Biomedical subjects

S A Stansfeld

Publications and source records attributed to S A Stansfeld.

At least 37 records · Page 2Linked to original sources

PubMed2001

Psychological distress and work and home roles: a focus on socio-economic differences in distress.

BACKGROUND: Home and work factors have been linked to psychological status, but less is known about their contribution to social inequalities in psychological status. We examine whether social inequalities in psychological distress can be explained by work-home factors and whether the impact of these potential explanatory factors is similar for men and women. METHODS: Data are from the 1958 British birth cohort study. We sought to explain social class differences in psychological distress at age 33. Explanatory factors were classified as work-home roles: i.e. employment, marital status, domestic responsibility, children and elderly care; and work-home characteristics: i.e. job-strain, insecurity, unsocial working hours, youngest child's age, number of children and level of involvement in childcare. RESULTS: A social gradient in psychological distress was found: odds ratios for classes IV and V v. I and II were 2.65 (men) and 3.02 (women). Work factors had consistently stronger associations with psychological distress and with social class among men than women. Work factors had a greater impact on class differences in psychological distress in men. Associations for home roles and characteristics were less consistent and their combined effect on class differences in distress was negligible for both sexes. CONCLUSION: Explanations for the social gradient differ for men and women. Work may be more important for men than women, but the impact of home factors was not strong during the early adulthood of this cohort.

Activities of Daily Living↗

PubMed2001

The West London Schools Study: the effects of chronic aircraft noise exposure on child health.

BACKGROUND: Previous field studies have indicated that children's cognitive performance is impaired by chronic aircraft noise exposure. However, these studies have not been of sufficient size to account adequately for the role of confounding factors. The objective of this study was to test whether cognitive impairments and stress responses (catecholamines, cortisol and perceived stress) are attributable to aircraft noise exposure after adjustment for school and individual level confounding factors and to examine whether children exposed to high levels of social disadvantage are at greater risk of noise effects. METHODS: The cognitive performance and health of 451 children aged 8-11 years, attending 10 schools in high aircraft noise areas (16 h outdoor Leq > 63 dBA) was compared with children attending 10 matched control schools exposed to lower levels of aircraft noise (16 h outdoor Leq < 57 dBA). RESULTS: Noise exposure was associated with impaired reading on difficult items and raised annoyance, after adjustment for age, main language spoken and household deprivation. There was no variation in the size of the noise effects in vulnerable subgroups of children. High levels of noise exposure were not associated with impairments in mean reading score, memory and attention or stress responses. Aircraft noise was weakly associated with hyperactivity and psychological morbidity. CONCLUSIONS: Chronic noise exposure is associated with raised noise annoyance in children. The cognitive results indicate that chronic aircraft noise exposure does not always lead to generalized cognitive effects but, rather, more selective cognitive impairments on difficult cognitive tests in children.

Aviation↗

PubMed2001

Job insecurity in white-collar workers: toward an explanation of associations with health.

This article describes 2 studies that examined changes in psychosocial work characteristics (job strain model) and health-related behaviors as potential explanations of the job insecurity-health relationship in a longitudinal cohort of white-collar British civil servants. Job insecurity arising from anticipation of change was associated with a modest increase in self-reported morbidity, whereas chronic job insecurity was associated with some adverse physiological changes. Anticipation of change and chronic job insecurity were associated with adverse changes in other psychosocial work characteristics, but few changes were significant and consistent across both exposure groups. Changes in health-related behaviors associated with either exposure were slight. Apart from a minor role for social support at work in both sexes and a modest role for job demands in women, adverse changes in these factors explain little of the job insecurity-health relationship.

Adult↗

PubMed2001

A follow-up study of effects of chronic aircraft noise exposure on child stress responses and cognition.

BACKGROUND: Children are a high-risk group vulnerable to the effects of chronic aircraft noise exposure. This study examines the effects of aircraft noise exposure on children's health and cognition around London Heathrow airport and tests sustained attention as an underlying mechanism of effects of noise on reading and examines the way children adapt to continued exposure to aircraft noise. METHODS: In this repeated measures epidemiological field study, the cognitive performance and health of 275 children aged 8-11 years attending four schools in high aircraft noise areas (16-h outdoor Leq > 66 dBA) was compared with children attending four matched control schools exposed to lower levels of aircraft noise (16-h outdoor Leq < 57 dBA). The children first examined at baseline were examined again after a period of one year at follow-up. Health questionnaires and cognitive tests were group administered to the children in the schools. RESULTS AND CONCLUSIONS: At follow-up chronic aircraft noise exposure was associated with higher levels of annoyance and perceived stress, poorer reading comprehension and sustained attention, measured by standardized scales after adjustment for age, social deprivation and main language spoken. These results do not support the sustained attention hypothesis previously used to account for the effects of noise on cognition in children. The reading and annoyance effects do not habituate over a one-year period and do not provide strong evidence of adaptation.

Adaptation, Psychological↗

PubMed2000

Predictors of early retirement in British civil servants.

BACKGROUND: it is uncertain how recent changes in labour force dynamics may have influenced the increasing numbers of people taking early retirement in industrialized countries. The Whitehall II study provides an opportunity to examine the predictors of early retirement in one of the largest employers in the United Kingdom. METHODS: we examined the factors predicting early retirement in a 7-year follow-up period from 1988 to 1995 using longitudinal data on 2532 male and female London-based civil servants aged between 50 and 59.5 years. Baseline data on employment grade and duration of time working for the Civil Service were obtained from self-completed questionnaires. The primary factors examined included health, work characteristics, questions about job demands and job satisfaction and financial insecurity, wealth and material problems. Time until early retirement was analysed using Cox proportional hazards model. RESULTS: of the 2532 civil servants, 26.7% retired early during the follow-up period. We found that men and women in the higher-paid employment grades, those that had suffered from ill health and those that were less satisfied with their jobs were more likely to retire early, whereas material problems tended to keep people working. CONCLUSIONS: our results show that self-perceived health, employment grade and job satisfaction are all independent predictors of early retirement. Qualitative analyses may further advance our understanding of the retirement process.

Age Factors↗

PubMed1999

Gender, social relations and mental health: prospective findings from an occupational cohort (Whitehall II study).

Gender differences in social support tend to suggest that women have larger social networks and both give and receive more support than men. Nevertheless, although social support has been identified as protective of mental health, women have higher rates of psychological distress than men. We examine the prospective association between social support and psychological distress by gender in a cohort study of middle aged British Civil Servants, the Whitehall II study. In this sample we found that women have a larger number of close persons than men although men have larger social networks. We also found that the effects of marital status, social support within and outside the workplace and social networks on subsequent occurrence of psychological distress were similar for men and women independently of baseline mental health status.

Adult↗

PubMed1999

Work characteristics predict psychiatric disorder: prospective results from the Whitehall II Study.

OBJECTIVES: The impact of work on the risk of future psychiatric disorder has been examined in few longitudinal studies. This was examined prospectively in a large epidemiological study of civil servants. METHODS: In the Whitehall II study, a longitudinal, prospective cohort study of 6895 male and 3413 female London based civil servants, work characteristics measured at baseline (phase 1: 1985-8) and first follow up (phase 2: 1989) were used to predict psychiatric disorder measured by a 30 item general health questionnaire (GHQ) at phase 2 and phase 3 follow up (phase 3: 1991-3). Work characteristics and GHQ were measured at all three phases. RESULTS: Low social support at work and low decision authority, high job demands and effort-reward imbalance were associated with increased risk of psychiatric disorder as assessed by the GHQ at follow up adjusting for age, employment grade, and baseline GHQ score. CONCLUSIONS: Social support and control at work protect mental health while high job demands and effort-reward imbalance are risk factors for future psychiatric disorder. Intervention at the level of work design, organisation, and management might have positive effects on mental health in working populations.

Adult↗

PubMed1998

Explaining social class differences in depression and well-being.

Work characteristics, including skill discretion and decision authority, explain most of the socioeconomic status gradient in well-being and depression in middle-aged British civil servants from the Whitehall II Study, London. Social support explained about one-third of the gradient, life events and material difficulties less than one-third. Socioeconomic status was measured by employment grade. Work characteristics were based on the Karasek model, social support was measured by the Close Persons Questionnaire, depression by the General Health Questionnaire and well-being by the Affect Balance Scale. Despite a small contribution from social selective factors measured by upward mobility, the psychosocial work environment explained most of the cross-sectional socioeconomic status gradient in well-being and depression.

Adult↗

PubMed1998

Paradigms of retirement: the importance of health and ageing in the Whitehall II study.

This paper evaluates four well established sociological theories of ageing using qualitative data from the British Whitehall II study. We attempt to apply the theories to contemporary retirement and through each theory examine the issue of health in retirement. The effect of lowered income in retirement is discussed in relation to Townsend's theory of structured dependency. Change in participant's health following retirement is examined in respect of the theory of disengagement by Cumming and Henry, adjustment to retirement in relation to Laslett's theory of the third age. Parson's role theory is used to examine how social interactions and relationships change for people who have recently retired. We discuss the need for a multifaceted theory of ageing which can accommodate the continually changing experience and age of retirement. We analysed interviews conducted with 25 male and female civil servants aged between 55 and 63 years, from different grades who had been retired for less than 2 years.

Aging↗

PubMed1998

Types of social support as predictors of psychiatric morbidity in a cohort of British Civil Servants (Whitehall II Study).

BACKGROUND: Few studies have examined prospectively both the direct and buffering effects of types of social support and social networks on mental health. This paper reports longitudinal associations between types of social support and psychiatric morbidity from the Whitehall II study. METHODS: Social support was measured by the Close Persons Questionnaire and psychiatric morbidity by the General Health Questionnaire at baseline (1985-1988) and at first follow-up (1989) in 7697 male and female London-based civil servants aged 35-55 years at baseline. The cohort was followed up and baseline measures were used to predict psychiatric disorder measured by the General Health Questionnaire at second follow-up (1991-1993). RESULTS: Longitudinal analyses showed that low confiding/emotional support in men and high negative aspects of close relationships in men and women were associated with greater risk of psychiatric morbidity even after adjustment for baseline General Health Questionnaire score. There was no evidence of a buffering effect among men or women who experienced life events or chronic stressors. Controlling for a personality measure of hostility did not affect the observed relations. CONCLUSIONS: The present findings illustrate that different types of support are risk factors for psychological distress and that they operate in different ways for men and women. Direct effects of emotional support are predictive of good mental health in men and negative aspects of close relations predict poor mental health in both men and women. Emotional support is predictive of good mental health in women whereas, confiding alone is not.

Adult↗

PubMed1998

Job control, personal characteristics, and heart disease.

This study examined the role of several personal characteristics in the association between low job control and coronary heart disease among male and female British civil servants. The logistic regression analyses were based on a prospective cohort study (Whitehall II), comprising 6,895 men and 3,413 women, age 35-55 years. Men and women with low job control at baseline had 1.5 to 1.8 higher risks of new heart disease during the 5.3-year follow-up. Psychological attributes, such as hostility, negative affectivity, minor psychiatric disorder, and coping, affected this association very little. The personal characteristics were not confounders, intermediate factors, or effect modifiers. Hence, increasing job control could, in principle, lower risks of heart disease for all employees.

Adult↗

PubMed1998

Behavioural and biological correlates of physical functioning in middle aged office workers: the UK whitehall II study.

STUDY OBJECTIVES: (1) To identify behavioural and biological correlates of poor physical functioning and (2) to determine whether such associations are independent of disease. DESIGN: Potential correlates were obtained from questionnaires and screening visits at baseline and five year follow up. Physical functioning was measured at follow up using the 10 item scale from the short-form 36 health survey. SETTING: London offices at baseline. PARTICIPANTS: 10,308 civil servants (6895 men and 3413 women), with a median age (range) of 49 years (39-63) at follow up. MAIN RESULTS: Multiple logistic regression showed that cigarette smoking, physical activity, body mass index (BMI), triglycerides, fibrinogen, and insulin were independently associated with poor physical functioning for men. For women, physical activity, eating habits, body mass index, fibrinogen, and insulin were independently associated with poor physical functioning. For example, among men, current smokers who had smoked more than 20 pack years were 1.89 (95% CI 1.35 to 2.67) times as likely to have poor physical functioning as never smokers. Men with BMI of 30 kg/m2 or more were 1.71 (95% CI 1.13 to 2.59) times as likely to have poor physical functioning as those with BMI < 20 kg/m2. The corresponding odds ratio for women was 2.66 (95% CI 1.80 to 3.93). With the exceptions of fibrinogen and insulin, associations remained on exclusion of subjects with physical disease. CONCLUSIONS: Risk factors established for physical diseases are associated with poor physical functioning in a population of working age. These associations may be independent of current disease.

Adult↗

PubMed1998

An uncertain future: the health effects of threats to employment security in white-collar men and women.

OBJECTIVES: This study examined changes in the health status of civil servants whose employment security was threatened. METHODS: Data were derived from a longitudinal cohort of 10,308 men and women, office staff in 20 British civil service departments. Physiological measurements, self-reported morbidity, and health-related behaviors for 530 members of the department under threat were compared with those of 19 other departments, during the period of uncertainty and during stable employment 5 years earlier. RESULTS: From a position of advantage or no difference at baseline, self-reported morbidity and physiological risk factors tended to increase among respondents from the threatened department compared with those from other departments. For both sexes, increases were significant for body mass index (P < .001) and sleeping 9 or more hours (odds ratio [OR] = 1.88; 95% confidence interval [CI] = 1.3, 2.8; P < .01); modest but significant increases were seen in ischemia (OR = 1.45; 95% CI = 1.0, 2.1) and cholesterol concentration (0.08 mmol/L; 95% CI = 0.01, 0.14). Among women only, a significant relative increase in blood pressure (P < .01) was recorded. Over the same period health-related behaviors changed little. CONCLUSIONS: Threats to employment security have adverse consequences for health status that are unexplained by health selection or health-related behaviors.

Adult↗

PubMed1997

Low job control and risk of coronary heart disease in Whitehall II (prospective cohort) study.

OBJECTIVE: To determine the association between adverse psychosocial characteristics at work and risk of coronary heart disease among male and female civil servants. DESIGN: Prospective cohort study (Whitehall II study). At the baseline examination (1985-8) and twice during follow up a self report questionnaire provided information on psychosocial factors of the work environment and coronary heart disease. Independent assessments of the work environment were obtained from personnel managers at baseline. Mean length of follow up was 5.3 years. SETTING: London based office staff in 20 civil service departments. SUBJECTS: 10,308 civil servants aged 35-55 were examined-6895 men (67%) and 3413 women (33%). MAIN OUTCOME MEASURES: New cases of angina (Rose questionnaire), severe pain across the chest, diagnosed ischaemic heart disease, and any coronary event. RESULTS: Men and women with low job control, either self reported or independently assessed, had a higher risk of newly reported coronary heart disease during follow up. Job control assessed on two occasions three years apart, although intercorrelated, had cumulative effects on newly reported disease. Subjects with low job control on both occasions had an odds ratio for any subsequent coronary event of 1.93 (95% confidence interval 1.34 to 2.77) compared with subjects with high job control at both occasions. This association could not be explained by employment grade, negative affectivity, or classic coronary risk factors. Job demands and social support at work were not related to the risk of coronary heart disease. CONCLUSIONS: Low control in the work environment is associated with an increased risk of future coronary heart disease among men and women employed in government offices. The cumulative effect of low job control assessed on two occasions indicates that giving employees more variety in tasks and a stronger say in decisions about work may decrease the risk of coronary heart disease.

Adult↗

PubMed1997

Social inequality in coronary risk: central obesity and the metabolic syndrome. Evidence from the Whitehall II study.

This report describes the social distribution of central obesity and the metabolic syndrome at the Whitehall II study phase 3 examination, and assesses the contribution of health related behaviours to their distribution. Cross-sectional analyses were conducted utilising data collected in 1991-1993 from 4978 men and 2035 women aged 39-63 years who completed an oral glucose tolerance test. There was an inverse social gradient in prevalence of the metabolic syndrome. The odds ratio (95% confidence interval) for having the metabolic syndrome comparing lowest with highest employment grade was: men 2.2 (1.6-2.9), women 2.8 (1.6-4.8). Odds ratios for occupying the top quintile of the following variables, comparing lowest with highest grade, were, for waist-hip ratio: men 2.2 (1.8-2.8), women 1.6 (1.1-2.4); post-load glucose: men 1.4 (1.1-1.8), women 1.8 (1.2-2.6); triglycerides: men 1.6 (1.2-2.0), women 2.2 (1.5-3.3); fibrinogen: men 1.7 (1.4-2.3), women 1.9 (1.2-2.8). Current smoking status, alcohol consumption and exercise level made a small contribution (men 11%, women 9%) to the inverse association between socioeconomic status and metabolic syndrome prevalence. In conclusion, central obesity, components of the metabolic syndrome and plasma fibrinogen are strongly and inversely associated with socioeconomic status. Our findings suggest the metabolic syndrome may contribute to the biological explanation of social inequalities in coronary risk. Health related behaviours appear to account for little of the social patterning of metabolic syndrome prevalence.

Adult↗

PubMed1997

Work and psychiatric disorder in the Whitehall II Study.

It is important that the effects of work on mental health are investigated when work practices are changing rapidly and there is decreasing job security. This has been examined in the Whitehall II Study, a cohort study of 6895 male and 3413 female, London-based civil servants, aged 35-55 years at baseline in 1985. Work characteristics were measured by modified Karasek indices in a self-report questionnaire. Psychiatric disorder was measured by the 30-item General Health Questionnaire (GHQ). In longitudinal analyses in men and women, high work social support predicted lower GHQ scores, and high job demands predicted higher GHQ scores at follow-up. High work social support and high skill discretion were protective against taking short spells of psychiatric sickness absence. The protective effects of social support at work and the potential risk of job demands have implications for management, job design, training, and further research.

Adult↗

PubMed1997

Social support and psychiatric sickness absence: a prospective study of British civil servants.

BACKGROUND: Studies on the direct and buffering effects of social support have not examined psychiatric sickness absence and few studies have considered support both at home and at work. This study addresses prospectively the effects of chronic stressors and social supports, at home and at work, on psychiatric sickness absence rates. METHODS: Sociodemographic factors, health and social support were measured at baseline, and short and long spells of sickness absence were measured prospectively over a 5-year period. The participants were a subsample of 4202 male and female civil servants, aged 35-55 years at baseline, from an occupational cohort, the Whitehall II Study, who completed detailed social support questions. RESULTS: Support from colleagues and supervisors at work is related to lower risk of short spells of psychiatric sickness absence, particularly for those also receiving high levels of negative aspects of close relationships from their closest person outside work. Negative aspects of close relationships from the closest person increase the risk of taking long spells of psychiatric sickness absence in men. High levels of material problems increase the risk of short spells of sickness absence. CONCLUSIONS: Negative aspects of close relationships may have an aetiological role in non-psychotic psychiatric disorder. Social support at work appears to protect against short spells of psychiatric sickness absence. This potentially implies that levels of short spells of absence might be reduced by increasing support at work. Conversely, emotional support at home may influenced absence-related behaviour and encourage a person to take absence at a time of illness.

Absenteeism↗

PubMed1997

Assessing the validity of the SF-36 General Health Survey.

Our objective was to assess the validity of the SF-36 General Health Survey against the Social Maladjustment Schedule (SMS) and two questionnaire measures, the Social Problem Questionnaire and the Nottingham Health Profile (NHP) in a random subsample of 206 men and women from the Whitehall II study, a longitudinal survey of health and disease amongst 10,308 London-based civil servants. We found that social functioning on the SF-36 correlated significantly with social contacts, total satisfaction and total management scores on the SMS, and social isolation and emotional reactions on the NHP. General mental health on the SF-36 was associated with marriage, social contacts, leisure scores, total satisfaction and total management scores on the SMS, and emotional reactions, energy level and social isolation on the NHP. Conversely, physical functioning and physical role limitations were generally not associated with the SMS but were associated with physical abilities and pain on the NHP. In conclusion, this study offers evidence of the discriminant validity of the general mental health and physical functioning scales of the SF-36. We also found moderate construct and criterion validity for the social functioning scale of the SF-36 and considerable overlap between the general mental health and social functioning scales.

Activities of Daily Living↗