Browsing by Subject "DETERMINANTS"

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  • Jakubaviciute, Egle; Candolin, Ulrika (2021)
    The invasion of non-native species into an ecosystem can markedly alter the structure and functioning of the system. Yet, we have limited knowledge of the factors that determine invasion success. Behavioural interactions have been suggested as critical determinants of invasion success in animals, but the exact mechanisms are less well known. We investigated if density-dependent behavioural interactions could have facilitated the invasion of the shrimp Palaemon elegans into the spawning habitat of the threespine stickleback Gasterosteus aculeatus in the Baltic Sea. This was done by manipulating the densities of the two species in mesocosms. We found the stickleback to dominate behaviourally over the shrimp through higher aggression, but that the impact on the shrimp was density-dependent; a high density of sticklebacks increased aggressive interactions, which caused the shrimps to decrease their activity and restrict their habitat use to dense vegetation, while a low density of sticklebacks had no impact on the distribution and activity of the shrimps. The density of the shrimps had no impact on stickleback behaviour. These results suggest that the present density of the stickleback has allowed the invasion of the shrimp into the habitat. However, a current increase in stickleback abundance caused by human-induced ecological disturbances could limit the further expansion of the shrimp. Thus, our results indicate that a behavioural mechanism-density-dependent aggression-can influence invasion success and subsequent population expansion. At a broader level, our results stress the importance of considering density-dependent behavioural interactions when investigating the mechanisms behind invasion success.
  • Vepsalainen, Henna; Korkalo, Liisa; Mikkila, Vera; Lehto, Reetta; Ray, Carola; Nissinen, Kaija; Skaffari, Essi; Fogelholm, Mikael; Koivusilta, Leena; Roos, Eva; Erkkola, Maijaliisa (2018)
    Objective: To study the associations between home food availability and dietary patterns among pre-school children. Design: Cross-sectional study in which parents of the participating children filled in an FFQ and reported how often they had certain foods in their homes. We derived dietary pattern scores using principal component analysis, and composite scores describing the availability of fruits and vegetables as well as sugar-enriched foods in the home were created for each participant. We used multilevel models to investigate the associations between availability and dietary pattern scores. Setting: The DAGIS study, Finland. Subjects: The participants were 864 Finnish 3-6-year-old children recruited from sixty-six pre-schools. The analyses included 711 children with sufficient data. Results: We identified three dietary patterns explaining 16.7% of the variance. The patterns were named 'sweets-and-treats' (high loadings of e.g. sweet biscuits, chocolate, ice cream), 'health-conscious' (high loadings of e.g. nuts, natural yoghurt, berries) and 'vegetables-and-processed meats' (high loadings of e.g. vegetables, cold cuts, fruit). In multivariate models, the availability of fruits and vegetables was inversely associated with the sweets-and-treats pattern (beta = -0.05, P <0.01) and positively associated with the health-conscious (beta = 0.07, P <0.01) and vegetables-and-processed meats patterns (beta = 0.06, P <0.01). The availability of sugar-enriched foods was positively associated with the sweets-and-treats pattern (beta = 0.10, P <0.01) and inversely associated with the health-conscious pattern (beta = -0.03, P <0.01). Conclusions: Considering dietary patterns, the availability of sugar-enriched foods in the home seems to have a stronger role than that of fruits and vegetables. Parents should restrict the availability of unhealthy foods in the home.
  • Idehen, Esther E.; Koponen, Päivikki; Härkänen, Tommi; Kangasniemi, Mari; Pietilä, Anna-Maija; Korhonen, Tellervo (2018)
    Background: Cervical cancer is currently ranked as the fourth commonly diagnosed cancer in women globally. A higher incidence has been reported in low- and-middle-income countries, and the disease poses significant public health challenges. Evidence suggests that this disease is preventable by means of regular screening using the Papanicolaou (Pap) test. However, limited knowledge exists about disparities in cervical screening participation among immigrants compared with non-immigrants, in countries with universal cervical screening programmes. We aimed to examine disparities in cervical screening participation among women of Russian, Somali, and Kurdish, origin in Finland, comparing them with the general Finnish population (Finns). We controlled for differences in several socio-demographic and health-related variables as potential confounders. Methods: We employed data from the Finnish Migrant Health and Well-being Study 2010-2012 and the National Health 2011 Survey. Data collection involved face-to-face interviews. Data on screening participation in the previous five years from women aged 29-60 were available from 537 immigrants (257 Russians, 113 Somalis, 167 Kurds) and from 436 Finns. For statistical analyses, we used multiple logistic regression. Results: Age-adjusted screening participation rates were as follows: Russians 79% (95% Cl 72.9-84.4), Somalis 41% (95% Cl 31.4-50.1), and Kurds 64% (95% Cl 57.2-70.8), compared with 94% (95% Cl 91.4-95.9) among Finns. After additionally adjusting for socio-demographic and health-related confounders, all the immigrant groups showed a significantly lower likelihood of screening participation when compared with Finns. The Odds Ratios were as follows: Russians 0.32 (95% Cl 0.18-0.58), Somalis 0.10 (95% Cl 0.04-0.23), and Kurds 0.17 (95% Cl 0.09-0.35). However, when additionally accounting for country of origin-confounder interactions, such differences were attenuated. Conclusions: Our results indicate disparities in screening participation among these immigrants and a lower likelihood of screening participation compared with the general Finnish population. To improve equity in cervical cancer screening participation, appropriate culturally tailored intervention programmes for each immigrant group might be beneficial.
  • Chen, Jing; Bacelis, Jonas; Sole-Navais, Pol; Srivastava, Amit; Juodakis, Julius; Rouse, Amy; Hallman, Mikko; Teramo, Kari; Melbye, Mads; Feenstra, Bjarke; Freathy, Rachel M.; Smith, George Davey; Lawlor, Deborah A.; Murray, Jeffrey C.; Williams, Scott M.; Jacobsson, Bo; Muglia, Louis J.; Zhang, Ge (2020)
    Author summaryWhy was this study done? Maternal height, BMI, blood glucose, and blood pressure are associated with gestational duration, birth weight, and birth length. These birth outcomes are subsequently associated with late-onset health conditions. The causal mechanisms and the relative contributions of maternal and fetal genetic effects underlying these observed associations are not clear. What did the researchers do and find? We dissected the relative contributions of maternal and fetal genetic effects using haplotype genetic score analysis in 10,734 mother-infant pairs of European ancestry. Genetically elevated maternal height is associated with longer gestational duration and larger birth size. In the fetus, alleles associated with adult height are positively associated with birth size. Alleles elevating blood pressure are associated with shorter gestational duration through a maternal effect and are associated with reduced fetal growth through a fetal genetic effect. Alleles that increase blood glucose in the mother are associated with increased birth weight, whereas risk alleles for type 2 diabetes in the fetus are associated with reduced birth weight. Alleles raising birth weight in fetus are associated with shorter gestational duration and higher maternal blood pressure during pregnancy. What do these findings mean? Maternal size and fetal growth are important factors in shaping the duration of gestation. Fetal growth is influenced by both maternal and fetal effects. Higher maternal BMI and glucose levels positively associate with birth weight through maternal effects. In the fetus, alleles associated with higher metabolic risks are negatively associated with birth weight. More rapid fetal growth is associated with shorter gestational duration and higher maternal blood pressure. These maternal and fetal genetic effects can largely explain the observed associations between maternal phenotypes and birth outcomes, as well as the life-course associations between these birth outcomes and adult phenotypes. Background Many maternal traits are associated with a neonate's gestational duration, birth weight, and birth length. These birth outcomes are subsequently associated with late-onset health conditions. The causal mechanisms and the relative contributions of maternal and fetal genetic effects behind these observed associations are unresolved. Methods and findings Based on 10,734 mother-infant duos of European ancestry from the UK, Northern Europe, Australia, and North America, we constructed haplotype genetic scores using single-nucleotide polymorphisms (SNPs) known to be associated with adult height, body mass index (BMI), blood pressure (BP), fasting plasma glucose (FPG), and type 2 diabetes (T2D). Using these scores as genetic instruments, we estimated the maternal and fetal genetic effects underlying the observed associations between maternal phenotypes and pregnancy outcomes. We also used infant-specific birth weight genetic scores as instrument and examined the effects of fetal growth on pregnancy outcomes, maternal BP, and glucose levels during pregnancy. The maternal nontransmitted haplotype score for height was significantly associated with gestational duration (p= 2.2 x 10(-4)). Both maternal and paternal transmitted height haplotype scores were highly significantly associated with birth weight and length (p<1 x 10(-17)). The maternal transmitted BMI scores were associated with birth weight with a significant maternal effect (p= 1.6 x 10(-4)). Both maternal and paternal transmitted BP scores were negatively associated with birth weight with a significant fetal effect (p= 9.4 x 10(-3)), whereas BP alleles were significantly associated with gestational duration and preterm birth through maternal effects (p= 3.3 x 10(-2)andp= 4.5 x 10(-3), respectively). The nontransmitted haplotype score for FPG was strongly associated with birth weight (p= 4.7 x 10(-6)); however, the glucose-increasing alleles in the fetus were associated with reduced birth weight through a fetal effect (p= 2.2 x 10(-3)). The haplotype scores for T2D were associated with birth weight in a similar way but with a weaker maternal effect (p= 6.4 x 10(-3)) and a stronger fetal effect (p= 1.3 x 10(-5)). The paternal transmitted birth weight score was significantly associated with reduced gestational duration (p= 1.8 x 10(-4)) and increased maternal systolic BP during pregnancy (p= 2.2 x 10(-2)). The major limitations of the study include missing and heterogenous phenotype data in some data sets and different instrumental strength of genetic scores for different phenotypic traits. Conclusions We found that both maternal height and fetal growth are important factors in shaping the duration of gestation: genetically elevated maternal height is associated with longer gestational duration, whereas alleles that increase fetal growth are associated with shorter gestational duration. Fetal growth is influenced by both maternal and fetal effects and can reciprocally influence maternal phenotypes: taller maternal stature, higher maternal BMI, and higher maternal blood glucose are associated with larger birth size through maternal effects; in the fetus, the height- and metabolic-risk-increasing alleles are associated with increased and decreased birth size, respectively; alleles raising birth weight in the fetus are associated with shorter gestational duration and higher maternal BP. These maternal and fetal genetic effects may explain the observed associations between the studied maternal phenotypes and birth outcomes, as well as the life-course associations between these birth outcomes and adult phenotypes.
  • Monden, Christiaan W. S.; Metsa-Simola, Niina; Saarioja, Saska; Martikainen, Pekka (2015)
    Background: There is an average negative mental health effect for individuals who experience divorce. Little is known whether the pattern of such divorce effects varies within couples. We study whether the husband and wife experience similar harmful effects of divorce, whether they experience opposite effects, or whether divorce effects are purely individual. Methods: We use Finnish registry data to compare changes over a period of 5 years in antidepressant use of husbands and wives from 4,558 divorcing couples to 108,637 continuously married pairs aged 40-64, all of whom were healthy at baseline. Results: In the period three years before and after divorce antidepressant use increases substantially. However, the likelihood of uptake of antidepressant medication during this process of divorce by one partner appears to be independent of medication uptake in the other partner. In contrast, among continuously married couples there is a clear pattern of convergence: If one partner starts to use antidepressants this increases the likelihood of uptake of antidepressant medication in the other partner. Conclusions: Our findings suggest that divorce effects on antidepressant use are individual and show no pattern of either convergence or divergence at the level of the couple. The increased incidence of antidepressant use associated with divorce occurs in individuals independent of what happens to their ex-partner.
  • von Bondorff, Mikaela B.; Tormakangas, Timo; Salonen, Minna; von Bonsdorff, Monika E.; Osmond, Clive; Kajantie, Eero; Eriksson, Johan G. (2015)
    Background There is some evidence linking sub-optimal prenatal development to an increased risk of disability pension (DP). Our aim was to investigate whether body size at birth was associated with transitioning into all-cause and cause-specific DP during the adult work career. Methods 10 682 people born in 1934-44 belonging to the Helsinki Birth Cohort Study had data on birth weight extracted from birth records, and on time, type and reason of retirement between 1971 and 2011 extracted from the Finnish Centre for Pensions. Results Altogether 21.3% transitioned into DP during the 40-year follow-up, mainly due to mental disorders, musculoskeletal disorders and cardiovascular disease. Average age of transitioning into DP was 51.3 (SD 8.4) for men and 52.2 (SD 7.6) for women. Cohort members who did not transition into DP retired 10 years later on average. Among men, higher birth weight was associated with a lower hazard of transitioning into DP, adjusted hazard ratio (HR) being 0.94 (95% confidence interval [CI] 0.88-0.99 for 1 SD increase in birth weight). For DP due to mental disorders the adjusted HR was 0.90, 95% CI 0.81, 0.99. A similar but non-significant trend was found for DP due to cardiovascular disease. Among women there were no associations between body size at birth and all-cause DP (p for interaction gender*birth weight on DP p = 0.007). Conclusions Among men disability pension, particularly due to mental disorders, may have its origins in prenatal development. Given that those who retire due to mental health problems are relatively young, the loss to the workforce is substantial.
  • Sumanen, Hilla; Lahelma, Eero; Lahti, Jouni; Pietiläinen, Olli; Rahkonen, Ossi (2016)
    Objective Socioeconomic differences in sickness absence (SA) are well established among older employees but poorly understood among the young. Our aim was to examine 12-year trends in educational differences in SA among young female and male employees, and to assess the magnitude of the differences. Design We examined annual SA spells. The data were obtained from the employer's registers and linked to Statistics Finland's register data on completed education and qualifications. Education was classified into four hierarchical groups. Joinpoint regression models were used to identify turning points in SA trends. The magnitude of the relative educational differences was estimated in accordance with the relative index of inequality for 2002, 2008 and 2013. Setting Employees of the City of Helsinki, Finland, in 2002-2013. Participants The analyses covered female and male employees aged 25-34years: employees aged 35-54years were used as a reference group. Outcome SA spells. Results An educational gradient emerged among younger and older women and men. SA spells increased in the early 2000s, and downward turning points were located in 2007-2010 in all educational groups among women and in most groups among men. The magnitude of the differences remained broadly stable among younger women from 2002 to 2013, and decreased slightly among older women and more strongly among younger and older men. The educational differences were greater among men than women in the early 2000s, but similar among both at the end of the study period. Conclusions The changes in SA spells may reflect the economic downturn started in 2008 and resulting job insecurity. Early preventive measures aimed at reducing educational differences in SA should be focused at an early stage on those with low levels of education in particular.
  • Kreivi, Hanna-Riikka; Itäluoma, Tuomas; Bachour, Adel (2020)
    Introduction: The prevalence of obesity is continually increasing worldwide, which increases the incidence of obesity hypoventilation syndrome (OHS) and its consequent mortality. Methods: We reviewed the therapy mode, comorbidity and mortality of all OHS patients treated at our hospital between 2005 and 2016. The control group consisted of randomly selected patients with obstructive sleep apnoea (OSA) treated during the same period. Results: We studied 206 OHS patients and 236 OSA patients. The OHS patients were older (56.3 versus 52.3 years, p Conclusions: The mortality rate in OHS was significantly higher than that in OSA patients even after adjusting for covariates. Ventilation therapy by continuous positive airway pressure or noninvasive ventilation have reduced mortality significantly in all patients.
  • Pedeliento, Giuseppe; Andreini, Daniela; Bergamaschi, Mara; Salo, Jari (2019)
  • Halonen, Jaana I.; Shiri, Rahman; Mänty, Minna; Sumanen, Hilla; Solovieva, Svetlana; Viikari-Juntura, Eira; Kähönen, Mika; Lehtimäki, Terho; Raitakari, Olli T.; Lallukka, Tea (2019)
    Objectives To examine whether exposure to heavy physical work from early to later adulthood is associated with primary healthcare visits due to cause-specific musculoskeletal diseases in midlife. Design Prospective cohort study. Setting Nationally representative Young Finns Study cohort, Finland. Participants 1056 participants of the Young Finns Study cohort. Exposure measure Physical work exposure was surveyed in early (18-24years old, 1986 or 1989) and later adulthood (2007 and 2011), and it was categorised as: 'no exposure', 'early exposure only', 'later exposure only' and 'early and later exposure'. Primary and secondary outcome measures Visits due to any musculoskeletal disease and separately due to spine disorders, and upper extremity disorders were followed up from national primary healthcare register from the date of the third survey in 2011 until 2014. Results Prevalence of any musculoskeletal disease during the follow-up was 20%, that for spine disorders 10% and that for upper extremity disorders 5%. Those with physically heavy work in early adulthood only had an increased risk of any musculoskeletal disease (risk ratio (RR) 1.55, 95% CI 1.05 to 2.28) after adjustment for age, sex, smoking, body mass index, physical activity and parental occupational class. Later exposure only was associated with visits due to any musculoskeletal disease (RR 1.46, 95%CI 1.01 to 2.12) and spine disorders (RR 2.40, 95%CI 1.41 to 4.06). Early and later exposure was associated with all three outcomes: RR 1.99 (95% CI 1.44 to 2.77) for any musculoskeletal disease, RR 2.43 (95% CI 1.42 to 4.14) for spine disorders and RR 3.97 (95% CI 1.86 to 8.46) for upper extremity disorders. Conclusions To reduce burden of musculoskeletal diseases, preventive actions to reduce exposure to or mitigate the consequences of physically heavy work throughout the work career are needed.
  • Almeda-Valdes, Paloma; Cuevas-Ramos, Daniel; Mehta, Roopa; Munoz-Hernandez, Liliana; Cruz-Bautista, Ivette; Perez-Mendez, Oscar; Teresa Tusie-Luna, Maria; Gomez-Perez, Francisco J.; Pajukanta, Paivi; Matikainen, Niina; Taskinen, Marja-Riitta; Aguilar-Salinas, Carlos A. (2014)
  • Karppinen, Jari E.; Rottensteiner, Mirva; Wiklund, Petri; Hamalainen, Kaisa; Laakkonen, Eija K.; Kaprio, Jaakko; Kainulainen, Heikki; Kujala, Urho M. (2019)
    Purpose We aimed to investigate if hereditary factors, leisure-time physical activity (LTPA) and metabolic health interact with resting fat oxidation (RFO) and peak fat oxidation (PFO) during ergometer cycling. Methods We recruited 23 male monozygotic twin pairs (aged 32-37 years) and determined their RFO and PFO with indirect calorimetry for 21 and 19 twin pairs and for 43 and 41 twin individuals, respectively. Using physical activity interviews and the Baecke questionnaire, we identified 10 twin pairs as LTPA discordant for the past 3 years. Of the twin pairs, 8 pairs participated in both RFO and PFO measurements, and 2 pairs participated in either of the measurements. We quantified the participants' metabolic health with a 2-h oral glucose tolerance test. Results Fat oxidation within co-twins was correlated at rest [intraclass correlation coefficient (ICC) = 0.54, 95% confidence interval (CI) 0.15-0.78] and during exercise (ICC = 0.67, 95% CI 0.33-0.86). The LTPA-discordant pairs had no pairwise differences in RFO or PFO. In the twin individual-based analysis, PFO was positively correlated with the past 12-month LTPA (r = 0.26, p = 0.034) and the Baecke score (r = 0.40, p = 0.022) and negatively correlated with the area under the curve of insulin (r = - 0.42, p = 0.015) and glucose (r = - 0.31, p = 0.050) during the oral glucose tolerance test. Conclusions Hereditary factors were more important than LTPA for determining fat oxidation at rest and during exercise. Additionally, PFO, but not RFO, was associated with better metabolic health.
  • Vartiainen, Outi; Elorinne, Anna-Liisa; Niva, Mari; Väisänen, Pertti (2020)
    Introducing and increasing the use of insect-based foods as an alternative source of protein has recently aroused academic and commercial interest in Europe. In this research, we examined Finnish consumers' intentions to consume insect-based foods in the near future. As a theoretical background we used Ajzen's theory of planned behaviour (TPB), where individuals' intentions to change their behaviour are affected by their attitude (A), subjective norm (SN) and perceived behavioural control (PBC). The data was obtained by using an online questionnaire and convenience sampling. For measuring TPB-components a self-administered 58-item Likert-type questionnaire was used. Food neophobia (FN) was measured by using the food neophobia scale. Respondents' (n=564) intentions to consume insect-based foods were explained significantly (80%) by their A (beta=0.749, P
  • Kaskela, Jenni; Vainio, Annukka; Ollila, Sari; Lundén, Janne (2019)
    Disclosure systems for official food safety inspection results have been introduced in many countries including Finland in order to increase compliance of food business operators (FBOs). Although the disclosure systems are intended to affect FBOs, few studies have been published on FBOs' experiences of these systems. To investigate FBOs' opinions of disclosed food safety inspections in Finland, a questionnaire was distributed in 2016. The questionnaire study also aimed to recognize factors affecting compliance and disagreements about gradings with a special focus on FBOs' risk perception. In total 1277 responses from FBOs in retail (n = 523), service (n = 507) and industry (n = 247) sectors revealed that the majority of FBOs perceived the disclosure to promote correction of non-compliance. However, many FBOs disagreed with the grading of inspection findings. Most common topics of disagreements were maintenance of premises, record-keeping of own-check plan and adequacy and suitability of premises for operations. Logistic regression analysis showed that the likelihood of occurrence of disagreements with grading was higher among those retail and service FBOs with a lower risk perception. Similarly, the occurrence of non-compliance was associated with FBOs' risk perception in all sectors. Thus, FBOs need proper guidance on food safety risks. These results can be used to improve the efficacy of disclosed food safety inspections.
  • Tripathi, Shankar; Subedi, Rajan; Adhikari, Hari (2020)
    An account of widespread degradation and deforestation in Nepal has been noticed in various literature sources. Although the contribution of community forests (CF) on the improvement of forest cover and condition in the Mid-hill of Nepal is positive, detailed study to understand the current situation seems important. The study area (Tanahun District) lies in the Gandaki Province of western Nepal. The objective of this study was to estimate the forest cover change over the specified period and to identify factors influencing the change. We used Landsat images from the years 1976, 1991, and 2015 to classify land use and land cover. We considered community perception in addition to the forest cover map to understand the different causes of forest cover change. Forest cover decreased from 1976 to 1991 annually at a rate of 0.96%. After 1991, the forest increased annually at a rate of 0.63%. The overall forest cover in the district regained its original status. Factors related to increasing forest cover were emigration, occupation shift, agroforestry practices, as well as particularly by plantation on barren lands, awareness among forest users, and conservation activities conducted by local inhabitants after the government forest was handed over to community members as a community forest management system.
  • Enlund-Cerullo, Maria; Koljonen, Laura; Holmlund-Suila, Elisa; Hauta-Alus, Helena; Rosendahl, Jenni; Valkama, Saara; Helve, Otto; Hytinantti, Timo; Viljakainen, Heli; Andersson, Sture; Mäkitie, Outi; Pekkinen, Minna (2019)
    Context: Single nucleotide polymorphisms (SNPs) of the vitamin D binding protein encoding the GC (group component) gene affect 25-hydroxyvitamin D (25OHD) concentrations, but their influence on vitamin D status and response to vitamin D supplementation in infants is unknown. Objective: To study GC genotype-related differences in 25OHD concentrations and the response to supplementation during a vitamin D intervention study in infants. Design: In this randomized controlled trial, healthy term infants received vitamin D-3 (10 or 30 mu g/d) from 2 weeks to 24 months of age. GC SNPs rs2282679, rs4588, rs7041, and rs1155563 were genotyped. rs4588/7041 diplotype and haplotypes of rs2282679, rs4588, and rs7041 (Haplo(3SNP)) and of all four SNPs (Haplo(4SNP)) were determined. Main Outcome Measures: 25OHD measured in cord blood at birth and at 12 and 24 months during intervention. Results: A total of 913 infants were included. Minor allele homozygosity of all studied GC SNPs, their combined haplotypes, and rs4588/rs7041 diplotype 2/2 were associated with lower 25OHD concentrations at all time points in one or both intervention groups [analysis of covariance (ANCOVA) P <0.043], with the exception of rs7041, which did not affect 25OHD at birth. In the high-dose supplementation group receiving 30 mu g/d vitamin D-3, but not in those receiving 10 mu g/d, genotype of rs2282679, rs4588, and rs7041; diplotype; and Haplo(3SNP) significantly affected intervention response (repeated measurement ANCOVA P-interaction <0.019). Minor allele homozygotes had lower 25OHD concentrations and smaller increases in 25OHD throughout the intervention. Conclusions: In infants, vitamin D binding protein genotype affects 25OHD concentration and efficiency of high-dose vitamin D-3 supplementation.
  • Silventoinen, Karri; Baker, Jennifer L.; Sorensen, Thorkild I. A. (2012)
  • Leinonen, Taina; Laaksonen, Mikko; Chandola, Tarani; Martikainen, Pekka (2016)
    Background: Little is known of how pension reforms affect the retirement decisions of people with different health statuses, although this is crucial for the understanding of the broader societal impact of pension policies and for future policy development. We assessed how the Finnish statutory pension age reform introduced in 2005 influenced the role of health as a predictor of retirement. Methods: We used register-based data and cox regression analysis to examine the association of health (measured by purchases of psychotropic medication, hospitalizations due to circulatory and musculoskeletal diseases, and the number of any prescription medications) with the risk of retirement at age 63-64 among those subject to the old pension system with fixed age limit at 65 (pre-reform group born in 1937-1941) and the new flexible system with 63 as the lower age limit (post-reform group born in 1941-1945) while controlling for socio-demographic factors. Results: Retirement at age 63-64 was more likely among the post- than the pre-reform group (HR = 1.50; 95% CI 1.43-1.57). This reform-related increase in retirement was more pronounced among those without a history of psychotropic medication or hospitalizations due to circulatory and musculoskeletal diseases, as well as among those with below median level medication use. As a result, poor health became a weaker predictor of retirement after the reform. Conclusion: Contrary to the expectations of the Finnish pension reform aimed at extending working lives, offering choice with respect to the timing of retirement may actually encourage healthy workers to choose earlier retirement regardless of the provided economic incentives for continuing in work. (C) 2016 The Authors. Published by Elsevier Ltd.