Piha Kustaa, Sumanen Hilla, Lahelma Eero, Rahkonen Ossi
Department of Public Health, University of Helsinki, Helsinki, Finland.
J Epidemiol Community Health. 2017 Apr;71(4):390-395. doi: 10.1136/jech-2016-208185. Epub 2016 Dec 2.
There is contradictory evidence on the association between health check-ups and future morbidity. Among the general population, those with high socioeconomic position participate more often in health check-ups. The main aims of this study were to analyse if attendance to health check-ups are socioeconomically patterned and affect sickness absence over a 10-year follow-up.
This register-based follow-up study included municipal employees of the City of Helsinki. 13 037 employees were invited to age-based health check-up during 2000-2002, with a 62% attendance rate. Education, occupational class and individual income were used to measure socioeconomic position. Medically certified sickness absence of 4 days or more was measured and controlled for at the baseline and used as an outcome over follow-up. The mean follow-up time was 7.5 years. Poisson regression was used.
Men and employees with lower socioeconomic position participated more actively in health check-ups. Among women, non-attendance to health check-up predicted higher sickness absence during follow-up (relative risk =1.26, 95% CI 1.17 to 1.37) in the fully adjusted model. Health check-ups were not effective in reducing socioeconomic differences in sickness absence.
Age-based health check-ups reduced subsequent sickness absence and should be promoted. Attendance to health check-ups should be as high as possible. Contextual factors need to be taken into account when applying the results in interventions in other settings.
关于健康检查与未来发病率之间的关联，存在相互矛盾的证据。在普通人群中，社会经济地位较高者更常参加健康检查。本研究的主要目的是分析参加健康检查是否存在社会经济模式差异，以及在10年的随访期内对病假情况的影响。
这项基于登记的随访研究纳入了赫尔辛基市的市政雇员。2000年至2002年期间，13037名雇员被邀请参加基于年龄的健康检查，出勤率为62%。采用教育程度、职业类别和个人收入来衡量社会经济地位。测量并控制了基线时经医学证明的4天及以上病假情况，并将其作为随访期间的一项结果。平均随访时间为7.5年。使用泊松回归分析。
社会经济地位较低的男性和雇员更积极地参加健康检查。在女性中，在完全调整模型中，未参加健康检查预示着随访期间病假率更高（相对风险=1.26，95%置信区间1.17至1.37）。健康检查在减少病假方面的社会经济差异方面并不有效。
基于年龄的健康检查减少了随后的病假情况，应予以推广。健康检查的参与率应尽可能高。在将结果应用于其他环境的干预措施时，需要考虑背景因素。
