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Occupational class and the changing patterns of hospitalization for affective and neurotic disorders: a nationwide register-based study of the Finnish working-age population, 1976–2010

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Abstract

Purpose

This study aimed to examine the long-term changes and socioeconomic disparities in hospitalization for affective and neurotic disorders among the Finnish working-age population from 1976 to 2010.

Methods

Register-based study, consisting of a 5-year follow-up of 3,223,624 Finnish working-age (18–64-year old) individuals in seven consecutive cohorts. We calculated the hazard ratios of psychiatric hospitalization for different occupational classes using Cox regression models.

Results

The risk of hospitalization for affective and neurotic disorders increased in all occupational classes after the economic recession in the 1990s, and then decreased in the 2000s. Before the 2000s, the risk was the highest among manual workers. In the 2000s the disparities between upper-level non-manual employees and other occupational classes increased. Hospitalization rates remained high among female manual workers and non-manual lower-level employees.

Conclusions

This study revealed important similarities and differences between occupational classes in terms of long-term changes in hospitalization for affective and neurotic disorders. The results suggest that the labor market changes and healthcare reforms during the 1990s and 2000s in Finland have been more beneficial for higher than for lower occupational classes.

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Acknowledgements

This work was funded by the Academy of Finland [Grant number 267172]; the Medical Research Council [Grant number MR/K023241/1]; and the Economic and Social Research Council [Grant number ES/L007509/1].

Author information

Authors and Affiliations

  1. Work Disability Prevention Centre, Finnish Institute of Occupational Health, PO Box 40, 00032, Helsinki, Finland

    Pekka Varje, Lauri Kokkinen, Aki Koskinen & Ari Väänänen

  2. Department of Philosophy, History, Culture and Art Studies, University of Helsinki, Helsinki, Finland

    Pekka Varje

  3. Faculty of Social Sciences, University of Helsinki, Helsinki, Finland

    Anne Kouvonen

  4. SWPS University of Social Sciences and Humanities in Wroclaw, Wroclaw, Poland

    Anne Kouvonen

  5. Administrative Data Research Centre Northern Ireland (ADRC-NI), Centre for Public Health, Queen’s University Belfast, Belfast, UK

    Anne Kouvonen

  6. Faculty of Social Sciences, University of Tampere, Tampere, Finland

    Lauri Kokkinen

  7. School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, UK

    Ari Väänänen

Authors
  1. Pekka Varje
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  2. Anne Kouvonen
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  3. Lauri Kokkinen
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Corresponding author

Correspondence to Pekka Varje.

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Ethical standards

This study was approved by the Ethics Committee of the Finnish Institute of Occupational Health.

Conflict of interest

The authors declare that they have no conflict of interest.

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Varje, P., Kouvonen, A., Kokkinen, L. et al. Occupational class and the changing patterns of hospitalization for affective and neurotic disorders: a nationwide register-based study of the Finnish working-age population, 1976–2010. Soc Psychiatry Psychiatr Epidemiol 53, 131–138 (2018). https://doi.org/10.1007/s00127-017-1472-z

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  • DOI: https://doi.org/10.1007/s00127-017-1472-z

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