizational justice, i.e. procedural and interactional justice, are related to short (i.e. non-certified) spells and long (i.e. medically certified) spells of sickness absence. Design/methodology/approach – The authors conducted a study on a large sample of Finnish public sector employees (n=37,324), in which they matched employees&amp;#39; 2004 survey data with their records-based sick absences in 2005 and 2006. Findings – The results suggest that age moderates the association between perceptions of procedural justice and long sickness absences after controlling for gender, tenure, occupational group, work unit, job demands and health behaviors. When older employees experienced a high level of procedural justice, they were 12 percent less likely to miss work due to medically certified illnesses. Overall, older employees were less likely to take short, non-certified sickness absences from work. Finally, the results suggest that high-quality relationships with supervisors can prevent both short and long spells of sickness absence at all ages Originality/value – The study contributes to the literature on age-related differences in the effects of psychosocial workplace conditions (organizational justice) on employee behavior (absenteeism).

Research paper thumbnail of daily working hours matter? subsequent sickness absence: does control over Long hours in paid and domestic work and

Research paper thumbnail of studypension: the 10-town prospective cohort Organisational downsizing as a predictor of

Research paper thumbnail of absence: the 10-town study job strain and effort-reward imbalance on sickness Employee worktime control moderates the effects of

Research paper thumbnail of Work Schedule Control Measure

Research paper thumbnail of Alcohol and coronary heart disease risk—is there an unknown confounder?

Addiction, 2005

ABSTRACTAims To evaluate whether confounding by several known or suspected coronary heart diseas... more ABSTRACTAims To evaluate whether confounding by several known or suspected coronary heart disease risk factors are likely to explain the lower coronary heart disease risk among light alcohol drinkers compared with never‐drinkers.Design A population‐based cross‐sectional study.Methods Hypertension, body mass index (BMI), diabetes, depression, sleep disturbances, smoking, physical activity, life satisfaction, psychological distress, trait anxiety, independent and dependent life events, length of working hours, job control, job strain and effort–reward imbalance were compared between never‐drinkers and light drinkers (<70 g of alcohol per week). Data on 41 099 participants (6222 men, 34 877 women) were derived from two ongoing cohort studies, the ‘10‐Town Study’ and ‘Finnish Hospital Personnel Study’, in Finland in 2000–02.Results Of the 16 comparisons under study, seven showed significant differences between never‐drinkers and light drinkers. Five of the differences favoured ne...

Research paper thumbnail of prospective cohort study Low organisational justice and heavy drinking: a

Objectives: To investigate whether low perceived organisational injustice predicts heavy drinking... more Objectives: To investigate whether low perceived organisational injustice predicts heavy drinking among employees. Methods: Data from a prospective occupational cohort study, the 10-Town Study, on 15 290 Finnish public sector local government employees nested in 2432 work units, were used. Non-drinkers were excluded. Procedural, interactional and total organisational justice, heavy drinking (>210 g of absolute alcohol per week) and other psychosocial factors were determined by means of questionnaire in 2000-2001 (phase 1) and 2004 (phase 2). Multilevel logistic regression analyses taking into account the hierarchical structure of the data were conducted and adjustments were made for sex, age, socioeconomic status, marital status, baseline heavy drinking, psychological distress and other psychosocial risk factors such as job strain and effort/reward imbalance. Results: After adjustments, participants who reported low procedural justice at phase 1 were approximately 1.2 times more likely to be heavy drinkers at phase 2 compared with their counterparts reporting high justice. Low perceived justice in interpersonal treatment and low perceived total organisational justice were associated with increased prevalence of heavy drinking only in the model adjusted for sociodemographics. Conclusions: This is the first longitudinal study to show that low procedural justice is weakly associated with an increased likelihood of heavy drinking. Main messages c Organisational justice is associated with employee health, but mechanisms underlying this association remain unclear. c There was a weak association between low procedural justice at baseline and an increased likelihood of heavy drinking at follow-up in a large sample of Finnish public sector employees. Policy implications Unfair managerial procedures might slightly increase risk of heavy drinking among employees.

Research paper thumbnail of Linna Elovainio Van den Bos Kivimäki Pentti Vahtera (2012, Int J HRM), 4-year longitudinal study of performance appraisal interviews and org justice

Research paper thumbnail of Työ ja ihminen

Research paper thumbnail of Job strain and leisure-time physical activity in female and male public sector employees

Research paper thumbnail of Effort-reward imbalance at work and the co-occurrence of lifestyle risk factors: cross-sectional survey in a sample of 36,127 public sector employees

Background: In occupational life, a mismatch between high expenditure of effort and receiving few... more Background: In occupational life, a mismatch between high expenditure of effort and receiving few rewards may promote the co-occurrence of lifestyle risk factors, however, there is insufficient evidence to support or refute this hypothesis. The aim of this study is to examine the extent to which the dimensions of the Effort-Reward Imbalance (ERI) model-effort, rewards and ERI-are associated with the co-occurrence of lifestyle risk factors. Methods: Based on data from the Finnish Public Sector Study, cross-sectional analyses were performed for 28,894 women and 7233 men. ERI was conceptualized as a ratio of effort and rewards. To control for individual differences in response styles, such as a personal disposition to answer negatively to questionnaires, occupational and organizational-level ecological ERI scores were constructed in addition to individual-level ERI scores. Risk factors included current smoking, heavy drinking, body mass index ≥25 kg/m 2 , and physical inactivity. Multinomial logistic regression models were used to estimate the likelihood of having one risk factor, two risk factors, and three or four risk factors. The associations between ERI and single risk factors were explored using binary logistic regression models. Results: After adjustment for age, socioeconomic position, marital status, and type of job contract, women and men with high ecological ERI were 40% more likely to have simultaneously ≥3 lifestyle risk factors (vs. 0 risk factors) compared with their counterparts with low ERI. When examined separately, both low ecological effort and low ecological rewards were also associated with an elevated prevalence of risk factor co-occurrence. The results obtained with the individual-level scores were in the same direction. The associations of ecological ERI with single risk factors were generally less marked than the associations with the co-occurrence of risk factors. Conclusion: This study suggests that a high ratio of occupational efforts relative to rewards may be associated with an elevated risk of having multiple lifestyle risk factors. However, an unexpected association between low effort and a higher likelihood of risk factor co-occurrence as well as the absence of data on overcommitment (and thereby a lack of full test of the ERI model) warrant caution in regard to the extent to which the entire ERI model is supported by our evidence.

Research paper thumbnail of Sex differences in health effects of family death or illness: are women more vulnerable than men?

To study sex differences in health after stressful life events in the family. We examined the ass... more To study sex differences in health after stressful life events in the family. We examined the association between a serious event (death or severe illness of spouse, death or severe illness of other family member, death of close relative) and health among 6,095 male and 21,217 female public sector employees in Finland by repeated measures Poisson regression analysis with the generalized estimating equations method. The longitudinal data comprised self-reports of 3,556 events and their timing in 2000 or 2001, monthly sickness absences between 1997 and 2003, and psychiatric morbidity and suboptimal health 0 to 3 months, 4 to 6 months, or 7 to 12 months after the event. Adjustments were made for age, education, and marital status. Exposure to stressful events was associated with a greater increase in sickness absence and a longer recovery period among women than among men. For the women, death or illness in the family was also associated with self-reported health problems irrespective of the time lag between the event and the measurement of health, whereas for the men, this association was found only in the first months after the event. Our findings suggest that women are more vulnerable than men in the aftermath of a death or illness in their extended family.

Research paper thumbnail of Effort/reward imbalance and sedentary lifestyle: an observational study in a large occupational cohort

To investigate the association between effort/reward imbalance (ERI) at work and sedentary lifest... more To investigate the association between effort/reward imbalance (ERI) at work and sedentary lifestyle. Methods: Cross sectional data from the ongoing Finnish Public Sector Study related to 30 433 women and 7718 men aged 17-64 were used (n = 35 918 after exclusion of participants with missing values in covariates). From the responses to a questionnaire, an aggregated mean score for ERI in a work unit was assigned to each participant. The outcome was sedentary lifestyle defined as ,2.00 metabolic equivalent task (MET) hours/day. Logistic regression with generalised estimating equations was used as an analysis method to include both individual and work unit level predictors in the models. Adjustments were made for age, marital status, occupational status, job contract, smoking, and heavy drinking. Results: Twenty five per cent of women and 27% of men had a sedentary lifestyle. High individual level ERI was associated with a higher likelihood of sedentary lifestyle both among women (odds ratio (OR) = 1.08, 95% CI 1.01 to 1.16) and men (OR = 1.17, 95% CI 1.02 to 1.33). These associations were not explained by relevant confounders and they were also independent of work unit level job strain measured as a ratio of job demands and control. Conclusions: A mismatch between high occupational effort spent and low reward received in turn seems to be associated with an increased risk of sedentary lifestyle, although this association is relatively weak.

Research paper thumbnail of Average household income, crime, and smoking behaviour in a local area: the Finnish 10-Town study

Social environments, like neighbourhoods, are increasingly recognised as determinants of health. ... more Social environments, like neighbourhoods, are increasingly recognised as determinants of health. While several studies have reported an association of low neighbourhood socio-economic status with morbidity, mortality and health risk behaviour, little is known of the health effects of neighbourhood crime rates. Using the ongoing 10-Town study in Finland, we examined the relations of average household income and crime rate measured at the local area level, with smoking status and intensity by linking census data of local area characteristics from 181 postal zip codes to survey responses to smoking behaviour in a cohort of 23,008 municipal employees. Gender-stratified multilevel analyses adjusted for age and individual occupational status revealed an association between low local area income rate and current smoking. High local area crime rate was also associated with current smoking. Both local area characteristics were strongly associated with smoking intensity. Among ever-smokers, being an ex-smoker was less likely among residents in areas with low average household income and a high crime rate. In the fully adjusted model, the association between local area income and smoking behaviour among women was substantially explained by the area-level crime rate. This study extends our knowledge of potential pathways through which social environmental factors may affect health.

Research paper thumbnail of Organizational justice in primary-care health centers and glycemic control in patients with type 2 diabetes

Organizational justice has been put forward as a measure of leadership quality that is associated... more Organizational justice has been put forward as a measure of leadership quality that is associated with better health among employees. We extended that idea to test whether perceived organizational justice among health care providers might be positively associated with glycemic control among their diabetic patients. Eighteen primary-care health centers (HCs) in Finland. Type 2 diabetes patients (n=8954) and HC staff (n=422). : Mean of 1 year&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s measurements of glycated hemoglobin [≥ 7.0 (the least optimal); 6.5-6.9; 6.0-6.4; and 4.5-5.9 (the most optimal)], health-center psychosocial work characteristics (staff-reported procedural justice and relational justice, effort-reward imbalance, and work-unit team climate), and individual-level and work-unit-level covariates. Perceptions of higher levels of procedural justice among staff were associated with more optimal glycated hemoglobin levels among patients (cumulative odds ratio per 1-U increase in justice=1.54, 95% confidence interval, 1.08-2.18) after adjustment for patient-level and unit-level covariates. Relational justice, effort-reward imbalance, and work-unit team climate were not associated with glycemic control. The quality of leadership at HCs, as indicated by staff perceptions of procedural justice, may play a role in achieving good glycemic control among type 2 diabetes patients.