Does non-standard work mean non-standard health? Exploring links between non-standard work schedules, health behavior, and well-being

How our longitudinal employment patterns might shape our health as we approach middle adulthood-US NLSY79 cohort

Recent labor market transformations brought on by digital and technological advances, together with the rise of the service economy since the 1980s, have subjected more workers to precarious conditions, such as irregular work hours and low or unpredictable wages, threatening their economic well-being and health. This study advances our understanding of the critical role employment plays in our health by examining how employment patterns throughout our working lives, based on work schedules, may shape our health at age 50, paying particular attention to the moderating role of social position. The National Longitudinal Survey of Youth-1979 (NLSY79), which has collected 30+ years of longitudinal information, was used to examine how employment patterns starting at ages 22 (n ≈ 7,336) might be associated with sleep hours and quality, physical and mental functions, and the likelihood of reporting poor health and depressive symptoms at age 50. Sequence analysis found five dominant employment patterns between ages 22 and 49: "mostly not working" (10%), "early standard hours before transitioning into mostly variable hours" (12%), "early standard hours before transitioning into volatile schedules" (early ST-volatile, 17%), "mostly standard hours with some variable hours" (35%), and "stable standard hours" (26%). The multiple regression analyses indicate that having the "early ST-volatile" schedule pattern between ages 22 and 49 was consistently, significantly associated with the poorest health, including the fewest hours of sleep per day, the lowest sleep quality, the lowest physical and mental functions, and the highest likelihood of reporting poor health and depressive symptoms at age 50. In addition, social position plays a significant role in these adverse health consequences. For example, whereas non-Hispanic White women reported the most hours of sleep and non-Hispanic Black men reported the fewest, the opposite was true for sleep quality. In addition, non-Hispanic Black men with less than a high school education had the highest likelihood of reporting poor health at age 50 if they engaged in an employment pattern of "early ST-volatile" between ages 22 and 49. In comparison, non-Hispanic White men with a college degree or above education had the lowest likelihood of reporting poor health if they engaged in an employment pattern of stable standard hours. This analysis underscores the critical role of employment patterns in shaping our daily routines, which matter to sleep and physical and mental health as we approach middle adulthood. Notably, the groups with relatively disadvantaged social positions are also likely to be subject to nonstandard work schedules, including non-Hispanic Blacks and people with low education; hence, they were more likely than others to shoulder the harmful links between nonstandard work schedules and sleep and health, worsening their probability of maintaining and nurturing their health as they approach middle adulthood.

Behavioural therapy for shift work disorder improves shift workers' sleep, sleepiness and mental health: A pilot randomised control trial

The present study evaluates the efficacy of behavioural therapy adapted for shift work disorder with a randomised control design in a healthcare population. Forty-three night shift workers (m. age: 34 years; 77% women) experiencing shift work disorder were randomised to either the behavioural therapy for shift work disorder (BT-SWD) or a waiting-list control group offered after the waiting period. Participants completed questionnaires on insomnia, sleepiness and mental health pre- and post-treatment, pre- and post-waiting, and at follow-up, and a sleep diary. As night shift workers alternate between sleeping during the day after their night shifts and transitioning to nighttime sleep on days off, insomnia severity and sleep variables were analysed for daytime and nighttime sleep. The BT-SWD involved sleep restriction therapy, stimulus control and fixed sleep periods in the dark. Statistical analyses were performed under intent-to-treat and per-protocol approaches. Repeated-measures two-way ANCOVA analysis, controlling for age, sex and pre-treatment daytime total sleep time, was performed with Bonferroni corrections, and between-group effect sizes computed. Fourteen participants dropped out after randomisation. Under the intent-to-treat analysis, BT-SWD participants had a significant greater decrease in daytime insomnia severity and an increase in daytime total sleep time at post-treatment than the control group, with large between-group effect sizes (-1.25 and 0.89). These corresponding results were also significant with large effect sizes under the per-protocol analysis. Sleepiness, anxiety and depression levels improved at post-treatment and maintained at follow-up when the BT-SWD treated controls were added to the BT-SWD group. The behavioural therapy for shift work disorder can be used to improve the sleep and mental health of healthcare night workers.

Association between Work-related Communication Devices Use during Work Outside of Regular Working Hours and Depressive Symptoms in Wage Workers

Background

This study aimed to investigate the relationship between work-related communication devices use during work outside of regular working hours and depressive symptoms in wage workers.

Methods

Data from 50,538 workers aged 15 years or older who had participated in the 6th Korean Working Condition Survey (KWCS) were used. The final sample was 32,994 wage workers. The questionnaire asked the respondents how often they used communication devices for work during work outside of regular working hours. Depressive symptoms were assessed using WHO-5 Well-Being Index. Multiple logistic regression analysis was used to analyze the association between work-related communication devices use during work outside of regular working hours and depressive symptoms.

Results

The rate of depressive symptoms was highest among workers who did not use work-related communication devices during work outside of regular working hours. After adjusting for socio-demographic and work-related factors, the odds ratio of depressive symptoms among workers who used communication devices when working outside of regular working hours was 1.20 (95% CI: 1.09-1.32); the odds ratio of depressive symptoms in the group not using communication devices for free-time work was 1.66 (95% CI: 1.37-2.00), which was higher than that of the reference group, that is, workers who did not work outside of regular working hours, and was statistically significant.

Conclusion

Regardless of whether work-related communication devices are used, working outside of regular working hours increases depressive symptoms. The use of work-related communication devices during work outside of regular working hours can reduce the rate of depressive symptoms.

[Physician working hours and effects on health, satisfaction and healthcare]

Changes in the working environment with respect to innovative working time models are also increasingly affecting patient care. The number of physicians working part-time, for example, is continuously rising. At the same time, a general increase in chronic diseases and multimorbid conditions as well as the growing shortage of medical staff, leads to more workload and dissatisfaction among this profession. This short overview summarizes the current study situation and associated consequences regarding working hours of physicians and gives a first explorative overview of possible solutions.

Changes in Precarious Employment and Health in the United States Amidst the COVID-19 Pandemic

This study aimed to investigate the association between changes in employment precarity and changes in health amidst the COVID-19 pandemic. We conducted an online survey of 623 U.S. adults at-risk for cardiovascular disease, which queried respondents on employment, food insecurity, and blood pressure measurements in the Fall of 2020 and retrospectively, in February 2020. Respondents were also queried on perceived stress in the Fall of 2020. We created a multidimensional precarious employment score (PES) using 13 survey indicators, that operationalized the following dimensions of employment precarity (PES range: 0-13): material rewards, working time arrangements, employment stability, workers' rights, collective organization, interpersonal relations, and training opportunities. Using adjusted linear regression models, we investigated the association between a change in the PES and 1) change in systolic blood pressure, 2) change in pulse pressure, 3) change in food insecurity, and 4) perceived stress. Models controlled for race/ethnicity, age, gender, and education. Results indicated that employment precarity was 13 % higher between February and Fall 2020, particularly among women and non-Hispanic Black respondents. A change in the PES was associated with a change in food insecurity ( β : 0.02; 95 % CI:0.01, 0.03) and higher perceived stress ( β : 0.39; 95 % CI:0.25, 0.53). The PES was not associated with a change in systolic blood pressure ( β : -0.22; 95 % CI:-0.76, 0.32) nor in pulse pressure ( β : -0.33; 95 % CI: -0.73, 0.07). Policy approaches to mitigate the growth in employment precarity, and in turn food insecurity and stress, warrant consideration to prevent widening of health inequities.

Association between precarious employment and BMI in the United States

OBJECTIVE

There is growing recognition that precarious employment is an important determinant of health, which may increase BMI through multiple mechanisms, including stress. It was investigated whether increases in precarious employment were associated with changes in BMI in the United States.

METHODS

Data were from the National Longitudinal Survey of Youth adult cohort (1996-2016) (N = 7280). Thirteen indicators were identified to operationalize seven dimensions of precarious employment (range: 0-7, 7 indicating most precarious): material rewards, working-time arrangements, stability, workers' rights, collective organization, interpersonal relationships, and training. The precarious employment-BMI association was estimated using linear regression models and an instrumental variables approach; state- and individual-level firm sizes were the instruments for precarious employment. Models also included individual and year fixed effects and controlled for age, marital status, education, region, and industry.

RESULTS

The average precarious employment score (PES) was 3.49 (95% CI: 3.46-3.52). The PES was the highest among Hispanic (4.04; 95% CI: 3.92-4.15) and non-Hispanic Black (4.02; 95% CI: 3.92-4.12) women with lower education. A 1-point increase in the PES was associated with a 2.18-point increase in BMI (95% CI: 0.30-4.01).

CONCLUSIONS

Given that even small changes in weight affect chronic disease risk, policies to improve employment quality warrant consideration.

Oral health outcomes and shift working among male workers: A cross-sectional survey

Working time outside routine daily working hours is known as shift working. Studies have shown adverse effects of shift working such as stress, obesity, and diabetes on the workers' health. The aim of the present study was to compare aspects of oral health in shift workers and non-shift workers of a cement factory in Shahroud, Iran. Study population comprised of 180 male workers of the factory in the year 2015. Convenience sampling was continued until recruiting 180 subjects of shift- and non-shift workers. Data collection included oral health questionnaire, health and safety executive (HSE) questionnaire, and clinical oral examination. The Chi-square test, Pearson correlation coefficient, and generalized Poisson model were employed for statistical evaluation. Mean age of the workers was 39.19 (±9.48); 53% had educational level of less than diploma. Their mean DMFT was 12.89 (±5.75) which correlated with number of years in shift work schedule (Pearson correlation coefficient: 0.41; p<0.001) but not correlated with job stress (Pearson correlation coefficient: -0.11; p = 0.12). Mean number of deep periodontal pockets among the workers was 5.03 (±1.84) that showed correlation with number of years in shift work schedule (Pearson correlation coefficient: 0.33; p<0.001) but no correlation with job stress (Pearson correlation coefficient: -0.03; p = 0.68). Adherence to various oral health behaviors was reported by less than half of the workers. Positive correlation of dental caries and periodontal diseases with shift working partly signals negative impact of working conditions on oral health among this group of workers which calls for modifications in their working environment to facilitate health practices.

Association between polarity of first episode and solar insolation in bipolar I disorder

OBJECTIVE

Circadian rhythm disruption is commonly observed in bipolar disorder (BD). Daylight is the most powerful signal to entrain the human circadian clock system. This exploratory study investigated if solar insolation at the onset location was associated with the polarity of the first episode of BD I. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area of the Earth.

METHODS

Data from 7488 patients with BD I were collected at 75 sites in 42 countries. The first episode occurred at 591 onset locations in 67 countries at a wide range of latitudes in both hemispheres. Solar insolation values were obtained for every onset location, and the ratio of the minimum mean monthly insolation to the maximum mean monthly insolation was calculated. This ratio is largest near the equator (with little change in solar insolation over the year), and smallest near the poles (where winter insolation is very small compared to summer insolation). This ratio also applies to tropical locations which may have a cloudy wet and clear dry season, rather than winter and summer.

RESULTS

The larger the change in solar insolation throughout the year (smaller the ratio between the minimum monthly and maximum monthly values), the greater the likelihood the first episode polarity was depression. Other associated variables were being female and increasing percentage of gross domestic product spent on country health expenditures. (All coefficients: P ≤ 0.001).

CONCLUSION

Increased awareness and research into circadian dysfunction throughout the course of BD is warranted.

The measure of precarious employment and its impact on the mental health of workers: A systematic review 2007–2020

BACKGROUND: Precarious employment conditions can influence the worker’s mental health; however, there is no consensus regarding the definition of precarious employment or the way it is measured. OBJECTIVE: The objective is to identify existing research of the conceptual framework, the ways to measure precarious employment and its impact on the mental health of workers. METHODS: A systematic review with the strategic search for observational-empirical and qualitative studies published between 2007 and 2020 in Embase, Scopus and PubMed, full text, in English and Spanish. Studies were selected and excluded, according to eligibility criteria. Two independent reviewers and one arbitrator evaluated the quality of selected papers with the STROBE guidelines for observational studies and SRQR for qualitative ones. RESULTS: 408 studies were obtained, 21 met inclusion criteria, in 14 studies precarious employment was measured one-dimensionally. Of these, 11 with the dimension of temporality and three with insecurity. Four studies it was measured in a multidimensional way, with the Employment Precariousness Scale (EPRES) and in three qualitative designs, with different categories of analysis. Mental health was measured with SF-36 (n = 4), GHQ-12 (n = 3) and CES-D (n = 3). CONCLUSIONS: The concept of precarious employment requires a multidimensional construct, although the tendency to measure precarious employment is one-dimensional. Regardless of how is measured, this has a negative impact on the mental health of workers. The outcomes related to this social determinant included depression, depressive symptoms, psychological distress, stress, and suicidal thoughts. Youths, women, people with low levels of education and immigrants are the groups that show the major precariousness.

It's about time - Associations between working time dimensions and well-being of physicians

Several working time characteristics have been linked to negative outcomes for health personnel. The aim was to investigate the impact of working time dimensions on well-being in a representative sample of physicians. Data was collected during a baseline study. Linear regression analysis was performed on a sample including 669 physicians of different medical specialties. The questionnaire included sociodemographic characteristics and information on working time dimensions (e.g. shift work). In addition, job satisfaction, workload and self-reported health were explored. The majority were female, working in internal medicine and the mean age was 42.5 years. Findings reveal that overtime hours (β = -0.478, p = .011) and autonomy (β = 0.444, p < .001) were significantly associated with job satisfaction. The number of free weekends (β = -2.622, p = .005) and autonomy significantly predicted personal (β = -6.153, p < .001), work-related (β = -6.597, p < .001) and patient-related workload (β = -4.731, p < .001). Overall health was only affected by working time autonomy (β = 3.804, p < .001). In conclusion, the study suggests that working time characteristics have negative consequences for well-being and need to be addressed to ensure health, performance and safety of physicians.

Shift work disorder and the prevalence of help seeking behaviors for sleep concerns in Australia: A descriptive study

Shift work disorder (SWD) is a circadian rhythm sleep-wake disorder, defined by symptoms of insomnia and excessive levels of sleepiness resulting from work that occurs during non-standard hours. Sleep problems are common in shift workers, yet our understanding of help seeking behaviours for sleep in shift workers is limited. The primary aim of this study was to examine the help seeking behaviours of Australian workers who meet criteria for SWD. Of the 448 (46% of sample, n = 964 total) Australian workers reporting non-standard work hours, 10.5% (n = 41) met the criteria for probable shift work disorder (pSWD). Non-standard workers with pSWD did not seek help for sleep problems at higher rates than workers without SWD. Of the small proportion of workers with pSWD who sought help, general practitioners were the most common healthcare professionals for sleep problems. Self-management was common in workers with pSWD, with a high self-reported prevalence of alcohol use (31.7%) as a sleep management strategy, and caffeine consumption (76.9%) as a sleepiness management strategy. The majority of individuals with pSWD reported the mentality of 'accept it and keep going' as a sleepiness management strategy, highlighting a potential barrier to help seeking behaviour in workers with pSWD. These findings provide novel insight into the help seeking behaviours of those with pSWD. There is a need for further research to understand why individuals at risk for SWD are not actively seeking help, and to develop health promotion and intervention strategies to improve help seeking when needed.

Precarious Work Schedules and Sleep: A Study of Unionized Full-Time Workers

Unlike precarious employment which is temporary and insecure, with inadequate pay, benefits, and legal protections, precarious work schedules can affect workers with permanent full-time jobs in sectors where employment has historically been secure, well-compensated, and even unionized. Precarious work schedules - characterized by long shifts, non-daytime hours, intensity and unsocial work hours - are increasingly prevalent. Relations between precarious work schedules and poor health are not well understood, and less is known about how to attenuate this relation. We examined the indirect effects of precarious work schedules on fatigue and depressive symptoms through sleep quantity. Two moderators - schedule flexibility and sleep quality - were examined as buffers of these associations. Workers from the Departments of Correction and Transportation in a northeast state (N = 222) took surveys and reported on demographics, work schedule characteristics, schedule flexibility, sleep quality and quantity, fatigue, and depressive symptoms. Results revealed that precarious work schedules had indirect effects on fatigue and depressive symptoms through sleep quantity. Schedule flexibility moderated the relation between precarious work schedules and sleep quantity, such that workers with greater schedule flexibility had more hours of sleep. Sleep quality moderated the association between sleep quantity and fatigue and depressive symptoms, such that workers reported greater fatigue and depressive symptoms when they had poorer sleep quality. Findings have direct applicability for developing initiatives that enhance Total Worker Health® through individual and organizational changes.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41542-022-00114-y.

Working Conditions Influencing Drivers' Safety and Well-Being in the Transportation Industry: "On Board" Program

The conditions of work for professional drivers can contribute to adverse health and well-being outcomes. Fatigue can result from irregular shift scheduling, stress may arise due to the intense job demands, back pain may be due to prolonged sitting and exposure to vibration, and a poor diet can be attributed to limited time for breaks and rest. This study aimed to identify working conditions and health outcomes in a bussing company by conducting focus groups and key informant interviews to inform a Total Worker Health^® organizational intervention. Our thematic analysis identified three primary themes: lack of trust between drivers and supervisors, the scheduling of shifts and routes, and difficulty performing positive health behaviors. These findings demonstrate the value of using participatory methods with key stakeholders to determine the unique working conditions and pathways that may be most critical to impacting safety, health, and well-being in an organization.

Association Between Unpredictable Work Schedules and Depressive Symptoms in Korea

Backgrounds

Irregular and unpredictable work schedules have become more common in most societies. The purpose of this study was to investigate the association between unpredictable work schedules and depressive symptoms in Korea.

Methods

Data from 34,486 workers who participated in the Korean Working Condition Survey in 2017 were used. Unpredictable work schedules were measured by questions about the frequency of changes in work schedule and limited advanced notice. Depressive symptoms were assessed by a single item asking if the participants had depressive symptoms over the last 12 months. Multivariable-adjusted logistic regression analysis was used to calculate odds ratios (ORs) for high depressive symptoms.

Results

The OR for depressive symptoms was significantly higher in the workers with unpredictable work schedules compared to those with predictable work schedules after controlling for age, sex, education, salary, marital status, occupation, contract period, full-time versus part-time, shift work, weekly working hours, and having a child under the age of 18 years (OR = 2.43, 95% confidence interval 1.93–3.07).

Conclusion

Unpredictable work schedules were associated with depressive symptoms controlling for the other dimensions of precarious employment in a representative working population in Korea.

Prevalence of Insomnia in Various Industries and Associated Demographic Factors in Night-Shift Workers Using Workers' Specific Health Examination Data

This study aimed to investigate the prevalence of insomnia in various industries and the associated demographic factors. We searched the nationwide night-shift Workers’ Specific Health Examination (nsWSHE) data extracted in 2015 information on factors associated with insomnia, including sex, age, and the number of workers in the workplace. The prevalence of moderate insomnia in the total industry was 4.6%. Industries with a high prevalence of insomnia included the arts, sports, and recreation-related services industry, followed by the activities of household as employers industry, financial and insurance activities industry, human health and social welfare industry, and accommodation and food services activities industry. The prevalence of insomnia was higher in women. Age was a significant factor. In general, insomnia was highest among those aged ≥60 years. Insomnia was highest in small-sized companies with fewer than five employees compared to large enterprises with more than 1000 employees. This study is the first to analyze the prevalence of insomnia among night-shift workers who participated in the WSHEs. The findings of this study can be used to prioritize intervention policies for insomnia among night-shift workers.

Work-related physical and psychosocial risk factors cluster with obesity, smoking and physical inactivity

Objective

This study investigated associations between the co-existence of multiple types of work-related psychosocial and physical risk factors, and (1) obesity; (2) smoking; and (3) leisure-time physical inactivity. It also aimed to identify sociodemographic characteristics related to clustering of work-related risk factors and lifestyle factors.

Methods

Cross-sectional data on work-related risk factors (e.g., decision authority and repetitive movements) and lifestyle was measured using a standardized questionnaire among 52,563 Dutch workers in health care, services, manufacturing and public sector. Multiple-adjusted logistic regression models assessed associations between the co-existence of multiple types of psychosocial and physical risk factors and lifestyle factors. Additionally, logistic regression models related age, gender and educational level to clustering of risk factors and lifestyle factors.

Results

The co-existence of multiple types of work-related psychosocial risk factors was associated with higher odds of smoking and being physically inactive. For example, workers exposed to three psychosocial risk factors had a 1.55 times higher odds of being physically inactive (95%CI: 1.42–1.70) compared to unexposed workers. A higher number of physical risk factors was also significantly associated with higher odds of smoking and obesity. The co-existence of multiple types of physical risk factors was not associated with higher odds of physical inactivity. Clustering of work-related risk factors and at least one unhealthy lifestyle factor occurred in particular among workers with low educational level.

Conclusions

Results imply that interventions are needed that focus on workers with a low educational level and address work-related physical and psychosocial risk factors as well as lifestyle.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-020-01627-1.

Men's Physical Activity and Sleep Following a Workplace Health Intervention: Findings from the POWERPLAY STEP Up challenge

The workplace provides an important delivery point for health promotion, yet many programs fail to engage men. A gender-sensitive 8-week team challenge-based intervention targeting increased physical activity was delivered at a petrochemical worksite. The purpose of this study was to examine men's pre-post physical activity and sleep following the intervention, as well as to explore program acceptability and gather men's recommendations for health promotion. Pre-post surveys assessed physical activity, sleep, program exposure, acceptability, and suggestions for continued support. Overall, 328 men completed baseline surveys and 186 (57%) completed follow-up surveys. Walking increased by 156.5 min/week, 95% confidence interval (61.2, 251.8), p = .001. Men with higher program exposure increased moderate and vigorous activity 49.4 min more than those with low exposure (p = .026). Sleep duration and quality were higher postintervention, though changes were modest. Program acceptability was high as was intention to maintain physical activity. Men's suggestions to enable physical activity involved workplace practices/resources, reducing workload, and leadership support. These findings suggest that a gender-sensitive physical activity workplace intervention showed promise for improving physical activity and sleep among men. The men's suggestions reflected workplace health promotion strategies, reinforcing the need for employers to support ongoing health promotion efforts.

Prevalence of Probable Shift Work Disorder in Non-Standard Work Schedules and Associations with Sleep, Health and Safety Outcomes: A Cross-Sectional Analysis

PURPOSE

We aimed to estimate the prevalence of probable shift work disorder (pSWD) in a representative sample of Australian workers and identify sleep, health and safety correlates.

PATIENTS AND METHODS

In 2019, data were collected from working respondents as part of a cross-sectional national sleep health survey conducted online (n=964 total; n=448 individuals on non-standard work schedules). We established the prevalence of pSWD according to International Classification of Sleep Disorders criteria (ICSD-R, ICSD-2 and ICSD-3). Poisson regression was used to determine crude and adjusted prevalence association (prevalence ratio, PR) of pSWD with sleep, health and safety outcomes.

RESULTS

Overall prevalence of pSWD in workers on non-standard work schedules was 10.5%, ranging from 9.6% in early morning workers to 12.7% in rotating shift workers. In adjusted models, workers who met the criteria for pSWD were 1.8 times more likely to report both depression/bipolar disorder, and anxiety/panic disorder, and 1.7 times more likely to report work errors due to a sleep problem.

CONCLUSION

The prevalence of pSWD in employees engaged in non-standard work schedules is influenced by selection of factors used to quantify pSWD, including sleep/wake patterns. Higher likelihoods of mental health problems and workplace errors in those with pSWD highlight the importance of intervention and management of this under-recognised sleep disorder.

TRABALHO POR TURNOS E VIDA FAMILIAR E SOCIAL NA PERSPECTIVA DOS/AS FILHOS/AS

Nos estudos sobre o impacto do trabalho por turnos nos domínios social e familiar é mais comum os efeitos serem estudados ao nível do/a trabalhador/a e na sua própria perspectiva. Tendo em consideração tal constatação, o presente estudo pretende compreender o impacto do trabalho por turnos na esfera familiar e social, tendo em conta a perspectiva dos/as filhos/as de trabalhadores/as por turnos. Participaram no estudo 19 filhos/as de trabalhadores/as por turnos. A recolha de dados foi realizada por meio de entrevista semiestruturada, tendo esta abordado temas como tempo em família, comunicação ou acompanhamento escolar. De um modo geral, os resultados indicaram a existência quer de impactos negativos (tempo em família, educação parental, acompanhamento escolar, atividades regulares, atividades pontuais e comunicação), quer de impactos positivos (acompanhamento escolar, atividades pontuais) ou, sem percepção de impacto, nas áreas avaliadas. O impacto percepcionado pelos/as filhos/as nas diferentes áreas avaliadas está em boa medida dependente do tipo de horário de trabalho a que está sujeito o progenitor que labora por turnos e da flexibilidade permitida ou não pela organização na gestão dos horários de trabalho (ex., possibilidade ou não de permutas).

Constrained choices: Combined influences of work, social circumstances, and social location on time-dependent health behaviors

BACKGROUND

Physical activity and sleep are two time-dependent behaviors with important health implications. The amount of time people have to engage in these behaviors may vary based on their everyday work, social circumstances (e.g., parenthood), and social location (e.g., gender).

AIMS

The current study aimed to explore the ways work, social circumstances, and social locations combine that lead to heterogeneity in the time-dependent health behaviors of physical activity and time spent in bed (i.e., sleep) among a young adult population. We drew upon two conceptual frameworks-Constrained Choices and an intersectionality perspective-and examined multiple work characteristics (e.g., number of jobs), social circumstances (e.g., household income), and social locations (e.g., U.S. nativity) relevant to young adulthood.

METHODS

2015-2016 data from a Minneapolis-St. Paul, U.S. cohort of 1830 young adults (25-36 years) were analyzed using conditional inference tree (CIT)-a data-driven approach which identifies population sub-groups that differ in their outcome values as well as in the interacting factors that predict outcome differences. Sensitivity analyses to evaluate CIT robustness were also performed.

RESULTS

CITs revealed four relevant sub-groups for physical activity (sub-group averages ranged = 2.9-4.9 h per week), with working mothers achieving the least activity, and six relevant sub-groups for time in bed (range = 7.8-8.7 h per day), with full-time working men obtaining the least. In both models, parent status and employment status/hours were found to consistently differentiate behavior among women but not men.

CONCLUSION

According to these data, time to engage in physical activity and time in bed was constrained by particular everyday contexts (work and parent status) and the extent to which these contexts mattered also depended on gender. If replicated in other studies, results suggest equitable strategies are necessary to assist all parents and workers in engaging in these time-dependent health behaviors for long-term health.

Resetting the Aging Clock: Implications for Managing Age-Related Diseases

Worldwide, individuals are living longer due to medical and scientific advances, increased availability of medical care and changes in public health policies. Consequently, increasing attention has been focused on managing chronic conditions and age-related diseases to ensure healthy aging. The endogenous circadian system regulates molecular, physiological and behavioral rhythms orchestrating functional coordination and processes across tissues and organs. Circadian disruption or desynchronization of circadian oscillators increases disease risk and appears to accelerate aging. Reciprocally, aging weakens circadian function aggravating age-related diseases and pathologies. In this review, we summarize the molecular composition and structural organization of the circadian system in mammals and humans, and evaluate the technological and societal factors contributing to the increasing incidence of circadian disorders. Furthermore, we discuss the adverse effects of circadian dysfunction on aging and longevity and the bidirectional interactions through which aging affects circadian function using examples from mammalian research models and humans. Additionally, we review promising methods for managing healthy aging through behavioral and pharmacological reinforcement of the circadian system. Understanding age-related changes in the circadian clock and minimizing circadian dysfunction may be crucial components to promote healthy aging.

Feasibility and Preliminary Efficacy of an m-Health Intervention Targeting Physical Activity, Diet, and Sleep Quality in Shift-Workers

Poor health behaviors are prevalent in shift-workers, but few multiple health-behavior interventions consider their unique needs. This study aimed to (1) evaluate the feasibility and acceptability of an existing app-based intervention to improve physical activity, diet, and sleep quality in a shift-worker population, (2) estimate intervention effect in a four-week pilot randomized controlled trial (RCT) (ACTRN12618001785291). Shift-workers (18–65 years old) were randomized to intervention (n = 20) or wait-list (n = 20) groups. Outcomes included recruitment, engagement, attrition, usefulness ratings, System Usability Scale (SUS), qualitative interviews, and estimation of treatment effect (minutes of physical activity, diet quality, and sleep quality) using mixed model analysis. Recruitment took one week. App-use at week four was 55% (11/20), 85% (34/40) completed the four-week follow-up questionnaire, and 20% (4/20) of the intervention group completed the qualitative interview. The intervention was rated as slightly to moderately useful by 76.9% (10/13) of participants on a five-point scale. The SUS score was 62.7 (12.7) out of 100. Diet quality improved for the intervention (4.5 points; 95% confidence interval (CI) = 0.1, 8.9; p = 0.047) vs. the wait-list group, but not physical activity or sleep quality. Qualitative interviews found that a more tailored intervention, more accessible information, and interactive features were desired. The intervention was feasible in terms of recruitment, but modifications to increase engagement are needed.

Change in Obesity Prevalence among New York City Adults: the NYC Health and Nutrition Examination Survey, 2004 and 2013-2014

The objective of this study was to measure change in obesity prevalence among New York City (NYC) adults from 2004 to 2013-2014 and assess variation across sociodemographic subgroups. We used objectively measured height and weight data from the NYC Health and Nutrition Examination Survey to calculate relative percent change in obesity (≥ 30 kg/m2) between 2004 (n = 1987) and 2013-2014 (n = 1489) among all NYC adults and sociodemographic subgroups. We also examined changes in self-reported proxies for energy imbalance. Estimates were age-standardized and statistical significance was evaluated using two-tailed T tests and multivariable regression (p < 0.05). Between 2004 and 2013-2014, obesity increased from 27.5 to 32.4% (p = 0.01). Prevalence remained stable and high among women (31.2 to 32.8%, p = 0.53), but increased among men (23.4 to 32.0%, p = 0.002), especially among non-Latino White men and men age ≥ 65 years. Black adults had the highest prevalence in 2013-2014 (37.1%) and Asian adults experienced the largest increase (20.1 to 29.2%, p = 0.06), especially Asian women. Foreign-born participants and participants lacking health insurance also had large increases in obesity. We observed increases in eating out and screen time over time and no improvements in physical activity. Our findings show increases in obesity in NYC in the past decade, with important sociodemographic differences.