Susanna Toivanen

Susanna Toivanen


Research Focus & Metrics

Academic Career Length

21Years (2006-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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2 August 2016 in BMC Public Health
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Journal Article
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CCCatarina Canivet
Catarina Canivet
TBTheo Bodin
Theo Bodin
MEMaria Emmelin
Maria Emmelin
STSusanna Toivanen
Susanna Toivanen
MMMahnaz Moghaddassi
Mahnaz Moghaddassi
PÖPer-Olof Östergren
Per-Olof Östergren
The globalisation of the economy and the labour markets has resulted in a growing proportion of individuals who find themselves in a precarious labour market situation, especially among the young. This pertains also to the Nordic countries, despite their characterisation as well developed welfare states with active labour market policies. This should be viewed against the background of a number of studies, which have shown that several aspects of precarious employment are detrimental to mental health. However, longitudinal studies from the Nordic region that examine the impact of precarious labour market conditions on mental health in young individuals are currently lacking. The present study aims to examine this impact in a general cohort of Swedish young people. Postal questionnaires were sent out in 1999/2000 to a stratified random sample of the Scania population, Sweden; the response rate was 58 %. All of those who responded at baseline were invited to follow-ups after 5 and 10 years. Employment precariousness was determined based on detailed questions about present employment, previous unemployment, and self-rated risk of future unemployment. Mental health was assessed by GHQ-12. For this study individuals in the age range of 18–34 years at baseline, who were active in the labour market (employed or seeking job) and had submitted complete data from 1999/2000, 2005, and 2010 on employment precariousness and mental health status, were selected (N = 1135). Forty-two percent of the participants had a precarious employment situation at baseline. Labour market trajectories that included precarious employment in 1999/2000 or 2005 predicted poor mental health in 2010: the incidence ratio ratio was 1.4 (95 % CI: 1.1–2.0) when excluding all individuals with mental health problems at baseline and adjusting for age, gender, social support, social capital, and economic difficulties in childhood. The population attributable fraction regarding poor mental health in the studied age group was 18 %. This study supported the hypothesis that precarious employment should be regarded as an important social determinant for subsequent development of mental health problems in previously mentally healthy young people.

12 February 2010 in Journal of Adolescence
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Journal Article
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BMBitte Modin
Bitte Modin
VÖViveca Östberg
Viveca Östberg
STSusanna Toivanen
Susanna Toivanen
KSKnut Sundell
Knut Sundell

31 March 2015 in BMC Public Health
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Journal Article
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RGRosane H. Griep
Rosane H. Griep
ANAline Araújo Nobre
Aline Araújo Nobre
MAMárcia Guimarães de Mello Alves
Márcia Guimarães de Mello Alves
MFMaria de Jesus Mendes da Fonseca
Maria de Jesus Mendes da Fonseca
LCLetícia de Oliveira Cardoso
Letícia de Oliveira Cardoso
DCDóra Chor
Dóra Chor
Unhealthy lifestyle choices, such as smoking and sedentary behavior, are among the main modifiable risk factors for chronic non-communicable diseases. The workplace is regarded as an important site of potential health risks where preventive strategies can be effective. We investigated independent associations among psychosocial job strain, leisure-time physical inactivity, and smoking in public servants in the largest Brazilian adult cohort. We conducted a cross-sectional analysis of baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)—a multicenter prospective cohort study of civil servants. Our analytical samples comprised 11,779 and 11,963 current workers for, respectively, analyses of job strain and leisure-time physical activity and analyses of job strain and smoking. Job strain was assessed using the Brazilian version of the Swedish Demand-Control-Support Questionnaire; physical activity was evaluated using a short form of the International Physical Activity Questionnaire. We also examined smoking status and number of cigarettes smoked per day. The association reported in this paper was assessed by means of multinomial and logistic regression, stratified by sex. Among men, compared with low-strain activities (low demand and high control), job strain showed an association with physical inactivity (odds ratio [OR] = 1.34; 95% confidence interval [CI] = 1.09–1.64) or with the practice of physical activities of less than recommended duration (OR = 1.44; 95% CI = 1.15–1.82). Among women, greater likelihood of physical inactivity was identified among job-strain and passive-job groups (OR = 1.47; 95% CI = 1.22–1.77 and OR = 1.42; 95% CI = 1.20–1.67, respectively). Greater control at work was a protective factor for physical inactivity among both men and women. Social support at work was a protective factor for physical inactivity among women, as was smoking for both genders. We observed no association between demand or control dimensions and smoking. Job strain, job control, and social support were associated with physical activity. Social support at work was protective of smoking. Our results are comparable to those found in more developed countries; they provide additional evidence of an association between an adverse psychosocial work environment and health-related behaviors.

21 July 2016 in Occupational and Environmental Medicine
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Journal Article
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STSusanna Toivanen
Susanna Toivanen
RGRosane H. Griep
Rosane H. Griep
CMChristin Mellner
Christin Mellner
SVStig Vinberg
Stig Vinberg
SESandra Eloranta
Sandra Eloranta
Objectives Analyse mortality differences between self-employed and paid employees with a focus on industrial sector, educational level and gender using Swedish register data. Methods A cohort of the total working population (4 776 135 individuals; 7.2% self-employed; 18–100 years of age at baseline 2003) in Sweden with a 5-year follow-up (2004–2008) for all-cause and cause-specific mortality (57 743 deaths). Self-employed individuals were categorised as sole proprietors or limited liability company (LLC) owners according to their enterprise's legal form. Cox proportional hazards models were applied to compare mortality rates between sole proprietors, LLC owners and paid employees, adjusted for sociodemographic confounders. Results Mortality from cardiovascular diseases was 16% lower and from suicide 26% lower among LLC owners than among paid employees, adjusted for confounders. Within the industrial category, all-cause mortality was 13–15% lower among sole proprietors and LLC owners compared with employees in manufacturing and mining (MM) as well as personal and cultural services (PCS), and 11–20% higher in sole proprietors in trade, transport and communication and the welfare industry (W). A significant three-way interaction indicated 17–23% lower all-cause mortality among male LLC owners in MM and female sole proprietors in PCS, and 50% higher mortality in female sole proprietors in W than in employees in the same industries. Conclusions Mortality differences between self-employed individuals and paid employees vary by the legal form of self-employment, across industries, and by gender. Differences in work environment exposures and working conditions, varying market competition across industries and gender segregation in the labour market are potential mechanisms underlying these findings.

1 April 2010 in Work & Stress
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Journal Article
Closed access
RGRosane H. Griep
Rosane H. Griep
LRLúcia Rotenberg
Lúcia Rotenberg
DCDora Chor
Dora Chor
STSusanna Toivanen
Susanna Toivanen
PLPaul Landsbergis
Paul Landsbergis
The Demand-Control-Support (DCS) and the Effort-Reward Imbalance (ERI) models assess different psychosocial factors. This study investigates whether a combination of these models increases their ability to predict sickness absence, as compared to results based on each model separately. A cross-sectional study with nursing personnel (N = 1307) in Brazil was performed. Regression analyses were conducted in three stages: analysis of each scale of the models and sickness absences; assessment of the independent association of each model with sickness absences; assessment of the associations of three combinations of models/scales with sickness absences: DC and social support (SS), ERI and overcommitment, and DC and ERI. As regards comparisons between the stress models, ERI was shown to be independently associated with short (up to 9 days) and long (10 days or more) spells of absenteeism. The same result held true for low social support. The combinations DC-ERI and DC-SS were better predictors for short spells than each model/scale separately, whereas for long spells, the combination DC-SS was the best predictor. ERI seems to be a good instrument for predicting absenteeism if used alone, whereas DC performed better when combined with ERI or SS. An improved risk estimation of sickness absences by combining information from the two models was observed.

29 November 2014 in BMC Health Services Research
Verified
Journal Article
Open access
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RGRosane H. Griep
Rosane H. Griep
LBLeonardo S Bastos
Leonardo S Bastos
MFMaria de Jesus Mendes da Fonseca
Maria de Jesus Mendes da Fonseca
ASAline Silva-Costa
Aline Silva-Costa
LPLuciana Portela
Luciana Portela
LRLucia Rotenberg
Lucia Rotenberg
Employees working night shifts are at a greater risk of being overweight or obese. Few studies on obesity and weight gain analyze the years of exposure to night work. The aim of this study was to determine the relationship between the years of exposure to night work and body mass index (BMI) among registered nurses. A cross-sectional analysis was performed in 18 largest public hospitals in Rio de Janeiro, Brazil. A total of 2,372 registered nurses (2,100 women) completed a comprehensive questionnaire concerning sociodemographic, professional, lifestyle, and health behavioral data. Current and past exposures to night shifts as well as BMI values were measured as continuous variables. A gamma regression model was used with an identity link function to establish the association. The association between years of exposure to night work and BMI was statistically significant for both women and men after adjusting for all covariates [β = 0.036; CI95% = 0.009–0.063) and β = 0.071 (CI95% = 0.012–0.129), respectively]. The effect of night work was greater among men than women. For example, for those women who have worked at night for 20 years the estimated average BMI was 25.6 kg/m2 [range, 25.0–26.2]. In relation to men, after 20 years of exposure to night work the estimated average BMI was 26.9 kg/m2 [range, 25.6–28.1]. These findings suggest that night shift exposure is related to BMI increases. Obesity prevention strategies should incorporate improvements in work environments, such as the provision of proper meals to night workers, in addition to educational programs on the health effects of night work.