Percentage Points For Men Research Articles

Own depression, partner's depression, and childlessness: A nationwide register-based study

Depression and other mental health disorders are increasing while childlessness is increasing. However, this relationship has rarely been studied. We examine how depression, as measured by antidepressant use, is related to childlessness. We add to the previous research by examining both the role of current partnership status and having a partner with depression as a mechanism.We use Finnish total population register data for cohorts born in 1977–1980. We estimate discrete time event history models for the likelihood of having a child with average marginal effects separately for men and women. Depression was measured annually with a time-varying indicator of having at least one purchase of antidepressants in the preceding year.We find a positive association between depression and childlessness; the annual probability of having a child was 2.7 percentage points lower for women with depression and 1.6 percentage points for men with depression in age-controlled models. When controlling for all background variables such as education, the likelihood of having a child was 1.9 percentage points lower for women with depression and 0.3 percentage points lower for men with depression. In total, 41% of men and 26% of women who had used antidepressant medication between ages 18–38 remained childless at age 39, compared to 30% of men and 22% of women who had not used antidepressant medication. We also find that a partner's depression increases the probability of being childless, and the likelihood of being childless is even higher if both an individual and their partner had depression.

Prevalence of nicotine dependence among smokers aged 40 years and older in China

BackgroundNicotine dependence, also known as tobacco dependence, is a common chronic disease and a major risk factor for chronic respiratory diseases. The present study was designed to determine the prevalence of nicotine dependence and its changes among smokers aged 40 years and older in China, to analyze the characteristics of nicotine dependence among smokers, and to provide a reference for smoking cessation interventions. MethodsThe data were sourced from nationally representative large-sample surveys conducted during 2014–2015 and 2019–2020 in the Chinese population, covering 125 counties (districts) in 31 provinces, autonomous regions and municipalities. Variables related to smoking and nicotine dependence among residents ≥40 years old were collected in face-to-face interviews. A total of 20,062 and 18,975 daily smokers were included in the 2014–2015 and 2019–2020 surveys, respectively. The severity of nicotine dependence was evaluated according to the Fagerström Test for Nicotine Dependence and Heaviness of Smoking Index. The level and change in nicotine dependence among daily smokers aged ≥40 years were estimated using a complex weighted sampling design, and their influencing factors were analyzed. ResultsLevels of nicotine dependence among daily smokers aged ≥40 years in China could be divided into very low, low, medium, high, and very high, accounting for 31.1%, 27.9%, 13.4%, 20.5%, and 7.1% of the total, respectively. The average Fagerström Test for Nicotine Dependence score was 3.9 (95% confidence interval [CI]: 3.8–4.0), with the prevalence of medium–high nicotine dependence being 41.0% (95% CI: 39.0–42.9%) and that of high and very high nicotine dependence being 27.6% (95% CI: 26.0–29.3%), both of which were significantly higher in men than in women (both P < 0.001). Among daily smokers, those with a low education level, age at smoking initiation <18 years, and with smoking duration of ≥20 years had a higher degree of nicotine dependence. In terms of geographic region, the level of medium–high nicotine dependence in South China was higher than in other areas, and the decline in the prevalence of high nicotine dependence was the greatest in Northwest China (P < 0.001). The prevalence of medium–high and high and very high nicotine dependence was significantly higher in men with chronic respiratory symptoms, chronic obstructive pulmonary disease (COPD), and/or chronic respiratory diseases than in men without these conditions (all P < 0.05). The prevalence of high and very high nicotine dependence in women with chronic respiratory symptoms and chronic respiratory diseases was significantly higher than that in women without these conditions (both P < 0.05). Compared with that during 2014–2015, the prevalence of high nicotine dependence among daily smokers decreased during 2019–2020 by 4.5 percentage points in the total population (P < 0.001) and by 4.8 percentage points in men (P < 0.001), with no significant change seen in women (P > 0.05). Additionally, the prevalence of high nicotine dependence in men with chronic respiratory symptoms and COPD decreased by 6.7 and 4.7 percentage points, respectively (P < 0.05), but showed no significant change in women with these conditions (P > 0.05). Multivariate logistic regression analysis showed that the risk of medium-high nicotine dependence was higher among daily smokers who were male; 50–59 years old; unmarried/divorced/widowed/separated; engaged in agriculture, forestry, husbandry, fishery and water conservancy; had a low education level; started smoking before the age of 18 years; and smoked for more than 20 years. ConclusionsThe past few years have seen a slight decline in the prevalence of high (severe) nicotine dependence among smokers aged ≥40 years in China. However, 41.0% of daily smokers had medium-high nicotine dependence, and 27.6% had high or very high nicotine dependence, with notable differences in population and geographic distributions. Development of tailored interventions, optimization of smoking cessation service systems, and integration of smoking cessation into the management of chronic diseases will effectively reduce the burden of nicotine dependence in China.

Evolution of smoking prevalence in Spain and its 17 autonomous regions (1987–2020)

Background and objectivesContinuous monitoring of smoking prevalence is essential to understand the evolution of the tobacco epidemic in a population. The objective of this study was to analyze the evolution of smoking prevalence in Spain and its 17 Autonomous Regions (ARs) in population ≥15 years during the period 1987–2020. MethodsTobacco consumption data were derived from the National Health Survey of Spain and the European Health Survey in Spain. A smoker was defined as a person who smoked at the time of the survey. The trend in prevalences by sex in Spain and its ARs was analyzed by applying joinpoint models. Age-standardized prevalences were calculated for Spain by applying the direct method. ResultsIn Spain, the prevalence of consumption decreased 29 percentage points in men and 4.5 in women between 1987–2020. In men, the smoking prevalence decreased in all the ARs and the absolute change varied between −19.5% in the Balearic Islands and −33.9% in Andalusia. In women, the evolution of smoking prevalence differed between ARs. The absolute change varied between −15.4% in Basque Country and 0.5% in Andalusia. ConclusionsThe number of men and women smokers has decreased in Spain between 1987–2020. Different patterns of evolution of the prevalence of consumption are observed among the ARs, especially among women. This reinforces the need for policies adapted to more local contexts and that take into account the gender perspective.

Evolución de la prevalencia de consumo de tabaco en España y sus 17 comunidades autónomas (1987-2020)

Background and objectivesContinuous monitoring of smoking prevalence is essential to understand the evolution of the tobacco epidemic in a population. The objective of this study was to analyze the evolution of smoking prevalence in Spain and its 17 Autonomous Regions (ARs) in population ≥15 years during the period 1987-2020. MethodsTobacco consumption data were derived from the National Health Survey of Spain and the European Health Survey in Spain. A smoker was defined as a person who smoked at the time of the survey. The trend in prevalences by sex in Spain and its ARs was analyzed by applying joinpoint models. Age-standardized prevalences were calculated for Spain by applying the direct method. ResultsIn Spain, the prevalence of consumption decreased 29 percentage points in men and 4.5 in women between 1987-2020. In men, the smoking prevalence decreased in all the ARs and the absolute change varied between −19.5% in the Balearic Islands and −33.9% in Andalusia. In women, the evolution of smoking prevalence differed between ARs. The absolute change varied between −15.4% in Basque Country and 0.5% in Andalusia. ConclusionsThe number of men and women smokers has decreased in Spain between 1987-2020. Different patterns of evolution of the prevalence of consumption are observed among the ARs, especially among women. This reinforces the need for policies adapted to more local contexts and that take into account the gender perspective.

INCONSISTENT ESTIMATES OF POOR HEALTH BETWEEN EUROPEAN SURVEYS—A MATTER OF SURVEY DESIGN?

Abstract Several studies have reported about inconsistencies in survey estimates on health, both within and between countries. One potential source of inconsistency in results from population surveys is survey quality. In particular, the prevalence of poor health among older people is sensitive for survey design factors and the inclusion of older people with poor health. We aimed to explore the association between survey design factors and within-country differences (between EU-SILC and SHARE) in estimated prevalence of poor health (long-term illness and global activity limitation (GALI)) among older people. The analyses include people 65 years and older from 25 European countries with data collections both in SHARE and EU-SILC 2017. Results show substantial differences in sociodemographic factors and estimates of poor health, both between and within countries. The within-country differences in the prevalence of long-term illness ranged from -18 percentage points for men in Denmark (lower in EU-SILC compared with SHARE) to 42 percentage points for women in Cyprus (higher in EU-SILC compared with SHARE). The prevalence of GALI showed similar patterns. We conclude that estimates of poor health, measured by long-term illness and GALI, have great variation between surveys within the same country. Survey design factors, such as response rate and the type and number of survey mode seems to explain part of these inconsistencies. Population surveys are widely used for monitoring health and the results from these surveys are utilized in health policy planning. Thus, it is crucial to understand the possible impact of survey design on health estimates.

Opioids and the labor market

This paper quantifies the relationship between local opioid prescription rates and labor market outcomes in the United States between 2006 and 2016. To understand this relationship at the national level, we assemble a data set that allows us both to include rural areas and to estimate the relationship at a disaggregated level. We control for geographic variation in both short-term and long-term economic conditions. We demonstrate that the level of geographic information included in the estimation qualitatively alters the estimated results. We focus on measuring the impact of opioid prescriptions on labor markets, so we evaluate the robustness of our estimates to an alternative causal path, unobserved selection, and an instrumental variable from the literature. In our baseline specification, a 10 percent higher local prescription rate is associated with a lower prime-age labor force participation rate of 0.53 percentage points for men and 0.10 percentage points for women.

Changes in loneliness prevalence in Denmark in the 21st century: Age-period-cohort analysis.

The aim of this study was to investigate changes in the prevalence of loneliness in Denmark from 2000 to 2021 by conducting age-period-cohort analysis. Our study was based on a sample (N=83,437; age: ⩾16 years) of the Danish Health and Morbidity Surveys conducted in Denmark in 2000, 2005, 2010, 2013, 2017 and 2021. We used logistic regression models by gender to estimate the age-period-cohort effects, with loneliness as the dependent variable and age, survey year and birth cohort as independent variables, mutually adjusted. The prevalence of adult loneliness increased by each survey year over the entire period (from 13.2% in 2000 to 27.4% in 2021 among men and from 18.8% to 33.7% among women). Overall, a U-shaped curve, for the prevalence of loneliness among different age groups, was observed, which was most pronounced among women. The greatest increase in the prevalence of loneliness from 2000 to 2021 was observed among the youngest age group (16-24 years), with 28.4 and 30.7 percentage points for men and women. No significant cohort effect was observed. The observed increase in loneliness prevalence from 2000 to 2021 was driven by period and age effects rather than cohort effects. It should be noted that data from 2021 were collected during a national lockdown due to an outbreak of COVID-19, which could explain part of the large increase in loneliness from 2017 to 2021.

Does education enhance entrepreneurship?

Formal education is correlated with entrepreneurial activity and success, but correlation does not indicate causation. Education and entrepreneurship are both influenced by other related factors. The current study estimates the causal effects of formal education on entrepreneurship outcomes by instrumenting for an individual’s years of schooling using cohort mean years of maternal schooling observed decades prior. We differentiate self-employment by industry employment growth and firm incorporation status. Policymakers are especially interested in entrepreneurship with the potential to create substantial employment growth. We find that an additional year of schooling increases self-employment in high-growth industries by 1.12 percentage points for women and by 0.88 percentage points for men. Education reduces the probability of male self-employment in shrinking industries. Education also increases incorporated self-employment for women and men and reduces unincorporated self-employment among men but not women. The overall probability of self-employment increases with education for women but is unaffected by education for men. The results suggest that formal education enhances entrepreneurship.

Increase in the prevalence of metabolic syndrome in Poland: comparison of the results of the WOBASZ (2003-2005) and WOBASZ II (2013-2014) studies.

INTRODUCTION Metabolic syndrome (MS) significantly increases cardiovascular risk. Knowledge about the current prevalence of MS in the Polish population is limited. OBJECTIVES The aim of this study was to assess the prevalence of MS in the Polish population based on the results of the WOBASZ II study (2013-2014) and to compare the obtained data with the results of the WOBASZ study (2003-2005). PATIENTS AND METHODS A representative sample of 19 751 Polish adults from the WOBASZ and WOBASZ II studies was analyzed. Diagnostic criteria for MS included abdominal obesity, elevated blood pressure, elevated fasting glucose values, and lipid disorders; MS was diagnosed if at least 3 individual components were present. RESULTS Based on the WOBASZ II study (2013-2014), the prevalence of MS in Poland was 32.8% in women and 39% in men. In women, the most frequent component of MS was abdominal obesity (64.7%), while in men it was increased blood pressure (62%). In the decade between the WOBASZ and WOBASZ II studies, there was a significant increase in the prevalence of MS in Polish adults aged 20 to 74 years: by 3.3 percentage points in women (26.6% vs 29.9%; P <0.001) and by 8.8 percentage points in men (30.7% vs 39.4%; P <0.001). The increase in the frequency of carbohydrate metabolism disorders was the greatest contributor to this phenomenon; however, abdominal obesity and lipid disorders were also significantly more frequent. CONCLUSIONS It is alarming that in the decade between the WOBASZ and WOBASZ II studies there was such a significant increase in the prevalence of MS and its individual components in Poland.

The Effect of Early Claiming Benefit Reduction on Retirement Rates

This paper examines the effect of the increase in the Social Security Full Retirement Age (FRA) and the associated decrease in benefits for early claimants on retirement rates at ages 62 to 65. It uses information on age, sex, and labor force participation from the monthly Current Population Survey from 1976 to 2019. Critical components of the analysis include a difference/in-difference framework, comparison of three measures of retirement status, estimation of nonparametric and parametric models, and a test of the assumptions underlying the difference-indifference approach. Although our model satisfied that test, the results do not guarantee that our specification is valid. The paper found that: • The increase in the FRA decreased the retirement rate at age 62 by about 5 percentage points (or 30 percent) for men and by about 2 percentage points (or about 20 percent) for women. The retirement rate at age 63 to 65 was not affected. • Estimates of the parametric model show that a 1 percent increase in the early claiming reduction decreases the retirement rate by between 0.7 and 0.9 percentage points for men and between 0.2 and 0.4 percentage points for women. The policy implications of the findings are: • Our findings can inform evaluations of policy proposals to further increase the Social Security FRA. • Our findings contribute to the understanding of the effects that the availability and generosity of pension benefits have on retirement decisions.

SOCIO-ECONOMIC-GENDER DISBALANCES IN GEORGIA

Introduction and aim According to the policy towards gender equality, Georgia has become one of the most reformed countries in the Caucasus. Despite the fact that many steps have been taken in this regard, the problems are still in the society. The main objective of the study is to identify and analyze gender imbalances in the country on the background of gender stereotypes in the context of civil cognitive levels. Research methodology: In development of the article, generally accepted qualitative and quantitative data analysis methods of the economic science were employed, among them, statistical data processing, data grouping, inductive deductive data analysis methods. The scientific study employs surveying, observation, as well as comparative, analytical, and graphical methods, which are used by the author to compare and analyze facts and assess solutions to specific issues. Results and implications: The paper considers the gender aspects of Discussion of inequality problems in Georgia. Besides, the trends of unemployment and their reasons are identified and the international instruments of protection of human rights regulating the equality between the men and the women in Georgia are considered. In addition, based on the statistical data, is given the analysis of employment and unemployment in a gender respect; a particular accent is made on the need of International practice of gender protection. Conclusion: Stereotypical views on gender roles still exist in Georgia: the function of women is the care and upbringing of children, doing homework, and man-taking care of family finances. The fact is that more men employed in Georgia than women. The level of inactivity in women is almost twice as high as in men with a similar indicator of 42.0% and 21.8% respectively. In 2017, unemployment rate for women Increased by 1.8 percentage points to 12.7 percent, and for men decreased by 1.6 percentage points and by 15 percent. Changes for to the same period are also indicators of activity level. The level of activity increased realised by 1.5 percentage points for women and decreased by 2.8 percentage points for men and 58.2 percent and 74.6 percent respectively. Interesting trends are shown by employment indicators according to age marks. The number of men employed by the 45-54 age group is significantly higher than the number of women employed for the whole nine years, indicating the employment rate of women, especially in the 15-24 age group where the number of men employed is twice as high as the number of women employed. It is also true that the average level of compensation for women is lower than men. Their rates of growth are also different.

The impact of diabetes on labour market outcomes in Mexico: A panel data and biomarker analysis

Recent evidence for Mexico suggests important differences in health status between people with diagnosed and undiagnosed diabetes. However, there is at best scarce evidence on the economic consequences of diabetes, especially in contexts where the condition often remains undiagnosed, as is typically the case in low- and middle income countries. Using Mexican longitudinal and biomarker data we estimated the relationship between diabetes, as well as its time since diagnosis, and employment probabilities, wages and working hours. We further explored how these relationships differ for those with diagnosed and undiagnosed diabetes. For the longitudinal analyses, nationally representative data from 11995 men and 13858 women 15–64 years old were taken from three waves (2002, 2005, 2009) of the Mexican Family Life Survey. We estimated a fixed effects model to account for unmeasured time-invariant confounders of diabetes. We found a reduction in the probability of being employed of 7.7 and 6.3 percentage points for men and women, respectively, but no significant relationship with hours worked or wages. Employment probabilities fell gradually with each year since diagnosis for men but not for women. Using cross-sectional biomarker data, our results indicate that 68% of those exhibiting glycated hemoglobin (HbA1c) levels above the clinical diabetes threshold did not self-report a diagnosis, hence were undiagnosed. Nevertheless, regression analysis revealed that there was no association of diabetes with labour outcomes for undiagnosed women or men. This suggests that results based on self-reported diabetes cannot be extended to the (rather large) part of the population with undiagnosed diabetes, likely because of a selection of people in worse health and with a longer diabetes duration into the diagnosed population. Earlier diagnosis and improved treatment of diabetes therefore may prevent adverse health effects and related economic hardship.

Follow-Up Data Improve the Estimation of the Prevalence of Heavy Alcohol Consumption.

We aim to adjust for potential non-participation bias in the prevalence of heavy alcohol consumption. Population survey data from Finnish health examination surveys conducted in 1987-2007 were linked to the administrative registers for mortality and morbidity follow-up until end of 2014. Utilising these data, available for both participants and non-participants, we model the association between heavy alcohol consumption and alcohol-related disease diagnoses. Our results show that the estimated prevalence of heavy alcohol consumption is on average of 1.5 times higher for men and 1.8 times higher for women than what was obtained from participants only (complete case analysis). The magnitude of the difference in the mean estimates by year varies from 0 to 9 percentage points for men and from 0 to 2 percentage points for women. The proposed approach improves the prevalence estimation but requires follow-up data on non-participants and Bayesian modelling.

Opioids and the Labor Market

This paper studies the relationship between local opioid prescription rates and labor market outcomes for prime-age men and women between 2006 and 2016. We estimate the relationship at the most disaggregated level feasible in the American Community Survey in order to provide estimates that include rural areas that have, in some cases, seen particularly high prescription rates. Given the limited time period, it is particularly important to account for geographic variation in both short-term and long-term economic conditions. We estimate three panel models to control for evolving local economic conditions: a difference-in-differences specification, a specification with specific controls for economic conditions, and a model that focuses on a comparison group of place with similar performance in 2000. These modelling approaches find a range of statistically significant and economically substantial results for both prime-age men and women. For example, we find that a 10 percent higher local prescription rate is associated with a decrease in the prime-age labor force participation rate of between 0.15 and 0.47 percentage points for men and between 0.15 and 0.19 percentage points for women, depending on the control strategy. We also estimate effects for narrower demographic groups and find substantially larger estimates for some groups, notably for white and minority men with less than a BA. We also present evidence on reverse causality. We show that a short-term unemployment shock did not increase the share of people misusing prescription opioids and that prescription levels vary substantially within quintiles of longer-term labor market performance. Our estimates are generally robust to estimation within those quintiles of 2000 labor market performance. These results argue against theories of reverse causation that rely on prescriptions rates being higher in labor markets that were already weaker.

Changes in waist circumference independent of weight: Implications for population level monitoring of obesity

Population monitoring of obesity is most commonly conducted using body mass index (BMI). We test the hypothesis that because of increases in waist circumference (WC) independent of increases in weight, BMI alone detects an increasingly smaller proportion of the population with obesity. MethodsAustralian adults with measured height, weight, and WC were selected from three nationally representative cross-sectional surveys (1989, 1999–2000, 2011–12; n=8313, 5903 & 3904). Participants were defined as having obesity using classifications for an obese BMI (≥30kg·m−2) and substantially-increased-risk WC (≥88cm [women], ≥102cm [men]). Age-standardised prevalence of obesity according to BMI and/or WC, and the proportion of these detected by BMI and by WC were compared across surveys. FindingsBetween 1989 and 2011–12, weight and WC increased by 5.4kg and 10.7cm (women), and by 7.0kg and 7.3cm (men). For women and men, 63% and 38% of increases in WC were independent of increases in weight. Over this period, the prevalence of obesity according to BMI and/or WC increased by 25.3 percentage-points for women (18.9% to 44.3%) and 21.1 percentage-points for men (17.1% to 38.2%). The proportion of these detected by BMI decreased for women by 20 percentage-points (77% to 57%) with no change for men. The proportion of these detected by WC increased for women and men by 10 percentage-points (87% to 97%) and 6 percentage-points (85% to 91%) respectively. ConclusionBMI alone is detecting a decreasing proportion of those considered obese by BMI and/or WC. Renewed discussion regarding how we monitor obesity at the population level is required.

Spillover improved survival in non-invited patients of the colorectal cancer screening programme.

Objectives In colorectal cancer screening, randomized clinical trials have shown a 16% mean reduction in colorectal cancer mortality, but the Finnish randomized health services study showed no effect. We quantified spillover (the total indirect effect caused by the programme on the non-invited) and corrected the effectiveness estimate of the Finnish programme. Methods We retrieved from the Finnish Cancer Registry data on all non-invited colorectal cancer patients diagnosed in 1999-2013 in municipalities that adopted screening ( n = 18,948). Patients were stratified by three 5-year diagnostic periods and two calendar periods of programme adoption in the municipality of residence. Follow-up ended on 31 December 2013. We measured the spillover effect in patient survival, based on differences of adjusted estimates of the colorectal cancer-related hazard of death between pairs of consecutive diagnostic periods. Results The spillover effect was estimated as 9 percentage points (95% confidence interval: -1 to 19 percentage points). It was 13 percentage points in men (-1 to 26 percentage points) and 5 percentage points in women (-9 to 20 percentage points). The corrected effect estimate of implementing screening in Finland was 5 percentage points. Conclusions The corrected Finnish effectiveness estimate was consistent with estimates from randomized trials. Indirect effects (spillover) bias the invitee-control contrast. In this case, spillover was an inherent benefit of the Finnish programme.

Age–period–cohort analyses of obesity prevalence in US adults

ObjectivesAge–period–cohort analysis is a stream of methodologies that decompose the temporal trends for disease risk into three time scales—age, calendar year (period) and year of birth (cohort). This study conducted age–period–cohort analyses of obesity prevalence in US adults. Study designRetrospective data analysis. MethodsWe constructed regression models based on anthropometric data from the 1999–2012 National Health and Nutrition Examination Survey to correct for the self-reported height/weight in the 1984–2014 Behavioral Risk Factor Surveillance System (BRFSS). We estimated fixed-effects age–period–cohort models based on the BRFSS data for the overall adult sample (n = 6,093,293) and by sex and race/ethnicity, adjusting for individual characteristics and the BRFSS survey design. ResultsAn inverted U-shaped age effect on obesity and a positive period effect characterized by over-time increase in obesity risk independent of age and cohort influences were identified in the overall sample and subgroups by sex and race/ethnicity. From 1984 to 2014, the adjusted obesity prevalence increased by 21.1 percentage points among US adults, and 20.9, 21.6, 21.0, 26.4 and 20.1 percentage points in men, women, non-Hispanic whites, African Americans and Hispanics, respectively. In contrast, no consistent evidence was found in support of the cohort effect—the adjusted obesity risk was comparable across birth cohorts after accounting for the age and period effects. ConclusionsShifts in the age distribution and nationwide secular changes may have fuelled the obesity epidemic in the USA over the past decades. Reversing the obesity epidemic may require understanding of the nationwide changes over time that affect weight gain across all population subgroups and promoting universal changes to diet, physical activity and the obesogenic environment.

Are workers with disabilities more likely to be displaced?

The literature on employment and disability has been relatively silent regarding the job loss experience of persons with disabilities. We document the gap in job displacement rates across disability status in the United States over the 2007–2013 period using data from the 2010, 2012 and 2014 Displaced Worker Supplements of the Current Population Survey. We find that men and women with disabilities are, respectively, 75 and 89% more likely to experience an involuntary job loss than men and women without disabilities in the United States over the 2007–2013 period, with gaps in displacement rates of eight and seven percentage points for men and women, respectively. A significant gap is found in most occupation-education subsamples. Using a logit decomposition, we find that differences in observable characteristics do not explain the gap in the job loss rate across disability status. Longitudinal tests following workers over a one-year period point to a causal effect of disability on the likelihood of displacement. While the disability gap may be due to unobservable characteristics, job mismatch and employer discrimination are also possible explanations, highlighting the potential importance of employer and public policies in improving the job security of workers with disabilities.

Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants.

SummaryBackgroundOne of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes.MethodsWe pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence—defined as fasting plasma glucose of 7·0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs—in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue.FindingsWe used data from 751 studies including 4 372 000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4·3% (95% credible interval 2·4–7·0) in 1980 to 9·0% (7·2–11·1) in 2014 in men, and from 5·0% (2·9–7·9) to 7·9% (6·4–9·7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28·5% due to the rise in prevalence, 39·7% due to population growth and ageing, and 31·8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target.InterpretationSince 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income countries than in high-income countries.FundingWellcome Trust.

Trends in mental health inequalities in England during a period of recession, austerity and welfare reform 2004 to 2013

Several indicators of population mental health in the UK have deteriorated since the financial crisis, during a period when a number of welfare reforms and austerity measures have been implemented. We do not know which groups have been most affected by these trends or the extent to which recent economic trends or recent policies have contributed to them.We use data from the Quarterly Labour Force Survey to investigate trends in self reported mental health problems by socioeconomic group and employment status in England between 2004 and 2013. We then use panel regression models to investigate the association between local trends in mental health problems and local trends in unemployment and wages to investigate the extent to which these explain increases in mental health problems during this time.We found that the trend in the prevalence of people reporting mental health problems increased significantly more between 2009 and 2013 compared to the previous trends. This increase was greatest amongst people with low levels of education and inequalities widened. The gap in prevalence between low and high educated groups widened by 1.29 percentage points for women (95% CI: 0.50 to 2.08) and 1.36 percentage points for men (95% CI: 0.31 to 2.42) between 2009 and 2013. Trends in unemployment and wages only partly explained these recent increases in mental health problems. The trend in reported mental health problems across England broadly mirrored the pattern of increases in suicides and antidepressant prescribing.Welfare policies and austerity measures implemented since 2010 may have contributed to recent increases in mental health problems and widening inequalities. This has led to rising numbers of people with low levels of education out of work with mental health problems. These trends are likely to increase social exclusion as well as demand for and reliance on social welfare systems.