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Terveyskäyttäytymisen sosioekonomisten erojen muutokset ennen eläköitymistä ja sen jälkeen : kohorttitutkimus

Year: 2025
Type: dissertation
Study design: Observational Study
Abstract: Populations are rapidly ageing worldwide. At the same time, the prevalence of noncommunicable diseases is rising, contributing to large and growing socioeconomic health disparities and increasing healthcare costs. Health behaviours are the most important modifiable risk factors for various diseases and contribute to quality of life and healthy ageing. These behaviours are not, however, evenly distributed across the socioeconomic stratum. Although individuals in lower socioeconomic positions are known to be less likely to engage in health-promoting behaviours and more likely to engage in health-impairing ones, little is known about how these differences evolve during ageing and over retirement transition. To address this knowledge gap, I examined the development of socioeconomic differences in leisure-time physical activity, fruit and vegetable consumption and alcohol use over a 15–22-year follow-up in an ageing Finnish occupational cohort. Furthermore, I explored the contribution of retirement to these changes. I used data from the Helsinki Health Study cohort. The data consists of five phases of questionnaire surveys, collected between years 2000 and 2022. These surveys include questions on a wide range of socioeconomic factors, health behaviours, family situation, working conditions, and various health-related indicators All of the participants were employees of the City of Helsinki, Finland and 40–60-year-old in Phase 1 (2000–2002, n=8960, response rate 67%). The follow-up surveys were conducted in 2007 (n=7332, response rate 83%), 2012 (n=6814, response rate 79%), 2017 (n=6832, response rate 82%), and 2022 (n=5950, response rate 75%). Baseline occupational class was used as a measure of socioeconomic position. I analyzed the changes in socioeconomic differences using mixed effect modelling. More specifically, I applied a linear mixed-effects model to F&V consumption and used generalized linear mixed-effects models to analyze LTPA and alcohol consumption. Changes in socioeconomic differences did not follow a uniform pattern across health behaviours. In sub-study I, socioeconomic differences in leisure-time physical activity widened over the follow-up, with retirement transition contributing to the growing differences. In sub-study II, differences in fruit and vegetable consumption remained stable throughout the study period and showed little change over the retirement transition. In sub-study III, alcohol use showed varying trajectories depending on the indicator examined, yet socioeconomic differences showed little change. Taken together, these findings suggest that a) socioeconomic differences in health behaviours develop in distinct ways during ageing, and b) the retirement transition relates to these developments differently by behaviour, contributing to widening differences in the case of leisure-time physical activity. The results from this thesis could be used in more effective targeting of health behaviour interventions and thus aid in promoting equitable, healthy, and functional ageing.
Language: English
Subfield: Health
Open Access status: green
OpenAlex ID: W7199715312
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