Does workplace social capital buffer the effects of job stress? A cross-sectional, multilevel analysis of cigarette smoking among U.S. manufacturing workers

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.

Adverse childhood experiences, adult anxiety and social capital among women in rural Kenya

Hundreds of millions of people suffer anxiety disorders globally, demonstrating need for scalable and effective interventions. Adverse childhood experiences contribute to this mental health burden. The stress-buffering hypothesis, which posits social factors moderate prior adversity and subsequent mental health outcomes, provides one theoretical avenue to consider observations that group-based microfinance programs improve social capital. We investigate associations between adverse childhood experiences, generalized anxiety among adults and social capital associated with participation in a group-based microfinance program in rural Kenya. Adult participants (n = 400 women) responded to standardized measures of childhood adversity in June 2018, group-affiliated social capital and generalized anxiety in June 2019. Cumulative adverse childhood experiences predicted higher anxiety, which was statistically moderated by the presence of group-affiliated interpersonal trust. This study is the first to find social capital associated with participation in a group-based microfinance program statistically moderates expected associations between adverse childhood experiences and adult generalized anxiety. Future study should be conducted using a cluster-randomized control design to further assess the potential of this intervention method to ameliorate associations between past adversity and current mental health.

Effects of Multifaceted Determinants on Individual Stress: The Mediating Role of Social Capital

Stress substantially results in various negative health outcomes. While there is a nexus between social capital and individual stress, previous studies have primarily explored the direct relationship between them. Social capital may potentially have an indirect effect on perceived stress via social networking pathways that provide accessible resources. This study addresses this research gap by exploring the mediating effect of social capital for associations between personal-level features, personal-level behaviors, physical environments, and perceived stress. A household drop-off survey of 600 respondents was collected from two neighborhoods in Korea and analyzed by structural equation models. Results showed that social capital acted as a mediator on perceived stress level. The frequency of community center use had both direct and indirect impacts on stress level through social capital. Those who were satisfied with the cleanliness of the neighborhood had a higher level of social capital and a lower level of stress indirectly through social capital. Households with more children had a lower level of social capital, while persons who had chronic disease and were more extroverted, agreeable, and open to others enjoyed a higher level of social capital. The results provide policy implications on how community revitalization affects social capital and perceived stress.

Multi-Level Social Capital and Subjective Wellbeing Among the Elderly: Understanding the Effect of Family, Workplace, Community, and Society Social Capital

Background

Maintaining the subjective wellbeing of the elderly people is one of the major concerns in promoting health aging. This study concerned the influence of multi-level social capital on subjective welling and explored the affecting path among the elderly.

Methods

A total of 1,078 elderly individuals anonymously and effectively surveyed in 2018, data was collected including their family, workplace, community, society social capital and subjective wellbeing, we used the structural equation modeling to test the hypothesis relationships among the variables.

Results

We found that the total score of subjective wellbeing among the aging participants was 72.36 ± 10.08 on a range of 0–100. Family (β = 0.151, P < 0.001), workplace (β = 0.090, P < 0.001), community (β = 0.163, P < 0.001) social capital had a direct positive effect on subjective wellbeing. Society social capital had a direct positive effect on family (β = 0.253, P < 0.001), workplace (β = 0.585, P < 0.001), community (β = 0.438, P < 0.001) social capital. And society social capital had an indirect positive effect on subjective wellbeing through the mediating role of family, workplace, and community social capital.

Conclusion

The research demonstrated that all the micro, meso and macro levels of social capital have protective effects for subjective wellbeing through direct or indirect way, inspiring to provide continuous improvement measures for multi-level social capital aimed at the elderly people.

Differences in occupational stress by smoking intensity and gender in cross-sectional study of 59 355 Japanese employees using the Brief Job Stress Questionnaire (BJSQ): the Niigata Wellness Study

OBJECTIVES

It has been hypothesised that smoking intensity may be related to occupational stress. This study aimed to investigate whether stress, including problems with superiors or co-workers, is a driver of smoking.

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

59 355 employees (34 865 men and 24 490 women) across multiple occupations who completed a self-reported questionnaire-based occupational stress survey between April 2016 and March 2017 in Niigata Prefecture.

MAIN OUTCOME MEASURES

Stress scores for the Brief Job Stress Questionnaire subscales summed up after assigning high points for high stress and converted to Z-scores based on the mean of all participants. Heavy smokers (HS) smoked ≥15 cigarettes/day and light smokers (LS) smoked <15 cigarettes/day and were compared with non-smokers (NS) by gender.

RESULTS

The main subscale items that were significantly associated with smoking status in both genders included 'physical burden', 'irritation' and 'physical symptoms'. In the analysis that included smoking intensity, the stress score for 'co-workers' support' was significantly lower for LS men than NS men (NS 0.091±0.98, LS -0.027±1.00, HS 0.033±0.99), and was significantly higher for HS women than NS women (NS -0.091±1.00, LS -0.080±1.05, HS 0.079±1.03). However, the stress score for 'co-workers' support' was low among LS women aged ≤39 years in the manufacturing industry.

CONCLUSIONS

It was speculated that LS men and some LS women gained 'co-workers' support' using smoking as a communication tool while reducing the degree of smoking. The existence of such 'social smokers' suggested that to promote smoking cessation, measures are essential to improve the communication between workers in addition to implementing smoking restrictions in the workplace.

Towards an understanding of how stress and resources affect the nonmedical use of prescription drugs for performance enhancement among employees

Based on assumptions of the Job Demands-Resources model, we investigated employees’ willingness to use prescription drugs such as methylphenidate and modafinil for nonmedical purposes to enhance their cognitive functioning as a response to strain (i.e., perceived stress) that is induced by job demands (e.g., overtime, emotional demands, shift work, leadership responsibility). We also examined the direct and moderating effects of resources (e.g., emotional stability, social and instrumental social support) in this process. We utilized data from a representative survey of employees in Germany (N = 6454) encompassing various job demands and resources, levels of perceived stress, and willingness to use nonmedical drugs for performance enhancement purposes. By using Structural Equation Models, we found that job demands (such as overtime and emotional demands) and a scarcity of resources (such as emotional stability) increased strain, consequently directly and indirectly increasing the willingness to use prescription drugs for cognitive enhancement. Moreover, emotional stability reduced the effect of certain demands on strain. These results delivered new insights into mechanisms behind nonmedical prescription drug use that can be used to prevent such behaviour and potential negative health consequences.

Workplace social capital and refraining from seeking medical care in Japanese employees: a 1-year prospective cohort study

OBJECTIVES

We examined the association of workplace social capital (WSC), including structural and cognitive dimensions, with refraining from seeking medical care (RSMC) among Japanese employees.

DESIGN

One-year prospective cohort study.

SETTING AND PARTICIPANTS

We surveyed 8770 employees (6881 men and 1889 women) aged 18-70 years from 12 firms in Japan using a self-administered questionnaire comprising the WSC scale and the items on potential confounders (ie, age, educational attainment and equivalent annual household income) at baseline (from April 2011 to March 2013).

OUTCOME MEASURES

At a 1-year follow-up, we measured RSMC using a single-item question 'In the past year, have you ever refrained from visiting a hospital, clinic, acupuncturist or dentist despite your sickness (including a slight cold or cavity) or injury?'

RESULTS

The results of Cox regression with robust variance showed that, after adjusting for potential confounders, the low WSC group (ie, the lowest tertile group) had a significantly higher relative risk (RR) of RSMC compared with the high WSC group (ie, the highest tertile group) among both men and women (overall WSC: RR 1.09 (95% CI 1.01 to 1.17) and 1.20 (95% CI 1.06 to 1.37); structural dimension: RR 1.13 (95% CI 1.04 to 1.22) and 1.25 (95% CI 1.07 to 1.45); and cognitive dimension: RR 1.11 (95% CI 1.03 to 1.20) and 1.21 (95% CI 1.06 to 1.38), respectively). Trend analysis using a continuous score of the WSC scale also showed a significant association of low WSC with a higher risk of RSMC among both men and women.

CONCLUSIONS

Our findings suggest that the lack of social capital in the workplace is associated with RSMC among Japanese employees.

Quality of supervisor behaviour, workplace social capital and psychological well-being

Background

Employees with a higher level of workplace social capital (i.e. relationships, trust and reciprocity at work) have a lower risk of mental health problems. Supervisor behaviour may be a predictor of workplace social capital.

Aims

To examine the associations between supervisor behaviour, workplace social capital and psychological well-being.

Methods

We conducted a secondary analysis of the sixth European Working Conditions Survey. The study sample included 28 900 employees in 35 European countries with an immediate line manager. Depression was assessed with the WHO-5 Well-Being Index. Supervisor behaviour quality and workplace social capital were each measured with a 6-item question. Association between quality of supervisor behaviour and workplace social capital was analysed using a hierarchical linear modelling. A mediation analysis was conducted by using hierarchical logistic models of depression with and without workplace social capital index.

Results

A higher supervisor behaviour quality index was associated with an increased workplace social capital index (β, 0.55; 95% confidence interval [CI], 0.51–0.59). A higher workplace social capital index was associated with lower odds of depression (odds ratio [OR], 0.89; 95% CI, 0.87–0.90). A higher supervisor behaviour quality index was associated with lower odds of depression (OR, 0.90; 95% CI, 0.89–0.92); 58% of the effect was mediated by workplace social capital.

Conclusions

Our findings support the hypothesis that better supervisor behaviour quality increases workplace social capital and contributes to psychological well-being of employees. This may be useful for planning organizational interventions to enhance mental health of workers.

Association of overtime work hours with various stress responses in 59,021 Japanese workers: Retrospective cross-sectional study

This study aims to clarify the relationships between length of overtime work and various stress responses using large-scale cross-sectional data of Japanese workers. This study's participants are 59,021 Japanese workers in 117 companies. Data was collected by self-reporting questionnaire. The Brief Job Stress Questionnaire was used to measure stress responses on six scales (i.e. "lack of vigor", "irritability", "fatigue", "anxiety", "depression", and "somatic responses"). Length of overtime work hours were classified as 0-20, 21-30, 31-40, 41-50, 51-60, 61-70, 71-80, and >80 hours/month. Multiple linear regression analyses were used to examine the association of stress responses with overtime while adjusting all possible confounders. In result, workers with longer overtime showed significantly higher "irritability", "fatigue", "anxiety", "depression", and "somatic responses" for both genders (p-for-trend <0.001), however, length of overtime was negatively associated with "lack of vigor" among men (p-for-trend <0.001). Men with 61-80 hours of overtime showed high fatigue with high vigor at the same time. Length of overtime was linearly associated with various stress responses, except for "lack of vigor". Length of overtime shows linear associations with various psychosomatic stress responses. However, "lack of vigor" was not consistently associated with overtime. Male workers with 61-80 hours of monthly overtime were more likely to feel vigorous than workers with shorter overtime. However, potential longterm effects of such extreme overtime should not be underestimated and must be paid attention to.

Successful Strategies to Address Disparities: Insurer and Employer Perspectives

Disparities in cancer have been documented for decades and continue to persist despite clinical advancements in cancer prevention, detection, and treatment. Disparate cancer outcomes continue to affect many populations in the United States and globally, including racial and ethnic minorities, populations with low income and education, and residents of rural areas or low socioeconomic neighborhoods, among others. Addressing cancer disparities requires approaches that are multilevel. Addressing social determinants of health, such as removing obstacles to health (e.g., poverty, discrimination, access to housing and education, jobs with fair pay, and health care) can reduce cancer disparities. However, to achieve cancer health equity, multilevel approaches are required to ensure that access to high-quality cancer care and equitable receipt of evidence-based services can reduce cancer disparities. Policy, health system interventions, and innovative delivery and health care coverage approaches by private and public payers, employer-based payers, and labor union organizations can assist in ensuring access to and receipt of high-quality cancer care while addressing the high costs of care delivery. Partnerships among patients, caregivers, employers, health care providers, and health care payers can make impactful changes in the way in which cancer care is delivered and, in turn, can assist in reducing cancer disparities.

Relationship between workplace social capital and suicidal ideation in the past year among employees in Japan: a cross-sectional study

Background

A growing body of evidence has demonstrated the associations between social capital and health. In residential or geographical areas, social capital has attracted attention for its protective effects against suicide. However, to this date, the relationship between social capital and suicidal ideation is not fully elaborated in the occupational setting. Therefore, the aim of the present study was to examine the association between workplace social capital and suicidal ideation in the past year among employees in Japan.

Methods

A cross-sectional, web-based survey was conducted in February/March 2017 via an anonymous self-administered questionnaire distributed to workers in Tsukuba Science City, Japan. Binomial logistic regressions were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for suicidal ideation in the past year, controlling for age group, marital status, educational attainment, and annual household income. The results were shown stratified by sex and occupation.

Results

In total, 7255 of 19,481 workers responded, out of which we could analyze 6325 responses (4030 men, 2295 women). The prevalence of suicidal ideation in the past year was 5.9% for men and 7.8% for women. Low workplace social capital was statistically significantly associated with suicidal ideation both for men (OR = 2.57, 95% CI = 1.72–3.83) and for women (OR = 1.75, 95% CI = 1.15–2.66), compared with high workplace social capital after controlling for socioeconomic factors.

Conclusion

Higher workplace social capital was associated with a reduced risk of suicidal ideation in the past year. Promoting workplace social capital could contribute to preventing suicide among employees in Japan.

Association of workplace social capital with psychological distress: results from a longitudinal multilevel analysis of the J-HOPE Study

OBJECTIVES

Workplace social capital (WSC) is increasingly recognised as a social contextual determinant of workers' mental health, but longitudinal data are sparse. We aimed to evaluate the impact of changes in unit-level WSC on psychological distress among Japanese employees using a prospective multilevel repeated-measures design.

PARTICIPANTS AND STUDY DESIGN

We conducted a 2-year prospective cohort study with 1,944 men and 786 women aged 18-65 years. Participants worked at two manufacturing worksites in Japan and were free from mental illness from the first to third study waves. We used a three-level multilevel regression design to evaluate the prospective association of unit-level WSC with individual-level psychological distress. WSC was measured using a validated six-item instrument and individual-level psychological distress with the Kessler Psychological Distress Scale (K6).

RESULTS

The null model indicated a significant degree of between-work unit variation in psychological distress (intraclass correlation=0.1%, p<0.001). In the full model, each SD increase in unit-level WSC was associated with 0.69 point improvement in K6 scores (95% CI -1.12 to -0.26).

CONCLUSIONS

This prospective study builds on existing knowledge by showing an association between unit-level WSC and modest improvements in mental health among employees in Japan. We recommend that WSC is considered alongside other contextual influences when assessing employees' mental health risks.

Investigation into the metric properties of the workplace social capital questionnaire and its association with self-rated health and psychological distress amongst Greek-Cypriot registered nurses: cross-sectional descriptive study

Background

Social capital can been described as an individual or a collective attribute, with structural and cognitive components, and a bonding, bridging and linking typology. While extensively studied in the community, studies in occupational settings are sparse by comparison. Furthermore, there is no uniformity in its measurement. This study investigated the construct validity of a Workplace Social Capital questionnaire (WSC), originally developed in the Finnish Public Sector occupational cohort, in a different socio-cultural setting (Cyprus), language (Greek) and occupational group (Registered Nurses). It also explored its criterion concurrent validity according to observed association with self-rated health and psychological distress.

Methods

Participants were 10% of all registered nurses (N = 362) who responded to the 8-item WSC scale during a nationwide educational programme. A unidimensional model was compared with the postulated two-factor (structural vs cognitive) and three-factor model (bonding, bridging, linking) in Confirmatory Factor Analyses. The association with self-rated health (0–100 Visual Analogue Scale) and mental distress (GHQ-12 ≥ 4) was assessed in linear and logistic regression models.

Results

A bonding (Cronbach’s a = 0.76), bridging (a = 0.78) and linking (a = 0.89) structure explained 77.6% of the variance and was a better fit as indicated by goodness of fit indices. Elevated odds of mental distress and poorer self-rated health were observed among participants with the lowest levels of perceived workplace social capital. In adjusted models, associations appeared stronger with bonding social capital (adjOR of mental distress = 2.71 95% CI = 1.08, 6.79) while those with the highest scores rated their health higher by 8.0 points on average (95% CI = 2.1, 13.8). Low linking social capital was also associated with poorer health but no consistent associations were observed with bridging.

Conclusion

While associations appeared stronger with bonding and linking, this may reflect a weakness of the measure to fully capture bridging social capital. Even though, this aspect might need strengthening, the WSC showed good metric properties in a different setting, language and occupational group. Cross-national and cognitive validation studies are needed.

Workplace social capital and mental health: a cross-sectional study among Iranian workers

Background

The psychosocial environment of the workplace has received less attention in terms of occupational health. Trust, social network and social cohesion at the workplace (that is, factors related to social capital) may have effects on employee health. Thus, the objective of this study was to examine the association between workplace social capital and mental health among Iranian workers.

Methods

In this cross-sectional study, data were obtained from 5 factories in Babol, Northern Iran, in 2016, where 280 workers responded to a survey on social capital at work and psychosocial distress.

Results

Approximately 23.6% of the workers had psychological distress, and 23.4% had low social capital in the workplace. There was a significant relationship between mental health and individual workplace social capital (p = 0.025) and aggregated workplace social capital (p = 0.027). After controlling for each individual’s characteristics, the prevalence ratio of psychological distress was 2.11 (95% CI: 1.43-3.17) times higher among workers with low individual social capital, and low aggregated workplace social capital was associated with 2.64 (95% CI: 1.28–5.45) times higher odds of psychological distress.

Conclusion

Higher social capital is associated with a reduced risk of psychological distress. The promotion of social capital can be considered as a means to increase workplace mental health among workers.

Neighborhood social capital and sleep duration: a population based cross-sectional study in a rural Japanese town

Background

Studies on social capital and health outcomes have become common, but the relationship between neighborhood social capital and sleep duration by gender is still unclear. We examined the relationship between neighborhood social capital and sleep duration by gender in adults living in a rural community in Japan.

Method

We conducted a cross-sectional survey of 12,321 residents aged ≥20 years in a town in Mie Prefecture in January–March 2013. Self-completed questionnaires were collected from the residents (n = 7782; valid participation rate, 63.2%). We used five items to assess the neighborhood social capital (Cronbach’s α = 0.86). We summed up the scores of each item, and then divided the participants into four groups by quartile of total scores of neighborhood social capital (lowest, low, high, and highest). Sleep duration of < 7 h/day was defined as insufficient sleep duration according to previous studies. To adjust for potential confounders, we performed a multiple log-binominal regression analysis and estimated the prevalence ratios (PRs) and 95% confidence intervals (CIs) for insufficient sleep.

Results

Overall 42% of the men and 45% of the women had insufficient sleep. In the men, the lowest group of neighborhood social capital presented a 22% higher prevalence of insufficient sleep (PR 1.22; 95% CIs 1.08–1.38) compared to the highest group of neighborhood social capital. Similarly the low group of neighborhood social capital and the high group of neighborhood social capital had 20 and 19% higher prevalence of insufficient sleep (PR 1.20; 95% CIs 1.06–1.36; PR 1.19; 95% CIs 1.06–1.34, respectively) compared to the highest group of neighborhood social capital. For women there was no significant association between neighborhood social capital and insufficient sleep after controlling for all potential confounders.

Conclusion

Having lower neighborhood social capital was associated with insufficient sleep among Japanese adults, particularly in the men. This suggests that the context of neighborhood social capital by gender should be considered to promote healthier behaviors with regard to getting enough sleep.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5204-4) contains supplementary material, which is available to authorized users.

The demands and resources arising from shared office spaces

The prevalence of flexible and shared office spaces is increasing significantly, yet the socioemotional outcomes associated with these environments are under researched. Utilising the job demands-resources (JD-R) model we investigate both the demands and the resources that can accrue to workers as a result of shared work environments and hot-desking. Data were collected from work experienced respondents (n = 1000) assessing the extent to which they shared their office space with others, along with demands comprising distractions, uncooperative behaviours, distrust, and negative relationships, and resources from co-worker friendships and supervisor support. We found that, as work environments became more shared (with hot-desking being at the extreme end of the continuum), not only were there increases in demands, but co-worker friendships were not improved and perceptions of supervisory support decreased. Findings are discussed in relation to employee well-being and recommendations are made regarding how best to ameliorate negative consequences of shared work environments.

Workplace social capital, mental health and health behaviors among Brazilian female workers

OBJECTIVE

Previous studies have investigated the relationship between workplace social capital and mental health, yet few have sought to examine the mediating mechanisms. We sought to explore the role of workplace social capital on health related behaviors and on mental health among female employees in Brazil.

METHODS

A cross-sectional study was undertaken with 553 women aged 28-50 years working in the production line of a poultry processing plant. We assessed workplace social capital, common mental disorders, stress (Perceived Stress Scale) and health related behaviors (physical activity, healthy eating habits and co-occurrence of risk behaviors). We used structural equation modeling to clarify relationships between exposures, outcomes, and mediating variables.

RESULTS

Our model demonstrated a direct effect of social capital on the outcomes studied. Higher workplace social capital was associated with lower stress and common mental disorders as well as more favorable health-related behaviors. Our model also showed an indirect effect of social capital on mental health and on behaviors that was mediated by lower levels of perceived stress.

CONCLUSION

Workplace social cohesion may play an important role in the promotion of mental health and healthy behaviors among women employees.

Buffering effect of workplace social capital on the association of job insecurity with psychological distress in Japanese employees: a cross-sectional study

Objectives:

The present study aimed to examine the buffering effect of workplace social capital (WSC) on the association of job insecurity with psychological distress in Japanese employees.

Methods:

2,971 employees from two factories of a manufacturing company in Japan completed a self-administered questionnaire including the scales on job insecurity, WSC, psychological distress, demographic and occupational characteristics, and quantitative workload. Using psychological distress (defined as a total score of the K6 scale ≥5) as a dependent variable, multiple logistic regression analyses were conducted. In a series of analyses, interaction term of job insecurity×WSC was included in the model.

Results:

After adjusting for demographic and occupational characteristics as well as for quantitative workload and interaction effect of quantitative workload×WSC, high job insecurity and low WSC were significantly associated with psychological distress. Furthermore, a significant interaction effect of job insecurity×WSC was observed. Specifically, the association of job insecurity with psychological distress was greater among those who perceived lower levels of WSC (prevalence odds ratio=3.79 [95% confidence interval=2.70-5.32] for high vs. low job insecurity subgroup) than among those who perceived higher levels of WSC (prevalence odds ratio=2.96 [95% confidence interval=2.19-4.01] for high vs. low job insecurity subgroup). These findings were replicated among permanent male employees in the gender-stratified analyses.

Conclusions:

The present study suggests that WSC has a buffering effect on the association of job insecurity with psychological distress at least among Japanese permanent male employees.

The Role of Relational Social Capital and Communication in the Relationship Between CSR and Employee Attitudes

This study examines the effects of corporate social responsibility (CSR) on employee attitudes (affective commitment and job satisfaction). Based on a sample of 1,249 employees in 40 firms, collected across multiple time points from multisource data, hierarchical linear modeling was employed to examine the mediating role of relational social capital between CSR and employee attitudes and the moderating role of communication in this relationship. The results indicate that CSR has a positive influence on affective commitment and job satisfaction and that this is fully mediated by relational social capital. However, the moderated mediation effects of communication were insignificant. The results suggest that firms may “do well” by eliciting positive employee attitudes through relational social capital stemming from “doing good.” Implications and directions for future research are discussed.

The Role of Labor Unions in Creating Working Conditions That Promote Public Health

We sought to portray how collective bargaining contracts promote public health, beyond their known effect on individual, family, and community well-being. In November 2014, we created an abstraction tool to identify health-related elements in 16 union contracts from industries in the Pacific Northwest. After enumerating the contract-protected benefits and working conditions, we interviewed union organizers and members to learn how these promoted health. Labor union contracts create higher wage and benefit standards, working hours limits, workplace hazards protections, and other factors. Unions also promote well-being by encouraging democratic participation and a sense of community among workers. Labor union contracts are largely underutilized, but a potentially fertile ground for public health innovation. Public health practitioners and labor unions would benefit by partnering to create sophisticated contracts to address social determinants of health.

Does worksite social capital enhance retention into a worksite weight-loss programme?

Objective

To determine if worksite social capital predicted retention in a worksite‐based weight‐loss programme using structural equation modelling. A secondary aim was to determine if worksite social capital was related to changes in weight at 6 months.

Methods

Overweight or obese employees from 28 worksites enrolled in a larger 12‐month worksite weight‐loss trial. Workplace social capital was assessed using an eight‐item scale specific to the workplace. Weight was measured using a HealthSpot^tm, and change in weight was computed from weigh‐ins at baseline and 6 months and reported as pounds (lbs) lost. Retention was defined as those employees who completed a weigh‐in at 6 months.

Results

Across the trial, N = 1,790; age = 46.6 ± 11; 73% women; 73% White overweight or obese employees participated. The odds of participant attrition were 1.12 times greater with each unit decrease in social capital score at baseline (p < 0.05), and while the model testing the direct effect of social capital at baseline on weight loss at 6 months demonstrated acceptable fit, social capital was not a significant predictor of weight loss (p > 0.05).

Conclusions

Increased worksite social capital was predictive of retention in a worksite weight‐loss programme. To maximize return on investments for employee wellness and weight‐loss programmes, employers may benefit from understanding the facets of the ‘social’ environment such as social capital that may increase the likelihood of sustained participation.

Characteristics of Employees of Small Manufacturing Businesses by Occupation: Informing Evidence-Based Intervention Planning

OBJECTIVES

We examined characteristics of employees in six occupational categories in small manufacturing businesses (20-150 employees).

METHODS

We analyzed survey data from 47 businesses (n = 2577 employees; 86% response rate) and examined relationships between job type and sociodemographic, health, and organizational support characteristics. Analyses were adjusted for age and sex, and company as a random effect.

RESULTS

Smoking rates were highest for production workers (33%), production managers (27%), and support staff (28%) and lowest for managers (11%) (P <0.001). Job stress was higher for production workers and support staff than managers (P < 0.0001). Managers perceived social capital (P<0.001), safety climate (P < 0.0001) and support for smoking cessation (P < 0.001) higher than production managers, production workers, and support staff.

CONCLUSIONS

Differences in characteristics by occupation call for integrated interventions that target working class employees, leverage the influence of production managers, and enhance organizational support.

Smoking patterns, quit behaviors, and smoking environment of workers in small manufacturing companies

BACKGROUND

This study describes smokers employed at 47 small manufacturing companies in Minnesota, USA.

METHODS

Smokers (n = 713) participating in a group-randomized trial completed a baseline survey on their smoking patterns, quit behaviors, smoking environment, workplace attitudes about smoking, and correlates of smoking. These characteristics were examined by job type and a latent class analysis (LCA) was performed to group workers with similar characteristics.

RESULTS

Production workers had the highest prevalence of daily smoking (88% vs. 68% among managers), and addiction (61% vs. 26% among managers), and the highest mean level of perceived stress (6.4 vs. 4.9 among managers). The LCA identified three subgroups of smokers that differed in levels of barriers to cessation. Production workers were most likely to be in the group with greater barriers (P = 0.01).

CONCLUSIONS

These results underscore the importance of targeting interventions to production workers and those who exhibit the greatest barriers to cessation.

Socio-economic and cultural factors associated with smoking prevalence among workers in the National Health System in Belo Horizonte

OBJECTIVE

To identify factors related to smoking among health workers of the National Health System in Belo Horizonte, Minas Gerais, Brazil.

METHODS

A cross-sectional study based on a survey conducted between September 2008 and January 2009 with a stratified sample. Data on sociodemographic, health, employment, and work characteristics were analyzed. Poisson regression models with robust variance and estimation of unadjusted and adjusted prevalence ratios were used to establish associations at a 5% significance level for inclusion in the final model.

RESULTS

In 1,759 questionnaires analyzed, in which the question related to smoking was answered, the overall prevalence of smoking was 15.7%. Reasonable relationship between requirements and available resources remained negatively correlated to smoking in the final model (PR = 0.75; 95%CI 0.58 - 0.96). The variables that remained positively associated with smoking were being male (PR = 1.75; 95%CI 1.36 - 2.25) and the following positions: community health workers (PR = 2.98; 95%CI 1.76 - 5.05), professionals involved in monitoring (PR = 3.86; 95%CI 1.63 - 5.01), administrative and other general services workers (PR = 2.47; 95%CI 1.51 - 4.05); technical mid-level workers (PR = 2.23; 95%CI 1.31 - 3.78), including nurses and practical nurses (PR = 2.07; 95%CI 1.18 - 3.64).

CONCLUSION

Specific occupational subgroups were identified and should be prioritized in smoking cessation and prevention programs.

Do time-invariant confounders explain away the association between job stress and workers' mental health? Evidence from Japanese occupational panel data

It is well known that job stress is negatively related to workers' mental health, but most recent studies have not controlled for unobserved time-invariant confounders. In the current study, we attempted to validate previous observations on the association between job stress and workers' mental health, by removing the effects of unobserved time-invariant confounders. We used data from three to four waves of an occupational Japanese cohort survey, focusing on 31,382 observations of 9741 individuals who participated in at least two consecutive waves. We estimated mean-centered fixed effects models to explain psychological distress in terms of the Kessler 6 (K6) scores (range: 0-24) by eight job stress indicators related to the job demands-control, effort-reward imbalance, and organizational injustice models. Mean-centered fixed effects models reduced the magnitude of the association between jobs stress and K6 scores to 44.8-54.2% of those observed from pooled ordinary least squares. However, the association remained highly significant even after controlling for unobserved time-invariant confounders for all job stress indicators. In addition, alternatively specified models showed the robustness of the results. In all, we concluded that the validity of major job stress models, which link job stress and workers' mental health, was robust, although unobserved time-invariant confounders led to an overestimation of the association.

Does workplace social capital associate with hazardous drinking among Chinese rural-urban migrant workers?

Background

The present study sought to investigate the associations between workplace social capital and hazardous drinking (HD) among Chinese rural-urban migrant workers (RUMW).

Methods

A cross sectional study with a multi-stage stratified sampling procedure was conducted in Shanghai during July 2012 to January 2013. In total, 5,318 RUMWs from 77 workplaces were involved. Work-place social capital was assessed using a validated and psychometrically tested eight-item measure. The Chinese version of Alcohol Use Disorders Identification Test (AUDIT) was used to assess hazardous drinking. Control variables included gender, age, marital status, education level, salary, and current smoking. Multilevel logistic regression analysis was conducted to test whether individual- and workplace-level social capital was associated with hazardous drinking.

Results

Overall, the prevalence of HD was 10.6%. After controlling for individual-level socio-demographic and lifestyle variables, compared to workers in the highest quartile of individual-level social capital, the odds of HD for workers in the three bottom quartiles were 1.13(95%CI: 1.04–1.23), 1.17(95%CI: 1.05–1.56) and 1.26(95%CI: 1.13–1.72), respectively. However, contrary to hypothesis, there was no relationship between workplace-level social capital and hazardous drinking.

Conclusions

Higher individual-level social capital may protect against HD among Chinese RUMWs. Interventions to build individual social capital among RUMWs in China may help reduce HD among this population.

Change in psychological distress following change in workplace social capital: results from the panel surveys of the J-HOPE study

PURPOSE

Research on the longitudinal association of workplace social capital and mental health is limited. The purpose of the present study was to investigate the prospective association of social capital in the workplace with mental distress, measured by K6, adjusting for individuals factors as well as workplace-related factors among employees in Japan.

METHODS

The participants included 6387 men and 1825 women from 12 private companies in Japan. Questionnaires, inquiring about workplace social capital, K6, job strain and effort-reward imbalance were administered at the baseline survey between October 2010 and December 2011 (response rate=77.4%). At 1-year follow-up, social capital and K6 were assessed again (follow-up rate=79.5%), and a generalised linear model was used to estimate the association between changes in workplace social capital and change in K6.

RESULTS

After adjusting for baseline demographic characteristics and workplace-related factors (Job Content Questionnaire (JCQ), Effort-Reward Imbalance Questionnaire (ERIQ)), increased workplace social capital between waves was associated with improved psychological distress (β=-0.2327, p<0.0001). An inverse association was found in both men and women, all age groups, and among employees with high or low baseline mental health. The association was stronger among those who reported higher stress at baseline.

CONCLUSIONS

Boosting workplace social capital may promote mental health in the workplace.

The mediating and moderating effects of workplace social capital on the associations between adverse work characteristics and psychological distress among Japanese workers

Our current study investigated how workplace social capital (WSC) mediates and moderates the associations between adverse work characteristics and psychological distress among Japanese workers. We collected cross-sectional data (N=9,350) from a baseline survey of an occupational Japanese cohort study. We focused on individual WSC and considered job demands/control, effort/reward, and two types (i.e., procedural and interactional) of organizational justice as work-characteristic variables. We defined psychological distress as a score of ≥5 on the Kessler Psychological Distress Scale (K6 scale). Multivariate logistic regression analyses predicted a binary variable of psychological distress by individual WSC and adverse work characteristics, adjusting for individual-level covariates. Individual WSC mediated the associations between adverse work characteristics and psychological distress in almost all model specifications. Additionally, individual WSC moderated the associations of psychological distress with high job demands, high effort, and low interactional justice when we used a high WSC cutoff point. In contrast, individual WSC did not moderate such interactions with low job control, reward, or procedural justice. We concluded that individual WSC mediated the associations between adverse work characteristics and psychological distress among Japanese workers while selectively moderating their associations at high levels of WSC.

[Health inequalities and occupational health]

There has been an emergent issue of health inequalities in Japan. Tackling health inequalities has been put on the primary agenda in the revised national health promotion campaign, so called "Kenko-Nippon-21"(Healthy Japan 21), which was announced in 2012. Against the background of this social movement, the present article argues how occupational health can contribute to health inequality issue based on the knowledge of public health and social epidemiology.Firstly, we reviewed a brief sketch of health inequality at occupational settings including position, job, and employment status. Secondly, we de scribed a conceptual model of a causal pathway of occupational class and health, based on the idea of life-course approach, and models such as cumulative model, trigger model and latent effect/sensitive period model. Finally, we proposed that health impact assessment as a tool to mitigate health inequality related to occupational policy.

Workplace social capital and mental health among Chinese employees: a multi-level, cross-sectional study

Background

Whereas the majority of previous research on social capital and health has been on residential neighborhoods and communities, the evidence remains sparse on workplace social capital. To address this gap in the literature, we examined the association between workplace social capital and health status among Chinese employees in a large, multi-level, cross-sectional study.

Methods

By employing a two-stage stratified random sampling procedure, 2,796 employees were identified from 35 workplaces in Shanghai during March to November 2012. Workplace social capital was assessed using a validated and psychometrically tested eight-item measure, and the Chinese language version of the WHO-Five Well-Being Index (WHO-5) was used to assess mental health. Control variables included sex, age, marital status, education level, occupation status, smoking status, physical activity, and job stress. Multilevel logistic regression analysis was conducted to explore whether individual- and workplace-level social capital was associated with mental health status.

Results

In total, 34.9% of workers reported poor mental health (WHO-5<13). After controlling for individual-level socio-demographic and lifestyle variables, compared to workers with the highest quartile of personal social capital, workers with the third, second, and lowest quartiles exhibited 1.39 to 3.54 times greater odds of poor mental health, 1.39 (95% CI: 1.10–1.75), 1.85 (95% CI: 1.38–2.46) and 3.54 (95% CI: 2.73–4.59), respectively. Corresponding odds ratios for workplace-level social capital were 0.95 (95% CI: 0.61–1.49), 1.14 (95% CI: 0.72–1.81) and 1.63 (95% CI: 1.05–2.53) for the third, second, and lowest quartiles, respectively.

Conclusions

Higher workplace social capital is associated with lower odds of poor mental health among Chinese employees. Promoting social capital at the workplace may contribute to enhancing employees’ mental health in China.

Workplace social capital and smoking among Chinese male employees: a multi-level, cross-sectional study

OBJECTIVES

The present study sought to investigate the associations between workplace social capital and smoking status among Chinese male employees.

METHODS

A cross sectional study with a two-stage stratified sampling procedure was conducted in Shanghai in 2012. In total, 1603 male workers from 35 workplaces were involved. Workplace social capital was assessed using a validated and psychometrically tested eight-item measure. Multilevel logistic regression analysis was conducted to explore whether individual-level social capital and aggregated workplace-level social capital were associated with smoking.

RESULTS

Overall, 54.2% of the subjects smoked currently. After controlling for individual covariates (age, education level, marital status, occupational status and job stress), compared to workers in the highest quartile of individual-level social capital, the prevalence ratios of smoking for workers in the third quartile, second quartile and lowest quartile were 1.26 (95% CI: 1.11-1.38), 1.35 (95% CI: 1.19-1.50) and 1.39 (95% CI: 1.24-1.51) respectively. However, there was no relationship between workplace-level social capital and smoking status.

CONCLUSIONS

Higher individual-level social capital was associated with a lower likelihood of smoking among Chinese male employees. By contrast, no clear association was found between workplace-level social capital and smoking. Further longitudinal studies are warranted to examine the possible link between workplace social capital and smoking cessation in Chinese workplaces.

Does Social Support Buffer the Effect of Financial Strain on the Trajectory of Smoking in Older Japanese? A 19-Year Longitudinal Study

OBJECTIVES

Although there is extensive research on the stress-buffering effects of social support on health, there is little understanding of this effect on health behaviors such as smoking, particularly during old age. This study aimed to estimate the effect of financial strain and the stress-buffering effect of social support, on the trajectory of smoking over an extended period of time among older Japanese.

METHOD

Data came from a national sample of more than 4,800 adults, aged 60 and older in Japan, with up to 7 repeated observations between 1987 and 2006 (16,669 observations). Hierarchical linear modeling was used to analyze the intrapersonal and interpersonal differences in smoking.

RESULTS

Higher financial strain at baseline was associated with greater amount of smoking, and a slower rate of decline, after adjusting for sociodemographic attributes. Greater instrumental support partially offset the deleterious effect of financial strain on the rate of decline in smoking.

DISCUSSION

Our findings add a dynamic dimension to understanding the relationship among financial strain, social support, and smoking in old age. This knowledge is significant when designing health policies and interventions regarding health behaviors in late life.

Reciprocity and depressive symptoms in Belgian workers: a cross-sectional multilevel analysis

OBJECTIVE

This study examines the multidimensional association between reciprocity at work and depressive symptoms.

METHODS

Data from the Belgian BELSTRESS survey (32 companies; N = 24,402) were analyzed. Multilevel statistical procedures were used to account for company-level associations while controlling for individual-level associations.

RESULTS

Different dimensions of individual reciprocity were negatively associated with depressive symptoms. On the company level, only vertical emotional reciprocity was negatively associated (β = -4.660; SE = 1.117) independently from individual reciprocity (β = -0.557; SE = 0.042). Complex interactions were found such that workplace reciprocity (1) may not uniformly benefit individuals and (2) related differently to depressive symptoms, depending on occupational group.

CONCLUSIONS

This study extends the existing literature with evidence on the multidimensional, contextual, and cross-level interaction associations of reciprocity as a key aspect of social capital on depressive symptoms.

A cross-sectional study of workplace social capital and blood pressure: a multilevel analysis at Japanese manufacturing companies

OBJECTIVES

We examined the contextual effect of workplace social capital on systolic blood pressure (SBP).

DESIGN

Cross-sectional.

SETTING

A conglomerate from 58 workplaces in Japan.

PARTICIPANTS

Of the 5844 workers at a Japanese conglomerate from 58 workplaces, 5368 were recruited. Individuals who received drugs for hypertension (n=531) and who lacked information on any variable (n=167) were excluded from the analyses, leaving 4735 individuals (3281 men and 1454 women) for inclusion.

PRIMARY AND SECONDARY OUTCOME MEASURES

Systolic blood pressure.

RESULTS

The contextual effect of workplace social capital on SBP was examined using a multilevel regression analysis with a random intercept. Coworker support had a contextual effect at the workplace level (coefficient=-1.97, p=0.043), while a lack of trust for coworkers (coefficient=0.27, p=0.039) and lack of helpfulness from coworkers were associated with SBP (coefficient=0.28, p=0.002).

CONCLUSIONS

The present study suggested that social capital at the workplace level has beneficial effects on SBP.

Invited commentary: job strain and health behaviors--developing a bigger picture

Investigation of the association between job stressors and health behaviors has a long history that has been marked by mixed findings. Fransson et al. (Am J Epidemiol. 2012;176(12):1078-1089) find robust prospective and cross-sectional associations between job strain and leisure-time physical inactivity in combined data from 14 cohort studies. Further research to better understand the observed heterogeneity in the contributing cohorts and other studies will be crucial for application to intervention design and tailoring. The population health significance of these findings requires consideration of other job strain-health behavior (particularly the parallel analyses conducted for body mass index and smoking in the same data set) and job strain-health outcome associations, as well as these same associations for other job stressors. Job strain can be seen as a "fundamental cause" of work-related disease, in that intervention to reduce exposure to job strain could have beneficial impacts on many outcomes, making a compelling case for intervention. The significantly strengthened evidence linking job stressors to health behaviors provided by Fransson et al. may help to further direct workplace health promotion research, policy, and practice towards an approach that better integrates intervention on working conditions and health behaviors. The benefits to population health could be substantial.

Job stressors and smoking cessation among Malaysian male employees

BACKGROUND

Job stressors may reduce the likelihood of quitting smoking.

AIMS

To assess the association between job strain, smoking behaviour and smoking cessation among Malaysian male employees involved in a smoking cessation programme.

METHODS

The study was conducted among employees in two major public universities in Malaysia. All staff from both universities received an invitation to participate in this study. At the start of treatment, participants completed a questionnaire on sociodemographic variables, smoking habits and the Malay version of the Job Content Questionnaire (JCQ). The JCQ consists of scales of job control, job demand, supervisor support, co-worker support, job insecurity, job decision latitude and job skill discretion. Behaviour therapy with free nicotine replacement therapy (NRT) was given as treatment for two months. Participants were contacted at 1 week, 3 months and 6 months to determine their smoking status.

RESULTS

One hundred and eighty five staff from both universities responded and voluntarily showed interest in quitting. At three months (OR = 8.96; 95% CI: 1.14-70.76) and six months (OR = 8.9; 95% CI: 1.15-68.65), men with higher co-workers' support demonstrated a higher likelihood of quitting. Smokers in a 'passive job' also demonstrated higher likelihood of quitting compared with those working in the 'low strain' category at six months (OR = 9.92; 95% CI: 1.20-82.68). No meaningful associations were found between other psychosocial job variables and smoking cessation.

CONCLUSIONS

A positive relationship with and support from co-workers are important factors for workplace smoking cessation.

Disparities in health behaviors and chronic conditions in health care providers in the Veterans Health Administration

OBJECTIVE

To determine baseline prevalence of health behaviors and chronic health conditions in Veterans Health Administration (VHA) employees and highlight disparities by occupation group.

METHODS

There were 29,834 responses to the survey. Age-standardized prevalence estimates for VHA employees were compared to national estimates from BRFSS surveys. The VHA estimates were analyzed for physicians and dentists; physician assistants and nurse practitioners; registered nurses; licensed practical nurses and nursing assistants; other clinical; nonclinical; and wage grade staff. Multilevel regression explored the effect of worksite.

RESULTS

The VHA employees have higher rates of unhealthy behaviors and chronic health conditions than US adults, except for smoking. Results illustrated significant disparities between occupation groups by demographics and variability by worksite.

CONCLUSIONS

Veterans Health Administration's population appears less healthy than the US general population. Disparities between occupation groups support the establishment of targeted health promotion programs, with attention paid to differences in local culture.

Workplace social capital and adherence to antihypertensive medication: a cohort study

BACKGROUND

While hypertension is a common and treatable health problem, adherence to antihypertensive medication remains a challenge. This study examines the hypothesis that workplace social capital may influence adherence to antihypertensive medication among hypertensive employees.

METHODOLOGY/PRINCIPAL FINDINGS

We linked survey responses to nationwide pharmacy records for a cohort of 3515 hypertensive employees (mean age 53.9 years, 76% women) who required continuous antihypertensive drug therapy (the Finnish Public Sector study). A standard scale was used to measure workplace social capital from co-workers' assessments and self-reports in 2000-2004. Non-adherence to antihypertensive medication was determined based on the number of days-not-treated at the year following the survey using comprehensive prescription records. Negative binomial regression models were conducted adjusting for socio-demographic characteristics, duration of hypertension, behaviour-related risk factors, and co-morbid conditions. The overall rate of days-not-treated was 20.7 per person-year (78% had no days-not-treated). Higher age, obesity, and presence of somatic co-morbidities were all associated with better adherence, but this was not the case for co-worker-assessed or self-reported workplace social capital. The rate of days-not-treated was 19.7 per person-year in the bottom fourth of co-worker-assessed workplace social capital, compared to 20.4 in the top fourth. The corresponding rate ratio from the fully-adjusted model was 0.95 (95% confidence interval (CI) 0.58-1.56). In a subgroup of 907 new users of antihypertensive medication this rate ratio was 0.98 (95% CI 0.42-2.29).

CONCLUSIONS/SIGNIFICANCE

We found no consistent evidence to support the hypothesized effect of workplace social capital on adherence to drug therapy among employees with chronic hypertension.