Non-manual Workers Research Articles

Exploring the Link Between Parental Sociodemographic Characteristics and Multiple Births: Insights from National Birth Data in Japan, 1995-2020.

This present study investigated the parental characteristics of multiple births using national birth data in Japan. This study included birth data from Vital Statistics: Occupational and Industrial Aspects every five fiscal years from 1995 to 2020. The multiple birth rates were defined as the number of live-birth deliveries with multiple fetuses (e.g., twins, triplets) per total live-birth deliveries. Parental ages, nationalities, occupations and household occupation (occupation of the top earner of the household) were considered as parental characteristics. The multiple birth rates were calculated based on parental characteristics for each year, and a log-binomial regression model was used to assess the association between parental characteristics and multiple births. The multiple birth rate for Japanese mothers consistently exceeded that for non-Japanese mothers over the years, and the rate increased progressively from manual workers to lower non-manual workers and then to upper non-manual workers for both maternal and paternal occupations. The regression results indicated that the risk ratio (RR) for multiple births among non-Japanese mothers was significantly lower than that among Japanese mothers. Moreover, concerning household occupation, the RRs of self-employed individuals, full-time employees at smaller companies, others, and the unemployed were significantly lower than those of full-time employees at larger companies. Furthermore, the RRs of lower non-manual and manual workers were significantly lower than those of upper non-manual workers in maternal and paternal occupations. The results suggested an association between multiple births and parental socioeconomic status in Japan.

Functional evaluation after cortical button fixation for distal biceps ruptures – Is there any difference between manual or non-manual workers?

BackgroundThis study aims to compare clinical and functional results after distal biceps tendon repair in manual workers vs. non-manual workers. MethodsThis is a retrospective comparative study which refers to 57 cases with distal biceps tendon rupture, divided in manual workers (24 elbows) and non-manual workers (33), that were treated by a single incision with cortical button and interference screw fixation. Included cases have a minimum of 3 months follow-up, post-operative X-ray and signed informed consent for the investigation. ResultsSupination and flexion strength was higher in manual workers vs. non-manual workers (p-value=0.192 and 0.878, respectively). Nine patients showed loss of range of motion, concerning supination and pronation, and this was correlated to worse functional scores. Functional scores tend to be superior in non-manual workers. Ten patients had heterotopic ossification and 20 patients reported lateral antebrachial cutaneous nerve neuropraxia; one had both. Most of them had a full recovery. ConclusionAccording to clinical evaluation and post-operative scores, the performed surgical procedure provides good to excellent mid-term functional results. Nevertheless, there were not any differences between manual or non-manual workers.

Prospective Association of the Mediterranean Diet with the Onset of Cardiometabolic Multimorbidity in a UK-Based Cohort: The EPIC-Norfolk Study

BackgroundCardiometabolic multimorbidity (CMM), defined as the co-occurrence of 2 or more cardiometabolic diseases, including myocardial infarction (MI), stroke, and type 2 diabetes (T2D), is an increasing public health challenge. Although poor diet is a known risk factor for a first cardiometabolic disease (FCMD), the relationship with subsequent occurrence of CMM is less studied. ObjectivesThis study aims to investigate the prospective association between baseline adherence to the Mediterranean diet and the onset of CMM across various follow-up durations. MethodsWe used data from the European Prospective Investigation into Cancer-Norfolk cohort study of 21,900 adults, aged 40–79 free of prevalent MI, stroke, and T2D at baseline (1993–1997). A median-based Mediterranean diet score and a pyramid-based MDS (pyr-MDS) were used to measure baseline adherence to the Mediterranean diet. Multistate modeling was employed to investigate associations with the FCMD and the subsequent CMM event. ResultsOver the entire follow-up period of 21.4 y (median), we observed 5028 FCMD and 734 CMM events. Multistate analysis indicated that the association between baseline Mediterranean diet and the risk of CMM may be stronger in shorter follow-up durations. Particularly, baseline pyr-MDS was significantly associated with the risk of subsequent CMM transitioning from FCMD when follow-up durations were limited to 10 and 15 y, with hazard ratio (95% confidence interval) being 0.67 (0.53, 0.84) and 0.80 (0.70, 0.92) per SD increase in pyr-MDS, respectively. Additionally, we observed that the risk of CMM transitioning from FCMD was modified by social class across shorter to longer follow-ups, where the impact of baseline Mediterranean diet was only significant in nonmanual workers. ConclusionsBaseline adherence to the Mediterranean diet was potentially associated with a lower risk of CMM transitioning from FCMD, particularly during shorter follow-up periods.

Prevalence and Determinants of Changes in Physical Activity and Sedentary Behavior during and after the COVID-19 Pandemic: A Swedish Repeated Cross-Sectional Study.

Physical activity (PA) and sedentary behavior (SB) changed during the COVID-19 pandemic; hence, this study examined PA and SB at four time points between December 2019 and December 2022. The participants' PA decreased during the pandemic and did not recover afterwards. Among women, PA increased slightly in 2022 but not at all in men. From 2019 to 2020, SB increased and then decreased to near the pre-pandemic level in both sexes. Regarding age, PA decreased in the oldest age group (65-79 years) across all time points, while SB increased in all age groups during 2019-2020 and then returned close to pre-pandemic levels among the two middle age groups (30-64 years), but not among the youngest and oldest groups. Considering occupation, PA decreased from 2020 to December 2022 among retired and "other" participants, while SB decreased among nonmanual workers and retired participants. The regression models associated better self-reported health, male sex, and those born overseas with higher PA. Higher age, better self-reported health, poor education, and later survey time points were associated with lower SB. These findings highlight the need to return PA and SB to at least pre-pandemic levels and that subgroups may need different interventions.

Comparing Exposure to Psychosocial Risks: Face-to-Face Work vs. Telework.

In recent years, substantial changes have occurred in the work organization and arrangements. One of the main ones has been the popularization of teleworking among non-manual workers. This paper aims to assess the exposure of psychosocial risks among non-manual Spanish wage-earners, depending on the working modality (mainly telework, combining teleworking with onsite work, or onsite work). Based on an online survey conducted between April and May 2021, a cross-sectional study was carried out among n=11,519 members ofa trade union where Psychosocial Risks (PSR) were measured through COPSOQ Questionnaire Scales. All analyses were performed stratifying by sex. Women who combine telework and face-to-face work (aPR: 1.21; 95%CI 1.07-1.37) and men who mainly telework (aPR: 1.26; 95%CI 1.11-1.43) and that combine (aPR: 1.27; 95%CI 1.11-1.45) are more exposed to quantitative demands than men and women who do not telework. On the other hand, women who telework, either entirely (aPR: 0.89; 95%CI 0.82-0.97) or combining (aPR: 0.89; 95%CI 0.81-0.98), are less exposed to emotional demands than women who do not telework, and the same occurs among men who mainly telework (aPR: 0.84; 95%CI 0.76-0.92). Telework and horizontal or vertical social support are not associated, except for supervisor support among males, nor with work-life conflict. Except for quantitative demands, employees who combine telework and face-to-face work are less exposed to psychosocial risks than those who mainly telework or work face-to-face only. More studies with a gender and class perspective are needed in this area.

Association of Life’s Simple 7 lifestyle metric with cardiometabolic disease-free life expectancy in older British men

BackgroundCardiometabolic diseases (CMD), including myocardial infarction, stroke, and type 2 diabetes, are leading causes of disability and mortality globally, particularly for people at an older age. The impact of adhering to the Life’s Simple 7 (LS7) on the number of years an individual will live without CMD in older adults remains less studied.MethodsThis study included a cohort of 2662 British men aged 60–79 years free of CMD at baseline from the British Regional Heart Study (BRHS). Each LS7 factor (BMI, blood pressure, blood glucose, total cholesterol, smoking, physical activity, and diet) was categorized as poor, intermediate, or ideal, and a composite LS7 adherence was determined by summing the number of LS7 ideal levels achieved. Flexible parametric Royston–Parmar proportional-hazards model was applied to estimate CMD-free life expectancy.ResultsHere we show that compared to men with the lowest LS7 adherence [with 18.42 years (95% CI: 16.93, 19.90) of CMD-free life at age 60], men having an ideal LS7 adherence are estimated to gain an additional 4.37 years (95% CI: 2.95, 5.79) of CMD-free life. The CMD-free life gain benefits are consistent across social class groups of manual and non-manual workers. Among LS7 factors, achieving an ideal physical activity provides the largest CMD-free survival benefit: 4.84 years (95% CI: 3.37, 6.32) of additional CMD-free life compared with the physically inactive group.ConclusionsOur study quantifies and highlights the benefits of adhering to the LS7 ideal levels for living a longer life without CMD in older adults.

Identifying the Risk Factors for Metabolic Syndrome in Bangladesh: Documented from a Nationwide Survey

Summary Metabolic syndrome is a complex of interrelated health conditions that pose a significant risk of developing cardiovascular disease, stroke, and type 2 diabetes. Resistance to insulin, genetic predisposition, high blood pressure, inflammation, and excess abdominal fat are the main stimuli of this syndrome. Metabolic syndrome is becoming more widespread due to fast and unplanned urbanization causing changes in lifestyle, such as poor dietary habits and sedentary behavior, that decrease the metabolic rate in the human body. A developing South Asian country like Bangladesh is most vulnerable to components of metabolic syndrome such as obesity, hypertension and diabetes. Consequently, it has become one of the major public health concerns. Prediction of disease status is a key component of community and health service policymaking. A nationally representative cross-sectional survey, the Bangladesh Demographic and Health Survey (BDHS), is used to find statistically significant variables for metabolic syndrome. BDHS datasets do not contain any direct data regarding metabolic syndrome. A binary variable is generated by utilizing the available data on blood pressure, blood glucose level, and body mass index (BMI). Overall, 34.33% of the population has metabolic syndrome. Primarily, bivariate analysis is performed using chi-square testing to find variables that are correlated with metabolic syndrome. Results of binary logistic analysis are presented in terms of coefficients and odds ratios (OR) with 95% confidence intervals (CI). Age, gender, education, division (province), occupation type, and wealth index are found to be important covariates for the syndrome. Age especially is seen as one of the most influential factors, since the prevalence of metabolic syndrome is only 12.17% for the age group younger than 18 years, while for the group older than 65 years it is 62.18%. Residents of Barishal have the highest rate of metabolic syndrome (38.58%). The rate in the country’s capital Dhaka is 34.48%. Individuals whose employment primarily involves manual labor are 11.1% less likely to suffer from metabolic syndrome than those doing non-manual work.

Incidence of coronary heart disease among remote workers: a nationwide web-based cohort study

Coronary heart disease (CHD) risk is influenced by socioeconomic status-related parameters, particularly occupation. We investigated occupational gaps in CHD risk and how the introduction of remote work moderated the observed occupational differences in CHD risk during the coronavirus disease 2019 pandemic in Japan. Data from a web-based, nationwide cohort study, comprising 17,640 workers (aged 20–65 years) with baseline data from December 2020, were analyzed. Participants were grouped by occupation as upper-level nonmanual workers (managers/professionals) and others (reference group). The primary outcome was CHD (angina pectoris/myocardial infarction) onset retrospectively confirmed at the 1-year follow-up survey. Upper-level nonmanual workers exhibited a higher CHD incidence than others (2.3% vs. 1.7%). This association was pronounced in the younger (20–49 years) population, with a significant CHD risk (adjusted risk ratio = 1.88). Upper-level nonmanual workers exhibited nearly 15% higher remote work prevalence, with a significant remote work-related CHD risk (adjusted risk ratio = 1.92). The mediating effects of remote work explained an overall disparity of 32% among the younger population. Occupational gaps in CHD incidence in Japan differ from those in Western countries, where upper-level nonmanual workers have lower cardiovascular risk. In Japan, remote work can mediate CHD risk in the younger population of upper-level nonmanual workers.

Occupation-specific risk estimates for suicide and non-fatal self-harm from a Swedish cohort of male construction workers followed 1987–2018

ObjectivesWhile suicidal behaviour has become less prevalent in non-manual workers in recent decades, rates have increased in manual workers. We aimed to identify occupations within the construction industry with excess...

CHANGES IN PHYSICAL ACTIVITY, SEDENTARY TIME, AND SELF-RATED HEALTH ACROSS THE RETIREMENT TRANSITION

Abstract The aim was to investigate concurrent changes in accelerometer-measured total physical activity (TPA), moderate-to-vigorous physical activity (MVPA) and sedentary time, and changes in self-rated health across the retirement transition. Data from two longitudinal studies was pooled: the Swedish Retirement Study (SRS) and the Finnish Retirement and Aging (FIREA) study that used similar methods. Data from three waves (each approximately 12 months apart) was included: one pre-retirement (wave 1, W-1) and two post-retirement follow-ups (W-2 and W-3). In total, 245 participants (27% men, mean age 64 years at W-1) were included. Thigh-worn accelerometers were used to collect data for TPA, MVPA and sedentary time at W-1 and W-2 and processed through ActiPASS and harmonized for time spent in different physical activity intensities. To be included in the analyses, a minimum of 4 days with at least 10 hours of accelerometer wear time during waking hours at both W-1 and W-2 was required. Questionnaires were used to collect data for self-rated health at W-1, W-2, and W-3. Ordinal regression models showed that 10 more minutes of MVPA at W-1 was significantly associated with higher odds of reporting better self-rated health at W-1 (OR: 1.12 [1.02-1.22]) in non-manual workers only. The association between MVPA and self-rated health was non-significant in the fully adjusted models. No significant associations were observed between changes in TPA, MVPA or sedentary time during retirement transition, and self-rated health at post-retirement follow-ups. In conclusion, this study showed a significant cross-sectional association between MVPA and better self-rated health before retirement.

MID-LIFE FINANCIAL STRESS AND COGNITIVE AND PHYSICAL PROBLEMS IN OLDER AGE: THE ROLE OF POTENTIALLY MODIFYING FACTORS

Abstract Financial stress is an important source of chronic stress and has been associated with cognitive and physical impairments. This study investigates whether midlife financial stress is associated with the combination of cognitive and physical impairment, the role of potentially modifiable factors, and sex differences. Methods: The Cardiovascular Risk Factors, Aging, and Dementia population-based cohort study from Finland was used (n=1497) (baseline collected 1972-1987, mean age 50 years). There were two late-life re-examinations (mean total follow-up 25 years). Midlife financial stress was measured using two questions on financial situation. Cognitive impairment was based on six cognitive domains. Physical impairment was self-reported. Potential modifying factors investigated were smoking, alcohol, physical activity, cohabiting/not, non-manual work, and sleep disturbances. Sex differences were investigated. We used path analyses with full information maximum likelihood estimation. Results: Among women and men, midlife financial stress associated with cognitive impairment, physical impairment and their combination. Smoking and sleep disturbances mediated associations between financial stress, physical impairment, and combined impairments. Among men: manual/non-manual work mediated the association to cognitive impairments; cohabitation mediated to cognitive impairment; financial stress was associated with cognitive impairment only among smokers and stress had a stronger association to physical and combined impairments among non-drinkers. Among women, sleep seems to have role in the association between financial stress and cognitive impairment. Conclusions: Midlife financial stress associates with late-life impairments, and lifestyle/sociodemographic factors may modify these associations. Sex differences were observed. Interventions promoting healthier lifestyle and psychosocial factors may buffer against the deleterious role of financial stress.

Self-reported sleep status and influencing factors: a web-based national cross-sectional survey in China

Objectives To investigate self-reported sleep duration, sleep timing, sleep status and influencing factors in the Chinese population. Methods This web-based cross-sectional survey was conducted in 2022, covering 31 provinces (91%) in China. 11,000 questionnaires were collected, of which 8970 were valid for analysis. Self-reported sleep habits, problems and quality were investigated. Good or fair sleep ratings, enough duration, regular, with no sleep disturbances and <30 min sleep latency was defined as a composite variable: ‘Good sleep’. Factors influencing sleep patterns and ‘Good sleep’ were analyzed by multivariate logistic regression. Results Most participants sleep less than 7 h per night (55.13%), usually go to bed at 10–12 pm (47.99%), wake up at 6–8 am (49.86%), and take less than 30 min to fall asleep (66.30%) with regular sleep schedule (76.01%). Only 12.36% have ‘Good sleep’. In the past 3 months, 46.80% of the participants reported symptoms of insomnia, and 21.54% had snoring problems. Among the adults, the young, males, college students, freelancers, and those who resided in urban areas and pandemic-free areas slept later, and the northerners woke up earlier. The adults with low-moderate and moderate income and the minors at elementary and middle school slept earlier and woke up earlier. Mid-aged adults who often napped at noon were more likely to have ‘Good sleep’ than any other age group, and urban dwellers with the same habit were more likely to have ‘Good sleep’ than people dwelled in other regions. While people who slept late, woke up too early or too late, slept too little or too much, resided at GMT 7–8 area or pandemic area, had high income, or took up some occupations (entrepreneurs/individuals, professionals, manual and non-manual workers, housewives) were less likely to get a ‘Good sleep’. Conclusions The national survey provided a sleep profile of the Chinese population. Both socio-economic status and personal sleep hygiene habits had an impact on ‘Good sleep’.

High prevalence of subjective cognitive decline in older Chinese adults: a systematic review and meta-analysis.

Subjective cognitive decline (SCD) is considered a preclinical stage of Alzheimer's disease. However, reliable prevalence estimates of SCD in the Chinese population are lacking, underscoring the importance of such metrics for policymakers to formulate appropriate healthcare strategies. To systematically evaluate SCD prevalence among older Chinese adults. PubMed, Web of Science, The Cochrane Library, Embase, CNKI, Wanfang, VIP, CBM, and Airiti Library databases were searched for studies on SCD in older Chinese individuals published before May 2023. Two investigators independently screened the literature, extracted the information, and assessed the bias risk of the included studies. A meta-analysis was then conducted using Stata 16.0 software via a random-effects model to analyze SCD prevalence in older Chinese adults. A total of 17 studies were included (n = 31,782). The SCD prevalence in older Chinese adults was 46.4% (95% CI, 40.6-52.2%). Further, subgroup analyzes indicated that SCD prevalence was 50.8% in men and 58.9% among women. Additionally, SCD prevalence in individuals aged 60-69, 70-79, and ≥ 80 years was 38.0, 45.2, and 60.3%, respectively. Furthermore, SCD prevalence in older adults with BMI <18.5, 18.5-24.0, and > 24.0 was 59.3, 54.0, and 52.9%, respectively. Geographically, SCD prevalence among older Chinese individuals was 41.3% in North China and 50.0% in South China. In terms of residence, SCD prevalence was 47.1% in urban residents and 50.0% among rural residents. As for retired individuals, SCD prevalence was 44.2% in non-manual workers and 49.2% among manual workers. In the case of education, individuals with an education level of "elementary school and below" had an SCD prevalence rate of 62.8%; "middle school, "52.4%; "high school, "55.0%; and "college and above, "51.3%. Finally, SCD prevalence was lower among married individuals with surviving spouses than in single adults who were divorced, widowed, or unmarried. Our systematic review and meta-analysis identified significant and widespread SCD prevalence in the older population in China. Therefore, our review findings highlight the urgent requirement for medical institutions and policymakers across all levels to prioritize and rapidly develop and implement comprehensive preventive and therapeutic strategies for SCD.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023406950, identifier: CRD42023406950.

The health consequences of returning to work after retirement: Evidence from a Japanese longitudinal survey

Prolonged and active old age provides individuals with more chances to work again after full retirement. Returning to work is an increasingly common form of the retirement process and influences the sustainability of social security systems. Previous studies show a beneficial relationship between returning to work and health; however, little is known about the causal effect of returning to work on health. This study used data from men and women aged 50 and older (11,991 individuals) in the Longitudinal Survey of Middle-aged and Older Adults, conducted annually from 2005 to 2019 in Japan. The effects of three types of labor force transitions (continued work, full retirement, and return to work) on physical and mental health were examined. To obtain the causal effects, an instrumental variable approach was used by exploiting the Japanese pension reform and labor market settings as instruments. Compared with full retirement, returning to work showed significantly worse mental health but no significant difference in physical health. The negative effect of returning to work was pronounced among men, former nonmanual workers, and low-wealth individuals. Contrary to the findings in previous studies, insignificant or detrimental effects of returning to work were found in this study. The rigorous causal analysis adds new evidence to the literature. The findings provide important implications for labor and health policy in aging societies.

Impact of transition to retirement on the risk of depression and suicidality: results from the Survey of Health, Ageing and Retirement in Europe (SHARE)

Abstract Background Depression is among the main contributors to older adults’ mental health burden. Retirement, as a major life transition, has been claimed to influence mental health substantially. Methods To assess short- and long-term impacts of transitioning to retirement on depression risk and suicidality in older adults across Europe, we conducted a longitudinal study using data from the SHARE, collected between 2004 and 2020 in 27 European countries plus Israel. To estimate relative risks (RR) for depression and suicidality at seven time intervals before and after retirement, we fitted adjusted generalised estimating equation models for repeated measures. Results We included 8,998 individuals employed at baseline and retired at follow-up. Compared to the year of retirement, the risk of depression was 11% lower in the following year (RR 0.89; 95% CI 0.81-0.99), 9% lower after 2 years (RR 0.91; 95% CI 0.82-1.00) and after 3 years (RR 0.91; 95% CI 0.81-1.01). Significant estimates remained among females, married individuals, those with an intermediate or higher level of education, former manual workers and those who retired at or before their country's median retirement age. A significant increase in depressive symptoms emerged from the tenth year after retirement among former non-manual workers (RR 1.21; 95% CI 1.05-1.40) and late retirees (RR 1.37; 95% CI 1.16-1.63). As for suicidality, we reported an increase in risk only 5 years or more after retirement: +30% 5-9 years after retirement (RR 1.30; 95% CI 1.04-1.64) and +47% 10 or more years after retirement (RR 1.47; 95% CI 1.09-1.98). Conclusions Longitudinal data suggest an independent effect of retiring associated with a reduction in depression and suicidality risk in the short run, with its effect decreasing in the long run. If greater flexibility in pensionable age may help prevent depression late in life, the transition to retirement is to be accompanied by targeted health promotion interventions.

Factors Associated with the Return to Work after Carpal Tunnel Release Surgery: A Cross-Sectional Study of the Worker Population.

Background: There is controversy regarding the factors influencing the duration of sickness absence and return to work (RTW) after surgical treatment of carpal tunnel syndrome (CTS). This study aimed to determine factors related to RTW in these patients. Methods: This descriptive-analytical study was performed on all patients with CTS who underwent surgery in a main orthopaedic centre from December 2020 to April 2021. Patients were followed for 90 days after surgery for the RTW. The patients were classified into two groups based on the time of RTW, early (<21 days) and late (>21 days). These two groups were compared in terms of occupational, individual and disease-related factors and the type of surgery. Results: The mean time to RTW in patients was 23.2 ± 7.1 days, with a range of 7-60 days. There was a statistically significant relationship between early RTW and gender (female) (p = 0.005 OR = 6.5), non-manual work (p = 0.002 OR = 1.2), the total score of the Boston carpal tunnel questionnaire before surgery and job satisfaction (p = 0.04). The mean time to RTW in patients who underwent open surgery was less than in endoscopic surgery (22.89 ± 6.29 vs. 24.58 ± 4.7), but this difference was not statistically significant (p > 0.05). Conclusions: Based on the findings of our study, the type of surgery does not affect the RTW of patients with CTS. Considering the effect of job type and job satisfaction on RTW, it is recommended to pay attention to the type of occupation in addition to the type of surgery so that this workforce can RTW with good performance. Level of Evidence: Level IV (Therapeutic).

Work characteristics and emotional exhaustion among young workers: a latent class analysis

ObjectivesThis study aims to assess the heterogeneity of psychosocial working conditions of young workers by identifying subgroups of work characteristic configurations within young workers and to assess these subgroups’ associations...

Old-age mortality and social class in northern Norway in the first half of the twentieth century

ABSTRACT The number of studies on social inequality in mortality in Norway before 1960 is limited and they often focus on early life outcomes. Little is known about socioeconomic differences in old-age mortality before the emergence of the welfare state. Linked census and church records from the Historical Population Register of Norway were used to study a sample of 10,457 men and women born 1841–1870 who lived in Troms, a province in northern Norway, in the early twentieth century. We analysed the association between social class, measured in adulthood, and mortality at age 60 and older using Cox proportional hazards models. The results do not indicate a clear social gradient in mortality. Differences between social classes varied in the magnitude and direction of effects, depending on gender and place of residence. For women, the association between social class and mortality was weaker overall. Only farming was significantly associated with decreased mortality risk compared to the group of lower-skilled and unskilled workers. Differences were more pronounced among men, with higher mortality for non-manual classes in towns, and lower mortality for skilled workers and farmers in rural areas. The advantage for farmers was amplified in combination with manual or non-manual work.

Trends in insufficient physical activity among adults in China 2010–18: a population-based study

BackgroundThe global prevalence of insufficient physical activity (PA) was reported to be 27.5% in 2016, and there were stable levels of insufficient PA worldwide between 2001 and 2016. The global target of a 10% reduction in insufficient PA by 2025 will not be met if the trends remain. The relevant data for trends in China were still scarce. This study aimed to determine nationwide temporal trends in insufficient PA among adults in China from 2010 to 2018.Methods645 903 adults aged 18 years or older were randomly selected from four nationally representative cross-sectional surveys of the China Chronic Disease and Risk Factor Surveillance conducted in 2010, 2013, 2015, and 2018. PA was measured using the Global Physical Activity Questionnaire. Temporal changes in insufficient PA prevalence and participation of domain-specific moderate- to vigorous-intensity PA (MVPA) were analyzed using logistic regression.ResultsFrom 2010 to 2018, the age-adjusted prevalence of insufficient PA in China increased from 17.9% (95% confidence interval 16.3% to 19.5%) in 2010 to 22.3% (20.9% to 23.8%) in 2018 (P for trend < 0.001). By age group, with a significant increase in insufficient PA in adults aged 18–34 years (P for trend < 0.001), which rose more rapidly than in adults aged ≥ 35 years (P for interaction < 0.001). Insufficient PA has increased significantly among adults engaged in agriculture-related work, non-manual work, and other manual work (all P for trend < 0.05). And among the occupational groups, those engaged in agriculture-related work had the fastest increase (P for interaction = 0.01). The percentage of adults participating in work-related MVPA decreased from 79.6% (77.8% to 81.5%) to 66.8% (64.9% to 68.7%) along with a decrease in time spent on work-related MVPA, while percentages of adults participating in recreation-related MVPA increased from 14.2% (12.5% to 15.9%) to 17.2% (16.0% to 18.4%) (all P for trend < 0.05).ConclusionsAmong Chinese adults, an increasing trend was found in insufficient PA from 2010 to 2018, with more than one-fifth of adults failing to achieve the recommendation of adequate PA. More targeted PA promotion strategies should be developed to improve population health.

Area-level and individual-level socio-economic differences in health-related quality of life trajectories: Results from a 10-year longitudinal stroke study

BackgroundWe examined area-level (aSES) and individual-level (iSES) socio-economic status on trajectories of HRQoL to 10 years following stroke. MethodsParticipants with strokes between 1/5/1996 and 30/4/1999 completed the Assessment of Quality of Life instrument (AQoL, range: -0.04 [worse than death] to 0 [death] to 1 [full health]) at ≥one of 3month, 6-month, 1-year, 2-year, 3-year, 4-year, 5-year, 7-year and 10-year interviews after stroke. Sociodemographic and health information were collected at baseline. We derived aSES from postcode using the Australian Socio-Economic Indexes For Area (2006) (categories: high, medium, low), and iSES from lifetime occupation (categories: non-manual, manual). Multivariable linear mixed effects modelling was used to estimate trajectories of HRQoL over 10 years, by aSES and iSES, adjusting for age, sex, cardiovascular disease, smoking, diabetes, stroke severity, stroke type, and the time influence on age and health conditions. ResultsOf 1,686 participants enrolled, we excluded 239 with ‘possible’ stroke and 284 with missing iSES. Among the remaining 1,163 participants, 1,123 (96.6%) had AQoL assessed at ≥3 timepoints. In multivariable analysis, over time, people in the medium aSES group had mean 0.02 (95% CI -0.06, 0.02) greater reduction in AQoL score, and people in the low aSES group had mean 0.04 (95% CI, -0.07, -0.001) greater reduction, than those in the high aSES group. Manual workers had an average 0.04 (95% CI, -0.07, -0.01) greater reduction in AQoL score over time than non-manual workers. ConclusionsOver time, HRQoL declines in all people with stroke, declining most rapidly in lower SES groups.