Does previous sickness absence affect work participation after vocational labour market training? A difference-in-differences propensity score matching approach.

BACKGROUND: Reduced work ability is relatively common among job seekers and it can hinder future labour market attachment. A commonly used measure to increase employability is the use of active labour market programmes. While vocational labour market training (LMT) has been shown to be an effective way to increase work participation among job seekers, there is still uncertainty about how LMT works in different population groups, for example, among persons with a work disability history. METHODS: We used nationally representative Finnish register data on 16 062 LMT participants in 2008-2015 aged 25-59 with a history of sickness absence (SA) and propensity score matched participants without such history. For matching, we used information on sociodemographic and work-related factors. We used difference-in-differences analysis to investigate the differential changes in work participation before and after LMT between those with and those without SA history. RESULTS: Having a history of SA was associated with a lower gain in work participation after LMT, but the magnitude varied by sex, employment history and follow-up time. In women, having a history of SA contributed to 3.9-6.2 percentage points smaller increase in work participation 1-3 years after LMT, depending on the employment history. In men, the corresponding numbers were 2.0-4.3 percentage points. The results were more pronounced if the SA was due to mental disorders. CONCLUSIONS: The results indicate that work disability, especially due to mental disorders, can hamper work participation after LMT and should be considered when planning employment-enhancing measures for job seekers.

Does Work Disability Contribute to Trajectories of Work Participation before and after Vocational Labour Market Training for Job Seekers?

The contribution of ill-health to labour market participation in relation to vocational training is unclear. Using nationally representative Finnish register data on 42,691 vocational labour market trainees in 2008-2010, we constructed latent trajectory groups of work participation in the open labour market three years before and after training, identifying groups called "High-High", "High-Low", "Low-High", and "Low-Low". We plotted further patterns of labour market participation within these trajectory groups and, using multinomial logistic regression, examined assignment to these groups focusing on previous work disability status. Those with compared to those without previous work disability had previous employment more often and spent less time in economic inactivity within the two trajectory groups with low pre-training levels of work participation. Having a previous work disability was associated with assignment to the "High-Low" trajectory group of work participation instead of the "High-High" comparison group. The associations of other background factors with the assignment to the different trajectory groups were relatively similar amongst those with and without previous work disability. However, some of these associations were weaker amongst the former. Along with other key background factors, previous work disability should be accounted for when assessing the effects of vocational training.

Controlling for Structural Changes in the Workforce Influenced Occupational Class Differences in Disability Retirement Trends.

We explored occupational class differences in disability retirement trends accounting for structural changes in the workforce induced by the recent economic crisis and the following economic stagnation. Using nationwide register data on the general Finnish population aged 30-59 years, we examined trends in disability retirement due to all causes, musculoskeletal diseases, and mental disorders in 2007, 2010, and 2013. Applying propensity score (PS) matching to control for bias induced by structural changes in the workforce over time, we obtained 885,807 matched triplets. In the original study population, all-cause and cause-specific disability retirement declined between 2007 and 2013 for most occupational classes. In the matched study population, the disability retirement among skilled and unskilled manual workers sharply increased in 2010 and then declined in 2013. PS matching considerably attenuated the decline in disability retirement, particularly between the years 2007 and 2010. In general, the differences in disability retirement between both skilled and unskilled manual workers and upper-level non-manual employees widened during the period of economic stagnation. In occupational epidemiology, structural changes in the workforce should be accounted for when analysing trends in ill-health. Controlling for these changes revealed widening occupational class differences in disability retirement during the period of economic stagnation.

Individual responses to combined endurance and strength training in older adults.

PURPOSE: A combination of endurance and strength training is generally used to seek further health benefits or enhanced physical performance in older adults compared with either of the training modes alone. The mean change within a training group, however, may conceal a wide range of individual differences in the responses. The purpose, therefore, was to examine the individual trainability of aerobic capacity and maximal strength, when endurance and strength training are performed separately or concurrently. METHODS: For this study, 175 previously untrained volunteers, 89 men and 86 women between the ages of 40 and 67 yr, completed a 21-wk period of either strength training (S) twice a week, endurance training (E) twice a week, combined training (ES) four times per week, or served as controls. Training adaptations were quantified as peak oxygen uptake (VO2peak) in a bicycle ergometer test to exhaustion and maximal isometric bilateral leg extension force (MVC) in a dynamometer. RESULTS: A large range in training responses, similar to endurance or strength training alone, was also observed with combined endurance and strength training in both ΔVO2peak (from -8% to 42%) and ΔMVC (from -12% to 87%). There were no significant correlations between the training responses in VO2peak and MVC in the E, S, or especially in the ES group, suggesting that the same subjects did not systematically increase both aerobic capacity and maximal strength. CONCLUSIONS: The goal of combined endurance and strength training--increasing both aerobic capacity and maximal strength simultaneously--was only achieved by some of the older subjects. New means are needed to personalize endurance, strength, and especially combined endurance and strength training programs for optimal individual adaptations.