"Doing what I do best": The association between skill utilization and employee health with healthy behavior as a mediator

The legacy of immigration policies and employment exclusion: Assessing the relationship between employment exclusions and immigrant health

Restrictive federal and state immigration policies create conditions of employment exclusion that may negatively influence the health of immigrants. In particular, these policy effects are reflected in labor market and workplace experiences that determine the types of work and employment opportunities that immigrants are able to access and pursue. This study examines the relationship between both cumulative and individual measures of employment exclusion and self-rated health and psychological distress among Asian and Latino immigrants in California, and whether this relationship is modified by legal status. We used data from the Research on Immigrant Health and State Policy (RIGHTS) study (n = 2010). We used both multivariable logistic regression and linear regression models for our analyses. For cumulative models, labor market exclusion was associated with poor health (OR = 1.21, 95% CI: 1.01, 1.46). Workplace exclusion was also associated with poor self-rated health (OR = 1.45, 95% CI: 1.15, 1.82) and increased psychological distress (β = 0.69, 95% CI: 0.31, 1.07). For individual measures of employment exclusion, settling for a job - a labor market exclusion - and working in a dangerous job and experiencing wage theft - workplace exclusions - were associated with poor health and increased psychological distress. There was no evidence that the association between employment exclusions and health varied by legal status. These findings demonstrate that the combined effect of employment exclusions is detrimental to immigrant health. To improve population health, public health researchers should continue to interrogate the policy conditions at the federal, state, and local level that exclude immigrants from employment opportunities and workplace protections.

Exploring the effects of predominantly female jobs on demands and resources at work and consequently on health and performance in the Province of Québec, Canada

PURPOSE

Predominantly female jobs are undervalued because the importance of the skills (e.g., empathy, meticulousness, patience) they require is underestimated. Based on a sample of 1831 workers, this cross-sectional study aimed to determine the effect of predominantly female jobs on demands and resources at work. It also aimed to evaluate if demands and resources at work played a mediating role in the relationship between female jobs and psychological well-being, psychological distress, insomnia, and intention to quit.

METHODS

Mediation analysis to test indirect effects was conducted using MPlus software.

RESULTS

Predominantly female jobs were directly associated with lower recognition and higher skill utilization and emotional demands. Also, predominantly female jobs were indirectly associated with health and performance via their effects on demands and resources at work. Therefore, these workers appear to face higher demands and lower resources, which in turn is harmful to them.

CONCLUSION

Consequently, we might conclude that in addition to the pay inequity that is still present between men and women, those who hold predominantly female jobs (mostly women) are more vulnerable to health and performance problems because of the working conditions (demands and resources) of these jobs. At the societal level, increased knowledge of predominantly female jobs could also be achieved by, for example, popularizing the training and skills they require. Information campaigns (not just to attract people but also to eliminate misunderstanding of these jobs) could be initiated by unions, professional associations, schools, private companies, guidance or employment counselors, government, etc. At the organizational level, action could be taken in terms of human resource management practices, including job evaluation and remuneration.

Considering the role of integration experiences in shaping immigrants' post-migration food choices and eating practices

This article draws on data collected from qualitative interviews with 38 recent immigrants in two Ontario cities to provide an overview of recent immigrants' general dietary acculturation experiences. With insights from both Cockerham's health lifestyle theory and Berry's acculturation model, this article explores how structural inequalities related to integration and settlement may shape recent immigrants' post-migration food choices and eating practices. The results of this study revealed that immigrants from non-Western countries experienced greater challenges in healthy eating. Findings are in line with Cockerham's health lifestyle theory: immigrants' post-migration food choices and dietary acculturation strategies were not only bounded by socioeconomic status and cultural differences but were also shaped by various structural inequalities, especially those related to systematic barriers during the integration and settlement process. Overall, this paper provides a more holistic understanding of the multifaceted nature of immigrants' dietary acculturation experiences.

The Relationship Between Overqualification and Incident Diabetes: A 14-Year Follow-Up Study

OBJECTIVE

Recent research identified that workplace factors play a role in the development of diabetes mellitus (DM). This study examines the longitudinal association of work-related overqualification with the incidence of DM over a 14-year follow-up period.

METHODS

We used data from the 2003 Canadian Community Health Survey linked to the Ontario Health Insurance Plan and the Canadian Institute for Health Information Discharge Abstract databases. Cox proportional hazards regression models were performed to evaluate the relationship between overqualification and the incidence of DM.

RESULTS

Over the study period, there were 91,835 person-years of follow-up (median follow-up = 13.7 years). The final sample included 7026 respondents (mean [standard deviation] age at baseline = 47.1 [8.2]; 47% female). An elevated risk of DM was associated with substantial overqualification (hazard ratio = 1.58, 95% confidence interval = 1.01-2.49) after adjustment for sociodemographic, health, and work variables. Additional adjustment for body mass index and health behaviors attenuated this risk (hazard ratio = 1.30, 95% confidence interval = 0.81-2.08). Underqualification was not associated with the incidence of DM in adjusted regression models. We did not observe any statistical difference in the effects of overqualification on DM risk across sex or education groups.

CONCLUSIONS

This study adds to the growing body of research literature uncovering the relationships between work exposures and DM risk. The results from the study suggest that higher body mass index and, to a lesser extent, health behaviors may be mediating factors in the association between overqualification and incident DM. Further research on the association of overqualification with DM is warranted.

Teleworking, Work Engagement, and Intention to Quit during the COVID-19 Pandemic: Same Storm, Different Boats?

The ability to retain and engage employees is now, more than ever, a major strategic issue for organizations in the context of a pandemic paired with a persistent labor shortage. To this end, teleworking is among the work organization conditions that merit consideration. The purpose of this cross-sectional study is to examine the direct and indirect effects of teleworking on work engagement and intention to quit, as well as the potential moderating effect of organizational and individual characteristics on the relationship between teleworking, work engagement, and intention to quit during the COVID-19 pandemic, based on a sample of 254 Canadian employees from 18 small and medium organizations. To address these objectives, path analyses were conducted. Overall, we found that teleworking, use of emotion, skill utilization, and recognition appear to be key considerations for organizations that wish to increase work engagement and decrease intention to quit, in the context of a pandemic paired with a labor shortage. Our results extend the literature by revealing the pathways through which teleworking, use of emotion, skill utilization, and recognition are linked to work engagement and intention to quit, and by suggesting specific interventions and formation plans that are needed.

Abusive leadership, psychological well-being, and intention to quit during the COVID-19 pandemic: a moderated mediation analysis among Quebec's healthcare system workers

Purpose

To examine the effects from work-organization conditions, abusive leadership, and their interaction on Quebec healthcare system workers’ psychological well-being and intention to quit during the COVID-19 pandemic.

Methods

Mediation and moderated mediation analyses were performed using MPlus software on a sample of 921 Quebec healthcare system workers.

Results

Skill utilization, decision authority, social support from co-workers and supervisors, and recognition were associated directly and positively with psychological well-being, while psychological and physical demands were associated directly and negatively with psychological well-being. Skill utilization, irregular work schedule, and recognition were associated directly and negatively with intention to quit, while psychological demands were associated directly and positively with intention to quit. Moreover, the results demonstrated that abusive leadership attenuated the effects from recognition and decision authority on psychological well-being (moderation effects), contributing to greater intention to quit among workers (moderated mediation effects).

Conclusions

The obtained results underline the importance of work-organization conditions and leadership style on healthcare system workers’ psychological health and their intention to quit their jobs during a pandemic. In particular, and given their key role, leaders/managers must be sensitized concerning leadership style and its possible effects on their employees’ psychological well-being and intention to quit. Therefore, training programs should be offered to leaders/managers to prevent adoption of abusive leadership styles.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-021-01790-z.

The effect of health literacy on health status among residents in Qingdao, China: a path analysis

BACKGROUND

Health literacy is a public health goal which can be used as an independent factor of health outcomes. This study aimed to assess the association between health literacy and health status, as well as the two mediating factors of behavior and self-efficacy among residents aged 15-69 years in Qingdao.

METHODS

A cross-sectional survey was implemented among residents aged 15-69 years (N = 3793) in Qingdao, China. A combination of stratified cluster random and proportional probability sampling methods was used to select subjects for this study. Data were collected using "The Chinese Citizen Health Literacy Questionnaire (2019)". We proposed a hypothetical model for the relationship between sociodemographic characteristics, health literacy, self-efficacy, health behavior, and health status, and used path analysis to validate the hypothesis.

RESULTS

The path analysis showed that higher education (β = 0.293) and income (β = 0.135) are positively and directly associated with greater health literacy, which was positively associated with health status (β = 0.057). Health literacy is a direct influencing factor of health behavior (β = 0.070) and self-efficacy (β = 0.099). Health behavior (β = 0.041) and self-efficacy (β = 0.173) exerted a positive direct effect on health status. The model explained 14.1% of variance for health literacy, 3.8% for self-efficacy, 5.7% for health behavior, and 15.0% for health status.

CONCLUSIONS

Health literacy was identified to be a critical factor in health status. The results emphasized that the dissemination of health knowledge, development of healthy behavior, and cultivation of self-efficacy should be jointly promoted to reinforce the level of health status among residents in future work.

The Disparities on Loss of Employment Income by US Households During the COVID-19 Pandemic

This paper examines the role of the COVID-19 pandemic on the loss of employment income on different ethnic groups in the USA using weekly Household Pulse Survey (HPS) data from the US Census Bureau from August 19 to November 9, 2020. This study is significant for two reasons. First, it documents the loss of employment income on various households in the USA during the COVID-19 pandemic period from March 13, 2020, to November 9, 2020. Second, it examines the effect on the different ethnic groups based on demographic and socioeconomic status of these households. We specifically examine the role of income, employment, education, location, access to technology, and health insurance among the different age groups, race/ethnicity, and gender. We employ multivariate logistic regression analysis for the study. The study also employs Oaxaca-Blinder decomposition analysis to investigate the source of disparities in loss of employment income on the different racial/ethnic groups. The multivariate regression examines the effects of income, employment, education, location, health insurance, access to technology, different age groups, race/ethnicity, and gender. This method enables us to estimate the level of differences in loss of employment income outcomes among the various race/ethnic groups based on their socioeconomic status. Our a priori expectation is that loss of employment income and household income, educational status, and employment will be positively correlated. However, we have no a priori expectation of the correlation with location, race/ethnicity, and gender. Our results show that Hispanics, Blacks, Other, and Asians experienced a loss of employment income of 35.6%, 25.3%, 31.2%, and 6.2% higher than Whites, respectively. Equally important is that 45.9%, 40.3%, and 25.2% of the differences are unexplained or attributed to discrimination for Hispanics, Other, and Blacks, respectively.

Does Depression Mediate the Effect of Work Organization Conditions on Job Performance?

OBJECTIVE

The present study proposes to shed light on the impact of workers' depression on their work performance.

METHODS

We implemented a path analyses adjusted for design effects resulting from cluster sampling using MPlus software on a sample of 1957 workers. These analyses allowed us to evaluate direct and indirect effects (mediation) while taking into account the nonindependence of observations due to cluster sampling (workers nested in their workplace).

RESULTS

Results indicate that three indirect associations were found to be significant. Psychological demands, work schedule, and job insecurity were indirectly associated with lower levels of professional efficacy/job performance because of their positive associations with depression.

CONCLUSIONS

The results obtained suggest that interventions targeting specific work organization conditions could be warranted.

Trust in the Work Environment and Cardiovascular Disease Risk: Findings from the Gallup-Sharecare Well-Being Index

This study examined associations between trust, an important aspect of workplace social capital, with seven cardiovascular disease (CVD) risk factors (American Heart Association Life’s Simple 7 (LS7)): smoking, obesity, low physical activity, poor diet, diabetes, high cholesterol, and high blood pressure. Data are from the U.S. Gallup-Sharecare Well-Being Index (2010–2012), a nationally representative telephone survey of U.S. workers (n = 412,884). The independent variable was the response to a work environment (WE) question as to whether their supervisor always creates an open and trusting environment. Regression models were adjusted for demographic characteristics with each of the LS7 CVD risk factors as dependent variables. Twenty-one percent of workers reported that their supervisor did not create an open and trusting environment. Trust was associated with increased adjusted odds of having many of the LS7 CVD risk factors. Among those workers whose supervisor created a mistrustful environment, the odds ratios were greatest (>20%) for having four or more of the LS7 CVD risk factors.

Explaining racial/ethnic differences in all-cause mortality in the Multi-Ethnic Study of Atherosclerosis (MESA): Substantive complexity and hazardous working conditions as mediating factors

Research on racial/ethnic health disparities and socioeconomic position has not fully considered occupation. However, because occupations are racially patterned, certain occupational characteristics may explain racial/ethnic difference in health. This study examines the role of occupational characteristics in racial/ethnic disparities in all-cause mortality. Data are from a U.S. community-based cohort study (n=6342, median follow-up: 12.2 years), in which 893 deaths (14.1%) occurred. We estimated mortality hazard ratios (HRs) for African Americans, Hispanics, and Chinese Americans compared with whites. We also estimated the proportion of the HR mediated by each of two occupational characteristics, substantive complexity of work (e.g., problem solving, inductive/deductive reasoning on the job) and hazardous conditions (e.g., noise, extreme temperature, chemicals), derived from the Occupational Information Network database (O*NET). Analyses were adjusted for age, sex, nativity, working status at baseline, and study sites. African Americans had a higher rate of all-cause death (HR 1.41; 95% confidence interval [CI]: 1.19–1.66) than whites. Chinese-American ethnicity was protective (HR 0.59, CI: 0.40–0.85); Hispanic ethnicity was not significantly different from whites (HR 0.88; CI: 0.67–1.17). Substantive complexity of work mediated 30% of the higher rate of death for African Americans compared with whites. For other groups, mediation was not significant. Hazardous conditions did not significantly mediate mortality in any racial/ethnic group. Lower levels of substantive complexity of work mediate a substantial part of the health disadvantage in African Americans. This job characteristic may be an important factor in explaining racial health disparities.

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Health disparities research rarely considers occupational characteristics.

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Occupation is strongly patterned by race/ethnicity in the United States.

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Different working conditions may explain racial health disparities.

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Complexity of the job explains one-third of black-white mortality difference.