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Templeman ME, Lee S, Haley WE. Factors Associated With Working Caregivers' Well-Being: Comparisons Between Black and White Working Caregivers in the United States. Int J Aging Hum Dev 2024; 99:179-199. [PMID: 37899571 DOI: 10.1177/00914150231208680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
This study investigated stressors and strains, resources, and well-being among Black working caregivers (BWC) and White working caregivers (WWC) who participated in the Midlife in the United States study (Black: n = 49, White: n = 250). Comparisons were made between BWC and WWC for primary caregiving stressors, secondary strains, resources, and well-being, and hierarchical regression models tested associations among these factors. BWC reported less negative work-to-family spillover, more perceived control and religious/spiritual coping, and higher positive affect than WWC, complementing existing evidence of greater resilience among BWC. Secondary strains stemming from the workplace had stronger associations with well-being than primary caregiving stressors, confirming that the workplace deserves greater attention in stress research and interventions for working caregivers. Finally, perceived control, optimism, and family support were important resources for well-being for both BWC and WWC, substantiating their valuable role in interventions for working caregivers.
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Affiliation(s)
- Maureen E Templeman
- Department of Sociology, Anthropology, and Gerontology, Missouri State University, Springfield, MO, USA
| | - Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, FL, USA
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Tannis C, Schanzer A, Milbank E, Afzal O, Meyer J. Perceptions of Job Hazards and Requests for Accommodation Among Pregnant Women in a Large Urban Hospital System. J Occup Environ Med 2023; 65:918-923. [PMID: 37464264 DOI: 10.1097/jom.0000000000002925] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND Many pregnant women remain uninformed about job accommodation options or have not been empowered to ask their employers. METHODS A cross-sectional survey of a sample base of pregnant women from late first through third trimester was conducted. Associations between job perception variables, work characteristics, race/ethnicity, and income were assessed using binary logistic regression. RESULTS Workers in service/support occupations were twice as likely as those in management to perceive need for job duty change and to request job accommodation. Perception of needed job change was higher when jobs had high physical demands and low substantive complexity. CONCLUSIONS We found positive relationships between highly physical work, perception of harm, and need for job change in pregnancy. Further research could explore worker/employer characteristics explaining why these perceptions did not translate into requesting and receiving job accommodation during pregnancy.
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Affiliation(s)
- Candace Tannis
- From the Icahn School of Medicine at Mount Sinai, New York, New York (C.T., A.S., E.M., O.A., J.M.); NYU Langone School of Medicine, New York, New York (A.S.); and Capital Health Medical Center, Trenton, New Jersey (O.A.)
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Whitley MD, Burgard SA. Working Conditions and Racial and Ethnic Disparities in Self-rated Health. J Occup Environ Med 2023; 65:533-540. [PMID: 37104706 PMCID: PMC10330089 DOI: 10.1097/jom.0000000000002868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE The aims of the study are to examine racial and ethnic differences in occupational physical demands, substantive complexity, time pressure, work hours, and establishment size and to assess whether working conditions contribute to racial and ethnic differences in self-rated health. METHODS We used 2017 and 2019 Panel Study of Income Dynamics data for 8439 adults. Using path models, we examined working conditions among Black, Latino, and White workers and explored whether those conditions mediated racial and ethnic differences in incident poor self-rated health. RESULTS Some working conditions disproportionately affected Black workers (high physical demands, low substantive complexity), Latino workers (low substantive complexity, small establishments), and White workers (time pressure). Time pressure predicted worse self-rated health; there was no evidence that the working conditions studied mediated racial/ethnic differences. CONCLUSIONS Working conditions vary by racial and ethnic group; some predict worse health.
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Affiliation(s)
- Margaret D. Whitley
- Behavioral and Policy Sciences Department, RAND Corporation, Santa Monica, CA, USA
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Sarah A. Burgard
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Department of Sociology, University of Michigan, Ann Arbor, MI, USA
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McClure ES, Robinson WR, Vasudevan P, Cullen MR, Marshall SW, Noth E, Richardson D. Disparities in job characteristics by race and sex in a Southern aluminum smelting facility. Am J Ind Med 2023; 66:307-319. [PMID: 36748848 DOI: 10.1002/ajim.23464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Former workers at a Southern aluminum smelting facility raised concerns that the most hazardous jobs were assigned to Black workers, but the role of workplace segregation had not been quantified or examined in the company town. Prior studies discuss race and gender disparities in working conditions, but few have documented them in the aluminum industry. METHODS We obtained workers' company records for 1985-2007 and characterized four job metrics: prestige (sociologic rankings), worker-defined danger (worker assessments), annual wage (1985 dollars), and estimated total particulate matter (TPM) exposure (job exposure matrix). Characteristics of job at hire and trajectories were compared by race and sex using linear binomial models. RESULTS Non-White males had the highest percentage of workers in low prestige and high danger jobs at hire and up to 20 years after. After 20 years tenure, 100% of White workers were in higher prestige and lower danger jobs. Most female workers, regardless of race, entered and remained in low-wage jobs, while 50% of all male workers maintained their initial higher-wage jobs. Non-White females had the highest prevalence of workers in low-wage jobs at hire and after 20 years-increasing from 63% (95% CI: 59-67) to 100% (95% CI: 78-100). All female workers were less likely to be in high TPM exposure jobs. Non-White males were most likely to be hired into high TPM exposure jobs, and this exposure prevalence increased as time accrued, while staying constant for other race-sex groups. CONCLUSIONS There is evidence of job segregation by race and sex in this cohort of aluminum smelting workers. Documentation of disparities in occupational hazards is important for informing health interventions and research.
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Affiliation(s)
- Elizabeth S McClure
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Whitney R Robinson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Pavithra Vasudevan
- Department of African and African Diaspora Studies/Center for Women's and Gender Studies, University of Texas, Austin, Texas, USA
| | - Mark R Cullen
- Center for Population Health Sciences Stanford, Stanford University, Stanford, California, USA
| | - Stephen W Marshall
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Elizabeth Noth
- Environmental Health Sciences Division, Berkeley Public Health University of California at Berkeley, Berkeley, California, USA
| | - David Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Environmental and Occupational Health, University of California at Irvine, Irvine, California, USA
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Lederer V, Messing K, Sultan-Taïeb H. How Can Quantitative Analysis Be Used to Improve Occupational Health without Reinforcing Social Inequalities? An Examination of Statistical Methods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:19. [PMID: 36612341 PMCID: PMC9819275 DOI: 10.3390/ijerph20010019] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/15/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
Taking account of sex and gender in occupational health studies poses statistical challenges. Other sociodemographic variables, such as racialization, class, and age, also affect the relations between workplace exposures and health and interact with sex and gender. Our objective was to perform a critical review of conventional and emerging statistical tools, examining whether each analysis takes account of sociodemographic variables (1) in a way that contributes to identification of critical occupational determinants of health (2) while taking account of relevant population characteristics to reflect intersectional approaches to health and (3) using sample sizes and population characteristics available to researchers. A two-step search was conducted: (1) a scientific watch concerning the statistical tools most commonly used in occupational health over the past 20 years; (2) a screening of the 1980-2022 literature with a focus on emerging tools. Our examination shows that regressions with adjustment for confounders and stratification fail to reveal the sociodemographic mechanisms that interact with occupational health problems, endangering the identification of occupational risks. Multilevel (notably MAIHDA) analyses, decision tree, cluster, and latent analyses are useful methods to consider when seeking to orientate prevention. Researchers should consider methods that adequately reveal the mechanisms connecting sociodemographic variables and occupational health outcomes.
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Affiliation(s)
- Valérie Lederer
- Department of Industrial Relations, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada
| | - Karen Messing
- Department of Biological Sciences, Université du Québec à Montréal, Montreal, QC H3C 3P8, Canada
| | - Hélène Sultan-Taïeb
- Department of Organization and Human Resources, School of Management (ESG-UQAM), Université du Québec à Montréal, Montreal, QC H3C 3P8, Canada
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Yolci A, Schenk L, Sonntag PT, Peppler L, Schouler-Ocak M, Schneider A. Observed and personally experienced discrimination: findings of a cross-sectional survey of physicians and nursing staff. HUMAN RESOURCES FOR HEALTH 2022; 20:83. [PMID: 36494666 PMCID: PMC9733037 DOI: 10.1186/s12960-022-00779-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Discrimination against hospital staff based on ascribed features is prevalent in healthcare systems worldwide. Detrimental effects on health and quality of patient care have been shown. Our study aims to describe and analyse the discrimination experiences of both physicians and nurses, specifically for the German hospital context. METHODS A cross-sectional online survey on observed and personally experienced discrimination at work addressed staff from 22 hospitals of two organizations in Germany. Sociodemographic and occupational as well as institutional characteristics served as independent variables. In multivariable analyses, block- and stepwise logistic regressions were calculated for the two dependent variables (witness and victim of discrimination). Sensitivity analyses with imputed data for missings were performed. RESULTS N = 800 healthcare professionals (n = 243 physicians, n = 557 nurses; response rate: 5.9%) participated in the survey. 305 respondents (38.1%) were witnesses of discrimination, while 108 respondents (13.5%) were victims of discrimination in their wards. Reasons for observed discriminatory acts were predominantly attributed to the ethnicity of the person concerned, their appearance and language, whereas personally affected staff most frequently cited gender as a reason, followed by ethnicity, and physical appearance. In multivariable models, cultural competence significantly increased the likelihood of witnessing discrimination (β = .575; p = .037). In terms of the likelihood of being a victim of discrimination, in addition to cultural competence (β = 2.838; p = < .001), the interaction of the effects of gender and professional group was statistically significant (β = .280; p = .010). CONCLUSIONS Given the extent of experienced and observed discrimination, appropriate institutional responses are needed. Further research on discriminatory structures in the German-speaking health care system should focus on discrimination at the intersection of ethnicity, gender and occupation.
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Affiliation(s)
- Arda Yolci
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Liane Schenk
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Pia-Theresa Sonntag
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Lisa Peppler
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Meryam Schouler-Ocak
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Psychiatrische Universitätsklinik der Charité im St. Hedwig-Krankenhaus, Berlin, Germany
| | - Anna Schneider
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
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7
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Raymond A, Grzywacz JG, Robertson AM. Job Demand-Control and Hypertension in African Americans and Non-African Americans. J Occup Environ Med 2022; 64:920-926. [PMID: 35901200 PMCID: PMC9637734 DOI: 10.1097/jom.0000000000002642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The aim of this study was to determine if occupational stress is a social determinant of elevated hypertension among African Americans. METHODS Currently employed, full-time adults from the Midlife in the United States Refresher and Midlife in the United States Milwaukee Refresher studies reported data on demographics, job characteristics, and medical history. RESULTS African American workers reported less job control and greater physical job demands than non-African Americans. Both physical and psychological job demands were independently associated with greater odds of high blood pressure. Job strain was associated with high blood pressure and differed by race ( P < 0.05). CONCLUSIONS The elements of the job-demand control model differed by race and were most relevant for African Americans when exposed to high job demands and low job control. However, there was no evidence of differential vulnerability for either psychological demands, control, or physical demands for African Americans.
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Abstract
BACKGROUND Low job control may predict shorter breastfeeding (BF) among working mothers and may contribute to racial disparities in BF. METHODS We used demographic, employment, and health data for n = 631 observations from the Panel Study of Income Dynamics. Job control scores came from a job-exposure matrix.Using path analysis, we assessed whether job control predicted BF and mediated Black-White BF differences. We controlled for education, working hours, marital status, and low birthweight. RESULTS Lower job control predicted decreased odds of BF for at least 6 months (odds ratio, 0.61; 95% confidence interval, 0.31-0.90; reference, no BF). Low job control explained 31% of the Black-White difference for both shorter-term and longer-term BF. CONCLUSIONS Low job contributes to shorter BF and to BF disparities by race. Intervening to enhance job control could improve BF.
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Affiliation(s)
- Margaret D Whitley
- From the Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan (Dr Whitley); Program in Public Health, University of California, Irvine, Irvine, California (Dr Ro); and Center for Work and Health Research, Irvine, California (Mr Choi)
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Cain-Shields L, Glover L, Joseph JJ, Bertoni AG, Sims M. Goal-striving stress and repeated measures of adiposity in the Jackson heart study. Stress Health 2022; 38:443-452. [PMID: 34643027 PMCID: PMC9023066 DOI: 10.1002/smi.3105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 11/10/2022]
Abstract
Psychosocial stressors are determinants of increases in adiposity. Both psychosocial stressors and adiposity are higher among African Americans (AAs). Therefore, clarifying the stress-obesity link in AAs is important. The stress associated with goal striving is particularly relevant to AAs because opportunity for upward mobility is not always equal. Goal-striving stress (GSS) has not been assessed with adiposity, a potential result of GSS. Therefore, the objective of this study was to determine whether GSS would be associated with repeated measures of adiposity [body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHR)] in AAs. Linear mixed models were used to assess the relationship between GSS with repeated measures of adiposity across three exam periods among 2902 AAs, and sex was assessed as a moderator. Models were adjusted for demographics, health behaviours, morbidities, and daily discrimination. GSS was positively associated with repeated measures of adiposity in women but not men: WC [estimate (standard error) p-value] [0.003 (0.001) p < 0.01] and WHR [0.003 (0.0007) p < 0.01]. This suggests that high stress due to goal striving may contribute to greater increases in adiposity in AA women over time. Community-based interventions should continue to consider focused support group models as viable options for goal-striving related stress reduction.
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Affiliation(s)
- Loretta Cain-Shields
- Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - LáShauntá Glover
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Joshua J. Joseph
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Alain G. Bertoni
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
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Chantarat T, Enns EA, Hardeman RR, McGovern PM, Myers SL, Dill J. Occupational Segregation And Hypertension Inequity: The Implication Of The Inverse Hazard Law Among Healthcare Workers. JOURNAL OF ECONOMICS, RACE, AND POLICY 2022; 5:267-282. [PMID: 35341024 PMCID: PMC8938730 DOI: 10.1007/s41996-022-00098-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 01/07/2023]
Abstract
In the United States (US), Black-particularly Black female-healthcare workers are more likely to hold occupations with high job demand, low job control with limited support from supervisors or coworkers and are more vulnerable to job loss than their white counterparts. These work-related factors increase the risk of hypertension. This study examines the extent to which occupational segregation explains the persistent racial inequity in hypertension in the healthcare workforce and the potential health impact of workforce desegregation policies. We simulated a US healthcare workforce with four occupational classes: health diagnosing professionals (i.e., highest status), health treating professionals, healthcare technicians, and healthcare aides (i.e., lowest status). We simulated occupational segregation by allocating 25-year-old workers to occupational classes with the race- and gender-specific probabilities estimated from the American Community Survey data. Our model used occupational class attributes and workers' health behaviors to predict hypertension over a 40-year career. We tracked the hypertension prevalence and the Black-white prevalence gap among the simulated workers under the staus quo condition (occupational segregation) and the experimental conditions in which occupational segregation was eliminated. We found that the Black-white hypertension prevalence gap became approximately one percentage point smaller in the experimental than in the status quo conditions. These findings suggest that policies designed to desegregate the healthcare workforce may reduce racial health inequities in this population. Our microsimulation may be used in future research to compare various desegregation policies as they may affect workers' health differently. Supplementary Information The online version contains supplementary material available at 10.1007/s41996-022-00098-5.
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Affiliation(s)
- Tongtan Chantarat
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
- Center for Antiracism Research for Health Equity, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
| | - Eva A. Enns
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
| | - Rachel R. Hardeman
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
- Center for Antiracism Research for Health Equity, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
| | - Patricia M. McGovern
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
| | - Samuel L. Myers
- Hubert H. Humphrey School of Public Affairs, University of Minnesota, Minneapolis, MN 55455 USA
| | - Janette Dill
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
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Toxic Psychosocial Stress, Resiliency Resources and Time to Dementia Diagnosis in a Nationally Representative Sample of Older Americans in the Health and Retirement Study from 2006-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042419. [PMID: 35206612 PMCID: PMC8875619 DOI: 10.3390/ijerph19042419] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 12/10/2022]
Abstract
Background: Toxic stress (TS), resiliency-promoting factors (RPFs) and their interactions were investigated in relationship to incident dementia in a nationally representative sample (n = 6516) of American adults ≥50 years enrolled in the Health and Retirement Study between 2006 and 2016. Methods: TS included experiences of everyday discrimination and RPF included personal mastery. Race/ethnicity was self-reported as African American, Caucasian, or Other. Multivariable Cox proportional hazards regression models estimated TS-, RPF- and race-associated hazard ratios (HR) for dementia diagnosis and 95% confidence intervals (CIs) with adjustment for comorbidity, lifestyle, and socio-demographic confounders. Results: Discrimination-associated risk of dementia diagnosis on average increased with education level [discrimination x education, p = 0.032; HR = 1.75 (95% CI: 1.01–3.03) if < high school, HR = 5.67 (95% CI: 2.94–10.94) if high school completed and HR = 2.48 (95% CI: 1.53–4.00) if ≥some college education]. Likewise, African American vs. Caucasian race disparity in new-onset dementia was evident (HR = 2.12, 95% CI: 1.42–3.17) among adults with high-mastery while absent (HR = 1.35, 95% CI: 0.75–2.41) among adults with low mastery (Mastery x Race, p = 0.01). Conclusions: TS is a contextual driver of incident dementia that seemingly operates in a race and RPF-dependent fashion among American adults. Association pattern suggests that TS may overwhelm the cognitive reserve benefit of RPF particularly in status-inconsistent contexts including persons subjected to discrimination despite high education and persons of African American descent despite high mastery. Policies that reduce discrimination and promote equitable treatment by race/ethnicity may support cognitive resiliency and reduce the risk of dementia diagnosis in adult Americans.
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Siqueira JSD, Fernandes RDCP. Physical and psychosocial demand at work: inequities related to race/skin color. CIENCIA & SAUDE COLETIVA 2021; 26:4737-4748. [PMID: 34730659 DOI: 10.1590/1413-812320212610.19982020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 08/13/2020] [Indexed: 11/22/2022] Open
Abstract
This cross-sectional study investigated the association between self-reported race/skin color and two outcomes - psychosocial demand and physical demand at work - in 1,032 workers in an urban cleaning services company and two footwear manufacturers, located in the State of Bahia, Brazil. Psychosocial demand was measured through the Job Content Questionnaire and physical demand was measured through questions about postures and cargo handling. A Cox regression analysis provided prevalence ratios (PR) adjusted by age, gender, and educational level. Among blacks, there is a higher proportion of garbage collectors and a lower proportion of supervisory positions. Black workers are more subject to high psychological demand and low job control and, consequently, to high strain (PR=1.65). Also, they are more exposed to work with arms above shoulder level (PR=1.93), and material handling (PR=1.62), compared to white workers. Brown workers are more exposed to low job control (PR=1.36), work with arms above shoulder level (PR=1.48), and material handling (PR=1.25), also compared with whites. Social support is lower among blacks and brown. The study demonstrated inequities in psychosocial and physical exposures at work that are in line with the structural conception of racism. This evidence can contribute to the adoption of practices that increase equity in the world of work.
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Affiliation(s)
- Janaína Santos de Siqueira
- Programa de Pós-Graduação em Saúde, Ambiente e Trabalho, Universidade Federal da Bahia (UFBA). Largo do Terreiro de Jesus s/n, Centro Histórico. 40026-010 Salvador BA Brasil.
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Nkwata AK, Zhang M, Song X, Giordani B, Ezeamama AE. The Relationship of Race, Psychosocial Stress and Resiliency Indicators to Neurocognitive Impairment among Older Americans Enrolled in the Health and Retirement Survey: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1358. [PMID: 33540911 PMCID: PMC7908633 DOI: 10.3390/ijerph18031358] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Race/ethnicity, toxic stress (TS), resilience-promoting factors (RPFs), and their interactions were investigated in relationship to neurocognitive impairment (NI) in a nationally representative sample of adult Americans ≥50 years enrolled in the Health and Retirement Study (HRS) between 2012 and 2014. METHODS NI was defined as physician diagnosis of Alzheimer's disease/dementia or HRS total cognition score ≤ 10. Race/ethnicity (i.e., African American, White, or Other), TS (i.e., everyday discrimination and chronic stressors), and mastery (as indicator of RPF) were self-reported. Multivariable logistic regression models estimated race-, TS-, RPF-associated odds ratios (ORs), and 95% confidence intervals (CI) for NI adjusting for socio-demographic confounders. RESULTS 6317 respondents interviewed between the years 2012 and 2014, age range 55-104 years old, 83% White, 13% Black and 4% Other race were included in the study. Chronic stress (OR = 1.88, 95% CI: 1.42-2.48), discrimination (OR = 3.31, 95% CI: 2.12-5.19) and low mastery (OR = 1.85, 95% CI: 1.38-2.48) were each associated with higher NI risk while low mastery was associated with higher NI risk in discrimination and race/ethnicity dependent manner. Specifically, low mastery-associated risk for NI was evident among adults that denied experiencing discrimination (OR = 2.01, 95% CI: 1.51-2.68), but absent among those that experienced discrimination (OR = 0.72, 95% CI: 0.32-1.62). Further, AA race was associated with NI risk but only among adults with high mastery (OR = 2.00, 95% CI: 1.20-3.35). CONCLUSIONS Discrimination, chronic stress, and low mastery were associated with worse cognition. Persisting cognitive disadvantage for AA vs. White/Other race only among high mastery adults suggests that adverse social experiences may counteract mastery-associated cognitive benefits among AA population. TS reduction through policies that promote equal treatment by race/ethnicity in social life, health, justice, and economic systems may promote successful cognitive aging.
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Affiliation(s)
- Allan K. Nkwata
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA 30602, USA; (M.Z.); (X.S.)
| | - Ming Zhang
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA 30602, USA; (M.Z.); (X.S.)
| | - Xiao Song
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA 30602, USA; (M.Z.); (X.S.)
| | - Bruno Giordani
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48105, USA;
| | - Amara E. Ezeamama
- Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, USA
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Cain-Shields L, Glover L, Young B, Sims M. Association between goal-striving stress and rapid kidney function decline among African Americans: the Jackson Heart Study. J Investig Med 2021; 69:382-387. [PMID: 33335024 PMCID: PMC8057281 DOI: 10.1136/jim-2020-001510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2020] [Indexed: 11/04/2022]
Abstract
African Americans (AAs) are disproportionately affected by kidney disease and also report higher psychosocial stressors than other racial groups. Goal-striving stress (GSS) is an understudied psychosocial stressor related to attempting to accomplish one's life goals. Given the numerous social determinants that contribute to health inequities among AAs, stress from goal striving may also disproportionately affect the health of AAs and in particular kidney disease outcomes. The objective of this study was to explore the association between GSS and rapid kidney function decline (RKFD) in an AA cohort. Using examination 1 (2000-2004) and examination 3 (2009-2013) data from the Jackson Heart Study (n=2630), we examined associations of baseline levels of GSS with RKFD among AAs using multivariable Poisson regression models, adjusting for sociodemographics, health behaviors, chronic disease and discrimination. We also explored baseline cortisol as a mediator. The incidence of RKFD in this sample was 7.34% (mean years of follow-up: 8.06±0.84 years). The mean GSS score was 3.80 (±4.88) and total GSS score ranged from 0 to 36. Those who reported high (vs low) GSS were 1.60 times more likely to experience RKFD after full adjustment (incidence rate ratio (IRR) 1.60; 95% CI 1.11 to 2.14, p=0.01). After confirming cortisol as a mediator and adding it to the model, those who reported high (vs low) GSS had 1.58 times the rate of RKFD (IRR 1.58; 95% CI 1.09 to 2.30, p=0.0153). Stress related to not achieving goals was associated with a greater risk of RKFD in this sample of AAs.
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Affiliation(s)
- Loretta Cain-Shields
- Department of Data Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - LáShauntá Glover
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Bessie Young
- Division of Nephrology and Kidney Research Institute, University of Washington, Seattle, Washington, USA
- Veterans Affairs, Hospital and Specialty Medicine and Center for Innovation, Seattle, Washington, USA
| | - Mario Sims
- School of Medicine, Jackson Heart Study, University of Mississippi Medical Center, Jackson, Mississippi, USA
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Lee S, Chang AM, Buxton OM, Jackson CL. Various Types of Perceived Job Discrimination and Sleep Health Among Working Women: Findings From the Sister Study. Am J Epidemiol 2020; 189:1143-1153. [PMID: 32406503 DOI: 10.1093/aje/kwaa075] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 04/29/2020] [Indexed: 12/27/2022] Open
Abstract
Job discrimination, a social stressor, may lead to sleep health disparities among workers; yet, limited research has examined this relationship and specific sources of job discrimination. We used a US sample of working women (n = 26,085), participants in the Sister Study (2008-2016), to examine the associations of perceived job discrimination due to sex, race, age, health conditions, and/or sexual orientation with sleep health. Cross-sectionally, linear or logistic regression models revealed that each source of job discrimination was independently associated with different sleep problems after controlling for other sources of job discrimination. Longitudinally, among participants without short sleep (<7 hours/night) at time 1 (2012-2014), age-specific job discrimination was associated with 21% increased odds of new-onset short sleep (odds ratio = 1.21, 95% confidence interval: 1.03, 1.43) at time 2 (2014-2016). Among those without insomnia symptoms at time 1, race-specific job discrimination was associated with 37% increased odds of new-onset insomnia symptoms (odds ratio = 1.37, 95% confidence interval: 1.07, 1.75) at time 2. Sex- and health-specific job discrimination also predicted new-onset sleepiness. There were dose-response relationships such that a greater number of sources of job discrimination (≥3) was associated with greater odds of prevalent and incident sleep problems. Perceived job discrimination may contribute to working women's poor sleep health over time, raising concerns about sleep health disparities emanating from the workplace.
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Implication of Vaginal and Cesarean Section Delivery Method in Black-White Differentials in Infant Mortality in the United States: Linked Birth/Infant Death Records, 2007-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093146. [PMID: 32365975 PMCID: PMC7246527 DOI: 10.3390/ijerph17093146] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/23/2020] [Accepted: 04/25/2020] [Indexed: 11/16/2022]
Abstract
Racial/ethnic disparities in infant mortality (IM) continue to persist in the United States, with Black/African Americans (AA) being disproportionally affected with a three-fold increase in mortality compared to Whites. Epidemiological data have identified maternal characteristics in IM risk such as preeclampsia, eclampsia, maternal education, smoking, maternal weight, maternal socioeconomic status (SES), and family structure. Understanding the social gradient in health including implicit bias, as inherent in the method of labor and delivery and the racial heterogeneity, may facilitate intervention mapping in narrowing the Black-White IM risk differences. We aimed to assess the temporal/racial trends and the methods of delivery, mainly vaginal vs. cesarean section (C-section) as an exposure function of IM. The United States linked birth/infant death records (2007-2016) were used with a cross-sectional ecological design. The analysis involved chi squared statistic, incidence rate estimation by binomial regression model, and period percent change. Of the 40,445,070 births between 2007 and 2016, cumulative mortality incidence was 249,135 (1.16 per 1000). The IM rate was highest among Black/AA (11.41 per 1000), intermediate among Whites (5.19 per 1000), and lowest among Asian /Pacific Islanders (4.24 per 1000). The cumulative incidence rate difference, comparing vaginal to cesarean procedure was 1.73 per 1000 infants, implying excess IM with C-section. Compared to C-section, there was a 31% decreased risk of IM among mothers with vaginal delivery, rate ratio (RR) = 0.69, 95% confidence interval (CI): 0.64-0.74. Racial disparities were observed in the method of delivery associated with IM. Black/AA mothers with vaginal delivery had a 6% decreased risk of IM compared to C-section, RR = 0.94, 95% CI: 0.92-0.95, while Whites with vaginal delivery had a 38% decrease risk of IM relative to C-section, RR= 0.68, 95% CI: 0.67-0.69, p < 0.001. Infant mortality varied by race, with Black/AA disproportionally affected, which is explained in part by labor and delivery procedures, suggestive of reliable and equitable intrapartum assessment of Black/AA mothers during labor, as well as implicit bias marginalization in the healthcare system.
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17
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Wesołowska K, Elovainio M, Komulainen K, Hietapakka L, Heponiemi T. Nativity status and workplace discrimination in registered nurses: Testing the mediating role of psychosocial work characteristics. J Adv Nurs 2020; 76:1594-1602. [PMID: 32202314 DOI: 10.1111/jan.14361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/11/2020] [Accepted: 03/03/2020] [Indexed: 12/30/2022]
Abstract
AIM To examine: (a) whether nativity status was associated with workplace discrimination, and (b) whether this association was mediated through psychosocial work characteristics (job strain, job demands, and job control) among registered female nurses. DESIGN Cross-sectional survey with a self-report questionnaire was conducted. METHODS A random sample of 610 native Registered Nurses and a total sample of 188 foreign-born Registered Nurses working in Finland were used. Data were collected between September-November of 2017 and analysed using a counterfactual approach in the causal mediation framework. RESULTS After adjusting for several potential confounders, foreign-born nurses scored higher on workplace discrimination than native nurses. Approximately 20% of the association between nativity status and workplace discrimination was mediated through job control. Job demands and job strain were unlikely to mediate this association. CONCLUSION The study provides further evidence that migrant status is associated with a higher risk of workplace discrimination among nurses. Lower levels of control over one's own job may partly contribute to the higher risk of workplace discrimination in foreign-born women nurses. IMPACT Our study addresses the relationship between nativity status and workplace discrimination among female nurses and its mediating factors. The findings suggest that healthcare organization leaders need to be aware of the increased risk of workplace discrimination among migrant nurses. Moreover, healthcare organizations need to consider psychosocial work characteristics, including job control, in the efforts aimed to prevent and reduce discrimination against their foreign-born employees.
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Affiliation(s)
- Karolina Wesołowska
- Department of Social and Health Systems Research, National Institute for Health and Welfare, Helsinki, Finland
| | - Marko Elovainio
- Department of Social and Health Systems Research, National Institute for Health and Welfare, Helsinki, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kaisla Komulainen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Laura Hietapakka
- Department of Social and Health Systems Research, National Institute for Health and Welfare, Helsinki, Finland
| | - Tarja Heponiemi
- Department of Social and Health Systems Research, National Institute for Health and Welfare, Helsinki, Finland
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18
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Narain KDC, Skrine Jeffers K. Exploring the Relationship Between Self-Employment and Health Among Blacks. Health Equity 2020; 4:1-8. [PMID: 32051923 PMCID: PMC6983738 DOI: 10.1089/heq.2019.0084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: There is some evidence that self-employment may improve measures of cardiovascular and general health among the general population; however, no studies have examined this relationship among Non-Hispanic Blacks (NHBs). Studying the health implications of self-employment among NHBs is important because of the disparities that persist in both cardiovascular health and self-employment rates between NHBs and other racial/ethnic subgroups. Methods: A pooled cross-sectional analysis of data from the Behavioral Risk Factor Surveillance System (2000 to 2014) was used to explore the association between self-employment and the following self-reported outcomes: “no exercise,” fruit consumption, vegetable consumption, days of alcohol consumption, fair or poor health, hypertension, poor mental health days, and poor physical health days among the total population of NHBs and across gender/income subgroups. Results: We find favorable associations between self-employment and several measures of cardiovascular health (increased fruit and vegetable consumption, reduced reports of “no exercise,” and reduced reports of hypertension) and positive associations between self-employment, poor mental health days, and days of alcohol consumption among the total population. The nature of these associations varies across gender/income subgroup. Conclusions: Given the disparities between racial/ethnic subgroups with respect to adverse cardiovascular outcomes and the well-documented roles of exercise and blood pressure control in limiting cardiovascular disease, it is important to probe the relationship between self-employment and health among NHBs further.
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Affiliation(s)
- Kimberly Danae Cauley Narain
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine and Center for Health Advancement, University of California, Los Angeles, Los Angeles, California
| | - Kia Skrine Jeffers
- School of Nursing, University of California, Los Angeles, Los Angeles, California
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Burris H, Lorch S, Kirpalani H, Pursley DM, Elovitz MA, Clougherty JE. Racial disparities in preterm birth in USA: a biosensor of physical and social environmental exposures. Arch Dis Child 2019; 104:931-935. [PMID: 30850379 PMCID: PMC6732250 DOI: 10.1136/archdischild-2018-316486] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 02/15/2019] [Accepted: 02/19/2019] [Indexed: 01/16/2023]
Abstract
Race is a social construct that involves a person’s self-assigned, and externally-perceived, group membership. Group membership can determine much about Americans’ lives and health. Complex health disorders such as cardiovascular disease, asthma, and obesity disproportionately affect Non-Hispanic black Americans. An individual’s risk of any of these disorders encompasses both genetic predisposition and environmental stimuli. We propose that environmental stressors may be large contributors to differences in preterm birth rates in the United States between racial groups. Environmental exposures differ by race due to ongoing residential, educational and economic racial segregation as well as discrimination. Characterizing and mitigating environmental factors that contribute to differential preterm risk could identify women at risk, prevent some preterm births, and reduce perinatal health disparities.
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Affiliation(s)
- Heather Burris
- Division of Neonatology, Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania;,Corresponding Author: Heather H. Burris, Center for Research on Reproduction and Women’s Health, Biomedical Research Building II/III, Room 1352, 421 Curie Blvd., Philadelphia, PA, 19104-6160, (215) 573-4916 (phone), (215) 573-5408 (fax),
| | - Scott Lorch
- Division of Neonatology, Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania
| | - Haresh Kirpalani
- Division of Neonatology, Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania
| | - DeWayne M. Pursley
- Department of Neonatology, Beth Israel Deaconess Medical Center, Department of Pediatrics at Harvard Medical School
| | - Michal A. Elovitz
- Department of Obstetrics and Gynecology, Maternal Child Health Research Center, Perelman School of Medicine, University of Pennsylvania
| | - Jane E. Clougherty
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University
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20
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Lee J, Allen J. Mother’s educational attainment and their young adult daughters’ fast food intake: The role of race/ethnicity. Health Care Women Int 2019; 41:169-187. [DOI: 10.1080/07399332.2019.1669606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Jaewon Lee
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
| | - Jennifer Allen
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
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21
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Lee S, Mogle JA, Jackson CL, Buxton OM. What's not fair about work keeps me up: Perceived unfairness about work impairs sleep through negative work-to-family spillover. SOCIAL SCIENCE RESEARCH 2019; 81:23-31. [PMID: 31130199 PMCID: PMC6984163 DOI: 10.1016/j.ssresearch.2019.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 10/27/2018] [Accepted: 03/04/2019] [Indexed: 06/09/2023]
Abstract
This study examined whether perceived unfairness about work was linked to midlife workers' insomnia symptoms over time, and if the association was mediated by negative work-to-family spillover (NWFS). We used 3 waves of longitudinal data across 20 years from the Midlife in the United States Study (N = 971, Mage = 40.52). Results revealed that, wave-to-wave increases in perceived unfairness about work predicted wave-to-wave increases in NWFS over 20 years. Wave-to-wave increases in NWFS, in turn, predicted wave-to-wave increases in insomnia symptoms. Perceived unfairness about work was indirectly, but not directly associated with insomnia symptoms through NWFS. These within-person indirect mediation pathways were found after controlling for sociodemographic and family characteristics, work hours, neuroticism, physical health, and between-person associations between perceived unfairness about work, NWFS, and insomnia symptoms. These findings suggest that perceived unfairness about work may degrade workers' sleep health over time, through the spillover of work stress to the personal domain.
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Affiliation(s)
- Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, FL, USA.
| | - Jacqueline A Mogle
- College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Orfeu M Buxton
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA; Department of Social and Behavioral Sciences, Harvard Chan School of Public Health, Boston, MA, USA; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
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22
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Fujishiro K, Needham BL, Landsbergis PA, Seeman T, Jenny NS, Diez Roux AV. Selected occupational characteristics and change in leukocyte telomere length over 10 years: The Multi-Ethnic Study of Atherosclerosis (MESA). PLoS One 2018; 13:e0204704. [PMID: 30261026 PMCID: PMC6160145 DOI: 10.1371/journal.pone.0204704] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 09/12/2018] [Indexed: 11/18/2022] Open
Abstract
Telomere length (TL) is considered as a marker of cell senescence, but factors influencing the rate of TL attrition are not well understood. While one previous study reported the association of occupation and TL, many subsequent studies have failed to find the association. This may be due to heterogeneity within the samples and cross-sectional designs. This longitudinal study examines two occupational characteristics, occupational complexity and hazardous conditions, as predictors of TL attrition in gender- and race/ethnicity-stratified analysis. Leukocyte TL (expressed as T/S ratio) was measured twice over a 10-year period in a multi-racial sample (n = 914). Linear mixed effect models were used to estimate TL attrition associated with occupational complexity and hazardous conditions. Analysis was stratified by gender and race/ethnicity (white, African American, and Latino) and controlled for baseline age, baseline TL, and time since baseline. Higher occupational complexity was associated with slower rates of TL attrition only among white men. Hazardous conditions were not associated with TL attrition for any gender-and-race/ethnicity stratified group. Occupational complexity may influence TL attrition, but the different findings for white men and other groups suggest that a more comprehensive framework is needed to better understand the potential link between occupational characteristics and biological aging.
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Affiliation(s)
- Kaori Fujishiro
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, United States of America
- * E-mail:
| | - Belinda L. Needham
- Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Paul A. Landsbergis
- Department of Environmental and Occupational Health Sciences, State University of New York Downstate Medical Center, Brooklyn, New York, United States of America
| | - Teresa Seeman
- Department of Medicine, University of California Los Angeles, Los Angeles, California, United States of America
| | - Nancy Swords Jenny
- Department of Pathology, University of Vermont, Burlington, Vermont, United States of America
| | - Ana V. Diez Roux
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, United States of America
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Stiehl E, Shivaprakash N, Thatcher E, Ornelas IJ, Kneipp S, Baron SL, Muramatsu N. Worksite Health Promotion for Low-Wage Workers: A Scoping Literature Review. Am J Health Promot 2018; 32:359-373. [PMID: 28893085 PMCID: PMC5770241 DOI: 10.1177/0890117117728607] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To determine: (1) What research has been done on health promotion interventions for low-wage workers and (2) what factors are associated with effective low-wage workers' health promotion programs. DATA SOURCE This review includes articles from PubMed and PsychINFO published in or before July 2016. Study Inclusion/Exclusion Criteria: The search yielded 130 unique articles, 35 met the inclusion criteria: (1) being conducted in the United States, (2) including an intervention or empirical data around health promotion among adult low-wage workers, and (3) measuring changes in low-wage worker health. DATA EXTRACTION Central features of the selected studies were extracted, including the theoretical foundation; study design; health promotion intervention content and delivery format; intervention-targeted outcomes; sample characteristics; and work, occupational, and industry characteristics. DATA ANALYSIS Consistent with a scoping review, we used a descriptive, content analysis approach to analyze extracted data. All authors agreed upon emergent themes and 2 authors independently coded data extracted from each article. RESULTS The results suggest that the research on low-wage workers' health promotion is limited, but increasing, and that low-wage workers have limited access to and utilization of worksite health promotion programs. CONCLUSION Workplace health promotion programs could have a positive effect on low-wage workers, but more work is needed to understand how to expand access, what drives participation, and which delivery mechanisms are most effective.
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Affiliation(s)
- Emily Stiehl
- 1 Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Namrata Shivaprakash
- 2 Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Esther Thatcher
- 3 University of Virginia Health System, University Medical Associates Clinic, Charlottesville, VA, USA
| | - India J Ornelas
- 4 Health Services, University of Washington, Seattle, WA, USA
| | - Shawn Kneipp
- 5 Health Care Environments Division, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sherry L Baron
- 6 Queens College, Barry Commoner Center for Health and the Environment, Flushing, NY, USA
| | - Naoko Muramatsu
- 7 School of Public Health and Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
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24
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Nesbitt S, Palomarez RE. Review: Increasing Awareness and Education on Health Disparities for Health Care Providers. Ethn Dis 2016; 26:181-90. [PMID: 27103768 DOI: 10.18865/ed.26.2.181] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The focus of this review is to highlight health care disparities and trends in several common diseases in selected populations while offering evidence-based approaches to mitigating health care disparities. Health care disparities cross many barriers and affect multiple populations and diseases. Ethnic minorities, the elderly, and those of lower socioeconomic status (SES) are more at-risk than others. However, many low SES Whites and higher SES racial minorities have poorer health than their racial or SES peers. Also, recent immigrant groups and Hispanics, in particular, maintain high health ratings. The so-called Hispanic Paradox provides an example of how culture and social background can be used to improve health outcomes. These groups have unique determinants of disparity that are based on a wide range of cultural and societal factors. Providing improved access to care and reducing the social determinants of disparity is crucial to improving public health. At the same time, for providers, increasing an understanding of the social determinants promotes better models of individualized care to encourage more equitable care. These approaches include increasing provider education on disparities encountered by different populations, practicing active listening skills, and utilizing a patient's cultural background to promote healthy behaviors.
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25
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Huang SL, Li RH, Huang FY, Tang FC. The Potential for Mindfulness-Based Intervention in Workplace Mental Health Promotion: Results of a Randomized Controlled Trial. PLoS One 2015; 10:e0138089. [PMID: 26367270 PMCID: PMC4569475 DOI: 10.1371/journal.pone.0138089] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 08/24/2015] [Indexed: 11/19/2022] Open
Abstract
Objectives This study aims to intensively evaluate the effectiveness of mindfulness-based intervention (MBI) on mental illness risks (including psychological distress, prolonged fatigue, and perceived stress) and job strain (job control and job demands) for employees with poor mental health. Methods A longitudinal research design was adopted. In total, 144 participants were randomized to the intervention group or the control group. The intervention group participated in MBI for eight weeks. Measurements were collected for both groups at five time points: at pre-intervention (T1), at mid-intervention (T2), at the completion of intervention (T3), four weeks after intervention (T4), and eight weeks after intervention (T5). Data were analyzed according to the intention-to-treat principle. A linear mixed model with two levels was employed to analyze the repeated measurement data. Results Compared with the control group, the intercepts (means at T3) for the intervention group were significantly lower on psychological distress, prolonged fatigue, and perceived stress when MBI was completed. Even with the demographic variables controlled, the positive effects remained. For growth rates of prolonged fatigue and perceived stress, participants in the intervention group showed a steeper decrease than did the participants in the control group. Regarding job strain, although the intercept (mean at T3) of job demands showed a significant decline when BMI was completed, the significance disappeared when the demographic variables were controlled. Moreover, the other results for job control and job demands did not show promising findings. Conclusion As a workplace health promotion program, the MBI seems to have potential in improving mental illness risks for employees with poor mental health. However, there was insufficient evidence to support its effect on mitigating job strain. Further research on maintaining the positive effects on mental health for the long term and on developing innovative MBI to suit job strain are recommended. Trial Registration ClinicalTrials.gov NCT02241070
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Affiliation(s)
- Shu-Ling Huang
- Department of Psychology, Chung-Shan Medical University, Taichung, Taiwan
- Room of Clinical Psychology, Chung-Shan Medical University Hospital, Taichung, Taiwan
| | - Ren-Hau Li
- Department of Psychology, Chung-Shan Medical University, Taichung, Taiwan
| | - Feng-Ying Huang
- Department of Education, National Taipei University of Education, Taipei, Taiwan
| | - Feng-Cheng Tang
- Department of Occupational Medicine, Changhua Christian Hospital, Changhua, Taiwan
- Department of Leisure Services Management, Chaoyang University of Technology, Taichung, Taiwan
- * E-mail:
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