The association of mobility disability and obesity with risk of unemployment in two cohorts from Sweden

Abstract

Background People with mobility disability (MD) or obesity often have more health problems and are less able to participate in work than individuals without these conditions. This study investigated whether people burdened with MD and obesity have a greater risk of unemployment than people with either one (MD only or obesity only) or none of these conditions. Methods The study included two Swedish population-based cohorts, a national cohort ( n = 39,947) and a regional cohort ( n = 40,088). Six exposure groups were created using baseline self-reported data on MD and body mass index from participants aged 19 to 64 years. The MD definition differed between the cohorts. Various sources of socio-demographic factors were used to address confounding. Participants’ risks of unemployment were assessed longitudinally in a nationwide register with objective data and with almost no loss of follow-up (< 1%). Cox regression was used to analyse associations of MD and/or obesity (BMI ≥ 30) with risk of any (≥1 day) and long-term unemployment (≥90 days during two consecutive years). Quantile regression was used to estimate participants’ unemployment risks as average days of unemployment. Normal-weight people without MD were used as a reference group. The Wald test was applied for specific group comparisons other than to the reference group. Results In summary, the groups with MD and the obese group without MD had a higher risk of becoming unemployed than the reference group (regional survey adjusted hazard ratio range: 1.30–1.59; 95% CI range: 1.06–1.90, national survey adjusted hazard ratio range: 1.11–1.34; 95% CI range: 0.88–1.81). The obese group with MD did not differ from the groups with MD only or obesity only in terms of unemployment risk. Conclusions People with MD and/or obesity are vulnerable groups at risk of prolonged unemployment during their working life in a country with a highly developed welfare system. Electronic supplementary material The online version of this article (10.1186/s12889-019-6627-2) contains supplementary material, which is available to authorized users.

Impact of sofosbuvir and daclastavir on health-related quality of life in patients co-infected with hepatitis C and human immunodeficiency virus

“…Protection from infectious diseases, improvement of health status, and the ability to live a productive life are promoted by better nutritional status [ 42 ]. Moreover, people with obesity have higher risk of having mobility disability, eventuating a higher risk of becoming unemployed [ 43 , 44 ].…”

Impact of Sofosbuvir and Daclastavir on Health-related Quality of Life in Patients Co-infected With Hepatitis C and Human Immunodeficiency Virus

“…Protection from infectious diseases, improvement of health status, and the ability to live a productive life are promoted by better nutritional status. [43] Moreover, people with obesity have higher risk of having mobility disability, eventuating a higher risk of becoming unemployed [44,45].…”

Health-related selection into employment among the unemployed

“…Based on previous literature [ 1 , 11 , 13 ], we controlled for the following additional characteristics: continuous age, native language (Finnish or Swedish, other), marital status (married or cohabiting, single, divorced or widowed), education (basic, secondary, or tertiary), occupational status (upper or lower-level white collar with managerial occupations, lower-level white collar, blue collar, farmer or self-employed, student, or other) [ 39 ], number of individuals living in the same household (continuous), home ownership (yes/no), unemployment history (number of months unemployed over the two calendar years preceding the onset of unemployment, continuous), running number of the unemployment spells (from the start of the study period, categorical), and the onset year of unemployment (categorical). As labor market prospects may be particularly limited in declining regions, we also included the region of residence (Nomenclature of Territorial Units for Statistics 3, categorical, 21 regions).…”

“…As for the former, poor health may negatively influence work performance (e.g., productivity, social relations) or increase workplace absences, causing an increased risk of being laid off [ 5 ]. Some empirical evidence suggests that poor mental health and substance-use problems are associated with an increased risk of job loss, while the evidence concerning physical health is weaker [ 6 – 13 ].…”