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      Workplace discrimination as risk factor for long-term sickness absence: Longitudinal analyses of onset and changes in workplace adversity

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          Abstract

          Workplace discrimination may affect the health of the exposed employees, but it is not known whether workplace discrimination is also associated with an increased risk of long-term sickness absence. The aim of this study was to examine the longitudinal associations of changes in and onset of workplace discrimination with the risk of long-term sickness absence. Data on workplace discrimination were obtained from 29,597 employees participating in survey waves 2004, 2006, 2008 and/or 2010 of the Finnish Public Sector Study. Four-year changes in long-term sickness absence (≥10 days of medically certified absence with a mental or non-mental diagnosis) were assessed. This covered successive study waves in analyses of onset of workplace discrimination as well as fixed effect analyses of change in workplace discrimination (concurrent i.e. during the exposure year and 1-year lagged i.e. within one year following exposure), by using each employee as his/her own control. The risk of long-term sickness absence due to mental disorders was greater for employees with vs. without onset of workplace discrimination throughout the 4-year period, reaching a peak at the year when the onset of discrimination was reported (adjusted risk ratio 2.13; 95% confidence interval (CI) 1.80–2.52). The fixed effects analyses showed that workplace discrimination was associated with higher odds of concurrent, but not 1-year lagged, long-term sickness absence due to mental disorders (adjusted odds ratio 1.61; 95% CI 1.33–1.96 and adjusted odds ratio 1.02; 95% CI 0.83–1.25, respectively). Long-term sickness absence due to non-mental conditions was not associated with workplace discrimination. In conclusion, these findings suggest that workplace discrimination is associated with an elevated risk of long-term sickness absence due to mental disorders. Supporting an acute effect, the excess risk was confined to the year when workplace discrimination occurred.

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          Perceived discrimination and health: a meta-analytic review.

          Perceived discrimination has been studied with regard to its impact on several types of health effects. This meta-analysis provides a comprehensive account of the relationships between multiple forms of perceived discrimination and both mental and physical health outcomes. In addition, this meta-analysis examines potential mechanisms by which perceiving discrimination may affect health, including through psychological and physiological stress responses and health behaviors. Analysis of 134 samples suggests that when weighting each study's contribution by sample size, perceived discrimination has a significant negative effect on both mental and physical health. Perceived discrimination also produces significantly heightened stress responses and is related to participation in unhealthy and nonparticipation in healthy behaviors. These findings suggest potential pathways linking perceived discrimination to negative health outcomes. Copyright (c) 2009 APA, all rights reserved.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Formal analysisRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                5 August 2021
                2021
                : 16
                : 8
                : e0255697
                Affiliations
                [1 ] Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
                [2 ] Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
                [3 ] Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
                [4 ] Faculty of Medicine, Clinicum, University of Helsinki, Helsinki, Finland
                [5 ] Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
                [6 ] Finnish Institute of Occupational Health, Helsinki, Finland
                [7 ] Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
                [8 ] Stress Research Institute, Stockholm University, Stockholm, Sweden
                [9 ] Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark
                [10 ] Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
                [11 ] Department of Epidemiology and Public Health, University College London, London, United Kingdom
                St John’s University, UNITED KINGDOM
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                ‡ These authors are joint senior authors on this work.

                Author information
                https://orcid.org/0000-0001-7560-0930
                https://orcid.org/0000-0001-7285-3422
                Article
                PONE-D-21-07363
                10.1371/journal.pone.0255697
                8341535
                34351965
                7133bfda-4048-4772-ab03-ed7e647a9d9e
                © 2021 Clark et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 5 March 2021
                : 22 July 2021
                Page count
                Figures: 1, Tables: 4, Pages: 15
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100004785, NordForsk;
                Award ID: 75021
                Award Recipient :
                Funded by: Danish Working Environment Foundation
                Award ID: 13-2015-09
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100004785, NordForsk;
                Award ID: 75021
                Award Recipient :
                Funded by: UK Medical Research Council
                Award ID: K013351
                Award Recipient :
                Funded by: academy of finland
                Award ID: 311492
                Funded by: finnish work environment foundation
                Funded by: Helsinki Institute of Life Scienc
                Award Recipient :
                This work was supported by NordForsk, the Nordic Research Program on Health and Welfare [grant no. 75021 to NHR], Project on Psychosocial Work Environment and Healthy Ageing and the Danish Working Environment Foundation [grant no. 13-2015-09 to NHR]. MK was supported by grants from NordForsk, the UK Medical Research Council [grant no. K013351], the Academy of Finland [grant no. 311492], the Finnish Work Environment Foundation and a Helsinki Institute of Life Science (HILIFE) fellowship. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Social Sciences
                Economics
                Labor Economics
                Employment
                Social Sciences
                Sociology
                Social Discrimination
                Racial Discrimination
                Medicine and Health Sciences
                Epidemiology
                Medical Risk Factors
                Social Sciences
                Sociology
                Social Discrimination
                People and Places
                Population Groupings
                Ethnicities
                Biology and Life Sciences
                Nutrition
                Diet
                Alcohol Consumption
                Medicine and Health Sciences
                Nutrition
                Diet
                Alcohol Consumption
                Social Sciences
                Economics
                Labor Economics
                Employment
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                Biology and Life Sciences
                Neuroscience
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                Cognitive Psychology
                Clinical Psychology
                Biology and Life Sciences
                Psychology
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                Clinical Psychology
                Social Sciences
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                Cognitive Psychology
                Clinical Psychology
                Custom metadata
                The outcome of this study, long-term sickness absence, is obtained from the Finnish Social Insurance Institution’s register and linked to survey data by using the unique personal identification number. According to the Finnish law, we are not allowed to share identified sensitive health data to other researchers. We are allowed to share anonymised questionnaire data of the Finnish Public Sector Study by application for with bona fide researchers with an established scientific record and bona fide organisations. For information about the Finnish Public Sector Study contact Prof. Mika Kivimaki mika.kivimaki[at]helsinki.fi / PI of the Finnish Public Sector study Dr. Jenni Ervasti jenni.ervasti[at]ttl.fi.

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