Background
Methods
Design, study population, and data
Exposure
Study cohorts
Outcome
Confounding factors
SPHS cohort, n = 40,088 | ULF/SILC cohort, n = 39,947 | |||||||
---|---|---|---|---|---|---|---|---|
Study groups | Normal weight without MD | Obese without MD | Normal weight with MD | Obese with MD | Normal weight without MD | Obese without MD | Normal weight with MD | Obese with MD |
Participants in each group (%)a | 22,886 (57.1) | 3117 (7.8) | 812 (2.0) | 443 (1.1) | 25,510 (63.9) | 3684 (8.2) | 419 (1.0) | 239 (0.6) |
Women | 14,327 (62.6) | 1558 (50.0) | 525 (64.7) | 254 (57.3) | 14,478 (56.8) | 1524 (41.4) | 291 (69.5) | 142 (59.4) |
Age, mean (SD) | 40.0 (12.2) | 44.9 (11.1) | 44.9 (12.2) | 49.7 (10.6) | 38.0 (12.4) | 42.6 (11.4) | 47.3 (11.9) | 48.7 (10.8) |
Age class, 18–29 | 5234 (22.9) | 309 (9.9) | 111 (13.7) | 26 (5.9) | 7924 (31.1) | 541 (14.7) | 39 (9.3) | 14 (5.9) |
30–54 | 13,891 (60.7) | 2035 (65.3) | 478 (58.9) | 221 (49.9) | 14,331 (56.2) | 2476 (67.2) | 232 (55.4) | 134 (56.1) |
55 and older | 3761 (16.4) | 773 (24.8) | 223 (27.5) | 196 (44.2) | 3255 (12.8) | 667 (18.1) | 148 (35.3) | 91 (38.1) |
Country of Birth, Sweden | 19,806 (86.5) | 2580 (82.8) | 535 (65.9) | 292 (65.9) | 22,551 (88.4) | 3209 (87.1) | 341 (81.4) | 191 (79.9) |
Other | 3080 (13.5) | 537 (17.2) | 277 (34.1) | 151 (34.1) | 2959 (11.6) | 475 (12.9) | 78 (18.6) | 48 (20.1) |
Education, Academic | 11,164 (48.8) | 1045 (33.5) | 287 (35.3) | 120 (27.1) | 12,376 (48.5) | 1082 (29.4) | 139 (33.2) | 54 (22.6) |
Upper secondary/gymnasium | 4867 (21.3) | 639 (20.5) | 172 (21.2) | 78 (17.6) | 5570 (21.8) | 778 (21.1) | 71 (16.9) | 40 (16.7) |
Lower secondary | 4195 (18.3) | 942 (30.2) | 201 (24.8) | 147 (33.2) | 5306 (20.8) | 1268 (34.4) | 130 (31.0) | 77 (32.2) |
Primary | 2660 (11.6) | 491 (15.8) | 152 (18.7) | 98 (22.1) | 2241 (8.8) | 554 (15.0) | 78 (18.6) | 67 (28.0) |
SEIb, Unskilled Workers | 3223 (14.02) | 586 (18.88) | 170 (21.30) | 99 (22.97) | 3934 (17.35) | 744 (22.84) | 92 (25.14) | 44 (21.15) |
Skilled Workers | 2141 (9.31) | 399 (12.86) | 108 (13.53) | 68 (15.78) | 3055 (13.48) | 602 (18.48) | 37 (10.11) | 36 (17.31) |
Lower non-manual | 3058 (13.30) | 454 (14.63) | 111 (13.91) | 58 (13.46) | 2499 (11.02) | 296 (9.09) | 46 (12.57) | 23 (11.06) |
Intermediate non-manual | 5829 (25.35) | 738 (23.78) | 155 (19.42) | 79 (18.33) | 4109 (18.13) | 456 (14.00) | 46 (12.57) | 27 (12.98) |
Higher non-manual | 5394 (23.46) | 503 (16.21) | 116 (14.54) | 46 (10.67) | 3098 (13.67) | 267 (8.20) | 36 (9.84) | 13 (6.25) |
Self-employed | 1738 (7.56) | 275 (8.86) | 59 (7.39) | 37 (8.58) | 1229 (5.42) | 168 (5.16) | 16 (4.37) | 9 (4.33) |
Other | 1613 (7.01) | 148 (4.77) | 79 (9.90) | 44 (10.21) | 4746 (20.94) | 725 (22.25) | 93 (25.41) | 56 (26.92) |
Income, 1st (lowest) quintile | 3905 (16.98) | 403 (12.99) | 233 (29.20) | 155 (35.96) | 5102 (22.51) | 559 (17.16) | 108 (29.51) | 59 (28.37) |
2nd | 4858 (21.13) | 572 (18.43) | 228 (28.57) | 101 (23.43) | 487 (21.48) | 619 (19.00) | 103 (28.14) | 53 (25.48) |
3rd | 4765 (20.72) | 777 (25.04) | 150 (18.80) | 73 (16.94) | 4612 (20.34) | 643 (19.74) | 68 (18.58) | 35 (16.83) |
4th | 4761 (20.70) | 724 (23.33) | 108 (13.53) | 56 (12.99) | 4142 (18.27) | 735 (22.56) | 46 (12.57) | 33 (15.87) |
5th (highest) | 4707 (20.47) | 627 (20.21) | 79 (9.90) | 46 (10.67) | 3944 (17.40) | 702 (21.55) | 41 (11.20) | 28 (13.46) |
Short-term unemployment before baseline (< 180 days), Yes | 1887 (8.2) | 253 (8.1) | 110 (13.5) | 67 (15.1) | 3546 (13.9) | 502 (13.6) | 66 (15.8) | 35 (14.6) |
Unadjusted unemployment rates (cases) | ||||||||
Any unemployment | 33.6 (3819) | 39.3 (572) | 70.1 (225) | 62.4 (102) | 47.9 (6366) | 55.6 (934) | 70.7 (117) | 79.2 (69) |
≥90 days during 2 years | 19.7 (2361) | 24.5 (374) | 42.7 (147) | 36.6 (63) | 29.6 (4384) | 34.9 (646) | 42.7 (81) | 54.3 (52) |
Person-years | 113,516 | 14,543 | 3211 | 1634 | 132,876 | 16,797 | 1655 | 871 |
Statistical analysis
Any unemployment or long-term unemployment
Median unemployment (days on average)
Group comparisons
Results
Baseline characteristics
Any and long-term unemployment
SPHS cohort, n = 40,088 | ULF/SILC cohort, n = 39,947 | |||||
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Model 1, HRs (95% CIs) | Model 2, HRs (95% CIs) | Model 3, HRs (95% CIs) | Model 1, HRs (95% CIs) | Model 2, HRs (95% CIs) | Model 3, HRs (95% CIs) | |
Any unemployment | ||||||
No mobility disability | ||||||
Normal weight | Reference group | Reference group | Reference group | Reference group | Reference group | Reference group |
Overweight | 1.07 (1.00–1.13) | 1.07 (1.01–1.14) | 1.06 (1.00–1.13) | 1.06 (1.01–1.11) | 1.07 (1.03–1.13) | 1.07 (1.02–1.12) |
Obese | 1.36 (1.24–1.49) | 1.32 (1.20–1.45) | 1.32 (1.20–1.45) | 1.32 (1.23–1.42) | 1.25 (1.15–1.34) | 1.24 (1.15–1.34) |
Mobility disability | ||||||
Normal weight | 2.26 (1.96–2.61) | 1.53 (1.33–1.77) | 1.54 (1.32–1.78) | 1.73 (1.42–2.10) | 1.19 (0.97–1.45) | 1.24 (1.01–1.53) |
Overweight | 2.19 (1.88–2.56) | 1.35 (1.15–1.59) | 1.39 (1.18–1.64) | 1.69 (1.39–2.05) | 1.17 (0.96–1.43) | 1.22 (1.00–1.50) |
Obese | 2.33 (1.90–2.86) | 1.40 (1.13–1.73) | 1.44 (1.16–1.79) | 2.00 (1.55–2.58) | 1.26 (0.97–1.64) | 1.40 (1.07–1.84) |
Other group comparisons | ||||||
Test Nwt/MD vs. Ob/MD1 | p = 0.82 | p = 0.47 | p = 0.61 | p = 0.37 | p = 0.72 | p = 0.48 |
Test Ob/noMD vs. Ob/MD2 | p < 0.001 | p = 0.61 | p = 0.47 | p = 0.002 | p = 0.94 | p = 0.40 |
Long-term unemployment | ||||||
No mobility disability | ||||||
Normal weight | Reference group | Reference group | Reference group | Reference group | Reference group | Reference group |
Overweight | 1.04 (0.97–1.12) | 1.04 (0.97–1.12) | 1.04 (0.96–1.12) | 1.09 (1.04–1.16) | 1.11 (1.05–1.17) | 1.09 (1.03–1.16) |
Obese | 1.38 (1.23–1.54) | 1.33 (1.19–1.49) | 1.33 (1.19–1.49) | 1.30 (1.19–1.42) | 1.22 (1.12–1.34) | 1.20 (1.10–1.32) |
Mobility disability | ||||||
Normal weight | 2.37 (1.99–2.82) | 1.59 (1.33–1.90) | 1.58 (1.32–1.90) | 1.68 (1.33–2.12) | 1.15 (0.91–1.46) | 1.18 (0.93–1.51) |
Overweight | 2.08 (1.71–2.53) | 1.30 (1.06–1.59) | 1.34 (1.09–1.65) | 1.62 (1.29–2.03) | 1.11 (0.88–1.41) | 1.18 (0.93–1.50) |
Obese | 2.27 (1.75–2.94) | 1.40 (1.07–1.83) | 1.37 (1.05–1.80) | 2.16 (1.61–2.89) | 1.34 (0.99–1.81) | 1.50 (1.11–2.05) |
Other group comparisons | ||||||
Test Nwt/MD vs. Ob/MD | p = 0.16 | p = 0.41 | p = 0.38 | p = 0.17 | p = 0.43 | p = 0.22 |
Test Ob/noMD vs. Ob/MD | p < 0.001 | p = 0.73 | p = 0.83 | p = 0.001 | p = 0.55 | p = 0.17 |
Results from group comparisons for both the SPHS and ULF/SILC cohorts
Days of unemployment
SPHS cohort, n = 40,088 | ULF/SILC cohort, n = 39,947 | |||||
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Days per year on average | Model 1, Median (95% CIs) | Model 2, Median (95% CIs) | Model 3, Median (95% CIs) | Model 1, Median (95% CIs) | Model 2, Median (95% CIs) | Model 3, Median (95% CIs) |
No mobility disability | ||||||
Normal weight | 31.9 (30.5–33.2) | 33.3 (31.9–34.6) | 34.6 (33.2–36.0) | 26.4 (25.3–27.4) | 27.6 (26.5–28.7) | 28.5 (27.4–29.5) |
Overweight | 32.9 (30.9–34.9) | 33.8 (31.8–35.8) | 35.4 (33.3–37.5) | 27.4 (25.9–28.9) | 28.6 (27.1–30.1) | 29.4 (28.0–30.9) |
Obese | 37.4 (33.8–41.0) | 38.3 (34.7–41.9) | 41.4 (37.7–45.1) | 30.0 (27.3–32.7) | 29.2 (26.4–32.0) | 30.0 (27.3–32.7) |
Mobility disability | ||||||
Normal weight | 42.4 (36.4–48.4) | 37.1 (31.1–43.2) | 38.6 (32.3–44.9) | 30.3 (22.6–37.9) | 25.5 (17.6–33.5) | 29.2 (21.6–36.7) |
Overweight | 41.6 (35.1–48.2) | 38.0 (31.4–44.6) | 35.4 (28.5–42.2) | 26.4 (18.8–33.9) | 26.1 (18.2–33.9) | 27.0 (19.5–34.5) |
Obese | 54.9 (45.6–64.2) | 47.0 (37.7–56.4) | 48.5 (38.8–58.2) | 38.2 (28.2–48.1) | 35.7 (25.3–46.0) | 37.5 (27.7–47.4) |
30 days or more per year on average | Model 1, RRs (95% CIs) | Model 2, RRs (95% CIs) | Model 3, RRs (95% CIs) | Model 1, RRs (95% CIs) | Model 2, RRs (95% CIs) | Model 3, RRs (95% CIs) |
No mobility disability | ||||||
Normal weight | Reference group | Reference group | Reference group | Reference group | Reference group | Reference group |
Overweight | 1.06 (0.99–1.13) | 1.05 (0.98–1.12) | 1.04 (0.98–1.11) | 1.08 (1.01–1.15) | 1.07 (1.00–1.14) | 1.05 (0.98–1.12) |
Obese | 1.31 (1.18–1.44) | 1.24 (1.12–1.37) | 1.23 (1.11–1.35) | 1.29 (1.17–1.43) | 1.19 (1.08–1.32) | 1.18 (1.07–1.30) |
Mobility disability | ||||||
Normal weight | 1.86 (1.59–2.17) | 1.25 (1.07–1.46) | 1.26 (1.07–1.47) | 1.56 (1.21–2.02) | 1.07 (0.83–1.39) | 1.07 (0.82–1.38) |
Overweight | 1.85 (1.58–2.18) | 1.14 (0.97–1.35) | 1.15 (0.98–1.36) | 1.49 (1.16–1.93) | 1.02 (0.79–1.32) | 1.07 (0.83–1.38) |
Obese | 1.80 (1.44–2.24) | 1.09 (0.87–1.36) | 1.06 (0.85–1.33) | 2.04 (1.51–2.76) | 1.31 (0.97–1.77) | 1.38 (1.02–1.87) |