Stockholm university

Hugo WesterlundProfessor

About me

 

Hugo Westerlund is professor of epidemiology at the Stress Research Institute, Department of Psychology, Stockholm University; project leader of the SLOSH (www.slosh.se) cohort and director of the national REWHARD infrastructure consortium (www.rewhard.se). He investigates how social and psychological exposures in and outside of working life affect health, mortality and quality of life over the life course. A recurring theme has been labour market participation, with a main focus on ageing workers and retirement, and the conditions for and consequences of extended working life. More recently, he has also taken the initiative to expand SLOSH to include younger people who are followed from secondary school, through studies and into adulthood, which is particularly important given the high levels of self-reported stress and mental health problems among young people today.


Hugo works mainly with large, longitudinal cohort studies from several different countries, including the French GAZEL, British Whitehall II and the Swedish SLOSH studies. He has a large international network of leading social epidemiologists. He has also worked on projects on open-plan offices, illegitimate taskts, early life mental health, physical activity among the elderly, risk factors for sickness absence and presenteeism, and validation of questionnaires to assess the psychosocial work environment. An overall ambition is to provide better evidence for causal links between modifiable environmental exposures and health outcomes, with increasing consideration of moderating factors such as personality and genetics.

Research projects

Publications

A selection from Stockholm University publication database

  • Association of workplace violence and bullying with later suicide risk: a multicohort study and meta-analysis of published data

    2023. Linda Magnusson Hanson (et al.). The Lancet Public Health 8 (7), e494-E503

    Article

    Background Workplace offensive behaviours, such as violence and bullying, have been linked to psychological symptoms, but their potential impact on suicide risk remains unclear. We aimed to assess the association of workplace violence and bullying with the risk of death by suicide and suicide attempt in multiple cohort studies. Methods In this multicohort study, we used individual-participant data from three prospective studies: the Finnish Public Sector study, the Swedish Work Environment Survey, and the Work Environment and Health in Denmark study. Workplace violence and bullying were self-reported at baseline. Participants were followed up for suicide attempt and death using linkage to national health records. We additionally searched the literature for published prospective studies and pooled our effect estimates with those from published studies. Findings During 1 803 496 person-years at risk, we recorded 1103 suicide attempts or deaths in participants with data on workplace violence (n=205 048); the corresponding numbers for participants with data on workplace bullying (n=191 783) were 1144 suicide attempts or deaths in 1 960 796 person-years, which included data from one identified published study. Workplace violence was associated with an increased risk of suicide after basic adjustment for age, sex, educational level, and family situation (hazard ratio 1.34 [95% CI 1.15-1.56]) and full adjustment (additional adjustment for job demands, job control, and baseline health problems, 1.25 [1.08-1.47]). Where data on frequency were available, a stronger association was observed among people with frequent exposure to violence (1.75 [1.27-2.42]) than occasional violence (1.27 [1.04-1.56]). Workplace bullying was also associated with an increased suicide risk (1.32 [1.09-1.59]), but the association was attenuated after adjustment for baseline mental health problems (1.16 [0.96-1.41]). Interpretation Observational data from three Nordic countries suggest that workplace violence is associated with an increased suicide risk, highlighting the importance of effective prevention of violent behaviours at workplaces. Funding Swedish Research Council for Health, Working Life and Welfare, Academy of Finland, Finnish Work Environment Fund, and Danish Working Environment Research Fund.

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  • Associations between COVID-19-related changes in the psychosocial work environment and mental health

    2023. Sandra Blomqvist (et al.). Scandinavian Journal of Public Health 51 (5), 664-672

    Article

    Background:

    Individuals' lives have been substantially affected by the COVID-19 pandemic. We aimed to describe changes in psychosocial work environment and mental health and to investigate associations between job insecurity and mental ill-health in relation to changes in other psychosocial work factors, loneliness and financial worries.

    Methods:

    A sub-sample of individuals from the eighth Swedish Longitudinal Occupational Survey of Health answered a web-based survey in early 2021 about current and pandemic-related changes in health, health behaviours, work and private life. We investigated participants working before the pandemic (N=1231) in relation to standardised measures on depression, anxiety and loneliness, together with psychosocial work factors, in descriptive and logistic regression analyses.

    Results:

    While 9% reached the clinical threshold for depression and 6% for anxiety, more than a third felt more worried, lonelier or in a low mood since the start of the pandemic. Two per cent had been dismissed from their jobs, but 16% experienced workplace downsizings. Conditioning on socio-demographic factors and prior mental-health problems, the 8% experiencing reduced job security during the pandemic had a higher risk of anxiety, but not of depression, compared to employees with unaltered or increased job security. Loneliness and other psychosocial work factors explained more of the association than objective measures of job insecurity and financial worries.

    Conclusions:

    Reduced job security during the COVID-19 pandemic seems to have increased the risk of anxiety among individuals with a strong labour market attachment, primarily via loneliness and other psychosocial work factors. This illustrates the potentially far-reaching effects of the pandemic on mental health in the working population.

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  • Estimating Working Life Expectancy: A Comparison of Multistate Models

    2023. Holendro Singh Chungkham (et al.). SAGE Open 13 (2)

    Article

    Increases in retirement ages make it particularly pressing to better understand how long people will work. Working life expectancy (WLE) is a useful measure for this and the current paper assesses the tools, that is, software packages, available to assess it. We do this using data from the English Longitudinal Survey on Ageing (ELSA, 2003-2018) and multistate models to estimate WLE stratified by sex and socioeconomic status. Men's versus women's WLEs were slightly higher at all ages. Estimates were similar in ELECT and SPACE by both sex and socioeconomic status. WLEs were comparatively higher from IMaCh, ranging from approximately 0.28 to 1.49 years. Life expectancy estimates from IMaCh were also higher compared to SPACE and ELECT. Using multistate models to estimate WLE provides a useful indication of the actual expected length of working life. More research is needed to better understand why estimates from IMaCh differed from ELECT and SPACE.

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  • Job Quality in the Late Career in Sweden, Japan and the United States

    2023. Loretta G. Platts (et al.). Research on Aging 45 (3-4), 259-279

    Article

    Increasing numbers of older workers continue to work after being eligible to claim a state pension, yet little is known about the quality of these jobs. We examine how psychosocial and physical job quality as well as job satisfaction vary over the late career in three contrasting national settings: Sweden, Japan and the United States. Analyses using random effects modelling drew on data from the Swedish Longitudinal Occupational Survey of Health (n = 13,936–15,520), Japanese Study of Ageing and Retirement (n = 3704) and the Health and Retirement Study (n = 6239 and 8002). Age was modelled with spline functions in which two knots were placed at ages indicating eligibility for pensions claiming or mandatory retirement. In each country, post-pensionable-age jobs were generally less stressful, freer and more satisfying than jobs held by younger workers, results that held irrespective of gender or education level.

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  • Leadership, work environment and caries prevention - what is good for the staff, is also good for the patients

    2023. Hanne Berthelsen, Mikaela Owen, Hugo Westerlund. Acta Odontologica Scandinavica 81 (3), 196-201

    Article

    Objectives: Dental caries is a health problem that can be prevented. The aim of this study is to analyse if the quality of leadership, in Swedish Public Dental Health clinics, influences the extent to which patients with caries receive preventive care, and if any such effect is mediated through a collaborative work climate, clear role expectations and a low average level of burnout among staff.

    Methods: The multilevel cross-sectional design includes work environment data from surveys of 75 general public dental clinics, register-based data on preventive measures provided to 5398 patients who received a dental filling due to a caries diagnosis, and patient demographics. Using a multilevel path analysis with logistic regression, we tested a model with one direct and three indirect pathways, controlling for the potential confounding effect of patient demographic factors.

    Results: Leadership quality, as assessed by the staff at the clinic, was associated with increased odds of patients with caries receiving prevention, controlling for patient demographic factors. Leadership quality was also positively related to a collaborative work climate, clear role expectations and a low average level of burnout among staff. Against expectations, however, no indirect effect from leadership quality on prevention through the other work environment factors was found.

    Conclusions: In conclusion, the quality of leadership in Swedish Public Dental Health clinics was positively related to a good work environment for staff and to delivery of preventive care to patients experiencing caries.

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  • A Quick "Environment Check "for All Ages: Validating the New Age-Inclusive Work Environments Instrument

    2022. Mikaela S. Owen (et al.). Innovation in Aging 6 (7), 1-13

    Article

    Background and Objectives: The global aging workforce necessitates new approaches in designing work environments to cater to the needs of increasingly age-diverse work groups. The Organisation for Economic Co-operation and Development (OECD) has in reaction outlined that organizations need to provide age-inclusive work environments that support the needs of their multigenerational workforce, to ensure their sustainability and profitability. To capture the age inclusiveness of the work environment, the present study proposes and validates an age-inclusive “environment check” for organizations referred to as the Age-Inclusive Work Environment Instrument (AIWEI), which covers discrimination, inclusion, and development opportunities.

    Research Design and Methods: We validate the 9-item AIWEI using cross-sectional and multilevel data from 2,892 Swedish workers across 101 workplaces who completed an online survey, using confirmatory factor analyses across young, middle-age, and older workers. Using a nomological approach, we also evaluate the concurrent validity of the AIWEI with a 2-1-1 path analysis.

    Results: The factor analyses supported a 3-factor model comprising of inclusion, discrimination, and development opportunities, across 3 age groups (i.e., young, middle-age, and older workers). These 3 factors had high Intraclass Coefficient (ICC) scores showing consistency in responding in the workplace. In accordance with the nomological approach, the factors of the AIWEI were linked with Psychosocial Safety Climate, burnout, and engagement, demonstrating concurrent validity for the AIWEI.

    Discussion and Implications: This new “environment check” provides a way to capture age-inclusive work environments for both younger and older workers, in an age-diverse workforce. In the validation process, age-inclusive work environments were found to exist as a group phenomenon, through shared perceptions within an organization, as well as an individual phenomenon, as experiences specific to an individual. This is important for the development and implementation of policies and strategies designed to benefit workers and organizations.

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  • Association of alcohol use with years lived without major chronic diseases: A multicohort study from the IPD-Work consortium and UK Biobank

    2022. Solja T. Nyberg (et al.). The Lancet Regional Health 19

    Article

    Background Heavy alcohol consumption increases the risk of several chronic diseases. In this multicohort study, we estimated the number of life-years without major chronic diseases according to different characteristics of alcohol use.

    Methods In primary analysis, we pooled individual-level data from up to 129,942 adults across 12 cohort studies with baseline data collection on alcohol consumption, drinking patterns, and history between 1986 and 2005 (the IPD-Work Consortium). Self-reported alcohol consumption was categorised according to UK guidelines – non-drinking (never or former drinkers); moderate consumption (1–14 units); heavy consumption (>14 units per week). We further subdivided moderate and heavy drinkers by binge drinking pattern (alcohol-induced loss of consciousness). In addition, we assessed problem drinking using linked data on hospitalisations due to alcohol abuse or poisoning. Follow-up for chronic diseases for all participants included incident type 2 diabetes, coronary heart disease, stroke, cancer, and respiratory disease (asthma and chronic obstructive pulmonary disease) as ascertained via linkage to national morbidity and mortality registries, repeated medical examinations, and/or self-report. We estimated years lived without any of these diseases between 40 and 75 years of age according to sex and characteristics of alcohol use. We repeated the main analyses using data from 427,621 participants in the UK Biobank cohort study.

    Findings During 1·73 million person-years at risk, 22,676 participants in IPD-Work cohorts developed at least one chronic condition. From age 40 to 75 years, never-drinkers [men: 29·3 (95%CI 27·9–30·8) years, women 29·8 (29·2–30·4) years)] and moderate drinkers with no binge drinking habit [men 28·7 (28·4–29·0) years, women 29·6 (29·4–29·7) years] had the longest disease-free life span. A much shorter disease-free life span was apparent in participants who experienced alcohol poisoning [men 23·4 (20·9–26·0) years, women 24·0 (21·4–26·5) years] and those with self-reported heavy overall consumption and binge drinking [men: 26·0 (25·3–26·8), women 27·5 (26·4–28·5) years]. The pattern of results for alcohol poisoning and self-reported alcohol consumption was similar in UK Biobank. In IPD-Work and UK Biobank, differences in disease-free years between self-reported moderate drinkers and heavy drinkers were 1·5 years or less.

    Interpretation Individuals with alcohol poisonings or heavy self-reported overall consumption combined with a binge drinking habit have a marked 3- to 6-year loss in healthy longevity. Differences in disease-free life between categories of self-reported weekly alcohol consumption were smaller.

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  • Characteristics of Workplace Psychosocial Resources and Risk of Diabetes: A Prospective Cohort Study 

    2022. Tianwei Xu (et al.). Diabetes Care 45 (1), 59-66

    Article

    OBJECTIVE

    To examine whether characteristics of workplace psychosocial resources are associated with the risk of type 2 diabetes among employees.

    RESEARCH DESIGN AND METHODS

    Participants were 49,835 employees (77% women, aged 40–65 years, and diabetes free at baseline) from the Finnish Public Sector cohort study. Characteristics of horizontal (culture of collaboration and support from colleagues) and vertical (leadership quality and organizational procedural justice) psychosocial resources were self-reported. Incident type 2 diabetes (n = 2,148) was ascertained through linkage to electronic health records from national registers. We used latent class modeling to assess the clustering of resource characteristics. Cox proportional hazards models were used to examine the relationship between the identified clusters and risk of type 2 diabetes during 10.9 years of follow-up, adjusting for age, sex, marital status, educational level, type of employment contract, comorbidity, and diagnosed mental disorders.

    RESULTS

    We identified four patterns of workplace psychosocial resources: unfavorable, favorable vertical, favorable horizontal, and favorable vertical and horizontal. Compared with unfavorable, favorable vertical (hazard ratio 0.87 [95% CI 0.78; 0.97]), favorable horizontal (0.77 [0.67; 0.88]), and favorable vertical and horizontal (0.77 [0.68; 0.86]) resources were associated with a lower risk of type 2 diabetes, with the strongest associations seen in employees at age ≥55 years (Pinteraction = 0.03). These associations were robust to multivariable adjustments and were not explained by reverse causation.

    CONCLUSIONS

    A favorable culture of collaboration, support from colleagues, leadership quality, and organizational procedural justice are associated with a lower risk of employees developing type 2 diabetes than in those without such favorable workplace psychosocial resources.

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  • Distance to sports facilities and low frequency of exercise and obesity: a cross-sectional study

    2022. Auriba Raza (et al.). BMC Public Health 22

    Article

    Background: Little research has investigated the associations between proximity to physical activity facilities and behavior-related health and the majority have focused on proximity from home address. We add to the literature by examining proximity of these facilities to work and home address and including a wide range of physical activity facilities. We assess the associations for proximity of physical activity facilities from home and work address with self-reported frequency of exercise and obesity.

    Methods: Our analytical sample of 7358 participants was from the 2018 wave of the Swedish Longitudinal Occupational Survey of Health. We used logistic binomial regression adjusting for age, sex, education, civil status, individual socioeconomic status, neighborhood socioeconomic status, number of children under 12 years of age, work strain, and chronic disease.

    Results: Longer distance from home to paid outdoor and paid indoor physical activity facilities was associated with low frequency of exercise (fully adjusted Relative Risk for both 1.01, 95% CI 1.01–1.02). Associations of any or free outdoor facility with low frequency of exercise were not robust. Findings also indicated associations between long distance from workplace to any and paid outdoor facility and low frequency of exercise. Results for obesity were in the similar direction, however, these were not statistically significant.

    Conclusion: Increased distance of paid outdoor and paid indoor physical activity facilities from home and of paid outdoor facilities from work was associated with low frequency of exercise. Longitudinal and larger studies are needed to confirm our findings, particularly regarding obesity.

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  • Informal Caregiving and Quality of Life Among Older Adults: Prospective Analyses from the Swedish Longitudinal Occupational Survey of Health (SLOSH)

    2022. Lawrence B. Sacco (et al.). Social Indicators Research 160 (2-3), 845-866

    Article

    Providing unpaid informal care to someone who is ill or disabled is a common experience in later life. While a supportive and potentially rewarding role, informal care can become a time and emotionally demanding activity, which may hinder older adults’ quality of life. In a context of rising demand for informal carers, we investigated how caregiving states and transitions are linked to overall levels and changes in quality of life, and how the relationship varies according to care intensity and burden. We used fixed effects and change analyses to examine six-wave panel data (2008–2018) from the Swedish Longitudinal Occupational Survey of Health (SLOSH, n = 5076; ages 50–74). The CASP-19 scale is used to assess both positive and negative aspects of older adults’ quality of life. Caregiving was related with lower levels of quality of life in a graded manner, with those providing more weekly hours and reporting greater burden experiencing larger declines. Two-year transitions corresponding to starting, ceasing and continuing care provision were associated with lower levels of quality of life, compared to continuously not caregiving. Starting and ceasing caregiving were associated with negative and positive changes in quality of life score, respectively, suggesting that cessation of care leads to improvements despite persistent lower overall levels of quality of life. Measures to reduce care burden or time spent providing informal care are likely to improve the quality of life of older people.

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  • It's giving me the blues: A fixed-effects and g-formula approach to understanding job insecurity, sleep disturbances, and major depression

    2022. Robin S. Högnäs (et al.). Social Science and Medicine 297

    Article

    Research suggests that work-related factors like job insecurity increases the risk of major depression (MD), although it is unclear whether the association is causal. Research further suggests that job insecurity increases sleep disturbances, which is also a risk factor for MD. Based on current knowledge, it is possible that job insecurity operates through sleep disturbances to affect MD, but this pathway has not been examined in the literature. The current study extends the literature by using two complementary, counterfactual approaches (i.e., random- and fixed-effects regression and a mediational g-formula) to examine whether job insecurity causes MD and whether sleep disturbances mediate the relationship. A methodological triangulation approach allowed us to adjust for unobserved and intermediate confounding, which has not been addressed in prior research. Findings suggest that the relationship between job insecurity and MD is primarily direct, that hypothetically intervening on job insecurity (in our g-formula) would reduce MD by approximately 10% at the population level, and this relationship operates via sleep disturbances to some degree. However, the indirect pathway had a high degree of uncertainty.

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  • Risk factors in adolescence as predictors of trajectories of somatic symptoms over 27 years

    2022. Noora Berg (et al.). European Journal of Public Health 32 (5), 696-702

    Article

    Background: Somatic symptoms among adolescents are common, yet little is known about long-term trajectories of somatic symptoms and the factors in adolescence that shape them. We examined individual, family and schoolbased factors at age 16 as predictors of trajectories of somatic symptoms over 27 years. Methods: Participants from the Northern Swedish Cohort (n ¼ 1001) responded to questions about individual factors (e.g. health behaviours), family factors (e.g. contact with parents, social and material adversity) and school satisfaction at age 16; as well as 10 somatic symptoms at ages 16, 18, 21, 30 and 43. Teacher assessments at age 16 included overall ability at school and peer relations. Age 16 predictors of somatic symptom trajectory group membership were analysed using multinomial logistic regression. Results: Poor contact with mother and poor school satisfaction were significant predictors of adverse symptom trajectories among both men and women. Low birth weight and low parental academic involvement were contributing factors for women, while smoking and social adversity were more relevant factors for men. Conclusions: Our findings emphasize the importance of a holistic approach that considers the unique contributions of individual, family and school-based factors in the development of trajectories of somatic symptoms from adolescence to middle age.

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  • Socioeconomic Status and Working Life Expectancy in Sweden

    2022. Holendro Singh Chungkham, Robin S. Högnäs, Hugo Westerlund. 33rd REVES – Advances in International Research on Health and Life Expectancy in the Covid-19 era, 6-6

    Conference

    Longer life expectancy and fertility decline have increased concerns about the security of old-age pensions. Raising retirement ages is one strategy to offset rising costs, though the option to retire varies considerably by socioeconomic status (SES) and sex. In terms of SES, the level of variation may depend on the measure used. Also, many workers now transition into retirement slowly, e.g., move from full- to part-time work. Thus, retirement age may not sufficiently capture how long people work. Working life expectancy (WLE)—the expected average number of years worked—better measures total working life. We use data from the Swedish Longitudinal Occupational Survey of Health (SLOSH) from 2008 to 2020 (n=4,940 people age 50+ and n=74,093 person-observations) to examine WLE by education and occupation. We estimate a three-state multistate model (i.e., working, not working, dead) and a four-state model (working part-time, working full-time, not working, and dead); both assume a continuous-time first-order Markov process. We estimate two sex-stratified models, cross-classified by: 1) occupation; and 2) education. We find that professionals work full-time 1 year more than routine workers, regardless of sex. The low educated work full-time 1 year less than the highly educated. In our weighted three-state model, where part-time work contributed ½ of full-time work, the difference increased to 1.14 and 1.05 years, respectively. Our unweighted three-state model showed slightly larger education differences. Findings suggest that WLE differs by SES, regardless of sex, and the differences are greater by education than occupation. This has implications for extending working life policies.

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  • The Implication of Physically Demanding and Hazardous Work on Retirement Timing

    2022. Johanna Stengård (et al.). International Journal of Environmental Research and Public Health 19 (13)

    Article

    The need to retain individuals longer in the workforce is acknowledged in many high-income countries. The present study therefore aimed to examine the importance of physically demanding work tasks (PDWT) and physically hazardous work environment (PHWE) in relation to retirement timing among pensionable workers (≥61 years). A particular question was whether PDWT and PHWE increased in importance with age. Six waves (2008–2018) of the Swedish Longitudinal Occupational Survey of Health (SLOSH) were used (n = 5201; 56% women and 44% men; mean age at first survey was 61.0 (SD 2.0) years). Discrete time-event history analysis, stratified by socioeconomic position and gender, showed that among blue-collar workers, PDWT and PHWE were associated with an increased likelihood of retiring within the next two years. With increasing age, high-level PHWE was associated with higher probability of retiring among blue-collar men, whereas heavy PDWT was associated with lower probability of retiring among blue-collar women. Among white-collar workers, having at least some PDWT compared to no PDWT was associated with a lower likelihood of retiring within the next two years. With increasing age, exposure to PHWE was associated with higher probability of retiring among white-collar women. These results suggest that to delay retirements, organizations could offer their older employees, especially blue-collar workers and the oldest white-collar women, alternatives to PDWT and PHWE.

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  • The Role of Staff-Assessed Care Quality in the Relationship between Job Demands and Stress in Human Service Work: The Example of Dentistry

    2022. Işıl Karatuna (et al.). International Journal of Environmental Research and Public Health 19 (19)

    Article

    The aim of this study was to investigate staff-assessed care quality at the clinic as a predictor of stress and as a moderator between job demands (quantitative demands and role conflict) and stress among dental professionals as an example of human service workers. Cross-sectional questionnaire data from 1012 dental professionals (i.e., dentists, dental hygienists and dental nurses) working at 99 clinics were analysed by confirmatory factor analysis and a two-level hierarchical linear model. Stress, quantitative demands and role conflict were measured by the Swedish standard version of COPSOQ III and care quality was measured by three proprietary items. The results showed that staff-assessed care quality at the clinic was of importance for the individual workers’ experiences of stress. Furthermore, the staff’s joint assessment of the care quality at the clinic mitigated the negative effect of role conflict on stress among dental nurses. These results indicate that a high level of staff-assessed care quality at the clinic can contribute to reduced stress in dental professionals.

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  • Workplace psychosocial resources and risk of cardiovascular disease among employees: a multi-cohort study of 135 669 participants

    2022. Tianwei Xu (et al.). Scandinavian Journal of Work, Environment and Health 48 (8), 621-631

    Article

    Objective In terms of prevention, it is important to determine effects on cardiovascular disease (CVD) when some workplace psychosocial resources are high while others are low. The aim of the study was to assess the prospective relationship between clustering of workplace psychosocial resources and risk of CVD among employees.

    Methods We pooled data from three cohort studies of 135 669 employees (65% women, age 18–65 years and free of CVD) from Denmark, Finland and Sweden. Baseline horizontal resources (culture of collaboration and support from colleagues) and vertical resources (leadership quality and procedural justice) were measured using standard questionnaire items. Incident CVD, including coronary heart and cerebrovascular disease, was ascertained using linked electronic health records. We used latent class analysis to assess clustering (latent classes) of workplace psychosocial resources. Cox proportional hazard models were used to examine the association between these clusters and risk of CVD, adjusting for demographic and employment-related factors and pre-existing physical and mental disorders.

    Results We identified five clusters of workplace psychosocial resources from low on both vertical and horizontal resources (13%) to generally high resources (28%). High horizontal resources were combined with either intermediate [hazard ratio (HR) 0.84, 95% confidence interval (CI) 0.74–0.95] or high (HR 0.88, 95% CI 0.78–1.00) vertical resources were associated with lower risks of CVD compared to those with generally low resources. The association was most prominent for cerebrovascular disease (eg, general high resources: HR 0.80, 95% CI 0.67–0.96).

    Conclusions Individuals with high levels of workplace psychosocial resources across horizontal and vertical dimensions have a lower risk of CVD, particularly cerebrovascular disease.

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  • How consistently does sleep quality improve at retirement? Prospective analyses with group-based trajectory models

    2022. Paraskevi Peristera (et al.). Journal of Sleep Research 31 (2)

    Article

    Growing evidence indicates that retiring from paid work is associated, at least in the short-term, with dramatic reductions in sleep difficulties and more restorative sleep. However, much is still not known, in particular how universal these improvements are, how long they last, and whether they relate to the work environment. A methodological challenge concerns how to model time when studying abrupt changes such as retirement. Using data from Swedish Longitudinal Occupational Survey of Health (n = 2,148), we studied difficulties falling asleep, difficulties maintaining sleep, premature awakening, restless sleep, a composite scale of these items, and non-restorative sleep. We compared polynomial and B-spline functions to model time in group-based trajectory modelling. We estimated variations in the individual development of sleep difficulties around retirement, relating these to the pre-retirement work environment. Reductions in sleep difficulties at retirement were sudden for all outcomes and were sustained for up to 11 years for non-restorative sleep, premature awakening, and restless sleep. Average patterns masked distinct patterns of change: groups of retirees experiencing greatest pre-retirement sleep difficulties benefitted most from retiring. Higher job demands, lower work time control, lower job control, and working full-time were work factors that accounted membership in these groups. Compared to polynomials, B-spline models more appropriately estimated time around retirement, providing trajectories that were closer to the observed shapes. The study highlights the need to exercise care in modelling time over a sudden transition because using polynomials can generate artefactual uplifts or omit abrupt changes entirely, findings that would have fallacious implications.

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  • Work changes and employee age, maladaptive coping expectations, and well-being

    2022. Annelies E. M. Van Vianen (et al.). International Archives of Occupational and Environmental Health

    Article

    Purpose Older workers are expected to suffer more from work changes than younger ones, but empirical evidence is lacking. Negative responses to work changes may result rather from maladaptive coping expectations. This study examined possible age differences in job and life satisfaction, and sleep disturbances, after work changes (voluntary and involuntary job changes, reorganizations) and the moderating role of maladaptive coping expectations.

    Methods Four biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH) including respondents who participated in all four waves (n = 3084). We used multilevel path analyses to estimate direct and moderated relationships between work changes and outcomes.

    Results Involuntary job changes were associated with lower job and life satisfaction and more sleep disturbances. Reorganizations were only associated with lower job satisfaction. Older employees were more satisfied with their jobs and lives than younger employees and experienced more sleep disturbances. After involuntary job changes, older employees had similar (lower) levels of well-being as younger ones, but they reported more sleep disturbances when having experienced reorganizations. Maladaptive coping expectations were related to lower job and life satisfaction and more sleep disturbances. Employees with maladaptive coping expectations reported more sleep disturbances after involuntary job changes and reorganizations.

    Conclusion Our results suggest that there are few age differences in well-being after work changes. Employee well-being seems to mostly depend on maladaptive coping expectations. Organizations aiming to prepare employees for job changes and reorganizations could focus their efforts on employees with maladaptive expectations rather than on older ones.

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  • Cohort Profile

    2018. Linda L. Magnusson Hanson (et al.). International Journal of Epidemiology 47 (3), 691-692

    Article

    Cohort Profile in a nutshell

    • The Swedish Longitudinal Occupational Survey of Health (SLOSH) is a longitudinal cohort study with repeated follow-ups aiming to investigate longitudinal associations between work organization, work environment, labour force participation, health and well-being, taking social conditions, individual differences, health behaviours, coping strategies, work-private life interaction, sleep and ageing into account.

    • In SLOSH, several nationally representative subsamples of working individuals, 16-64 years of age at inclusion, responding to baseline questionnaires, have been followed up biennially with more comprehensive self-report questionnaires.

    • Since the start in 2006, six waves of follow-up data have been collected with successively increasing numbers of men and women invited. In total 40 877 individuals have been invited, and 28 672 (70%) have responded to follow-up questionnaires at least once.

    • Further waves of follow-up are planned in 2018 and every second year in the foreseeable future.

    • The follow-up questionnaires include a wide range of measures on work or non-work situation/leaving the labour force temporarily or permanently, social situation, health and well-being. The questionnaire data are also linked to register data on demographics, employment, enterprises and establishments and health.

    • A strategy for data access has been developed, striving to satisfy legal requirements and ethical principles. Requests for data for specific research questions or collaboration are welcome via email: data@slosh.se. For more information, visit www.slosh.se.

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Show all publications by Hugo Westerlund at Stockholm University