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Workplace socioeconomic characteristics and coronary heart disease : a nationwide follow-up study

Forsberg, Per Ola LU ; Ohlsson, Henrik LU and Sundquist, Kristina LU (2023) In BMJ Open 13(7).
Abstract

Objectives Important gaps in previous research include a lack of studies on the association between socioeconomic characteristics of the workplace and coronary heart disease (CHD). We aimed to examine two contextual factors in association with individuals' risk of CHD: the mean educational level of all employees at each individual's workplace (education work) and the neighbourhood socioeconomic characteristics of each individual's workplace (neighbourhood SES work). Design Nationwide follow-up/cohort study. Setting Nationwide data from Sweden. Participants All individuals born in Sweden from 1943 to 1957 were included (n=1 547 818). We excluded individuals with a CHD diagnosis prior to 2008 (n=67 619), individuals without workplace... (More)

Objectives Important gaps in previous research include a lack of studies on the association between socioeconomic characteristics of the workplace and coronary heart disease (CHD). We aimed to examine two contextual factors in association with individuals' risk of CHD: the mean educational level of all employees at each individual's workplace (education work) and the neighbourhood socioeconomic characteristics of each individual's workplace (neighbourhood SES work). Design Nationwide follow-up/cohort study. Setting Nationwide data from Sweden. Participants All individuals born in Sweden from 1943 to 1957 were included (n=1 547 818). We excluded individuals with a CHD diagnosis prior to 2008 (n=67 619), individuals without workplace information (n=576 663), individuals lacking residential address (n=4139) and individuals who had unknown parents (n=7076). A total of 892 321 individuals were thus included in the study (426 440 men and 465 881 women). Primary and secondary outcome measures The outcome variable was incident CHD during follow-up between 2008 and 2012. The association between education work and neighbourhood SES work and the outcome was explored using multilevel and cross-classified logistic regression models to determine ORs and 95% CIs, with individuals nested within workplaces and neighbourhoods. All models were conducted in both men and women and were adjusted for age, income, marital status, educational attainment and neighbourhood SES residence. Results Low (vs high) education work was significantly associated with increased CHD incidence for both men (OR 1.29, 95% CI 1.23 to 1.34) and women (OR 1.38, 95% CI 1.29 to 1.47) and remained significant after adjusting for potential confounders. These findings were not replicable for the variable neighbourhood SES work. Conclusions Workplace socioeconomic characteristics, that is, the educational attainment of an individual's colleagues, may influence CHD risk, which represents new knowledge relevant to occupational health management at workplaces.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cardiology, public health, social medicine
in
BMJ Open
volume
13
issue
7
article number
e065285
publisher
BMJ Publishing Group
external identifiers
  • pmid:37463808
  • scopus:85165518267
ISSN
2044-6055
DOI
10.1136/bmjopen-2022-065285
language
English
LU publication?
yes
id
37b3331e-a5d2-488d-8261-3a7ccdad1b86
date added to LUP
2023-09-11 12:56:54
date last changed
2024-04-20 03:03:00
@article{37b3331e-a5d2-488d-8261-3a7ccdad1b86,
  abstract     = {{<p>Objectives Important gaps in previous research include a lack of studies on the association between socioeconomic characteristics of the workplace and coronary heart disease (CHD). We aimed to examine two contextual factors in association with individuals' risk of CHD: the mean educational level of all employees at each individual's workplace (education work) and the neighbourhood socioeconomic characteristics of each individual's workplace (neighbourhood SES work). Design Nationwide follow-up/cohort study. Setting Nationwide data from Sweden. Participants All individuals born in Sweden from 1943 to 1957 were included (n=1 547 818). We excluded individuals with a CHD diagnosis prior to 2008 (n=67 619), individuals without workplace information (n=576 663), individuals lacking residential address (n=4139) and individuals who had unknown parents (n=7076). A total of 892 321 individuals were thus included in the study (426 440 men and 465 881 women). Primary and secondary outcome measures The outcome variable was incident CHD during follow-up between 2008 and 2012. The association between education work and neighbourhood SES work and the outcome was explored using multilevel and cross-classified logistic regression models to determine ORs and 95% CIs, with individuals nested within workplaces and neighbourhoods. All models were conducted in both men and women and were adjusted for age, income, marital status, educational attainment and neighbourhood SES residence. Results Low (vs high) education work was significantly associated with increased CHD incidence for both men (OR 1.29, 95% CI 1.23 to 1.34) and women (OR 1.38, 95% CI 1.29 to 1.47) and remained significant after adjusting for potential confounders. These findings were not replicable for the variable neighbourhood SES work. Conclusions Workplace socioeconomic characteristics, that is, the educational attainment of an individual's colleagues, may influence CHD risk, which represents new knowledge relevant to occupational health management at workplaces.</p>}},
  author       = {{Forsberg, Per Ola and Ohlsson, Henrik and Sundquist, Kristina}},
  issn         = {{2044-6055}},
  keywords     = {{cardiology; public health; social medicine}},
  language     = {{eng}},
  number       = {{7}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open}},
  title        = {{Workplace socioeconomic characteristics and coronary heart disease : a nationwide follow-up study}},
  url          = {{http://dx.doi.org/10.1136/bmjopen-2022-065285}},
  doi          = {{10.1136/bmjopen-2022-065285}},
  volume       = {{13}},
  year         = {{2023}},
}