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Work Disability among Employees with Diabetes: Latent Class Analysis of Risk Factors in Three Prospective Cohort Studies

Author

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  • Marianna Virtanen
  • Jussi Vahtera
  • Jenny Head
  • Rosemary Dray-Spira
  • Annaleena Okuloff
  • Adam G Tabak
  • Marcel Goldberg
  • Jenni Ervasti
  • Markus Jokela
  • Archana Singh-Manoux
  • Jaana Pentti
  • Marie Zins
  • Mika Kivimäki

Abstract

Background: Studies of work disability in diabetes have examined diabetes as a homogeneous disease. We sought to identify subgroups among persons with diabetes based on potential risk factors for work disability. Methods: Participants were 2,445 employees with diabetes from three prospective cohorts (the Finnish Public Sector study, the GAZEL study, and the Whitehall II study). Work disability was ascertained via linkage to registers of sickness absence and disability pensions during a follow-up of 4 years. Study-specific latent class analysis was used to identify subgroups according to prevalent comorbid disease and health-risk behaviours. Study-specific associations with work disability at follow-up were pooled using fixed-effects meta-analysis. Results: Separate latent class analyses for men and women in each cohort supported a two-class solution with one subgroup (total n = 1,086; 44.4%) having high prevalence of chronic somatic diseases, psychological symptoms, obesity, physical inactivity and abstinence from alcohol and the other subgroup (total n = 1,359; 55.6%) low prevalence of these factors. In the adjusted meta-analyses, participants in the ‘high-risk’ group had more work disability days (pooled rate ratio = 1.66, 95% CI 1.38–1.99) and more work disability episodes (pooled rate ratio = 1.33, 95% CI 1.21–1.46). These associations were similar in men and women, younger and older participants, and across occupational groups. Conclusions: Diabetes is not a homogeneous disease in terms of work disability risk. Approximately half of people with diabetes are assigned to a subgroup characterised by clustering of comorbid health conditions, obesity, physical inactivity, abstinence of alcohol, and associated high risk of work disability; the other half to a subgroup characterised by a more favourable risk profile.

Suggested Citation

  • Marianna Virtanen & Jussi Vahtera & Jenny Head & Rosemary Dray-Spira & Annaleena Okuloff & Adam G Tabak & Marcel Goldberg & Jenni Ervasti & Markus Jokela & Archana Singh-Manoux & Jaana Pentti & Marie , 2015. "Work Disability among Employees with Diabetes: Latent Class Analysis of Risk Factors in Three Prospective Cohort Studies," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-14, November.
    • Handle: RePEc:plo:pone00:0143184
    DOI: 10.1371/journal.pone.0143184
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    References listed on IDEAS

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    1. Gilles Celeux & Gilda Soromenho, 1996. "An entropy criterion for assessing the number of clusters in a mixture model," Journal of Classification, Springer;The Classification Society, vol. 13(2), pages 195-212, September.
    2. Jenni Ervasti & Jussi Vahtera & Jaana Pentti & Tuula Oksanen & Kirsi Ahola & Mika Kivimäki & Marianna Virtanen, 2013. "Depression-Related Work Disability: Socioeconomic Inequalities in Onset, Duration and Recurrence," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-8, November.
    3. Hamparsum Bozdogan, 1987. "Model selection and Akaike's Information Criterion (AIC): The general theory and its analytical extensions," Psychometrika, Springer;The Psychometric Society, vol. 52(3), pages 345-370, September.
    4. Stanley Sclove, 1987. "Application of model-selection criteria to some problems in multivariate analysis," Psychometrika, Springer;The Psychometric Society, vol. 52(3), pages 333-343, September.
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    1. Vijayasingham, Lavanya & Jogulu, Uma & Allotey, Pascale, 2021. "Ethics of care and selective organisational caregiving by private employers for employees with chronic illness in a middle-income country," Social Science & Medicine, Elsevier, vol. 269(C).

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