The contribution of work and lifestyle factors to socioeconomic inequalities in self-rated health-a systematic review by Dieker ACM, IJzelenberg W, Proper KI, Burdorf A, Ket JCF, van der Beek AJ, Hulsegge G This study is the first systematic review on the contribution of work and lifestyle factors to socioeconomic inequalities in perceived health among workers. Work and lifestyle factors partly explained socioeconomic health inequalities. This has important implications for public and occupational health policy as it emphasizes to focus on both work and lifestyle factors to reduce socioeconomic inequalities in perceived health.

The aim of this study was to compare chronotype‐ and age‐dependent sleep disturbances and social jetlag between rotating shift workers and non‐shift workers, and between different types of shifts. In the Klokwerk+ cohort study, we included 120 rotating shift workers and 74 non‐shift workers who were recruited from six Dutch hospitals. Participants wore Actigraph GT3X accelerometers for 24 hr for 7 days. From the Actigraph data, we predicted the sleep duration and social jetlag (measure of circadian misalignment). Mixed models and generalized estimation equations were used to compare the sleep parameters between shift and non‐shift workers. Within shift workers, sleep on different shifts was compared with sleep on work‐free days. Differences by chronotype and age were investigated using interaction terms. On workdays, shift workers had 3.5 times (95% confidence interval: 2.2–5.4) more often a short (< 7 hr per day) and 4.1 times (95% confidence interval: 2.5–6.8) more often a long (≥ 9 hr per day) sleep duration compared with non‐shift workers. This increased odds ratio was present in morning chronotypes, but not in evening chronotypes (interaction p‐value < .05). Older shift workers (≥ 50 years) had 7.3 times (95% confidence interval: 2.5–21.8) more often shorter sleep duration between night shifts compared with work‐free days, while this was not the case in younger shift workers (< 50 years). Social jetlag due to night shifts increased with increasing age (interaction p‐value < .05), but did not differ by chronotype (interaction p‐value ≥ .05). In conclusion, shift workers, in particular older workers and morning chronotypes, experienced more sleep disturbances than non‐shift workers. Future research should elucidate whether these sleep disturbances contribute to shift work‐related health problems.

BackgroundThe associations between overall lifestyle profile and cardiovascular disease (CVD) and death have been mainly investigated in cross‐sectional studies. The full benefits of a healthy lifestyle may therefore be underestimated, and the magnitude of benefits associated with changes in lifestyle remains unclear. We quantified the association of changes in lifestyle profiles over 5 years with risk of CVD and all‐cause mortality.Methods and ResultsLifestyle factors (ie, diet, physical activity, smoking, alcohol consumption) and body mass index were assessed and dichotomized as healthy/unhealthy among 5263 adults ages 26 to 66 in 1993–1997 and 5 years later (1998–2002). Multivariable‐adjusted hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were estimated to quantify associations of change in lifestyle with fatal/nonfatal CVD and all‐cause mortality that occurred 8 to 15 years after 1998–2002. Independent of baseline lifestyles, each decrement in number of healthy lifestyle factors was, on average, associated with 35% higher risk of CVD (HR, 1.35; 95% CI, 1.12–1.63) and 37% higher risk of all‐cause mortality (HR, 1.37; 95% CI, 1.10–1.70); no association was noted with increase in the number of healthy lifestyle factors (P>0.5). Individuals who maintained 4 to 5 healthy lifestyle factors had 2.5 times lower risk of CVD (HR, 0.43; 95% CI, 0.25–0.63) and all‐cause mortality (HR, 0.40; 95% CI, 0.22–0.73) than those who maintained only 0 to 1 healthy lifestyle factor.ConclusionsOur findings suggest that the benefits of healthy lifestyles may be easier lost than gained over a 5‐year period. This underscores the need for efforts to promote maintenance of healthy lifestyles throughout the life course.