Job Characteristics Associated With Self-Rated Fair or Poor Health Among U.S. Workers

Vital Signs: Health Worker-Perceived Working Conditions and Symptoms of Poor Mental Health - Quality of Worklife Survey, United States, 2018-2022

Introduction

Health workers faced overwhelming demands and experienced crisis levels of burnout before the COVID-19 pandemic; the pandemic presented unique challenges that further impaired their mental health.

Methods

Data from the General Social Survey Quality of Worklife Module were analyzed to compare self-reported mental health symptoms among U.S. adult workers from 2018 (1,443 respondents, including 226 health workers) and 2022 (1,952, including 325 health workers). Logistic regression was used to examine associations between health workers' reported perceptions of working conditions and anxiety, depression, and burnout.

Results

From 2018 to 2022, health workers reported an increase of 1.2 days of poor mental health during the previous 30 days (from 3.3 days to 4.5 days); the percentage who reported feeling burnout very often (11.6% to 19.0%) increased. In 2022, health workers experienced a decrease in odds of burnout if they trusted management (odds ratio [OR] = 0.40), had supervisor help (OR = 0.26), had enough time to complete work (OR = 0.33), and felt that their workplace supported productivity (OR = 0.38), compared with those who did not. Harassment at work was associated with increased odds of anxiety (OR = 5.01), depression (OR = 3.38), and burnout (OR = 5.83).

Conclusions and implications for public health practice

Health workers continued to face a mental health crisis in 2022. Positive working conditions were associated with less burnout and better mental health. CDC's National Institute for Occupational Safety and Health has developed a national campaign, Impact Wellbeing, to provide employers of health workers with resources to improve the mental health of these workers.

Labour-Market Characteristics and Self-Rated Health: Evidence from the China Health and Retirement Longitudinal Study

In the face of labour-force ageing, understanding labour-market characteristics and the health status of middle-aged and older workers is important for sustainable social and economic development. Self-rated health (SRH) is a widely-used instrument to detect health problems and predict mortality. This study investigated labour-market characteristics that may have an impact on the SRH among Chinese middle-aged and older workers, using data from the national baseline wave of the China Health and Retirement Longitudinal Study. The analytical sample included 3864 individuals who at the time held at least one non-agricultural job. Fourteen labour-market characteristics were clearly defined and investigated. Multiple logistic regression models of the associations of each labour-market characteristic with SRH were estimated. Seven labour-market characteristics were associated with higher odds of poor SRH when controlled for age and sex. Employment status and earned income remained significantly associated with poor SRH, when controlling for all the sociodemographic factors and health behaviours. Doing unpaid work in family businesses is associated with 2.07 (95% CI, 1.51-2.84) times probability of poor SRH, compared with employed individuals. Compared with more affluent individuals (highest quintile of earned income), people in the fourth and fifth quintiles had 1.92 (95% CI, 1.29-2.86) times and 2.72 (95% CI, 1.83-4.02) times higher chance, respectively, of poor SRH. In addition, residence type and region were important confounders. Measures improving adverse working conditions should be taken to prevent future risk of impaired health among the Chinese middle-aged and older workforce.

Social Capital and Self-Rated Health: A Cross-Sectional Study among Rural Japanese Working Residents

Social capital is positively associated with self-rated health; however, this association among workers is still unclear. Thus, this study examined the relationship between social capital and self-rated health with special attention to the employment type. A cross-sectional survey was conducted with 6160 workers aged 20-64 years from two towns in Mie Prefecture in January-March 2013. Social capital was assessed using five items in 4816 income-earning workers. The social capital scores were summed and then divided into three groups. The self-rated health responses were dichotomised into 'poor' and 'good'. The association was examined using a stepwise binomial logistic regression stratified by employment type and adjusted for potential confounders. Regular employees with low social capital had a higher significant odds ratio of poor self-rated health than medium (OR 0.58 95% CIs 0.39-0.87) and high (OR 0.39; 95% CIs 0.26-0.59) social capital levels after controlling for all potential confounders. Similar patterns were observed for non-regular employees with medium and high social capital. There was a significant relationship between some indicators of social capital and poor self-rated health among self-employees. These results highlight that social capital acts as an unequal health resource for different types of workers.

Does the Number of Reasons for Seeking Care and Self-Rated Health Predict Sick Leave during the Following 12 Months? A Prospective, Longitudinal Study in Swedish Primary Health Care

BACKGROUND

Sick leave has major social and economic consequences for both individuals and society. Primary Health Care (PHC) meets people who seek care before they risk going on sick leave. This study examined the impact of self-perceived health on sick leave within 12 months for workers seeking care in PHC.

METHODS

The study had a prospective longitudinal design with 271 employed, non-sick-listed patients aged 18-64 years seeking care for physical and/or mental symptoms at PHC. In a logistic regression, an estimation of the odds ratio (OR) for belonging to the group workers with >14 days of sick-leave (W-SL) was made.

RESULTS

A high number of reasons when seeking care, with an OR of 1.33 (confidence interval 1.14 to 1.56), and lower self-rated health, with an OR of 1.45 (confidence interval 1.10 to 1.91), were determinants for sick leave at 12 months after adjusting for covariates and confounders. Mental symptoms constituted the main reason for seeking care, followed by musculoskeletal pain, and significant differences in proportions regarding most symptoms were shown between the groups with and without sick-leave >14 days.

CONCLUSION

Health care professionals in PHC need to be aware of the risk of future sick leave at comorbidity and low self-perceived health. Preventive rehabilitation interventions should be offered to improve health and prevent sick leave for this group.

Paid Sick Leave and Sleep: An Analysis of US Adult Workers

OBJECTIVE

This study examines links between paid sick leave benefits and sleep as an indicator of well-being.

METHODS

Using data from 12,780 employed adult US workers in the 2018 National Health Interview Survey, the relationship between paid sick leave and sleep was explored while controlling for demographic and health status variables.

RESULTS

Logistic multiple regression analyses revealed that compared with workers without paid sick leave, workers with paid sick leave had significantly higher odds of staying asleep, lower odds of feeling rested, and marginally significantly higher odds of having little trouble falling asleep. The groups did not differ regarding the odds of taking sleep medication or getting the ideal amount of sleep.

CONCLUSION

The findings suggest a link between sleep quality and access to paid sick leave, adding to a growing list of health and well-being variables associated with paid sick leave benefits.

Consistent Honor, Persistent Disadvantage: American Indian and Alaska Native Veteran Health in the National Survey of Veterans

Objective: To examine self-rated health and activities of daily living (ADLs) limitations among American Indian and Alaska Native (AI/AN) veterans relative to white veterans. Methods: We use the 2010 National Survey of Veterans and limit the sample to veterans who identify as AI/AN or non-Hispanic white. We calculated descriptive statistics, confidence intervals, and used logistic regression. Results: AI/AN veterans are younger, have lower levels of income, and have higher levels of exposure to combat and environmental hazards compared to white veterans. We found that AI/AN veterans are significantly more likely to report fair/poor health controlling for socioeconomic status and experience an ADL controlling for age, health behaviors, socioeconomic status, and military factors. Discussion: The results indicate that AI/AN veterans are a disadvantaged population in terms of their health and disability compared to white veterans. AI/AN veterans may require additional support from family members and/or Veteran Affairs to address ADLs.

The correlation between workers' working pressure and physical and mental health analyzed by the job demand-resource stress model

BACKGROUND

Under the background of the information society, teachers' pressure from work and life is increasing. Meanwhile, the working pressure has a potential inevitable connection with the physical and mental health of teachers.

OBJECTIVE

To analyze the correlation between working pressure of workers and mental health status, expand the application of the job demand-resource stress (JD-RS) model in the adjustment of working characteristic pressure, and achieve the coordinated development between working pressure and mental health.

METHODS

The occupation of the teacher is taken as the research object. First, the pressure source questionnaire and Symptom Check List 90 (SCL-90) are chosen to measure the working pressure and mental health. Also, the reliability and validity of the pressure source questionnaire are tested. Second, the gender, duty, teaching age, and workload of teachers are chosen as the foundation for comparing and analyzing the impact of various dimensions and project factors on teachers' working pressure and mental health. Finally, based on the method of univariate linear regression analysis, the correlation between teachers' working pressure and mental health is analyzed and characterized.

RESULTS

The measurement tool based on the pressure source questionnaire has good performance reliability and validity. The five dimensions of Cronbach's coefficients are all greater than 0.8, and the indicators of fitting all meet psychometrics requirements. Significance analysis shows that different genders, duties, teaching ages, and workloads have different levels of significant influence on teachers' working pressure and mental health. Linear regression analysis shows that teachers' working pressure has a significant impact on their physical and mental health, which has a predictive effect. Teachers who bear high-intensity pressure have psychological problems.

CONCLUSIONS

The research based on the JD-RS model has a positive role in promoting the balanced and coordinated development of working pressure and the physical and mental health of employed workers.

The Impact of Connecticut's Paid Sick Leave Law on the Use of Preventive Services

INTRODUCTION

Paid sick leave laws have received more attention in recent years as a way to improve public health. This study estimates the impact of paid sick leave laws on the use of preventive services using a quasi-experimental design created by the implementation of Connecticut's paid sick leave law in 2012, the first statewide mandate in the U.S.

METHODS

Data were obtained from the 2007-2018 Behavioral Risk Factor Surveillance System. The analyses were conducted from spring 2018 to fall 2019. This study applied a difference-in-differences model to examine preventive service use (routine checkups, influenza vaccinations, dental visits, Pap tests, mammograms, and clinical breast examinations) in Connecticut and other New England states before and after the implementation of Connecticut's paid sick leave law in 2012.

RESULTS

The use of preventive services increased in Connecticut compared with other New England states after implementation of Connecticut's paid sick leave law. Specifically, the rate of routine checkups (2.7 percentage points, p<0.001), influenza vaccinations (2.1 percentage points, p<0.01), dental visits (2.3 percentage points, p<0.01), and Pap tests (2.6 percentage points, p<0.01) increased compared with other New England states.

CONCLUSIONS

This study found that adult workers' use of preventive services increased in Connecticut after implementation of its paid sick leave law. State-paid sick leave laws can improve public health by supporting the use of preventive care services among workers.

Health status among NEET adolescents and young adults in the United States, 2016-2018

Adolescents and young adults not employed or in education/training (NEET) could be at higher risk of adverse health outcomes. Approximately 4.6 million Americans aged between 16 and 24 fall in this group. However, differences in health between NEET and non-NEET population remain unaddressed. This study examines the association of NEET status and poor/fair self-reported health status (SRH), among adolescents and young adults in the United States. Data for this study come from the 2016–2018 National Survey on Drug Use and Health (NSDUH). Our analytical sample consisted of 53,690 respondents. We used logistic regression models to investigate the association between NEET and health status in the United States, while controlling for potential covariates. Approximately 14% of our analytical sample was classified as NEET. NEET report poor/fair health status at higher rates than their counterparts who remained in school and/or had a job (11.30% vs. 5.62%). The NEET population was older, had a higher proportion of non-Hispanic Blacks, engaged in more smoking but in less alcohol drinking than non-NEET. In our initial model, NEET were more likely report poor/fair SRH than their non-NEET counterparts (OR = 2.14; p < 0.001). This difference remains strong when demographic and socioeconomic characteristics are accounted for in our empirical models (OR = 1.93, p < 0.001). In our fully specified model, which accounts for health behaviors, NEET continue to have higher odds of reporting poor/fair SRH (OR = 1.77, p < 0.001). Our analyses suggest that NEET populations report worse health than non-NEETs. The health of this population may improve if interventions to reinsert them into either education or employment are effectively deployed.

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Approximately 14% of the population aged 16 to 25 are not employed or participating in education/training activities (NEET).

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The NEET population report worse health status than their non-NEET peers.

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NEETs report worse health even when accounting for demographic and socioeconomic characteristics and metropolitan residence.

The Association Between Health Literacy and Self-rated Health Among Residents of China Aged 15-69 Years

INTRODUCTION

Health literacy is a critical determinant of health. However, the association between health literacy and outcomes among Chinese residents has not been studied using nationally representative data. This study examines the association between health literacy and self-rated health among Chinese residents based on the 2017 China Health Literacy Survey.

METHODS

The 2017 China Health Literacy Survey was conducted among non-institutionalized residents aged 15-69 years from 31 provinces in China. Self-rated health was measured using a single question with a 1-5 scale. Health literacy was assessed using the Chinese Health Literacy Scale. Multilevel linear regression models examined the association between health literacy and self-rated health. Data were collected in 2017 and analyzed between 2018 and 2019.

RESULTS

The final sample size was 85,384. The overall weighted mean of the self-rated health score was 4.02 (95% CI=4.00, 4.03). After adjusting for individual-, county-, and province-level covariates, Chinese residents with higher levels of health literacy were more likely to have better self-rated health (β=0.0007, SE=0.0002, p<0.001). Of 6 dimensions of health literacy, 4 (i.e., infectious diseases literacy, chronic diseases literacy, medical care literacy, and health information literacy) were associated with self-rated health. Additionally, self-rated health was associated with gender, age, education, occupation, annual household income, and chronic conditions.

CONCLUSIONS

Using nationally representative data collected in 2017, this study found that self-rated health is associated with health literacy among Chinese residents aged 15-69 years. The promotion of health literacy should be an important component of health education, patient management, and health promotion.

Opportunities at the intersection of work and health: Developing the occupational data for health information model

OBJECTIVE

The study sought to develop an information model of data describing a person's work for use by health information technology (IT) systems to support clinical care, population health, and public health.

MATERIALS AND METHODS

Researchers from the National Institute for Occupational Safety and Health worked with stakeholders to define relationships and structure, vocabulary, and interoperability standards that would be useful and collectable in health IT systems.

RESULTS

The Occupational Data for Health (ODH) information model illustrates relationships and attributes for a person's employment status, retirement dates, past and present jobs, usual work, and combat zone periods. Key data about the work of a household member that could be relevant to the health of a minor were also modeled. Existing occupation and industry classification systems were extended to create more detailed value sets that enable self-reporting and support patient care. An ODH code system, available in the Public Health Information Network Vocabulary Access and Distribution System, was established to identify the remaining value sets. ODH templates were prepared in all 3 Health Level 7 Internationalinteroperability standard formats.

DISCUSSION

The ODH information model suggests data elements ready for use by health IT systems in the United States. As new data elements and values are better defined and refined by stakeholders and feedback is obtained through experience using ODH in clinical settings, the model will be updated.

CONCLUSION

The ODH information model suggests standardized work information for trial use in health IT systems to support patient care, population health, and public health.

Associations between occupational factors and self-rated health in the national Brazilian working population

BACKGROUND

The literature remains seldom on the topic of self-rated health (SRH) among the national working populations of emerging countries. The objectives of the study were to examine the associations of occupational factors with SRH in a national representative sample of the working population in Brazil.

METHODS

This study relied on a cross-sectional sample of 36,442 workers, 16,992 women and 19,450 men. SRH was the studied health outcome. Sixteen occupational factors related to four topics were studied: employment characteristics, working time/hours, psychosocial work factors and physical and chemical work exposures. The associations between occupational factors and SRH were studied using logistic regression models with adjustment for sociodemographic characteristics (age, ethnicity and marital status). The analyses were performed for each gender separately and using weights.

RESULTS

The prevalence of poor SRH was 26.71%, this prevalence being higher among women (29.77%) than among men (24.23%). The following risk factors for poor SRH were found among men and women: working as a self-employed worker, clerk/service worker, manual worker, part-time (≤ 20 h/week), exposure to work stress, exposure to high physical activity and exposure to sun. The risk factors for poor SRH among women only were: working as a domestic worker and exposure to noise, and among men, working in the agriculture sector.

CONCLUSIONS

Our study suggested that occupational factors related to both physical and psychosocial work environment may be associated with SRH in the working population in Brazil. Improving working conditions may be beneficial for health at work in Brazil.

Decline in the rate of occupational injuries and illnesses following the implementation of a paid sick leave law in Connecticut

BACKGROUND

Workers with paid sick leave may have a lower rate of occupational injuries compared with other workers. This study sought to determine whether there was a decline in the rate of occupational injuries and illnesses following the implementation of a paid sick leave law in Connecticut (CT).

METHODS

Data from the Bureau of Labor Statistics was used to calculate the rate of occupational injuries and illnesses in CT in the 3 years before (2009-11) and after (2012-14) the law was implemented. These numbers were compared with New York (NY) and the United States, and between the occupations specified by the CT law and other occupations.

RESULTS

Among service occupations addressed by the CT paid-sick-leave law, the rate of occupational injuries declined more in CT compared to rates for those same occupations in NY and the United States. Within CT, injury and illness rates showed a greater decline in occupations specified by the law (-17.8%; 95% confidence interval [CI] = -15.6--19.9) compared with other occupations (-6.8%; 95% CI = -6.6%--7.0%) between the two periods.

CONCLUSIONS

A paid sick leave law was associated with an increased decline in occupational injuries and illnesses in affected service workers in the period after implementation. Further research should examine the possible reasons for the associations seen here.

Long Working Hours and Poor Self-Rated Health in the Young Working Population in Korea

: This cross-sectional study investigated the association between long working hours and prevalence of poor self-rated health (SRH) in Korean young workers using data from the 6th Korea Youth Panel Survey 2007. A total of 3317 young wage workers were included. Weekly working hours were divided into four groups (36 to 40 hours, 41 to 52 hours, 53 to 60 hours, and more than 60 hours per week). Multiple logistic regression was performed to investigate the association between long working hours and SRH, adjusting for demographic and work-related factors. Long working hours were associated with increased risk of poor SRH, in both the men and women. Legal restriction on working hours should be suitably applied to help improve the health status of Korean young workers.

Does paid vacation leave protect against depression among working Americans? A national longitudinal fixed effects analysis

Objectives The United States is the only advanced economy globally that does not guarantee its workers paid vacation leave. Although empirical studies have linked paid vacation leave to happiness and stress, no study has investigated the association between paid vacation leave and depression. Using a nationally-representative longitudinal sample of 3380 working men and women aged 45-52 years from the National Longitudinal Survey of Youth 1979, this study explored whether paid vacation leave may protect against depression. Methods Multivariate linear and logistic regression models were employed to estimate the impacts of the number of annual paid vacation days of leave measured at age 40 on depression measured using the 7-item Center for Epidemiologic Studies Depression Scale short form (CES-D-SF) scale at age 50. Models were adjusted for demographic and socioeconomic factors, physical health, weekly hours, and individual fixed effects. Results For every ten additional days of paid vacation leave, the odds of depression in women was 29% lower [odds ratio (OR) 0.71, 95% confidence interval (CI) 0.55-0.92, P=0.01); there was no association in men. Linear regression models showed no association in either men or women. For every 10 days of paid leave, the odds of depression were 36% lower in White women and 38% lower in women with ≥2 children. Conclusions This study provides the first evidence on the linkage between paid vacation leave and depression, and supports a protective effect in White women with ≥2 children. Should this association be truly causal, and assuming a uniform effect across all ages in working adult women, the results from this study would suggest that a hypothetical increase in the average number of days of paid vacation leave of 10 days could avoid an estimated 568 442 cases of depression in women each year and lead to a cost savings of US$2.94 billion annually. Policies that mandate paid vacation leave may have marked positive impacts on the population health and economic burden of depression among working women in the USA.

Research Methodologies for Total Worker Health®: Proceedings From a Workshop

OBJECTIVE

There is growing interest in the NIOSH Total Worker Health program, specifically in the process of designing and implementing safer, health-promoting work and workplaces. A Total Worker Health (TWH) Research Methodology Workshop was convened to discuss research methods and future needs.

METHODS

Twenty-six experts in occupational safety and health and related fields reviewed and discussed current methodological and measurement issues and those showing promise.

RESULTS

TWH intervention studies face the same challenges as other workplace intervention studies and some unique ones. Examples are provided of different approaches and their applications to TWH intervention studies, and desired developments in the TWH literature.

CONCLUSIONS

This report discusses and outlines principles important to building the TWH intervention research base. Rigorous, valid methodologic, and measurement approaches are needed for TWH intervention as well as for basic/etiologic, translational, and surveillance research.