Job mobility and health in the Danish workforce

Exploring the Impact of Labour Mobility on the Mental Health and Wellbeing of Skilled Trades Workers in Ontario, Canada

Labour mobility and subsequent workers migration is an increasing trend worldwide and can be a force that counteracts Canada's shortage of skilled labour. Supercommuting allows workers facing economic challenges to pursue more financially advantageous work opportunities in other regions. This study aimed to evaluate the "supercommuting" labour mobility model and its impact on long-distance mobile workers' mental health and wellbeing. We utilized a non-experimental research design using convenience sampling from workers who participated in Blue Branch Inc.'s (Hamilton, Canada) supercommuting labour mobility model. An online questionnaire collected demographic data, work-related data, occupational stress measures related to burnout, and job-related stress data. Data collection was started on 1 April 2021, and of the total 58 participants, the majority (44, 76%) were male, born outside Canada, and had an average age of 32.8 years. Workplace Safety (95%), full-time employment opportunity (95%), career advancement possibility (95%), and income and benefits (94.9%) were found to be the most crucial factors to keep study participants working in their current position. Of the 47 participants who experienced burnout, only one showed severe burnout in each domain (personal, work-related, and colleague-related). There is a great need for preventative burnout programs and supportive employer resources for those who engage in long-distance labour commuting. The study emphasizes the need to encourage policymakers to develop solutions for training future Ontario workers to support mobile employment and long-distance labour commuting.

The long-term effect of job mobility on workers' mental health: a propensity score analysis

OBJECTIVES

The main purpose of this longitudinal study was to elucidate the impact of external job mobility, due to a change of employer, on mental health.

METHODS

A cohort of Belgian employees from the IDEWE occupational medicine registry was followed-up for twenty-seven years, from 1993 to 2019. The use of drugs for neuropsychological diseases was considered as an objective indicator of mental health. The covariates were related to demographic, physical, behavioural characteristics, occupational and work-related risks. Propensity scores were calculated with a Cox regression model with time-varying covariates. The PS matching was used to eliminate the systematic differences in subjects' characteristics and to balance the covariates' distribution at every time point.

RESULTS

The unmatched sample included 11,246 subjects, with 368 (3.3%) that changed their job during the baseline year and 922 (8.2%) workers that left their employer during the follow-up. More than half of the matched sample were males, were aged less than 38 years old, did not smoke, were physically active, and normal weighted, were not exposed to shift-work, noise, job strain or physical load. A strong association between job mobility and neuropsychological treatment was found in the matched analysis (HR = 2.065, 95%CI = 1.397-3.052, P-value < 0.001) and confirmed in the sensitivity analysis (HR of 2.012, 95%CI = 1.359-2.979, P-value < 0.001). Furthermore, it was found a protective role of physical activity and a harmful role of job strain on neuropsychological treatment.

CONCLUSIONS

Our study found that workers with external job mobility have a doubled risk of treatment with neuropsychological medication, compared to workers without job mobility.

Prognostic factors for work disability in patients with chronic widespread pain and fibromyalgia: protocol for a cohort study

INTRODUCTION

The association between chronic widespread pain (CWP) and disability is well established. Although research support large interindividual differences in functional outcomes, limited studies are available on the socio-economic consequences of offering stratified treatment based on prognostic factors. Identification of predictors of long-term functional outcomes such as work disability as a critical consequence, could assist early and targeted personalised interventions. The primary objective of this cohort study is to identify prognostic factors for the primary endpoint work status (employed and working vs not working) in patients with CWP assessed 3 years from baseline, that is, at referral for specialist care.

METHODS AND ANALYSES

Data are collected at the diagnostic unit at Department of Rheumatology, Frederiksberg Hospital. The first 1000 patients ≥18 years of age registered in a clinical research database (DANFIB registry) with CWP either 'employed and working' or 'not working' will be enrolled. Participants must meet the American College of Rheumatology 1990 definition of CWP, that is, pain in all four body quadrants and axially for more than 3 months and are additionally screened for fulfilment of criteria for fibromyalgia. Clinical data and patient-reported outcomes are collected at referral (baseline) through clinical assessment and electronic questionnaires. Data on the primary endpoint work status at baseline and 3 years from baseline will be extracted from the Integrated Labour Market Database, Statistics Denmark and the nationwide Danish DREAM database. Prognostic factor analysis will be based on multivariable logistic regression modelling with the dichotomous work status as dependent variable.

ETHICS AND DISSEMINATION

Sensitive personal data will be anonymised according to regulations by the Danish Data Protection Agency, and informed consent are obtained from all participants. Understanding and improving the prognosis of a health condition like CWP should be a priority in clinical research and practice. Results will be published in international peer-reviewed journals.

TRIAL REGISTRATION NUMBER

NCT04862520.

Defining 'Integration' for Total Worker Health®: A New Proposal

The effects of work and the conditions of employment on health behaviors and intermediate health conditions have been demonstrated, to the extent that these relationships should be addressed in efforts to prevent chronic disease. However, conventional health promotion practice generally focuses on personal risk factors and individual behavior change. In an effort to find solutions to the myriad of health challenges faced by the American workforce, the U.S. National Institute for Occupational Safety and Health (NIOSH) established the Total Worker Health® (TWH) program. Originally organized around the paradigm of integrating traditional occupational safety and health protections with workplace health promotion, TWH has evolved to a broader emphasis on workplace programs for enhancing worker safety, health, and well-being. Among the research programs and approaches developed by investigators at NIOSH Centers of Excellence for TWH and elsewhere, definitions of 'integration' in workplace interventions vary widely. There is no consensus about which organizational or individual outcomes are the most salient, how much to emphasize organizational contexts of work, or which program elements are necessary in order to qualify as 'Total Worker Health'. Agreement about the dimensions of integration would facilitate comparison of programs and interventions which are self-defined as TWH, although diverse in content. The specific criteria needed to define integration should be unique to that concept-i.e. distinct from and additive to conventional criteria for predicting or evaluating the success of a workplace health program. We propose a set of four TWH-specific metrics for integrated interventions that address both program content and process: (i) coordination and interaction of workplace programs across domains; (ii) assessment of both work and non-work exposures; (iii) emphasis on interventions to make the workplace more health-promoting; and (iv) participatory engagement of workers in pivotal ways during intervention prioritization and planning to develop self-efficacy in addressing root causes, skill transfer, building program ownership, empowerment, and continuous improvement. Thus we find that integration requires organizational change, both to engage two managerial functions with different goals, legal responsibilities, and (often) internal incentives & resources, and also to orient the organization toward salutogenesis. Examples from research activity within the Center for the Promotion of Health in the New England Workplace illustrate how these criteria have been applied in practice.

Association between the return-to-work hierarchy and self-rated health, self-esteem, and self-efficacy

PURPOSE

This study aimed to examine whether change of employer and/or job upon return-to-work after work-related injuries and diseases is related to health outcomes; self-rated health, self-esteem, and self-efficacy were used as indicators.

METHODS

Data from the Panel Study of Workers' Compensation Insurance in Korea were used. A total of 1,610 workers who had returned to work after work-related injuries and diseases were included. The workers were divided into four groups according to their return-to-work characteristics: same employer, same job (n = 660); same employer, different job (n = 57); different employer, same job (n = 318); and different employer, different job (n = 575). Self-rated health, Rosenberg Self-Esteem Scale, and Self-Efficacy Scale scores were used as outcome variables. Logistic regression analysis was used.

RESULTS

Compared to workers who had returned to the same employer and same job, those who had returned to the same employer but a different job were less likely to report good self-rated health (odds ratio [OR] 0.54; confidence interval [CI] 0.30-0.97). Those returning to a different employer but the same job were less likely to report good self-rated health (0.47, 0.35-0.64) and high self-esteem (0.73, 0.55-0.96). Those returning to a different employer and different job were less likely to report good self-rated health (0.49, 0.38-0.63), high self-esteem (0.68, 0.54-0.86), and high self-efficacy (0.66, 0.52-0.83).

CONCLUSIONS

Change of employer and/or job related to health outcomes. Returning to the same employer and same job should be set as a goal in the vocational rehabilitation process.

New hypotheses regarding the Danish health puzzle

AIMS

Nordic welfare states have achieved admirable population health profiles as a result of public policies that provide economic and social security across the life course. Denmark has been an exception to this rule, as its life expectancies and infant mortality rates since the mid-1970s have lagged behind the other Nordic nations and, in the case of life expectancy, behind most Organisation for Economic Co-operation and Development nations.

METHODS

In this review paper, we identify a number of new hypotheses for why this may be the case.

RESULTS

These hypotheses concern the health effects of neo-liberal restructuring of the economy and its institutions, the institution of flexi-security in Denmark's labour market and the influence of Denmark's tobacco and alcohol industries. Also of note is that Denmark experienced higher unemployment rates during its initial period of health stagnation, as well as its treatment of non-Western immigrants and high wealth inequality and, until recently, the fact that Denmark did not systematically address the issue of health inequalities.

CONCLUSIONS

These hypotheses may serve as covering explanations for the usually provided accounts of elevated behavioural risks and psychosocial stress as being responsible for Denmark's health profile.