OBJECTIVE: To investigate the effect of psychosocial stress at work on risk of type 2 diabetes, adjusting for conventional risk factors, among a sample of British, white-collar, middle-aged men and women. RESEARCH DESIGN AND METHODS: This was a prospective analysis (1991–2004) from the Whitehall II cohort study. The current sample consists of 5,895 Caucasian middle-aged civil servants free from diabetes at baseline. Type 2 diabetes was ascertained by an oral glucose tolerance test supplemented by self-reports at baseline and four consecutive waves of data collection including two screening phases. The job strain and iso-strain models were used to assess psychosocial work stress. RESULTS: Iso-strain in the workplace was associated with a twofold higher risk of type 2 diabetes in age-adjusted analysis in women but not in men (hazard ratio 1.94 [95% CI 1.17–3.21). This effect remained robust to adjustment for socioeconomic position and outside work stressors and was only attenuated by 20% after adjustment for health behaviors, obesity, and other type 2 diabetes risk factors. CONCLUSIONS: Psychosocial work stress was an independent predictor of type 2 diabetes among women after a 15-year follow-up. This association was not explained by potential confounding and mediating factors. More evidence from prospective studies using the same work stress models is needed to support the current findings and provide further information on sex differences.

Background Social mobility (movement up or down the social hierarchy) and social accumulation (accumulating social advantage or disadvantage) across the life course have been shown to affect adult health. There is no evidence on how these processes simultaneously affect adult overweight and obesity. Methods Cross-sectional analysis using data from phase 5 of the Whitehall II study (1997–1999), including retrospective information on past socioeconomic position (SEP) for 4598 participants (44–69 years). The effect of social mobility and social accumulation, from childhood social class to educational attainment to current employment grade, on prevalent adult overweight and obesity was examined. Results Upwardly socially mobile participants did not have lower prevalence of overweight and obesity compared to the socially stable at low SEP (62.3 vs 63.9% in women). Downwardly socially mobile participants had higher prevalence of overweight and obesity than the socially stable at high SEP (52.0% vs 36.1% in women). The odds of adult overweight and obesity increased with social accumulation of disadvantage. Among women, one life phase in low SEP was associated with 61% higher odds (OR 1.61; 95% CI 1.05 to 2.47), two phases low with 66% higher odds (1.66; 1.14 to 2.42) and all phases low with 2.6 times the odds (2.61; 1.79 to 3.78) of overweight and obesity compared to women with all phases in high SEP. Conclusions Social mobility and social accumulation can operate simultaneously across the life course. Prevention of downward social mobility and social accumulation of disadvantage could reduce the overall prevalence of adult overweight and obesity.

Background: This study aimed to investigate overall and sex-specific excess all-cause mortality since the inception of the COVID-19 pandemic until August 2020 among 22 countries. Methods: Countries reported weekly or monthly all-cause mortality from January 2015 until the end of June or August 2020. Weekly or monthly COVID-19 deaths were reported for 2020. Excess mortality for 2020 was calculated by comparing weekly or monthly 2020 mortality (observed deaths) against a baseline mortality obtained from 2015–2019 data for the same week or month using two methods: (i) difference in observed mortality rates between 2020 and the 2015–2019 average and (ii) difference between observed and expected 2020 deaths. Results: Brazil, France, Italy, Spain, Sweden, the UK (England, Wales, Northern Ireland and Scotland) and the USA demonstrated excess all-cause mortality, whereas Australia, Denmark and Georgia experienced a decrease in all-cause mortality. Israel, Ukraine and Ireland demonstrated sex-specific changes in all-cause mortality. Conclusions: All-cause mortality up to August 2020 was higher than in previous years in some, but not all, participating countries. Geographical location and seasonality of each country, as well as the prompt application of high-stringency control measures, may explain the observed variability in mortality changes.