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Gibbons RD, Olfson M, Saulsberry L, Edlund MJ, Zangeneh S, Bareis N, Chwastiak L, Gibbons JB, Kessler RC. Social Vulnerability and Prevalence and Treatment for Mental Health and Substance Use Disorders. JAMA Psychiatry 2024; 81:976-984. [PMID: 39046728 PMCID: PMC11446668 DOI: 10.1001/jamapsychiatry.2024.1870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Importance Community-level social vulnerability (SV) is associated with physical illness and premature mortality. Its association with mental health (MH) and substance use disorders (SUDs) needs further study. Objective To study associations of SV with clinical diagnoses of MH disorders, SUDs, and related treatments in the US noninstitutionalized population of adults aged 18 years and older. Design, Setting, and Participants A survey of adults in a national sample of US households between October 2020 and October 2022. Participants drawn from a multistage, clustered, and stratified area probability sample of US households were included, excluding adults older than 65 years because of the difficulty of differentiating mental disorders from symptoms of dementia. The sample also included adults living in prisons, state psychiatric hospitals, and homeless shelters who were excluded from the sample of US households used in these analyses. Each sample household was sent a letter explaining the study and offering the option to complete the household roster online, by phone, or by email. Of the 12 906 adults selected for clinical interviewing in the household sample, 4674 completed clinical interviews. Main Outcomes and Measures Main outcomes were Structured Clinical Interview for DSM-5 past-year diagnoses of MH disorders and SUDs and responses to survey questions regarding treatment received. The Social Vulnerability Metric (SVM) and the Area Deprivation Index (ADI) were used to determine SV at the residential zip code level. Results The analysis involved 4674 participants (2904 [62.13%] female and 1770 [37.87%] male; mean [SD] age, 41.51 [13.41] years). Controlling for measured confounders, the SVM was significantly associated with diagnoses of schizophrenia spectrum disorder (SSD; adjusted odds ratio [aOR], 17.22; 95% CI, 3.05-97.29), opioid use disorder (OUD; aOR, 9.47; 95% CI, 2.30-39.02), stimulant use disorder (aOR, 6.60; 95% CI, 2.01-21.67), bipolar I disorder (aOR, 2.39; 95% CI, 1.19-4.80), posttraumatic stress disorder (aOR, 1.63; 95% CI, 1.06-2.50), and any MH disorder (aOR, 1.44; 95% CI, 1.14-1.83), but not major depressive disorder (MDD), generalized anxiety disorder (GAD), or any SUD. Results were similar for the ADI but generally of lower magnitude (SSD aOR, 11.38; 95% CI, 1.61-80.58; OUD aOR, 2.05; 95% CI, 0.30-14.10; stimulant use disorder aOR, 2.18; 95% CI, 0.52-9.18). Among participants with SSDs, SV was associated with reduced MH treatment (aOR, 0.001; 95% CI, 0.00-0.18) and reduced SUD treatment in participants with OUD or stimulant use disorder (aOR, 0.24; 95% CI, 0.02-2.80). Conclusions and Relevance In contrast to previous studies using nonclinical symptom-based survey data, we found no association between SV and GAD or MDD. By contrast, there were associations of SV with prevalence of SSD, stimulant use disorder, and OUD with corresponding decreases in treatment. These results suggest that the SVM might assist in developing more comprehensive care models that integrate medical and social care for MH disorders and SUDs.
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Affiliation(s)
- Robert D Gibbons
- Department of Medicine, Division of Biological Sciences, University of Chicago, Chicago, Illinois
- Department of Public Health Sciences, Division of Biological Sciences, University of Chicago, Chicago, Illinois
- Center for Health Statistics, University of Chicago, Chicago, Illinois
| | - Mark Olfson
- Department of Psychiatry, Columbia University, New York, New York
| | - Loren Saulsberry
- Department of Public Health Sciences, Division of Biological Sciences, University of Chicago, Chicago, Illinois
| | | | - Sahar Zangeneh
- RTI International
- Department of Biostatistics, School of Public Health, University of Washington, Seattle
| | - Natalie Bareis
- Department of Psychiatry, Columbia University, New York, New York
| | - Lydia Chwastiak
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
| | - Jason B Gibbons
- Department of Health Systems, Management and Policy, University of Colorado, Aurora
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
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Shahidi FV, Tracey M, Gignac MAM, Oudyk J, Smith PM. Unpaid overtime and mental health in the Canadian working population. Am J Ind Med 2024; 67:741-752. [PMID: 38849975 DOI: 10.1002/ajim.23622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/14/2024] [Accepted: 05/27/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Unpaid overtime-describing a situation where extra hours are worked but not paid for-is a common feature of the labor market that, together with other forms of wage theft, costs workers billions of dollars annually. In this study, we examine the association between unpaid overtime and mental health in the Canadian working population. We also assess the relative strength of that association by comparing it against those of other broadly recognized work stressors. METHODS Data were drawn from a survey administered to a heterogeneous sample of workers in Canada (n = 3691). Generalized linear models quantified associations between unpaid overtime, stress, and burnout, distinguishing between moderate (1-5) and excessive (6 or more) hours of unpaid overtime. RESULTS Unpaid overtime was associated with higher levels of stress and burnout. Relative to those working no unpaid overtime, men working excessive unpaid overtime were 85% more likely to report stress (prevalence ratios [PR]: 1.85, 95% confidence interval [CI]: 1.26-2.72) and 84% more likely to report burnout (PR: 1.84, 95% CI: 1.34-2.54), while women working excessive unpaid overtime were 90% more likely to report stress (PR: 1.90, 95% CI: 1.32-2.75) and 52% more likely to report burnout (PR: 1.52; 95% CI: 1.12-2.06). The association of excessive unpaid overtime with mental health was comparable in magnitude to that of shift work and low job control. CONCLUSIONS Unpaid overtime may present a significant challenge to the mental health of working people, highlighting the potential role of wage theft as a neglected occupational health hazard.
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Affiliation(s)
- Faraz Vahid Shahidi
- Institute for Work and Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Matthew Tracey
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Monique A M Gignac
- Institute for Work and Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - John Oudyk
- Occupational Health Clinics for Ontario Workers, Hamilton, Ontario, Canada
| | - Peter M Smith
- Institute for Work and Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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O’Campo P, Gunn V, Perri M, Buhariwala P, Rasoulain E, Daneshvardfard M, Ma RW, Lewchuck W, Baron S, Bodin T, Muntaner C. Working Conditions, Worker Rights, and Managerial Domination During the COVID-19 Pandemic: Assessing Their Toll on Precariously Employed Workers and Family Well-Being. INTERNATIONAL JOURNAL OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SERVICES 2024; 54:233-246. [PMID: 38813773 PMCID: PMC11157980 DOI: 10.1177/27551938241253789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/01/2024] [Accepted: 02/28/2024] [Indexed: 05/31/2024]
Abstract
Precarious Employment (PE) is characterized by job, income, and benefit insecurities. Studies surrounding PE and well-being have been predominantly quantitative, leaving a gap in rich descriptions of employment experiences. We recruited a sample of 40 adults aged 25-55 who were involved in PE during the beginning of the COVID-19 pandemic or lost employment due to the pandemic. Semi-structured interviews were administered. Employment and income insecurities were common and had negative impacts on the well-being of participants and their families. Uncertainty about future employment prospects and job and income loss resulted in chronic distress. Other insecurities-access to benefits, violation of worker rights, worker safety-was also reported as impacting well-being. The COVID-19 pandemic deepened insecurities, hardships, and distress among workers with PE conditions. Given the myriad insecurities experienced by those engaged in PE, the focus of precarious work research should also include working conditions, violation of worker rights, and managerial domination.
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Affiliation(s)
- Patricia O’Campo
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Virginia Gunn
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
- Cape Breton University, Halifax, NS, Canada
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Melissa Perri
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Pearl Buhariwala
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Elham Rasoulain
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | | | - Rachel W Ma
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Wayne Lewchuck
- Department of Economics and School of Labour Studies, McMaster University, Hamilton, ON, Canada
| | - Sherry Baron
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Queens, NY, USA
| | - Theo Bodin
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Stockholm Region, Stockholm, Sweden
| | - Carles Muntaner
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
- Lawrence S. Bloomberg School of Nursing, University of Toronto, Toronto, ON, Canada
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4
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Boufkhed S, Thorogood N, Ariti C, Durand MA. 'They treat us like machines': migrant workers' conceptual framework of labour exploitation for health research and policy. BMJ Glob Health 2024; 9:e013521. [PMID: 38316464 PMCID: PMC10860016 DOI: 10.1136/bmjgh-2023-013521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/25/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The exploitation of migrant workers ranks high on global political agendas including the Sustainable Development Goals. Research on exploited workers, using assessment tools where exploitation is defined by professional experts, indicates serious health concerns and needs. Yet, migrant workers are rarely asked about their understanding of a phenomenon they may experience. Our study aimed to conceptualise 'labour exploitation' from the perspective of migrant workers employed in manual low-skilled jobs. METHODS Twenty-seven Latin Americans working in London (UK) participated in Group Concept Mapping; a participatory mixed-method where qualitative data are collected to define a concept's content and then analysed using quantitative methods to generate a structured conceptual framework. Participants generated statements describing the concept content during brainstorming sessions, and structured them during sorting-rating exercises. Multi-Dimensional Scaling and Cluster Analysis were performed, generating a conceptual framework that clarified the dimensions, subdimensions and constituent statements of the concept of labour exploitation from migrant workers' perspectives. RESULTS Three key dimensions were identified: 'poor employment conditions and lack of protection', covering contractual arrangements and employment relations; 'disposability and abuse of power' (or 'dehumanisation') covering mechanisms or means which make migrant workers feel disposable and abused; and 'health and safety and psychosocial hazards' encompassing issues from physical and psychosocial hazards to a lack of health and social protection. 'Dehumanisation' has not been included in mainstream tools assessing exploitation, despite its importance for study participants who also described harsh situations at work including sexual, physical and verbal abuse. CONCLUSION Our study provides a conceptual framework of labour exploitation that gives voice to migrant workers and can be operationalised into a measure of migrant labour exploitation. It also calls for the dimension 'dehumanisation' and structural forms of coercion to be integrated into mainstream conceptualisations, and their workplace hazards to be urgently addressed.
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Affiliation(s)
- Sabah Boufkhed
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Humanitarian and Conflict Response Institute, The University of Manchester, Manchester, UK
| | - Nicki Thorogood
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Cono Ariti
- Centre for Trials Research, Cardiff University School of Medicine, Cardiff, UK
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Mary Alison Durand
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
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Gelaw A, Parker S, Johnson A, Nguyen H, Jolly A, Forner V, Deng C, Collie A. Determinants of psychological injury among health and social care workers in community settings: A systematic review. Work 2024; 78:3-27. [PMID: 38578915 DOI: 10.3233/wor-230426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Health and Social Care (HSC) workers face psychological health risks in the workplace. While many studies have described psychological injuries in HSC workers, few have examined the determinants. Previous research has primarily focused on hospitals, lacking systematic reviews of community-based settings. OBJECTIVE To systematically identify and appraise current evidence on the determinants of psychological injuries among HSC workers in community settings. METHODS Searches were conducted in three bibliographic databases, supplemented by citation searches. Included studies focused on community-based HSC workers, reporting statistical associations between psychological injury and personal, health, occupational, or organizational factors. Quantitative studies published in English between January 1, 2000 and August 15, 2023 were included. Quality appraisal was undertaken using the JBI critical appraisal checklist. RESULTS Sixty-six studies were included. Study quality was highly variable, and all studies were cross-sectional. Twenty-three studies linked psychological injury with occupational factors (e.g. low job control, high job demands and low job satisfaction). Thirteen studies observed an association between work environment and psychological injury, and a further eleven between workplace social support and psychological injury. Fewer studies have examined the relationship between psychological injury and personal/individual factors. CONCLUSION Occupational and organisational factors are significantly associated with psychological health among HSA workers, in community settings. These aspects of job design, work environment and workplace relationships are modifiable, suggesting an opportunity for work design interventions to improve workers' psychological health and reduce the prevalence of psychological injury in this sector.
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Affiliation(s)
- Asmare Gelaw
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Sharon Parker
- Future of Work Institute, Curtin University, Perth, WA, Australia
| | - Anya Johnson
- The University of Sydney Business School, The University of Sydney, Sydney, NSW, Australia
| | - Helena Nguyen
- The University of Sydney Business School, The University of Sydney, Sydney, NSW, Australia
| | - Anu Jolly
- Future of Work Institute, Curtin University, Perth, WA, Australia
| | - Vivien Forner
- The University of Sydney Business School, The University of Sydney, Sydney, NSW, Australia
| | - Connie Deng
- The University of Sydney Business School, The University of Sydney, Sydney, NSW, Australia
| | - Alex Collie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Lindmark T, Engström M, Trygged S. Psychosocial Work Environment and Well-Being of Direct-Care Staff Under Different Nursing Home Ownership Types: A Systematic Review. J Appl Gerontol 2023; 42:347-359. [PMID: 36214292 PMCID: PMC9841825 DOI: 10.1177/07334648221131468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 08/15/2022] [Accepted: 09/19/2022] [Indexed: 01/15/2023] Open
Abstract
This systematic review investigated the psychosocial work environment and well-being of direct-care staff under different nursing home ownership types. Databases searched: Scopus, Web of Science, Cinahl, and PubMed, 1990-2020. Inclusion criteria: quantitative or mixed-method studies; population: direct-care staff in nursing homes; exposure: for-profit and non-profit ownership; and outcomes: psychosocial work environment and well-being. In total, 3896 articles were screened and 17(n = 12,843 participants) were assessed using the Joanna Briggs Institute Critical Appraisal tools and included in the narrative synthesis. The results were inconsistent, but findings favored non-profit over for-profit settings, for example, regarding leaving intentions, organizational commitment, and stress-related outcomes. There were no clear differences concerning job satisfaction. Job demands were higher in non-profit nursing homes but alleviated by better job resources in one study. The result highlights work environment issues, with regulations concerning for-profit incentives being discussed in terms of staff benefits.
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Affiliation(s)
- Tomas Lindmark
- Faculty of Health and Occupational Studies, Department of Social Work, University of Gävle, Gävle, Sweden
| | - Maria Engström
- Faculty of Health and Occupational Studies, Department of Caring Science, University of Gävle, Gävle, Sweden
| | - Sven Trygged
- Faculty of Health and Occupational Studies, Department of Social Work, University of Gävle, Gävle, Sweden
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Boufkhed S, Thorogood N, Ariti C, Durand MA. Building a better understanding of labour exploitation's impact on migrant health: An operational framework. PLoS One 2022; 17:e0271890. [PMID: 35913945 PMCID: PMC9342789 DOI: 10.1371/journal.pone.0271890] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 07/10/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND There is limited evidence on labour exploitation's impact on migrant health. This population is, however, often employed in manual low-skilled jobs known for poor labour conditions and exploitation risks. The lack of a common conceptualisation of labour exploitation in health research impedes the development of research measuring its effects on migrant health and, ultimately, our understanding of migrants' health needs. AIM To develop an operational conceptual framework of labour exploitation focusing on migrant workers in manual low-skilled jobs. METHODS Non-probabilistic sampling was used to recruit multidisciplinary experts on labour exploitation. An online Group Concept Mapping (GCM) was conducted. Experts: 1) generated statements describing the concept 'labour exploitation' focusing on migrants working in manual low-skilled jobs; 2) sorted generated statements into groups reflecting common themes; and 3) rated them according to their importance in characterising a situation as migrant labour exploitation. Multidimensional Scaling and Cluster Analysis were used to produce an operational framework detailing the concept content (dimensions, statements, and corresponding averaged rating). FINDINGS Thirty-two experts sorted and rated 96 statements according to their relative importance (1 "relatively unimportant" to 5 "extremely important"). The operational framework consists of four key dimensions of migrant labour exploitation, distributed along a continuum of severity revealed by the rating: 'Shelter and personal security' (rating: 4.47); 'Finance and migration' (4.15); 'Health and safety' (3.96); and 'Social and legal protection' (3.71). CONCLUSION This study is the first to both generate an empirical operational framework of migrant labour exploitation, and demonstrate the existence of a "continuum from decent work to forced labour". The framework content can be operationalised to measure labour exploitation. It paves the way to better understand how different levels of exploitation affect migrant workers' health for global policymakers, health researchers, and professionals working in the field of migrant exploitation.
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Affiliation(s)
- Sabah Boufkhed
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Humanitarian and Conflict Response Institute, The University of Manchester, Manchester, United Kingdom
| | - Nicki Thorogood
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Cono Ariti
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre for Medical Education, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Mary Alison Durand
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Periodontal diseases and potential risk factors in Egyptian adult population-Results from a national cross-sectional study. PLoS One 2021; 16:e0258958. [PMID: 34731192 PMCID: PMC8565785 DOI: 10.1371/journal.pone.0258958] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 10/09/2021] [Indexed: 01/02/2023] Open
Abstract
Background Despite the interdependence of general and periodontal health, there is paucity of national representative data on the prevalence of periodontal diseases and their associated risk factors in Egyptian population. This cross-sectional study, thus, aimed to assess the prevalence of periodontitis and tooth loss among Egyptian adults and investigate the association between potential risk factors and periodontal diseases. Methods A total of 5,954 adults aged ≥ 20 years were included in this study as a subsample from Egypt’s national oral health survey. Periodontitis was diagnosed with Community Periodontal Index ‘CPI’ scores ≥3 and tooth loss not due to caries was included in the analysis. Socio-demographic data and information on behavioral factors and history of diabetes were gathered in a face-to-face interview. Logistic regression was done to interpret the impact of potential predictors on the incidence of the two selected outcome variables. Results The overall prevalence of periodontitis was 26% and regression analysis revealed that higher odds of periodontitis existed among illiterate participants (OR = 1.74; 95% CI: 1.40–2.17), smokers (OR = 1.93; 95% CI: 1.69–2.20) and rural residents (OR = 1.16; 95% CI: 1.03–1.30). On the other hand, old age, frequency of dental attendance and history of diabetes were the main predictive factors for tooth loss. Conclusions Among Egyptian adults, periodontal diseases were strongly associated with a multitude of modifiable and non-modifiable risk factors and inequalities in distribution of periodontal treatment needs were determined mainly by age, gender, level of education and residency location.
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Whither Occupational Class Health Gradients?: Why We Need More Social Class Theory, Mechanisms, Indicators, and Scientific Realism. Epidemiology 2019; 30:445-448. [PMID: 30964815 DOI: 10.1097/ede.0000000000000994] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Muntaner C, Augustinavicius J. Intersectionality: A Scientific Realist Critique. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2019; 19:39-41. [PMID: 31543026 DOI: 10.1080/15265161.2018.1557296] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Prins SJ, McKetta S, Platt J, Muntaner C, Keyes KM, Bates LM. Mental illness, drinking, and the social division and structure of labor in the United States: 2003-2015. Am J Ind Med 2019; 62:131-144. [PMID: 30565724 DOI: 10.1002/ajim.22935] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 11/22/2018] [Indexed: 11/05/2022]
Abstract
BACKGROUND We draw on a relational theoretical perspective to investigate how the social division and structure of labor are associated with serious and moderate mental illness and binge and heavy drinking. METHODS The Panel Study of Income Dynamics and the Occupational Information Network were linked to explore how occupation, the productivity-to-pay gap, unemployment, the gendered division of domestic labor, and factor-analytic and theory-derived dimensions of work are related to mental illness and drinking outcomes. RESULTS Occupations involving manual labor and customer interaction, entertainment, sales, or other service-oriented labor were associated with increased odds of mental illness and drinking outcomes. Looking for work, more hours of housework, and a higher productivity-to-pay gap were associated with increased odds of mental illness. Physical/risky work was associated with binge and heavy drinking and serious mental illness; technical/craft work and automation were associated with binge drinking. Work characterized by higher authority, autonomy, and expertise was associated with lower odds of mental illness and drinking outcomes. CONCLUSIONS Situating work-related risk factors within their material context can help us better understand them as determinants of mental illness and identify appropriate targets for social change.
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Affiliation(s)
- Seth J. Prins
- Department of Epidemiology; Columbia University; New York New York
- Department of Sociomedical Sciences; Columbia University; New York New York
| | - Sarah McKetta
- Department of Epidemiology; Columbia University; New York New York
| | - Jonathan Platt
- Department of Epidemiology; Columbia University; New York New York
| | - Carles Muntaner
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Toronto Ontario
| | - Katherine M. Keyes
- Department of Epidemiology; Columbia University; New York New York
- Center for Research on Society and Health; Universidad Mayor; Santiago Chile
| | - Lisa M. Bates
- Department of Epidemiology; Columbia University; New York New York
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Novrinda H, Han DH, Jung-Choi K, Ryu JI. Neo-Marxian social class inequalities in oral health among the South Korean population. Community Dent Oral Epidemiol 2018; 47:162-170. [PMID: 30548668 DOI: 10.1111/cdoe.12439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 12/27/2022]
Abstract
AIM The aims of this study were to examine inequalities in periodontitis and tooth loss among South Korean adults using the Wright's Neo-Marxian social class (NMSC) indicator and to assess the impact of material, psychosocial, health behavioural and workplace environmental factors in the association of social class with oral health. METHODS This study used the data from the 4th Korea National Health and Nutrition Examination Survey with 6710 participants aged 19-54 years old. Participants were classified into 12 social class positions based on the Wright's social class map. Healthy gum and absence of tooth loss were the health outcomes. Mediating factors were material (M), psychosocial (PS), health behavioural (HB) and workplace environmental (WPE) factors. A series of logistic regressions were performed to analyse the data. Odds ratio (OR) and 95% confidence interval (CI) were used to report the results. RESULTS For the absence of periodontal pockets status, expert supervisors were the healthiest periodontal group among the social classes (OR = 2.15 95% CI 1.59-2.90) in the age and gender adjusted model. For the absence of tooth loss, skilled workers had the highest OR for absence of tooth loss (OR = 1.64 95% CI 1.31-2.05) in the age- and gender-adjusted model. For absence of periodontal pockets, the explanatory power of the M factor was the highest in all social class positions except for nonskilled supervisors followed by the HB factor. Additionally, the absence of tooth loss had a fairly similar pattern. The explanatory power of the M factor was the highest in all social class positions except for the petty bourgeoisie (highest: HB) and nonskilled supervisors (highest: WPE) followed by the HB and WPE factors. CONCLUSION There were nongradient oral health inequalities among the South Korean population according to the NMSC. Oral health promotion programmes that focus on changing the socioeconomic environment and health behaviours should be implemented.
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Affiliation(s)
- Herry Novrinda
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Department of Dental Public Health and Preventive Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Dong-Hun Han
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Kyunghee Jung-Choi
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jae-In Ryu
- Department of Preventive and Social Dentistry, Kyung Hee University, Seoul, Korea
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Alegría M, NeMoyer A, Falgas I, Wang Y, Alvarez K. Social Determinants of Mental Health: Where We Are and Where We Need to Go. Curr Psychiatry Rep 2018; 20:95. [PMID: 30221308 PMCID: PMC6181118 DOI: 10.1007/s11920-018-0969-9] [Citation(s) in RCA: 321] [Impact Index Per Article: 53.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW The present review synthesizes recent literature on social determinants and mental health outcomes and provides recommendations for how to advance the field. We summarize current studies related to changes in the conceptualization of social determinants, how social determinants impact mental health, what we have learned from social determinant interventions, and new methods to collect, use, and analyze social determinant data. RECENT FINDINGS Recent research has increasingly focused on interactions between multiple social determinants, interventions to address upstream causes of mental health challenges, and use of simulation models to represent complex systems. However, methodological challenges and inconsistent findings prevent a definitive understanding of which social determinants should be addressed to improve mental health, and within what populations these interventions may be most effective. Recent advances in strategies to collect, evaluate, and analyze social determinants suggest the potential to better appraise their impact and to implement relevant interventions.
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Affiliation(s)
- Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, USA. .,Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Amanda NeMoyer
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital,Department of Health Care Policy, Harvard Medical School
| | - Irene Falgas
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital
| | - Ye Wang
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital
| | - Kiara Alvarez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital,Department of Psychiatry, Harvard Medical School
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Workplace Hazards Faced by Nursing Assistants in the United States: A Focused Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050544. [PMID: 28534859 PMCID: PMC5451994 DOI: 10.3390/ijerph14050544] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 05/08/2017] [Accepted: 05/16/2017] [Indexed: 11/16/2022]
Abstract
Nursing assistants (NAs) make up a large share of the healthcare provider workforce and their numbers are expected to grow. NAs are predominantly women who earn a low wage and report financial, work, and family demands. Working as a NA is hazardous; this manuscript specifically examines the biological/infectious, chemical, enviromechanical, physical and psychosocial hazards that appear in the literature to date. A focused search strategy was used to review literature about hazards that fell into each of the five aforementioned domains. While some hazards that were documented were clear, such as exposure to influenza because of close contact with patients (biological/infectious), or exposure to hazardous drugs (chemical), literature was limited. The majority of the literature we reviewed fell into the domain of psychosocial hazards and centered on stress from workplace organization issues (such as mandatory overtime, lack of managerial support, and feeling rushed). More research is needed to understand which hazards NAs identify as most concerning and tailored interventions are needed for risk mitigation.
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Muntaner C, Ng E, Chung H, Prins SJ. Two decades of Neo-Marxist class analysis and health inequalities: A critical reconstruction. SOCIAL THEORY & HEALTH 2015; 13:267-287. [PMID: 26345311 PMCID: PMC4547054 DOI: 10.1057/sth.2015.17] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Most population health researchers conceptualize social class as a set of attributes and material conditions of life of individuals. The empiricist tradition of 'class as an individual attribute' equates class to an 'observation', precluding the investigation of unobservable social mechanisms. Another consequence of this view of social class is that it cannot be conceptualized, measured, or intervened upon at the meso- or macro levels, being reduced to a personal attribute. Thus, population health disciplines marginalize rich traditions in Marxist theory whereby 'class' is understood as a 'hidden' social mechanism such as exploitation. Yet Neo-Marxist social class has been used over the last two decades in population health research as a way of understanding how health inequalities are produced. The Neo-Marxist approach views social class in terms of class relations that give persons control over productive assets and the labour power of others (property and managerial relations). We critically appraise the contribution of the Neo-Marxist approach during the last two decades and suggest realist amendments to understand class effects on the social determinants of health and health outcomes. We argue that when social class is viewed as a social causal mechanism it can inform social change to reduce health inequalities.
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Affiliation(s)
- Carles Muntaner
- Bloomberg School of Nursing, Dalla Lana School of Public Health, University of Toronto , 155 College Street, Suite 386, Toronto, Ontario, Canada M5T 1P8 ; Department of Public Health Sciences, Korea University , Suite 365, Hana Science Building, 145 Anam-Ro, Seongbuk-Gu, Seoul, 136-713 Republic of Korea . E-mail:
| | - Edwin Ng
- Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute , 209 Victoria Street, 3rd Floor, Toronto, Ontario, Canada M5B 1C6. E-mail:
| | - Haejoo Chung
- Department of Public Health Sciences, Korea University , Suite 365, Hana Science Building, 145 Anam-Ro, Seongbuk-Gu, Seoul, 136-713 Republic of Korea . E-mail:
| | - Seth J Prins
- Department of Epidemiology, Columbia University, Mailman School of Public Health , 722 West 168th Street, Suite #720C, New York, NY 10032, USA . E-mail:
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