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Assisted dying and euthanasia (ADE) for patients with psychiatric disorders or dementia have increased in jurisdictions where the practice is legal. In this study, we examine trends in euthanasia cases involving patients with these conditions in Belgium, where the law makes a distinction based on whether a patient's death is not expected in the foreseeable future (>12 months)-a common situation in cases of dementia or psychiatric disorders. We use data on all cases of euthanasia reported to the Federal Commission for the Control and Evaluation of Euthanasia from 2002 (when the legislation was introduced) to 2023 (N = 33,592). Psychiatric disorders and dementia represent 1.27% and 0.92% of all cases, respectively. Using time-series zero-inflated negative binomial regression, we model trends by first examining interactions between euthanasia reasons and year, then extending to three-way interactions with patients' characteristics. The model calculates change in count and is replicated with an offset to account for demographic changes and generate rates. Our results show that euthanasia for psychiatric disorders and dementia showed distinct trends over time. Although slightly increasing, euthanasia for psychiatric disorders followed trends similar to the other types of euthanasia (count = 1.00 [95%CI: 0.98; 1.03]-rate = 1.02 [95%CI: 0.99; 1.04]), while euthanasia cases for dementia increased faster than other types of euthanasia (count = 1.03 [95%CI: 1.00; 1.06]-rate = 1.04 [95%CI: 1.01;1.07]). Trends in euthanasia for dementia and psychiatric disorders coincide with demographic changes. While euthanasia rates for psychiatric disorders were initially higher among women, the rate among men has been increasing over time. Regional trends show higher overall euthanasia rates in the Dutch-speaking population, but with faster increases in the French-speaking population. A key limitation of this study is the lack of information on patients' socio-economic profiles. In Belgium, between 2002 and 2023, there are distinct trends for euthanasia for non-terminal illnesses. Euthanasia for psychiatric disorders followed similar trends as euthanasia for terminal illnesses, whereas euthanasia cases involving cognitive conditions increased at a faster rate. Furthermore, there were gender and regional differences, which diminished over time.

Background Cases of reported euthanasia or assisted dying have increased in all countries that provide such legislation. In Belgium, the number of annual reported cases rose from 1,928 in 2014 to 3,423 in 2023. However, no study has addressed how this change reflects demographic composition. Using Belgian administrative data, the study shows actual trends and how population composition explains variations across sub-groups including age, gender, region and reason for euthanasia. Methods We use complete micro-data on all cases of euthanasia reported between 2014 and 2023 ( N  = 24,840) gathered by the Belgian Federal Commission for the Control and Evaluation of Euthanasia (FCCEE). We apply Poisson regression controlling for time and use interaction terms to address time change over subgroups and provide Incidence Rate Ratios (IRR). We compare net estimates with a modelling weighting for population demographics generated from the Belgian Office for Statistics data. Results Data show an IRR of euthanasia of 1.06 (95%CI = 1.056;1.066) – i.e., an increase of 6% per year. Weighted for population characteristics, the IRR is 1.04 (95%CI = 1.039;1.049). Demographic composition explains such a difference, not demographic change. Unweighted data show higher incidence amongst female [male = 0.934 (95%CI = 0.911;0.958)] but the trend is reversed when weighting for demographics [male = 1.076 (95%CI = 1.046;1.105)]. Gender differences in reasons for euthanasia exist with cancers and psychiatric disorders more often observed in male and female respectively. Euthanasia is more common in the Flanders [3.058 (95%CI = 2.949;3.171)] and the demographic adjustment does not fully reduce the regional divide. Conclusions Analysis on euthanasia and assisted dying should consider population demographics when addressing incidence amongst populations to better capture age, regional and gender differences.

Growing aging populations pose a threat to global health because of the social and psychological challenges they experience. To mitigate this, many countries promote hobby engagement to support and improve mental health. Yet, it remains unclear whether there is consistency in benefits across different national settings. We harmonized measures of hobby engagement and multiple aspects of mental wellbeing across 16 nations represented in five longitudinal studies ( N  = 93,263). Prevalence of hobby engagement varied substantially across countries, from 51.0% of Spanish respondents to 96.0% of Danish respondents. Fixed effects models and multinational meta-analyses were applied to compare the longitudinal associations between hobbies and mental wellbeing. Independent of confounders, having a hobby was associated with fewer depressive symptoms (pooled coefficient = −0.10; 95% confidence intervals (CI) = −0.13, −0.07), and higher levels of self-reported health (pooled coefficient = 0.06; 95% CI = 0.03, 0.08), happiness (pooled coefficient = 0.09; 95% CI = 0.06, 0.13) and life satisfaction (pooled coefficient = 0.10; 95% CI = 0.08, 0.12). Further analyses suggested a temporal relationship. The strength of these associations, and prevalence of hobby engagement, were correlated with macrolevel factors such as life expectancy and national happiness levels but overall, little variance in findings was explained by country-level factors (<9%). Given the relative universality of findings, ensuring equality in hobby engagement within and between countries should be a priority for promoting healthy aging. A meta-analysis of longitudinal studies representing 16 countries found that hobby engagement was associated with better mental and self-reported health in adults aged 65 years and older as well as correlation with higher life expectancy and national happiness levels.

BackgroundTrade union membership has massively declined in economically advanced economies. In addition, considerable variation exists between indicators of unionization, including trade union membership or presence rates. However, trade union membership and collective bargaining rates have recently risen in the UK. Yet, studies on the association between collective bargaining and workers’ mental health are sparse and non-existent in the current pandemic context. This study examines whether the impact of the COVID-19 pandemic on UK workers’ mental health is moderated by the presence of trade unions within their industrial sector.MethodsWe used UK Household Longitudinal Study (Understanding Society) data from adults in paid employment, who participated in at least: one pre-COVID-19 Wave (9 or 10/11) and one COVID-19 wave. Primary outcome was probable psychological distress, defined by ‘caseness’ (score≥4) in the General Health Questionnaire-12 (GHQ-12). In model 1, exposure was trade union presence in workplaces, interacting with a variable splitting time between the pre and pandemic periods. In model 2, industry was added to the exposure in model 1 (3-way interaction). We fitted mixed-effects logistic regression models, adjusting for age, gender, ethnicity, UK country of residence and dummy variables for Understanding Society waves.ResultsOur final sample included 69,348 observations across 9,075 individuals. Pre-pandemic, odds of GHQ-12 caseness were almost 11% (OR:1.11 95%CI:0.98,1.26) higher for workers in unionised compared to non-unionised workplaces; however post-pandemic there was no difference between the two groups. Examining changes over the pre- to pandemic period, showed that odds of GHQ-12 caseness for those in non-unionised workplaces increased by 42% (OR:1.42 95%CI:1.23,1.64), whereas for those in unionised workplaces odds increased by 28% (OR:1.28 95%CI:1.11,1.47). Overall, industrial classification did not modify the relationship between trade union presence and GHQ-12 caseness, except for workers in Manufacturing (OR:0.61 95%CI:0.40,0.95) where we found a protective effect but the opposite stands for those in Transportation and Storage (OR:1.89 95%CI:1.18,3.03). Pre-pandemic, odds of GHQ-12 caseness for education sector workers were considerably higher in unionised workplaces (OR:1.70 95%CI:1.15,2.53) but declined during the pandemic period (OR:0.62 95%CI:1.05,2.47).ConclusionTrade union presence appears to have a protective effect for worker mental health during the pandemic. However, apart from Manufacturing, Transportation and Storage and Education, there is no evidence that type of industry modifies this effect. Therefore, policies should be designed to encourage and facilitate trade union presence across industries as they are likely to mitigate adverse mental health effects in times of extreme uncertainty.

Japan has one of the highest longevity rates and the second highest average effective age of retirement within the OECD. To face declining birth-rates and growing labour shortage, the Japanese government made the choice to postpone retirement ages. However, an important part of the ageing workforce is in non-standard employment such as part-time, temporary or contract work. The potential health impact of such transitions has not been analysed so far. Using four waves from the Japanese Study of Aging and Retirement (JSTAR), this article assesses, using a latent growth curve method, the impact of moving to non-standard employment in late career on general and mental health for the population aged 50 to 75 after controlling for fixed and time-varying covariates. Analyses are replicated separately by gender. Mixed results flow from the study. Those keeping being in non-standard employment have a better health than those working in full-time employment. However, moving from full-time employment to non-standard employment has negative effects on mental health, particularly for women.

Home working has increased since the Coronavirus Disease 2019 (COVID-19) pandemic's onset with concerns that it may have adverse health implications. We assessed the association between home working and social and mental wellbeing among the employed population aged 16 to 66 through harmonised analyses of 7 UK longitudinal studies. We estimated associations between home working and measures of psychological distress, low life satisfaction, poor self-rated health, low social contact, and loneliness across 3 different stages of the pandemic (T1 = April to June 2020 -first lockdown, T2 = July to October 2020 -eased restrictions, T3 = November 2020 to March 2021 -second lockdown) using modified Poisson regression and meta-analyses to pool results across studies. We successively adjusted the model for sociodemographic characteristics (e.g., age, sex), job characteristics (e.g., sector of activity, pre-pandemic home working propensities), and pre-pandemic health. Among respectively 10,367, 11,585, and 12,179 participants at T1, T2, and T3, we found higher rates of home working at T1 and T3 compared with T2, reflecting lockdown periods. Home working was not associated with psychological distress at T1 (RR = 0.92, 95% CI = 0.79 to 1.08) or T2 (RR = 0.99, 95% CI = 0.88 to 1.11), but a detrimental association was found with psychological distress at T3 (RR = 1.17, 95% CI = 1.05 to 1.30). Study limitations include the fact that pre-pandemic home working propensities were derived from external sources, no information was collected on home working dosage and possible reverse association between change in wellbeing and home working likelihood. No clear evidence of an association between home working and mental wellbeing was found, apart from greater risk of psychological distress during the second lockdown, but differences across subgroups (e.g., by sex or level of education) may exist. Longer term shifts to home working might not have adverse impacts on population wellbeing in the absence of pandemic restrictions but further monitoring of health inequalities is required.

Following the acute phase of the COVID-19 pandemic, a record number of people became economically inactive in the UK. We investigated the association between coronavirus infection and subsequent economic inactivity among people employed pre-pandemic, and whether this association varied between self-report versus healthcare recorded infection status. We pooled data from five longitudinal studies (1970 British Cohort Study, English Longitudinal Study of Ageing, 1958 National Child Development Study, Next Steps, and Understanding Society), in two databases: the UK Longitudinal Linkage Collaboration (UKLLC), which links study data to NHS England records, and the UK Data Service (UKDS), which does not. The study population were aged 25-65 years between April 2020 to March 2021. The outcome was economic inactivity measured at the time of the last survey (November 2020 to March 2021). The exposures were COVID-19 status, indicated by a positive SARS-CoV-2 test in NHS records (UKLLC sample only), or by self-reported measures of coronavirus infection (both samples). Logistic regression models estimated odds ratios (ORs) adjusting for potential confounders including sociodemographic variables and pre-pandemic health. Within the UKLLC sample (N = 8,174), both a positive SARS-CoV-2 test in NHS records (5.9% of the sample; OR 1.08, 95%CI 0.68-1.73) and self-reported positive tests (6.5% of the sample; OR 1.07, 95%CI 0.68-1.69), were marginally and non-significantly associated with economic inactivity (5.3% of the sample) in adjusted analyses. Within the larger UKDS sample (n = 13,881) reliant on self-reported ascertainment of infection (6.4% of the sample), the coefficient indicated a null relationship (OR 0.98, 95%CI 0.68-1.40) with economic inactivity (5.0% of sample). Among people employed pre-pandemic, testing positive for SARS-CoV-2 was not associated with increased economic inactivity, although we could not exclude small effects. Ascertaining infection through healthcare records or self-report made little difference to results. However, processes related to record linkage may introduce small biases.

For about 20 years, Belgium has successfully implemented working-time reduction policies for the older workforce. However, the impact of such policies on health has not been explored yet. Using longitudinal data from Waves 5 and 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) (N = 1,498), the paper assesses whether working-time reduction in late career is associated with a change in self-perceived health, depression (EURO-D) and quality of life (CASP-12). For that purpose, ordered logit and ordinary least squares regressions are performed, using four different models for defining working-time reductions. Results show that people reducing working time with or without additional social benefits tend to have a poorer self-perceived health at follow-up compared with people keeping the same or increasing working time. By comparison, people moving to retirement are more likely to present a better self-perceived health, depression level and quality of life compared to people increasing or keeping the same working-time level. Although, introducing an interaction effect, the paper shows that the change in quality of life for respondents reducing working hours in addition to social benefits tends to be less negative for those who wished to retire early at baseline than for those who did not.