Journal of epidemiology and community health
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J Epidemiol Community Health · Nov 2015
The influence of chronic health problems and work-related factors on loss of paid employment among older workers.
With an ageing society and increasing retirement ages, it is important to understand how employability can be promoted in older workers with health problems. The current study aimed to determine whether (1) different chronic health problems predict transitions from paid employment to disability benefits, unemployment and early retirement, and (2) how work-related factors modify these associations. ⋯ All health problems affected disability benefits to a similar extent, but psychological health problems especially predicted unemployment and early retirement. For older workers with health problems, promoting an optimal work environment has the potential to contribute to sustainable employment.
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J Epidemiol Community Health · Nov 2015
Do macroeconomic contractions induce or 'harvest' suicides? A test of competing hypotheses.
Researchers often invoke a mortality displacement or 'harvesting' mechanism to explain mortality patterns, such that those with underlying health vulnerabilities die sooner than expected in response to environmental phenomena, such as heat waves, cold spells and air pollution. It is unclear if this displacement mechanism might also explain observed increases in suicide following economic contraction, or if suicides are induced in persons otherwise unlikely to engage in self-destructive behaviour. Here, we test two competing hypotheses explaining an observed increase in suicides following unemployment-induction or displacement. ⋯ Displacement and induction both appear to have operated following unexpected labour market contractions in Sweden, though with different population segments.
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A conflict of interest arises by having two conflicting goals in one's research. The primary goal of research relevant to public health is to produce impartial evidence on health hazards for humans. Several entities - including industry - may have public health as a goal among others, but this is not their primary goal. ⋯ Disclosure of conflicts of interest is not enough: the view that disclosure solves all problems amounts to say that a declaration of having produced unbiased evidence is a self-fulfilling guarantee that the evidence will not be affected by conflicts of interest. This concept is seriously misleading. A conflict of interest arises from the circumstances in which research occurs and does not exist only in the opinion of some people or groups (or the authors of a paper).
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J Epidemiol Community Health · Aug 2015
The real ecological fallacy: epidemiology and global climate change.
Prompted by my participation in the People's Climate March held in New York City on 21 September 2014, as part of the 'Harvard Divest' contingent, in this brief essay I reflect on the late 20th century development of--and debates over--the necessity of ecological thinking in epidemiology, and also the still limited engagement of our field with work on the health impact of global climate change. Revisiting critiques about the damaging influence of methodological individualism on our field, I extend critique of the still influential notion of 'ecological fallacy,' including its wilful disregard for ecology itself as being pertinent to people's ways of living--and dying. Indeed, the real 'ecological fallacy' is to think epidemiologists or others could ever understand the people's health except in societal and ecological, and hence historical, context. I conclude by urging all of us, as members of the broader scientific community, whether or not we directly study the health impacts of the planetary emergency of global climate change, to step up by joining the call for universities to divest from fossil fuels.