Tag Archives: Well-being

Work and family – how it affects our health

How our working and family lives affect our health as we get older is of increasing interest to us all. Researchers at the ESRC International Centre for Lifecourse Studies have used the 1958 Cohort Study to look at levels of inflammation (indicators of being at risk of illnesses such as heart disease) and and how people combine their work and family lives to see if any patterns emerge that could tell us more.

In this episode of the ICLS Podcast, Dr Rebecca Lacey explains the background and context of the research and what the team has found.

You can also listen to a policy seminar talk about the research.

Working longer: is it good for your health?

Across Europe we are all living and working longer. Many of us in the UK are working past state pension retirement age. But what sorts of jobs do older workers opt for and why and what does all this mean for our health, especially in the context of changes to the age at which we can collect our state pension?  In this policy presentation from the ESRC International Centre for Lifecourse Studies at UCL, Professor David Blane looks at what these changes mean for our quality of life as we get older and the implications for those working in occupational health.

A full transcription of David Blane’s talk is also available on the ICLS website.

Photo credit: Scott Lewis

How travelling to work can work for you

There can’t be too many commuters who aren’t now aware that ditching the car and walking to work is much better for them. Considerable evidence has shown that walkers and cyclists are likely to weigh less and be slimmer than their car commuting counterparts. What they may be less aware of is that ditching the car in favour of the bus, train or the tube could have nearly the same benefits. A programme of research by a team at the London School of Hygiene and Tropical Medicine and the ESRC International Centre for Lifecourse Studies, UCL has been taking a closer look at the benefits of being an ‘active commuter’. As researcher Ellen Flint explains, the findings point to some clear ways forward, not just for individuals, but for policy makers too.

Physical inactivity and being sedentary for large parts of the day are a leading cause of obesity and premature death. In England alone something like two thirds of adults do not meet the recommended levels of daily exercise. At the same time there are growing numbers of people commuting to work. In England and Wales that figure is around 24 million people, 67% of whom take the car.

The time of life when most adults become obese is in middle age, with 50-65 year-olds less than half as likely as young adults aged 16-29 to use public transport, nearly half as likely to walk to and from work and two thirds less likely to get on their bikes. So it’s this age group that we have focused on in our programme of research looking at the relationship between active commuting and obesity in mid life.

To help us do this, we have used information from a long term household survey called Understanding Society and a large study called UK Biobank.

Public transport benefits

Our first piece of research used Understanding Society and showed us that not just walking or cycling to work but even catching the bus or the tube are all linked to lower body weight and body fat composition compared with those who get to work by car.

7,534 BMI and 7,424 percentage body fat measurements from men and women who took part in the survey were used in conjunction with information about journeys to work.

Men who commuted via public or active modes had BMI scores around 1 point lower than those who used private transport, equating to a difference in weight of 3kg (almost half a stone) for the average man.

Women who commuted via public or active transport had BMI scores around 0.7 points lower than their private transport using counterparts, equating to a difference in weight of 2.5kg (5.5lb) for the average woman.

When it came to body fat, men who actively travelled to work (walking, cycling or public transport) had body fat that was roughly one per cent point lower than those who commuted by car, confirming the picture seen when looking at BMI.

What’s important to note here is that these differences are larger than those seen in the majority of individually focused diet and physical activity interventions to prevent overweight and obesity.

Second study reinforces

In work just published in The Lancet Diabetes and Endocrinology, we were able to use information from more than 70,000 men and 80,000 women aged 40-69.

More than 60% of these people commuted by car, with only 4 percent and 7 percent respectively reporting walking as their only method of commute and 4 percent and 2 percent cycling. Around one in five was an active commuter some or all of the time.

Except for those who mixed car and public transport, all other groups had significantly lower BMI and percentage body fat than those men and women who ONLY commuted by car.

The biggest differences were for cyclists and the results stayed strong even when we accounted for a wide range of other factors such as social and economic background, their general health and even whether or not they did exercise outside of their daily commute.

The men who cycled were around 5 kg lighter whilst women cyclists were on average nearly 4.5kg lighter than their car commuting counterparts.

Unsurprisingly, walking to work had the next biggest association with reduced obesity. Compared with their car commuting counterparts, men who walked to work were on average 3.0kg lighter; and women typically weighed 2.1kg less.

However, what was perhaps more interesting, and what also reinforced our interesting earlier findings from Understanding Society, was that even those who used a mixture of public transport and active methods of commuting still had significantly lower BMI and body fat percentage than those who commuted exclusively by car.

In fact, it was similar to those who only walked to work. Compared with car commuters, men and women who mixed public transport with some walking or cycling typically weighed 3.1kg and 2.0kg less, respectively.

Active commuting at heart of policy

Separately these two studies make interesting reading, but together they combine to make a powerful and growing body of evidence around the benefits of active commuting and do more than hint at potential interventions for policy makers.

There is now a clear case for the health benefits of active commuting to be taken into consideration by transport planners, town planners and urban designers.

Cities can be active by design and the more evidence that we have to confirm that people who commute actively really are lighter and have a healthier body composition, the more impetus there is for these health related outcomes to be at the heart of policy.

It is time to realise the untapped population health improvements potential of these big shifts we can make in how people travel to and from work.

Photo credit: Chris Rubberdragon

Can unemployment kill – Podcast

Our first blog showcased recent research from the team at ESRC International Centre for Lifecourse Studies about the links between long term unemployment and stress markers linked to killer diseases. If you were interested in that, you can also listen on Soundcloud to researcher Amanda Hughes discussing the research for the ICLS Podcast.

Can unemployment kill?

At the height of the recent recession around 2.7 million people were unemployed, and youth unemployment accounted for nearly 40 per cent of that total. Given growing evidence that unemployment is linked to long term illness and increased mortality, we can expect health implications for those affected. In a week when unemployment rose for the first time in over a year, Amanda Hughes presents new evidence from the ESRC International Centre for Lifecourse Studies on the links between unemployment and killer diseases such as heart disease.

In 1984 a study was published which had linked census data to mortality records and found that men unemployed in the week of the 1971 census were 36 per cent more likely to have since died than men of the same age who had been in work. Accounting for differences in social background only explained part of the excess, raising the question: can unemployment kill, and if so how?

That unemployment might damage health was not a new idea. Marie Jahoda’s research on unemployment in the 1930s had shown that the non-financial benefits of work, such as defining aspects of status and identity and providing regular social contact, are for many people crucial to mental wellbeing. And since job loss usually brings a sharp drop in income, it is intuitive that unemployment could affect physical health by reducing quality of diet or opportunities for exercise.

But there tends to be more scepticism as to whether serious physical illness or mortality could be causally influenced by the undoubtedly stressful experience of unemployment. Might those unemployed men have developed serious illness when employed, lost their jobs as a result, and then died from their illness? Or might their increased mortality simply be caused by unemployed people smoking and drinking more? In neither case could it be claimed that unemployment itself has caused any deaths.

New approach

Since the 1980s, the tools available to scientists researching the health impacts of social conditions have moved on considerably. One new approach involves molecules called ‘inflammatory markers’ which circulate in the bloodstream and appear to be influenced by stressful experiences.

Elevated concentrations have been found in the recently bereaved and caregivers; inflammatory markers are also typically higher for people of disadvantaged socioeconomic position as measured by income or occupational social class. Crucially, raised concentrations of these molecules are linked to atherosclerosis and predict heart disease, presenting a possible causal pathway between a stressful social environment and increased mortality.

It was for this reason that we wanted to see if two inflammatory markers – C-reactive protein and fibrinogen – were elevated in jobseekers compared to employed counterparts.

We used the Health Survey for England and Scottish Health Survey, annual government surveys used to track changes in the health of both countries’ populations. To isolate elevations in these molecules due to unemployment-related stress, we considered a number of additional factors beyond participants’ age and gender.

To rule out elevations due to serious illness predating job loss, we considered whether participants had a long-term illness of any type. To rule out elevations caused by disadvantaged socioeconomic position more generally, we took into account housing tenure and occupational social class from current or most recent job.

Finally, to test whether elevations might be explained by worse health-related behaviours of jobseekers, we took into account participants’ smoking, alcohol consumption and body mass index.

Stress markers

In our sample of over 23,000 men and women of working age, unemployed people had elevated circulating levels of both molecules even after consideration of these factors. These differences were moreover clinically relevant, since unemployed participants were 40 per cent more likely to have C-reactive protein over 3mg/L, the level at which cardiovascular risk becomes elevated.

Effects were not uniform across the population. Firstly, older jobseekers (48-64) were more affected than younger jobseekers. This might indicate that unemployment is more stressful for jobseekers facing age discrimination, or equipped with outdated skills.

Since older jobseekers will have accumulated more unemployment over their lifetimes than younger counterparts, it could alternatively indicate that long-term or repeated unemployment is especially damaging to this aspect of health.

Secondly, we found substantial differences in results by country, with much greater elevations in both molecules for jobseekers in Scotland than in England. Data from the Labour Force Survey and the British Household Panel Study show that during the years of data collection (1998-2010) unemployment was higher in Scotland than England, and unemployment spells on average longer, which suggests two possible explanations.

Firstly, the jobseekers in Scotland may have been unemployed for longer, or had more recent unemployment spells, than English counterparts. Secondly, unemployment could be more stressful in times and places where the background rate is higher, since jobseekers will rationally perceive their prospects for re-employment as worse.

Since these surveys only collect information from people at one point in time, it was not possible in this analysis to investigate effects in the context of people’s employment histories. But unpicking these explanations will be crucial if we are to better understand the conditions under which unemployment is most likely to damage health, and which groups are most at risk.

Crucially, given last week’s news of a 21,000 rise in unemployment for the first time in a year  to 1.7 million people, policy makers interested in the long term health of the population should not divert their gaze from its wider consequences.

Photo credit: Kate Hiscock

Further information

Amanda Hughes is a Senior Research Officer at the Institute for Social and Economic Research at the University of Essex.

Elevated inflammatory biomarkers during unemployment: modification by age and country in the UK is research by Amanda Hughes, Anne McMunn, Mel Bartley and Meena Kumari and is published in the Journal of Epidemiology and Community Health.

References

Unemployment and mortality in the OPCS Longitudinal study is research by K.A Moser, A.J Fox, and D.R. Jones, and is published in the Lancet.

Unemployment durations: evidence from the British Household Panel Survey is research by K. Long and is published in Economic & Labour Market Review.