Effects of chronic job insecurity and change in job security on self reported health, minor psychiatric morbidity, physiological measures, and health related behaviours in British civil servants: the Whitehall II study

Sociodemographic Factors, Health-Risk Behaviors, and Chronic Conditions Are Associated with a High Prevalence of Depressive Symptoms: Findings from the Indonesian Family Life Survey-5

Depression is a significant public health challenge. However, limited research exists regarding the risk of sociodemographic factors, health-risk behavior, and chronic conditions in relation to the development of depression in Indonesia. This study assesses the prevalence of depressive symptoms in adolescents and adults, and identifies its potential associations with sociodemographic factors, health-risk behaviors, and chronic conditions. A national cross-sectional population-based survey was performed, using the Indonesian Family Life Survey (IFLS-5), to assess depressive symptoms in respondents aged 15 years and older. Depression was evaluated using the Center for Epidemiologic Studies-Depression (CES-D) scale, and potential associations with sociodemographic factors, health-risk behaviors, and chronic conditions were examined using logistic regression analysis. The study revealed a high prevalence of depressive symptoms, with the highest incidence observed in the age group of 25-34 years. Factors such as unmarried status, younger age, good physical activity, and having chronic conditions showed associations with depression. These findings have implications for developing public mental health strategies to reduce the prevalence of depression in Indonesia.

Working Conditions and Self-Reported Health Among Undocumented and Newly Regularized Migrants in Geneva: A Cross-Sectional Study

Objectives: Most undocumented migrants are employed in so-called "dirty jobs" or "3D jobs" (dangerous, dirty and degrading) due to their lack of legal status. This study aimed to describe the self-reported health of undocumented and newly regularized migrants in relation to their working conditions. Methods: A cross-sectional study was conducted using data collected during the first phase of the Parchemins study (2017-18), a survey that monitors the socioeconomic and health impact of a regularization scheme for undocumented workers in Geneva, Switzerland. The sample consists of 395 undocumented and newly regularized migrants. Results: Overall, 147 (37.2%) rated their health as very good or excellent. Multivariable regression analysis indicated that work-related factors associated with better self-reported health included higher satisfaction with working conditions, while legal status regularization showed only a borderline association. By contrast, workers performing very demanding tasks and having more difficulties finding a new job were less likely to report very good or excellent health. Conclusion: Findings show that work-related factors had a stronger influence on self-reported health compared to legal status change. Further research is needed to evaluate the long-term impact of regularization on working conditions and self-rated health.

Effect of trajectory of employment status on all-cause mortality in the late middle-aged and older population: results of the Korea Longitudinal Study of Aging (2006-2020)

OBJECTIVES

This study conducted a longitudinal analysis of the effect of trajectory of employment status (TES) on all-cause mortality in late middle-aged and older Koreans based on the Korean Longitudinal Study of Aging (KLoSA).

METHODS

After excluding missing values, data on 2,774 participants were analyzed using the chi-square test and the group-based trajectory model (GBTM) for data from the first to fifth KLoSA and the chi-square test, log-rank test, and Cox proportional hazard regression for data from the fifth to eighth KLoSA.

RESULTS

The GBTM analysis identified 5 TES groups: sustained white collar (WC; 18.1%), sustained standard blue collar (BC; 10.8%), sustained self-employed BC (41.1%), WC to job loss (9.9%), and BC to job loss (20.1%). Compared to the sustained WC group, the WC to job loss group had higher mortality at 3 years (hazard ratio [HR], 4.04, p=0.044), 5 years (HR, 3.21, p=0.005), and 8 years (HR, 3.18, p<0.001). The BC to job loss group had higher mortality at 5 years (HR, 2.57, p=0.016) and 8 years (HR, 2.20, p=0.012). Those aged 65 years and older and males in the WC to job loss and BC to job loss groups had an increased risk of death at 5 years and 8 years.

CONCLUSIONS

There was a close association between TES and all-cause mortality. This finding highlights the need for policies and institutional measures to reduce mortality within vulnerable groups with an increased risk of death due to a change in employment status.

Racial/ethnic differences in social determinants of health and health outcomes among adolescents and youth ages 10-24 years old: a scoping review

INTRODUCTION

With the recent emergence of the Healthy People 2030 goals there is a need to understand the role of SDOH on health inequalities from an upstream perspective. This review summarizes the recent body of evidence on the impact of SDOH across adolescence and youth health outcomes by race/ethnicity using the Health People 2030 Framework.

METHODS

A systematic, reproducible search was performed using PubMed, Academic Search Premier, PsychInfo, and ERIC. A total of 2078 articles were screened for inclusion. A total of 263 articles met inclusion criteria, resulting in 29 articles included for final synthesis.

RESULTS

Across the 29 articles, 11 were cross-sectional, 16 were cohort, and 2 were experimental. Across SDOH categories (economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context), 1 study examined self-efficacy, 6 educational attainment, 10 behavior, 5 smoking, 11 alcohol use, 10 substance use, and 1 quality of life. The majority of outcomes represented in this search included health behaviors such as health risk behavior, smoking, alcohol use, and substance use. Across the 29 articles identified, significant differences existed across outcomes by race/ethnicity across SDOH factors, however magnitude of differences varied by SDOH category.

DISCUSSION

SDOH differentially affect adolescents and youth across race/ethnicity. The lived adverse experiences, along with structural racism, increase the likelihood of adolescents and youth engaging in risky health behaviors and negatively influencing health outcomes during adolescence and youth. Research, public health initiatives, and policies integrating SDOH into interventions at early stage of life are needed to effectively reduce social and health inequalities at a population level.

Psychosocial risk factors for low back pain in US workers: Data from the 2002-2018 quality of work life survey

BACKGROUND

Examining workplace psychosocial risk factors for back pain becomes increasingly important because of the changing nature of work and rising healthcare costs. Some psychosocial risk factors for back pain, such as work and family imbalance, exposure to a hostile work environment, and job insecurity, are understudied for the working population in the United States.

METHODS

Data used in this study came from the Quality of Work Life Survey (QWL), a supplementary module of the General Social Survey conducted in the United States. Data from the 2002, 2006, 2010, 2014, and 2018 QWL surveys were used in these analyses, giving a total sample size of 6661. Five domains of workplace psychosocial risk factors for back pain were examined, including job strain, low social support, work-family imbalance, exposure to a hostile work environment (harassment and discrimination), and job insecurity. The adjusted odds ratio (aOR) of each psychosocial risk factor for back pain with 95% confidence intervals (CI) was estimated using a multivariable logistic regression model after controlling for job physical factors, occupation, and demographic and socioeconomic characteristics.

RESULTS

Significant associations were found between back pain and several psychosocial factors including job strain (aOR 1.19; CI 1.00,1.41), work-family imbalance (aOR,1.42; CI 1.22,1.64), harassment (aOR 1.40; CI 1.15,1.71), and discrimination (aOR 1.20 CI 1.00,1.44).

CONCLUSION

This study contributes to the understanding of the relationship between a variety of workplace psychosocial factors and back pain. Our findings suggest directions in future longitudinal research to examine emerging workplace psychosocial factors for back pain.

Contributing risk factors of common psychiatric disorders in the Pakistani population

With an increasing incidence of psychiatric disorders worldwide, there is a need for a better understanding of the population-specific contributing risk factors that are associated with common psychiatric conditions. This study aimed to assess the correlation between socioeconomic, environmental and clinical features associated with major depression (MDD n = 479), bipolar disorder (BD n = 222) and schizophrenia (SHZ n = 146), in the Pakistani population. Multinomial logistic regression and Pearson's correlation were applied to assess the association and correlation between demographic, socioeconomic, environmental, and clinical features of MDD, BD and SHZ. In the present study, MDD was found to be more prevalent than BD and SHZ. The average age at onset (AAO), was observed to be earlier in females with BD and SHZ, in addition, females with a positive family history of MDD, BD and SHZ also had an earlier AAO. The fitted multinomial logistic regression model indicated a significant association of; aggression, tobacco use, drugs abuse, history of head injuries and family history with BD as compared to MDD, while insomnia and suicidality were significantly associated with MDD. Strong positive correlations were observed mainly between age/AAO, AAO/tobacco use and aggression/insomnia in all three cohorts. In conclusion, the present study identifies possible contributing socio-demographic, biological and environmental factors that are correlated and associated with the psychiatric conditions in the Pakistani population.

Employees Perceptions of Job Insecurity and Performance: A Qualitative Approach

The purpose of this article is to understand the experience of workers' perceptions of job insecurity and its relation to performance. To this end, we conducted semi-structured interviews with 38 workers in the retail, services, education, financial, construction, and pharmaceutical industries in Chile. Using content analysis based on workers' accounts of their own experience, we identified two main categories: (a) the experience of job insecurity viewed in relation to the context of the COVID-19 pandemic and emotional aspects of job insecurity, and (b) the relation between job insecurity and performance. The possibility of job loss expresses itself in experiences and emotions that are related to the performance of workers in different ways. These findings are discussed in terms of stress theory and the motivation to preserve jobs.

Does persistent precarious employment affect health outcomes among working age adults? A systematic review and meta-analysis

OBJECTIVE

To evaluate the impact of persistent precarious employment (lasting 12+ months) on the health of working age adults, compared with more stable employment. Persistent precarity reflects a shift towards less secure forms of employment and may be particularly important for health.

METHODS

Nine databases were systematically searched to identify quantitative studies that assessed the relationship between persistent precarious employment and health outcomes. Risk of bias (RoB) was assessed using an adaptation of the Effective Public Health Practice Project tool. Narrative synthesis and random effects meta-analysis were conducted. Certainty of evidence was assessed using the Grades of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

RESULTS

Of 12 940 records screened, 50 studies met the inclusion criteria and 29 were included in meta-analyses. RoB was generally high (n=18). The most reported outcome domain was mental health; with evidence also reported relating to general health, physical health,and health behaviours. Of GRADE assessed outcomes, persistent precarious employment was associated with increased risk of poor self-rated health (OR 1.53, 95% CI 1.09 to 2.14, I2=80%) and mental health symptoms (OR 1.44, 95% CI 1.23 to 1.70, I2=65%). The association with all-cause mortality was imprecisely estimated (OR 1.10, 5% CI 0.91 to 1.33, I2=73%). There was very low GRADE certainty across all outcomes.

CONCLUSIONS

Persistent precarious employment is associated with poorer health, particularly for outcomes with short time lags, though associations are small and causality is highly uncertain. Further research using more robust methods is needed but given potential health harms of persistent precarious employment, exploration of precautionary labour regulations and employment policies is warranted.

Dualized Labor Market and Polarized Health: A Longitudinal Perspective on the Association between Precarious Employment and Mental and Physical Health in Germany

This study analyzes the longitudinal association between precarious employment and physical and mental health in a dualized labor market by disaggregating between-employee and within-employee effects and considering mobility in precariousness of employment. Analyses were based on the German Socio-Economic Panel from 2002 to 2018 considering all employees ages 18 to 67 years (n = 38,551). Precariousness of employment was measured as an additive index considering working poverty, nonstandard working time arrangements, perceived job insecurity, and low social rights. Health outcomes were mental and physical health. Random effects models were used and controlled for sociodemographic and socioeconomic variables. Results indicated that the association between precariousness of employment and mental and physical health is mainly based on between-employee differences and that prolonged precariousness of employment or upward or downward mobility are associated with poor health. We found evidence of polarization in health by precariousness of employment within a dualized labor market.

Psychosocial work environment as a dynamic network: a multi-wave cohort study

While characteristics of psychosocial work environment have traditionally been studied separately, we propose an alternative approach that treats psychosocial factors as interacting elements in networks where they all potentially affect each other. In this network analysis, we used data from a prospective occupational cohort including 10,892 participants (85% women; mean age 47 years) and repeated measurements of seven psychosocial work characteristics (job demands, job control, job uncertainty, team climate, effort-reward imbalance, procedural justice and interactional justice) assessed in 2000, 2004, 2008 and 2012. Results from multilevel longitudinal vector autoregressive models indicated that job demands as well as interactional and procedural justice were most broadly associated with the subsequent perceptions of the work-related psychosocial factors (high out-Strength), suggesting these factors might be potentially efficient targets of workplace interventions. The results also suggest that modifying almost any of the studied psychosocial factors might be relevant to subsequent perceptions of effort-reward imbalance and interactional justice at the workplace.

Prospective associations between psychosocial work factors and self-reported health: study of effect modification by gender, age, and occupation using the national French working conditions survey data

Background

Prospective studies exploring the effects of psychosocial work factors on self-reported health (SRH) are lacking, especially those studying effect modifications. The objectives were to examine the prospective associations of these factors, and multiple exposures to these factors, with SRH in a national representative sample, and effect modifications by gender, age, and occupation.

Methods

The prospective study relied on the three data collection waves (2013, 2016, and 2019) of the national French Working Conditions survey and was based on a sample of 15,971 employees, in good SRH at the beginning of the follow-up period. The occupational exposures were time-varying variables measured in 2013 and 2016, and included: 20 psychosocial work factors grouped into 5 broad domains, 4 exposures related to working time/hours and 4 physical-biomechanical-chemical exposures. The incidence of poor SRH three years later was the outcome. Discrete time Poisson regression models were performed using weighted data and with adjustment for gender, age, marital status, life events, and occupation.

Results

Almost all the studied psychosocial work factors were predictive of poor SRH. Some physical-biomechanical-chemical exposures were found to predict poor SRH. Only rare effect modifications were observed according to gender, age, and occupation. Dose-response associations between multiple exposures and the incidence of poor SRH were observed for 4 among 5 domains of psychosocial work factors.

Conclusions

Our study underlined the effects of psychosocial work factors, as well as multiple exposure effects, on the incidence of poor SRH. However, most of these effects were the same across population groups related to gender, age, and occupation.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13773-x.

Unrevealing the Hidden Effects of Job Insecurity: A Moderated-Mediation Model of Moral Disengagement and Moral Identity

Moral disengagement is an intensely negative reaction that triggers unethical behavior in the workplace. By integrating the conservation of resources and moral disengagement theories, the current research examined how moral disengagement can explain the mechanism through which job insecurity results in adverse consequences. Furthermore, moral identity was theorized to moderate the hypothesized relationships. The theoretical model was tested by using time-lagged multisource data collected from 425 Chinese employees and their respective supervisors associated with the healthcare sector. The study concluded that job insecurity was positively linked with employees’ moral disengagement, which, in turn, led to coworker undermining behavior. Furthermore, moral identity moderated the relationship between job insecurity, moral disengagement, and coworker undermining such that employees high in moral identity experience less moral disengagement and are less involved in coworker undermining. Theoretical and practical implications along with future research avenues are discussed.

High Emotional Demands at Work and Poor Mental Health in Client-Facing Workers

This study investigated the association between emotional demands and depression or anxiety in a wide range of jobs. We used data from the third Korean Working Conditions Survey (n = 50,032) for all occupational classifications, with no limitations placed on job title or employment type. Among the full set of regular paid workers in addition to self-employed, unpaid family workers, and informal employees such as independent contractors, 23,989 respondents worked with “customers, passengers, students, or patients” (i.e., clients). Emotional demands were evaluated using two questions: handling angry clients and needing to hide feelings for work performance. Any depression or anxiety over the last 12 months was taken to indicate poor mental health. Multivariable logistic regression modeling was performed to calculate adjusted ORs with 95% confidence intervals for the influence of emotional demands on mental health, adjusting for demographic factors (age, gender, education, income), occupational psychological demands, decision latitude, social support, weekly work hours and job insecurity. The prevalence of emotional demands was higher in self-employed and informal employees than in regular paid employees. The more frequent the exposure to the two emotional demands combined was, the higher the risk of depression or anxiety. High psychological demands, low social support, and low job security each further increased the risk of poor mental health. Emotional demands turned out to be widespread in the entire economy, were not limited to service or sales occupations, and were more evident in precarious work. The contribution of emotional demands and other preventable job stressors to the burden of depression or anxiety in society may be substantial.

Association between informal employment and depressive symptoms in 11 urban cities in Latin America

Background

Mental health is an important contributor to the global burden of disease, and depression is the most prevalent mental disorder in Latin America and the Caribbean (LAC). Informal jobs, often characterized by precarious working conditions, low wages, and limited employment benefits, are also highly prevalent in LAC and may be associated with poorer mental health. Our study tests the association between informal employment and major depressive symptoms in LAC cities.

Methods

We used individual-level data collected by the Development Bank of Latin America via their “Encuesta CAF” (ECAF) 2016, a cross-sectional household survey of 11 LAC cities (N = 5430). Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Short Depression Scale with possible total score ranging from 0 to 30. Scores were dichotomized, with a score >‾ 16 indicating the presence of major depressive symptoms. Informal employment was defined based on self-reported lack of contribution to the social security system. We used generalized estimating equation (GEE) log-binomial models to estimate the association between informal employment and depressive symptoms overall and by gender. Models were adjusted for age, education, and household characteristics.

Results

Overall, individuals employed in informal jobs had a 27% higher prevalence of major depressive symptoms (Prevalence Ratio [PR]: 1.27; 95% Confidence Interval [CI]: 1.00, 1.62) compared to those in formal jobs. The prevalence of depressive symptoms among individuals with informal jobs was higher compared to those with formal jobs in both women (PR: 1.36, 95% CI: 1.06, 1.74) and men (PR: 1.22; 95% CI: 0.90, 1.65).

Conclusions

Informal employment in LAC was associated with a higher prevalence of major depressive symptoms. It is important to develop policies aiming at reducing informal jobs and increasing universal social protection for informal workers.

•

Informal employment is associated with a higher prevalence of depressive symptoms in Latin America.

•

Associations for both men and women were similar in direction and magnitude but only among women was the association statistically significant.

Association of Perceived Job Insecurity With Subsequent Memory Function and Decline Among Adults 55 Years or Older in England and the US, 2006 to 2016

Importance

Intensified global economic competition and recent financial crises, including those associated with the COVID-19 pandemic, have contributed to uncertainty about job security. However, little is known about the association of perceived job insecurity with memory function and decline among older adults.

Objectives

To investigate the association between perceived job insecurity and subsequent memory function and rate of memory decline among older adults in the US and England.

Design, Setting, and Participants

This 10-year prospective population-based cohort study used data from the US Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA) collected from 2006 to 2016. Participants included 9538 adults 55 years or older. Data were analyzed from August 1 to 31, 2021.

Exposures

Perceived job insecurity (yes vs no) at baseline.

Main Outcomes and Measures

Episodic memory z scores at baseline and rate of decline during the follow-up.

Results

Among the 9538 study participants, the mean (SD) age at baseline was 60.97 (6.06) years, and 4981 (52.22%) were women. A total of 2320 participants (24.32%) reported job insecurity at baseline (1088 of 3949 [27.55%] in England and 1232 of 5589 [22.04%] in the US). Perceived job insecurity after 55 years of age was associated with lower baseline memory z scores in the fully adjusted model (β = -0.04 [95% CI, -0.08 to -0.01]) but not with rate of memory decline (β = 0.01 [95% CI, -0.01 to 0.01]). The association appeared to be stronger in the US than in England (job insecurity × US, β = -0.05 [95% CI, -0.11 to 0.02]), but the estimate was imprecise, potentially owing to low statistical power.

Conclusions and Relevance

The findings of this cohort study suggest that exposure to job insecurity in middle to late life was associated with worse memory function among older adults in the US and England. This association may vary across socioeconomic and social welfare contexts, although future studies with large samples from diverse socioeconomic settings are warranted.

The Association Between Men's Mental Health During COVID-19 and Deterioration in Economic Status

This study investigated associations among economic status deterioration, mental health, and gender during the COVID-19 pandemic. A total of 1,807 participants completed an online questionnaire that included demographic variables and questions measuring three mental health variables: psychological distress (as measured by symptoms of depression, anxiety, and stress), adjustment disorder, and emotional eating. Results indicated that women reported higher mental health impairment than men. Men and women whose economic status significantly deteriorated because of the COVID-19 pandemic reported greater mental health impairment than those whose economic status did not significantly deteriorate. However, men whose economic status significantly deteriorated reported high mental health impairment (emotional eating and adjustment difficulties) similar to women in the same situation. This change in men's reporting pattern suggests that the economic impact of COVID-19 severely impacted their mental health and affected how they view their masculinity, which, in turn, further impaired their mental health. As the COVID-19 outbreak has had a significant impact on mental health worldwide, it is important to identify individuals and groups who are at high risk of mental health impairment. The current study demonstrates that men's distress, which is frequently complex to identify, can be detected using standardized measures and analyzing these according to changes in reporting patterns as opposed to simply examining means and frequencies. The results suggest that the COVID-19 crisis may provide an opportunity to understand more about mental health, in particular, that of men.

The impact of changes in job security on mental health across gender and family responsibility: evidence from the UK Household Longitudinal Study

PURPOSE

While there is strong evidence that job insecurity leads to mental distress, little is known about how gender and parental responsibilities may exacerbate this relationship. Examining their contribution as potential effect modifiers may provide insights into gender inequalities in mental health and inform gender-sensitive labour policies to ameliorate the negative effects of job insecurity. Our study addresses this gap by examining the longitudinal association between job insecurity and mental health across different configurations of gender and parental responsibilities.

METHODS

Our sample includes 34,772 employed participants over the period of 2010-2018. A gender-stratified fixed-effect regression was used to model the within-person change over time in mental health associated with loss of job security, and effect modification by parent-partner status (e.g. childfree men, partnered father, etc.).

RESULTS

Loss of job security was associated with a moderate decrease in mental health functioning for partnered fathers, partnered mothers, and childfree men and women ranging between a reduction in MCS-12 by 1.00 to 2.27 points (p < 0.05). Lone fathers who lose their job security experienced a higher decrease in mental health functioning at - 7.69 (95% CI - 12.69 to - 2.70), while lone mothers did not experience any change.

CONCLUSION

The effects of job insecurity on mental health is consistent across gender and parent-partner status with the exception of lone fathers and lone mothers. Future studies should investigate the effects of policies that may reduce mental distress in the face of the threat of job loss such as reducing wait time for payment of unemployment benefits.

Precarious work and heath: Do occupation- and state-specific unemployment rates matter for women and for men?

Precarious work has the potential to undermine workers' health and well-being, and linkages between precarious work and health may depend on contextual measures of unemployment. The present study uses data from the Current Population Survey (CPS; 2001-2019) to examine whether several characteristics of precarious work are associated with self-rated health, with attention to differences in these associations by occupation- and state-specific unemployment rates. Findings indicate that experiences of unemployment, part-time work, and poor work quality (limited social benefits and low wages) are associated with worse self-rated health for working women and men. Moreover, associations between some measures of precarious work and health are weaker at higher levels of occupation- and state-specific unemployment for men, but not for women. The present study points to precarious work as a chronic stressor for many workers that must be considered within broader economic contexts.

Community Resident Perceptions of and Experiences with Precarious Work at the Neighborhood Level: The Greater Lawndale Healthy Work Project

Work is a key social determinant of health. Community health and well-being may be impacted in neighborhoods with high proportions of people engaged in precarious work situations compounded by health inequities produced by other social determinants associated with their residential geography. However, little is known about how community residents experience work at the neighborhood level nor how work impacts health at the community-level, particularly in communities with a high proportion of residents engaged in precarious work. We sought to understand, through participatory research strategies, how work is experienced at the community level and to identify community interventions to establish a culture of healthy work. As part of a mixed-methods community health assessment, community researchers conducted focus groups with residents in two high social and economic hardship neighborhoods on Chicago’s southwest side. Community and academic researchers engaged in participatory data analysis and developed and implemented member-checking modules to engage residents in the data interpretation process. Twelve focus group discussions (77 community resident participants) were completed. Three major themes emerged: systematic marginalization from the pathways to healthy work situations; contextual and structural hostility to sustain healthy work; and violations in the rights, agency, and autonomy of resident workers. Findings were triangulated with findings from the concept-mapping research component of the project to inform the development of a community health survey focused on work characteristics and experiences. Listening to residents in communities with a high proportion of residents engaging in precarious work allows for the identification of nuanced community-informed intervention points to begin to build a culture of healthy work.

The Contribution of Occupation-Specific Factors to the Deaths of Despair, Massachusetts, 2005-2015

OBJECTIVES

In the USA, deaths from poisonings (especially opioids), suicides, and alcoholic liver disease, collectively referred to as 'deaths of despair', have been increasing rapidly over the past two decades. The risk of deaths from these causes is known to be higher among certain occupations. It may be that specific exposures and experiences of workers in these occupations explain these differences in risk. This study sought to determine whether differences in the risk of deaths of despair were associated with rate of occupational injuries and illnesses, job insecurity, and temporal changes in employment in non-standard work arrangements.

METHODS

Usual occupation information was collected from death certificates of Massachusetts residents aged 16-64 with relevant causes of death between 2005 and 2015. These data were combined with occupation-level data about occupational injuries and illnesses, job insecurity, and non-standard work arrangements. We calculated occupation-specific mortality rates for deaths of despair, categorized by occupational injury and illnesses rates and job insecurity. We calculated trends in mortality according to changes in non-standard work arrangements.

RESULTS

Workers in occupations with higher injury and illnesses rates and more job insecurity had higher rates of deaths of despair, especially opioid-related deaths. Rates of deaths of despair increased most rapidly for occupations with increasing prevalence of workers employed in non-standard work arrangements.

CONCLUSIONS

The findings suggest occupational factors that may contribute to the risk of deaths of despair. Future studies should examine these factors with individual-level data. In the meantime, efforts should be made to address these factors, which also represent known or suspected hazards for other adverse health outcomes.

The Moderator Role of Financial Well-Being on the Effect of Job Insecurity and the COVID-19 Anxiety on Burnout: A Research on Hotel-Sector Employees in Crisis

During the coronavirus disease 2019 (COVID-19) pandemic, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), hotel-sector employees attempted to cope with the fear of becoming infected; however, they were also faced with job insecurity. Both the anxiety over COVID-19 and the risk of job insecurity have affected the employees’ economic and social conditions as well as their mental state. The present study examined the effect of COVID-19 anxiety and job insecurity perceptions on the burnout levels of hotel-sector employees and the moderator role of the employees’ financial well-being on this relationship. The study was conducted by collecting data from 396 participants who worked in 17 different five-star hotels in Antalya, Turkey. Because of social isolation and social distancing rules, our research data were obtained using an online questionnaire to avoid close contact with other people. The findings showed that COVID-19 anxiety and perceptions of job insecurity had negative effects on hotel employees in the form of mental burnout. In addition, we determined that as an individual characteristic, financial well-being was a moderator variable that affected the severity of burnout based on COVID-19 anxiety and job insecurity. The research findings exhibited theoretical and practical contributions for decision makers and researchers.

Homeworking, Well-Being and the COVID-19 Pandemic: A Diary Study

As a response to the COVID-19 pandemic, many governments encouraged or mandated homeworking wherever possible. This study examines the impact of this public health initiative on homeworkers’ well-being. It explores if the general factors such as job autonomy, demands, social support and work–nonwork conflict, which under normal circumstances are crucial for employees’ well-being, are outweighed by factors specific to homeworking and the pandemic as predictors of well-being. Using data from four-week diary studies conducted at two time periods in 2020 involving university employees in the UK, we assessed five factors that may be associated with their well-being: job characteristics, the work–home interface, home location, the enforced nature of the homeworking, and the pandemic context. Multi-level analysis confirms the relationship between four of the five factors and variability in within-person well-being, the exception being variables connected to the enforced homeworking. The results are very similar in both waves. A smaller set of variables explained between-person variability: psychological detachment, loneliness and job insecurity in both periods. Well-being was lower in the second than the first wave, as loneliness increased and the ability to detach from work declined. The findings highlight downsides of homeworking, will be relevant for employees’ and employers’ decisions about working arrangements post-pandemic, and contribute to the debate about the limits of employee well-being models centred on job characteristics.

Association of social deprivation with cognitive status and decline in older adults

OBJECTIVES

Social deprivation, i.e. the relative deprivation in socioeconomic domains, is known to exacerbate disease risk. Less is known about its role in cognitive functioning and decline in older adults. This study aimed to investigate the association between social deprivation and cognitive status as well as rate of decline.

METHODS

We analysed data from the nationally representative Health and Retirement study (HRS) of individuals aged 50 and older. The analysis sample contained 11,101 respondents (mean age at baseline: 69.4, SD: 8.6%, 55% female) with at least two cognitive assessments (mean follow up: 11.2, SD: 5.4). To quantify social deprivation we constructed a social deprivation index (SDI) with structural equation modelling. Multiple growth curve modelling was used to model cognitive status and decline as predicted by SDI.

RESULTS

After adjusting for covariates, greater social deprivation was associated with poorer cognitive status (β = -0.910, p < 0.001; 95% CI: -0.998-0.823) and faster cognitive decline (β = -0.005, p = 0.002; 95% CI:-0.009-0.002). Of the covariates, depressive symptoms, chronic disease burden, belonging to a racial or ethnical minority, and male gender were also associated with poorer cognitive status. Marriage statuses other than being married or partnered had a positive association with cognitive status.

CONCLUSIONS

Our findings indicate that greater social deprivation was associated with significantly poorer cognitive status implying that preventing social deprivation can contribute to raising cognitive functioning in the older population and help reduce the incidence of dementia. Policy that facilitates early intervention in social deprivation will be key.

On demonetization short term effects: Psychosocial risks in tea garden workers

BACKGROUND

In November 2016, the government of India declared 86%of the total money in circulation as demonetized. This policy was brought into effect overnight, and it had great macro socioeconomic impact not only on the economy of the country but on the common people, especially the socioeconomically challenged. While several researchers have focused on, and continue to investigate, the effects of demonetization on the economy, its impact on the psychosocial health of workers has not yet been studied.

OBJECTIVE

To provide an exploratory investigation of the psychosocial consequences of demonetization on the workers in Indian tea gardens.

METHODS

A qualitative research approach was employed. Face-to-face interviews were conducted with seven key informants (clinicians and executives/managers), and 36 tea garden workers were involved in six focus groups. Collected data were analyzed using the Template Analysis technique.

RESULTS

From the data analysis, five main themes emerged concerning the psychosocial factors involved in demonetization effects: socioeconomic changes, organizational consequences, workplace interpersonal relationships, work-family interface, and psychophysical symptoms.

CONCLUSIONS

This preliminary study highlighted the significant impact that demonetization had on tea gardens at both the organizational and individual levels.

Could Gamification Be a Protective Factor Regarding Early School Leaving? A Life Story

The European Union has recognized the close relationship between mental health, well-being, and education, encouraging studies and whole school interventions that work in the interrelationship between mental health and school, especially in aspects related to Early School Leaving (ESL). Literature shows that there are research gaps in this regard, but there are some inklings to think that innovative teaching methods can improve both adolescent´s mental health and reduce the rates of ESL. The main objective of this article was to find out how the use of game-based teaching techniques affects the well-being of students at risk of ESL. The life story of one young student that has left school early has been studied, focusing on the impact that gamification had in his scholar trajectory and well-being. Data analysis was carried using the constructivist version of the grounded theory. Results showed a certain degree of interrelation between all three aspects. Pointing that a period of gamification can have a positive effect in school engagement as a result of better levels of wellbeing, but also, that if this methodology is not maintained or accompanied it can cause a rebound effect acting as a risk factor to ESL.

Invited Commentary: Linking Job Security and Mental Health-Challenges and Future Directions

Research in the social and health sciences has linked job insecurity to poorer mental health but relies on observational data and faces challenges of causal inference. LaMontagne et al. (Am J Epidemiol. 2021;190(2):207-215) innovate by using both within-person fixed-effects and random-effects regression to analyze data from 14 annual waves of an Australian survey spanning 2002-2015. Using this more rigorous design, they find that improvements in perceived job insecurity were associated with improvements in Mental Health Inventory-5 scores in a large, nationally representative panel study. By using each respondent as their own control, fixed-effects models remove the influence of time-invariant confounders. Innovative new approaches are still needed to address the causal directionality of the association and to capture both those whose exposure changes as well as those for whom it persists. Future work should also consider potential modifying factors including societal conditions, macroeconomic and other period effects, and characteristics of individuals, as well as drawing on multidisciplinary approaches that consider jobs as a combination of multiple health-relevant exposures and embed individual workers in families and communities to assess the full reach and consequences of perceived job insecurity.

The role of time in the relation between perceived job insecurity and perceived job performance

BACKGROUND

Insufficient evidence exists that can explain two conflicting views (i.e. positive and negative relationship) regarding the effect of job insecurity on job performance.

OBJECTIVE

To investigate the importance of time in explaining these ambiguous views. A positive association was expected cross-sectionally and a negative relationship longitudinally. I hypothesized that available coping resources may delay the negative effect on job performance until being exhausted.

METHODS

Longitudinal self-reported data of 928 participants were used. Job performance was operationalized as core task performance and productivity loss. Cross-sectional and longitudinal associations were analyzed using linear and logistic regressions. Duration analyses were performed using the two-year duration of job insecurity.

RESULTS

Short-term and long-term, job insecurity was only related with increased productivity loss. No evidence was found for core task performance. The duration of job insecurity, and chronic job insecurity in particular, did not predict core task performance or productivity loss two years later.

CONCLUSIONS

The factor time, operationalized as the time of follow-up and the duration of exposure to job insecurity, did not clarify the conflicting views. Managers should be more aware of the adverse effects of using job insecurity as a motivational strategy to increase job performance.

Employment Status Change and New-Onset Depressive Symptoms in Permanent Waged Workers

Background

This study aimed to investigate the relationship between changes in employment status and new-onset depressive symptoms through a one-year follow-up of permanent waged workers.

Methods

We analyzed the open-source data from the Korea Welfare Panel Study. Using the 2017 data, we selected 2,314 permanent waged workers aged 19 to 59 years without depressive symptoms as a base group. The final analysis targeted 2,073 workers who were followed up in 2018. In 2018, there were five categories of employment status for workers who were followed up: permanent, precarious, unemployed, self-employed, and economically inactive. Multiple logistic regression was used to determine the association between employment status change and new-onset depressive symptoms.

Results

Adjusted multiple logistic regression analysis showed that among male workers, workers who went from permanent status to being unemployed (odds ratio: 4.50, 95% confidence interval: 1.19 to 17.06) and from permanent status to being precarious workers (odds ratio: 3.15, 95% confidence interval: 1.30 to 7.65) had significantly high levels of new-onset depressive symptoms compared with those who retained their permanent employment status. There were no significant increases in new-onset depressive symptoms of male workers who went from permanent status to being self-employed or economically inactive. On the other hand, no significant differences were found among female workers.

Conclusion

Our study suggests that the change of employment status to precarious workers or unemployment can cause new-onset depressive symptoms in male permanent waged workers.

Impact of Job Insecurity on Psychological Well- and Ill-Being among High Performance Coaches

Background: The evaluative nature of high performance (HP) sport fosters performance expectations that can be associated with harsh scrutiny, criticism, and job insecurity. In this context, (HP) sport is described as a highly competitive, complex, and turbulent work environment. The aim of this longitudinal, quantitative study was to explore whether HP coaches’ perceptions of job insecurity and job value incongruence in relation to work would predict their psychological well- and ill-being over time. Methods: HP coaches (n = 299) responded to an electronic questionnaire at the start, middle, and end of a competitive season, designed to measure the following: job insecurity, values, psychological well-being (vitality and satisfaction with work), and psychological ill-being (exhaustion and cynicism). Structural equation model analyses were conducted using Mplus. Results: Experiencing higher levels of job insecurity during the middle of the season significantly predicted an increase in coaches’ psychological ill-being, and a decrease in their psychological well-being at the end of the season. However, value incongruence did not have a significant longitudinal impact. Conclusions: These findings cumulatively indicate that coaches’ perceptions of job insecurity matter to their psychological health at work. Consequently, it is recommended that coaches and organizations acknowledge and discuss how to handle job security within the HP sport context.

Job insecurity fluctuations and support towards Italian precarious schoolteachers

Purpose

The negative consequences of job insecurity on the well-being of individuals are well known. However, the perceptions of job insecurity over time and how some factors such as social support may affect them have received limited attention. This study follows precarious schoolteachers for three weeks before the end of their contract to explore how their perceptions of job insecurity evolve over time.

Design/methodology/approach

The participants were 47 precarious schoolteachers who first completed a general questionnaire, then a diary survey on nine occasions over the course of the three weeks. Data was analysed with MPLUS 7.3.

Findings

The results suggest intra-individual differences regarding the way job insecurity was perceived over time. An additional discovery was that support provided by the school principal was negatively related to changes in job insecurity over time.

Research limitations/implications

The relatively small sample size, which includes only precarious schoolteachers, and the methodology complexity of the diary are limitations of this study.

Practical implications

This study highlights the subjective nature of the perceptions of job insecurity. It also shows the importance of the school principal's social support towards precarious schoolteachers; therefore, practitioners should propose interventions to enhance the quality of principal–teachers relationships.

Originality/value

This study contributes to the literature by investigating how perceptions of job insecurity evolve over time and the role of social support.

Job insecurity and risk of coronary heart disease: Mediation analyses of health behaviors, sleep problems, physiological and psychological factors

Job insecurity has been linked to increased risk of coronary heart disease (CHD), but underlying mechanisms remain uncertain. Our aim was to assess the extent to which this association is mediated through life style, physiological, or psychological factors. A total of 3917 men and women free from CHD provided data on job insecurity in the Whitehall II cohort study in 1997-1999. The association between job insecurity and CHD was decomposed into a direct and indirect effect mediated through unhealthy behaviors (smoking, high alcohol consumption, physical inactivity), sleep disturbances, 'allostatic load', or psychological distress. The counterfactual analyses on psychological distress indicated a marginally significant association between job insecurity and incident CHD (hazard ratio (HR) 1.32; 95 % confidence interval (CI) 1.00-1.75). This association was decomposed into a direct (HR 1.22, 95 %CI 0.92-1.63) and indirect association (1.08, 95 %CI 1.01-1.15), suggesting that about 30 % of the total relationship was mediated by psychological distress. No mediation was indicated via health behaviors, sleep disturbances, or allostatic load, although job insecurity was related to disturbed sleep and C-reactive protein, which, in turn were associated with CHD. In conclusion, our results suggest that psychological distress may play a role in the relation between job insecurity and CHD.

Effects of Emotional Labor Factors and Working Environment on the Risk of Depression in Pink-Collar Workers

Analyzing men and women separately, we examined the associations between six key elements of the psychosocial work environment of pink-collar workers (n = 7633) and the risk of depression, using logistic regression analysis with data from the Fifth Korean Working Conditions Survey (KWCS) conducted in 2017. We assessed the risk of depression according to the presence of emotional display rules (EDR), health and safety information (HSI), and emotional labor. In males, the risk of depression increased when there were no EDR and they had to interact with angry customers (OR 1.94, 95% CI 1.14–3.30). For women, the risk of depression increased if they had to interact with angry customers and EDR were present (OR, 1.73; 95% CI, 1.00–3.00), and if they did not receive HSI but had to interact with angry customers (OR, 1.66; 95% CI, 1.02–2.71), or hid their emotions and did not receive HSI (OR, 1.90; 95% CI, 1.50–2.40). The risk of depression increased more in the presence of EDR among women who hid their emotions (OR 1.80, 95% CI, 1.40–2.31) compared to women who did not hide their emotions and in the absence of EDR. Therefore, it is necessary to consider the effects of gender-specific factors on the risk of depression and revise current guidelines accordingly.

The Evolution of Mental Health in the Context of Transitory Economic Changes

BACKGROUND

Mental health disorders are highly prevalent across countries. They increase over time and impose a severe burden on individuals and societies.

OBJECTIVE

This paper examines the evolution of mental health over a period of 15 years, paying special attention on the impact of the most recent economic downturn and subsequent recovery, in Spain.

METHOD

We use data coming from the National Health Surveys of 2006/2007, 2011/2012 and 2016/2017. Mental health is proxied by two measures, doctor-diagnosed mental disorder and psychological distress (based on the 12-item General Health Questionnaire). To account for the relationship between the two mental health indicators, we estimate a bivariate probit model. The potential endogeneity of unemployment status is considered.

RESULTS

We observe different patterns of the two mental health indicators over time. Psychological distress in men increased during recession years, but slightly decreased among women. Diagnosed mental disorders declined during the peak years of the crisis. Unemployment is a major risk factor for mental distress. Irrespective of the economic conditions, belonging to a higher social class acts as a buffer against psychological distress for women, but not for men. The remaining determinants acted as expected. Women declared worse psychological health than men, and were also more often diagnosed with mental disorders. Having a partner had a protective impact, while providing intensive care to a dependent relative exerted the opposite effect. Education acted as buffer against the onset of psychological distress in women.

CONCLUSION

Even though the need for mental healthcare increased during the recession, the fact that fewer people were diagnosed suggests that barriers to accessing mental healthcare may be aggravated during the crisis. Policies aiming to tackle the challenges posed by the high prevalence of mental disorders have to be particularly attentive to changes in individuals' socioeconomic situation, including education, unemployment and social class.

Associations between cognitive and affective job insecurity and incident purchase of psychotropic drugs: A prospective cohort study of Swedish employees

BACKGROUND

Previous research suggests that job insecurity is associated with poor mental health, but research examining how different aspects of job insecurity relate to clinical measures of poor mental health are lacking. We aimed to investigate the association between cognitive and affective job insecurity and incident purchases of psychotropic drugs.

METHODS

We included 14,586 employees participating in the Swedish Longitudinal Occupational Survey of Health (SLOSH), who answered questions on cognitive and/or affective job insecurity in 2010, 2012 or 2014. Respondents were followed in the Swedish Prescribed Drug Register (2.5 years on average). We investigated the association between job insecurity and incident psychotropic drugs with marginal structural Cox models.

RESULTS

Affective job insecurity was associated with an increased risk of purchasing any psychotropic drugs (Hazard Ratio (HR) 1.40 (95% Confidence Interval (CI) 1.04-1.89)) while cognitive job insecurity was not (HR 1.15 (95% CI 0.92-1.43)). Cognitive and affective job insecurity were both associated with antidepressants, affective job insecurity with anxiolytics, but no association was found with sedatives. Women and younger workers seemed to have higher risk compared to men and older workers, but differences were not statistically significant.

LIMITATIONS

Although job insecurity and psychotropic drugs were assessed through independent sources and several covariates were considered, unmeasured confounding cannot be ruled out.

CONCLUSIONS

The findings support that affective job insecurity is a risk factor for psychotropic drug treatment, that it may be relevant to distinguish between different types of job insecurity, and to consider sex and age as moderating factors.

The institutionalization of part-time work: Cross-national differences in the relationship between part-time work and perceived insecurity

We propose an institutionalization of part-time work model to account for the cross-national variation in workers' perceptions of insecurity in their jobs and in the labor market, arguing that part-time work is institutionalized as high quality or marginal employment depending on the extent to which it is voluntary, gendered, and legally protected. Using heterogeneous choice models on 2005 ISSP data linked to country-level characteristics, we find that the relationship between part-time work and insecurity is gendered and contingent upon the type of insecurity (cognitive job insecurity, labor market insecurity, or affective job insecurity) and whether or not one works part-time on a voluntary basis. At the individual level, working in a part-time job is associated with greater cognitive job insecurity but lower labor market and affective job insecurity. At the national level, the expected negative association between the part-time work rate and insecurity is most consistent for affective job insecurity. The findings also indicate that the strength of the association between working in a part-time job and insecurity varies by the national institutional context of part-time work, including the degree of gender segregation of part-time work and legal protections for part-time workers. Overall, the results from this study provide support for our institutionalization of part-time work perspective. Part-time work is not inherently secure or insecure employment. The amount of insecurity associated with this type of non-standard work is contingent upon the prevailing local myths or scripts that structure the ways that the state, employers, and workers view part-time work.

Influence of combined exposure to perceived risk at work and unstable employment on self-rated health: a comparison of two cross-sectional surveys in Europe and Korea

OBJECTIVES

The purpose of this study was to investigate the combined effect of exposure to perceived risk at work and unstable employment on self-rated health in both Korea and the European Union.

DESIGN

Cross-sectional study.

SETTING

We conducted the analyses using employees data from the third Korean Working Conditions Survey (KWCS) conducted in 2011 and the fifth European Working Conditions Survey (EWCS) conducted in 2010.

PARTICIPANTS

Employees of the third KWCS and the fifth EWCS from 35 European countries were the participants of the study.

PRIMARY OUTCOME MEASURES

Employment status was divided into two categories: stable and unstable employment. Perceived risk regarding safety and health at work were assessed. Primary health outcomes were poor or moderate self-rated health. Exposures and health status were assessed via a questionnaire.

RESULTS

Among Korean employees, the OR of poor self-rated health was 2.00 (95% CI: 1.80 to 2.22) for those with perceived risk at work, 1.18 (95% CI: 1.09 to 1.28) for those with unstable employment and 3.22 (95% CI: 2.72 to 3.81) for those with both perceived risk at work and unstable employment. Relative excess risk due to interaction (RERI) was 1.03 (95% CI: 0.48 to 1.58). Among European employees, the OR for poor self-rated health was 3.20 (95% CI: 2.93 to 3.49) for those with perceived risk at work, 1.04 (95% CI: 0.97 to 1.13) for those with unstable employment and 3.41 (95% CI: 2.93 to 3.98) for those with both perceived risk at work and unstable employment. The RERI was 0.18 (95% CI: -0.36 to 0.71).

CONCLUSIONS

Among Korean employees, a supra-additive interaction between perceived risk at work and unstable employment on poor self-rated health was observed. Conversely, a supra-additive interaction was not observed among European employees.

The Effect of Organizational Changes on the Psychosocial Work Environment: Changes in Psychological and Social Working Conditions Following Organizational Changes

Purpose: The present study aimed to clarify the prospective effects of various types and frequencies of organizational changes on aspects in the psychosocial work environment. Methods: The study had a prospective, full-panel, repeated measures design. Data were collected by self-administered, online questionnaires, with a 2-year interval between measurement occasions. Five types of organizational change were assessed - company restructuring, downsizing, layoffs, partial closure, and partial outsourcing. The effects of change on eleven, specific work factors were measured utilizing QPS Nordic. At baseline, 12652 employees participated, while 8965 responded at follow-up. Generalized estimating equations were utilized to estimate the effects of change taking place within the last 12 months or more than 24 months prior. Results: Cross-sectional analyses, i.e., changes occurring within the last 12 months, showed all 11 work factors to be statistically significantly associated with the organizational changes restructuring, downsizing, and partial closure (coefficients ranging -0.28 to 0.04). In the prospective analyses, i.e., the effects of change taking place more than 24 months prior, associations were no longer significant for a number of work factors, although all types of organizational change remained significantly associated with at least three work factors (coefficients ranging -0.14 to 0.05). Following repeated organizational changes, statistically significant associations were shown for all 11 work factors (coefficients ranging from 0.39 to -0.04). Conclusion: Following both separate and repeated organizational change, various psychological and social work factors were altered, with the most pronounced effects following repeated change. These results suggest the implementing organizational change, especially repeated change, may have an adverse effect on various parts of the psychosocial work environment. The negative effects of a company's psychosocial working conditions may contribute to the adverse health effects often observed following such changes and help explain why many change initiatives fail to reach its intended results.

Employment relations and dismissal regulations: Does employment legislation protect the health of workers?

Sociologists have long acknowledged that being in a precarious labour market position, whether employed or unemployed, can harm peoples' health. However, scholars have yet to fully investigate the possible contextual, institutional determinants of this relationship. Two institutions that were overlooked in previous empirical studies are the regulations that set minimum compensation for dismissal, severance payments, and entitlements to a period of notice before dismissal, notice periods. These institutions may be important for workers' health as they influence the degree of insecurity that workers are exposed to. Here, we test this hypothesis by examining whether longer notice periods and greater severance payments protect the health of labour market participants, both employed and unemployed. We constructed two cohorts of panel data before and during the European recession using data from 22 countries in the European Union Statistics on Income and Living Conditions (person years = 338,000). We find more generous severance payments significantly reduce the probability that labour market participants, especially the unemployed, will experience declines in self-reported health, with a slightly weaker relationship for longer notice periods.

Patterns of Change in Employment Status and Their Association with Self-Rated Health, Perceived Daily Stress, and Sleep among Young Adults in South Korea

We identified distinct trajectories of temporal changes in employment status and investigated their association with self-rated health, perceived stress, and sleep. Data pertaining to 1228 respondents (age: 17–31 years) were extracted from the Korea Youth Panel (YP2007) survey (3rd–9th wave) datasets. Participants were either paid employees (permanent or precarious) or currently unemployed but seeking a job at baseline. Latent class growth analyses were employed to extract different classes based on the annual change in employment status (permanent/precarious/unemployed). Logistic regression analyses were performed using extracted classes as predictor variables and health-related variables at the final time-point as outcome variables. Five trajectories of employment status change were identified: stability sustained; gradually deteriorated; swiftly alleviated; gradually alleviated; instability sustained. Compared with the stability sustained group, the gradually deteriorated and gradually alleviated groups showed higher odds of perceived stress. The gradually deteriorated, instability sustained, and gradually alleviated groups showed significantly higher odds of shorter sleep than the stabilized group. We highlight the adverse health effects of prolonged unstable employment and the need for interventions to mitigate these effects.

How Stress Hinders Health among Chinese Public Sector Employees: The Mediating Role of Emotional Exhaustion and the Moderating Role of Perceived Organizational Support

Drawing on the conservation of resources theory, this study examines the detrimental effect of hindrance stressors on self-rated health among a sample of Chinese public sector employees. Analysis of survey data based on 404 MPA students from a leading Chinese university who are working in various public organizations across China suggested that hindrance stressors were negatively related to both physical and mental health (β = −0.11, p < 0.01 and β = −0.38, p < 0.001, respectively), and emotional exhaustion mediated those relationships (95% bias-corrected confidence intervals for the indirect effects on physical and mental health based on 5000 bootstrapped samples were −1.64 to −0.35 and −3.51 to −1.81, respectively, excluding 0). Furthermore, perceived organizational support moderated the effect of hindrance stressors on emotional exhaustion (β = −0.10, p < 0.05), and moderated the indirect effects of hindrance stressors on physical and mental health via emotional exhaustion (index of moderated mediation was 0.116 with bootstrapped confidence interval of 0.018–0.296 for physical health, and 0.317 with bootstrapped confidence interval of 0.008–0.663 for mental health). The effects of hindrance stressors were weaker when perceived organizational support was high, suggesting a moderating effect. Our findings not only provide important theoretical contributions to the literature on public employees’ work-related stress and associated health outcomes, but also offer practical implications to those who are interested in stress intervention to improve the wellbeing of public employees and general society.

Mental Health Problems and Associated Predictors Among Bangladeshi Students

Common mental health problems are regarded as public health concerns and can contribute to risky behaviors such as suicide among university students in extreme cases. However, there is a lack of studies concerning such issues in Bangladesh. The present study aimed to fill this knowledge gap by investigating the prevalence and associated risk predictors of depression, anxiety, and stress among Bangladeshi university students. The sample comprised 590 undergraduates attending Jahangirnagar University (Dhaka, Bangladesh) who completed an offline survey including sociodemographic questions, behavioral variables, and the 21-item Bangla Depression, Anxiety and Stress Scale (BDASS-21). The prevalence of moderate to the extremely severe levels of depression, anxiety, and stress was 52.2%, 58.1%, and 24.9%, respectively. There were no significant gender differences in depression, anxiety, and stress. Risk factors for depression included coming from a lower class family, being a cigarette smoker, and engaging in less physical exercise. Risk factors for anxiety and stress included being engaged in a relationship. The findings need to be further replicated among other Bangladeshi university students to help in the development of better intervention programs and appropriate support services targeting this vulnerable group including a focus of suicide prevention and awareness.

Readmissions Among Patients Admitted With Acute Decompensated Heart Failure Based on Income Quartiles

OBJECTIVE

To determine the impact of socioeconomic status using median household income within the patient's community on rate of readmission among patients with heart failure (HF).

PATIENTS AND METHODS

We derived a study cohort of patients who were admitted from January 1, 2013, through December 31, 2014, with congestive HF from the Healthcare Cost and Utilization Project National Readmission Database. Patients were stratified into quartiles according to the estimated median household income of residents in the patient's ZIP Code (quartile 1, lowest; quartile 4, highest). The primary outcome was 30-day readmission. We used univariate and multivariate models to compare patients with respect to baseline characteristics, income quartiles, and 30-day readmission.

RESULTS

About 20% (110,152 of 546,841) of patients with an index HF admission were readmitted within the first 30 days. Patients in the lowest income quartile had a higher readmission rate compared with those in the highest income quartile (21.1% [35,422 of 167,625] vs 19.5% [20,771 of 106,353]; P<.001). Patients within the lowest income group had higher odds of readmission for cardiovascular causes compared with the highest income group (50.6% [17,923 of 35,422] vs 48.8% [10,136 of 20,771; P<.001). Readmissions within the lowest income group accounted for 30% of all rehospitalization-related costs at $715 million. Multivariate analysis confirmed a higher rate of 30-day readmission among patients in the lowest income group compared with those in the highest group (adjusted odds ratio, 1.11; 95% CI, 1.08-1.13).

CONCLUSION

Our study shows that patients in communities with the lowest quartile of income have a higher rate of readmission following the index HF admission with high associated costs. Readmission reporting and reimbursement adjustments should account for these socioeconomic inequalities.

Temporary employment, work stress and mental health before and after the Spanish economic recession

PURPOSE

This paper analyses the effects of temporary employment on work stress and mental health before (2006/2007) and during the economic recession (2011/2012), and examines whether the economic recession worsened these two health outcomes.

METHODS

To control for selection bias, propensity scores (PS) are computed separately for salaried men and women using microdata from two cross-sectional health surveys in Spain, considering temporary (treatment group) versus permanent employment (control group). Next, we use difference-in-difference estimators stratifying by age, education level, and regional unemployment differences using PS as weights.

RESULTS

Our results indicate that salaried worker with a temporary labour contract tends to have similar levels of high work stress and poorer mental health (only for men) than permanent ones for both periods. The economic recession does not appear to worsen both outcomes. However, when stratifying the sample, the economic recession is responsible for increasing stress among older temporary workers and male university graduates, without affecting women. Regarding mental health, we only find evidence of a negative impact of the economic recession on male temporary workers with university education.

CONCLUSION

The economic recession has not affected poor mental health, but it has accentuated the adverse effects of work stress among some specific subgroups of male workers. These subgroups require specific preventive and support actions as the Spanish firms have not substantially changed their hiring practices after the recession.