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Stelson EA, Sabbath-Clayton LL, Sorensen G, Kubzansky LD, Berkman LF, Sabbath EL. Residential addiction treatment providers: Identifying the role of social context in worker health and turnover. Soc Sci Med 2022; 314:115462. [PMID: 36327634 DOI: 10.1016/j.socscimed.2022.115462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/26/2022] [Accepted: 10/14/2022] [Indexed: 11/18/2022]
Abstract
Increased lethality and availability of addictive substances has strained US addiction treatment services, further exacerbating workforce shortages in these settings. The emotional and physical health toll of providing treatment may contribute to shortages. This community-initiated qualitative study aimed to identify conditions that affect provider health and turnover in residential addiction treatment from a Total Worker Health® perspective. Providers (direct service, supervisors, leaders) working in nonprofit residential treatment facilities in Massachusetts were recruited by role and geography to participate in interviews and focus groups. NVivo12 facilitated coding and analysis. 25% of transcripts were double coded to assess interrater reliability and coding consistency (mean Kappa = 0.82). Providers (N = 49) participated in 33 interviews and 4 focus groups. Many participants reported personal addiction histories. Analysis revealed how socio-contextual factors originating outside of residential facilities were dominant influences on "downstream" working conditions, worker health, staff turnover, and by extension, client care. Four primary socio-contextual themes surfaced:1) Changes in type and potency of substances and client need not reliably accompanied by shifts in treatment practices; 2) challenges balancing state requirements and state-provided resources; 3) influence of structural discrimination and addiction stigma on pay and professional advancement; and 4) geographic location of facilities shape work and quality of life. Results were used to develop a conceptual model for residential addiction treatment to illustrate pathways by which ecological factors interact to affect provider health and turnover. Findings indicate that protecting health and wellbeing of providers-many of whom are in addiction recovery themselves- is integral to improving addiction treatment. From this workforce's perspective, recent changes in socio-contextual factors have intensified already challenging working conditions (job demands, pay, advancement), negatively impacting worker health, turnover, and client care. Any interventions to improve treatment outcomes or working conditions in nonprofit addiction facilities must consider larger socio-contextual factors influencing these organizations.
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Affiliation(s)
- Elisabeth A Stelson
- Harvard T.H. Chan School of Public Health, Dept. of Social and Behavioral Sciences, 677 Huntington Ave., Boston, MA, 02115, USA.
| | | | - Glorian Sorensen
- Harvard T.H. Chan School of Public Health, Dept. of Social and Behavioral Sciences, 677 Huntington Ave., Boston, MA, 02115, USA; Dana-Farber Cancer Institute, Boston, MA, USA
| | - Laura D Kubzansky
- Harvard T.H. Chan School of Public Health, Dept. of Social and Behavioral Sciences, 677 Huntington Ave., Boston, MA, 02115, USA
| | - Lisa F Berkman
- Harvard T.H. Chan School of Public Health, Dept. of Social and Behavioral Sciences, 677 Huntington Ave., Boston, MA, 02115, USA
| | - Erika L Sabbath
- Boston College School of Social Work, Chestnut Hill, MA, USA
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Rothermund E, Pößnecker T, Antes A, Kilian R, Kessemeier F, von Wietersheim J, Mayer D, Rieger MA, Gündel H, Hölzer M, Balint EM, Mörtl K. Conceptual Framework of a Psychotherapeutic Consultation in the Workplace: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14894. [PMID: 36429612 PMCID: PMC9690206 DOI: 10.3390/ijerph192214894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/28/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: A new health care offer called 'psychotherapeutic consultation in the workplace' is an early and effective intervention for employees with common mental disorders. Although cost-effective, it lacks a broader roll-out. This might be attributable to undefined context, mechanisms of change, and a lack of communication; therefore, this study explores how the new model works and where problems occur. (2) Methods: Semi-structured interviews on motivation, expectations and experiences with 20 involved experts. Experts were members of the company health promotion team, service users, and cooperating mental health specialists. Analysis was conducted with ATLAS.ti. (3) Results: The conceptual framework comprises three main topics: (a) structured implementation concept; (b) persons involved, shaping the concept's processes; (c) and meaning and function of the offer within the given context. Concerning (c) we found three potential areas of conflict: (1) intra-corporate conflicts, (2) conflicts between company and employee, (3) and conflicts between the company health promotion and the health care system. Category (c) comprises the offer's core characteristics which were described as low-threshold and preventive. Furthermore, the offer was perceived as convenient in handling, confidential, and having immediate impact on a person's well-being. (4) Conclusions: Here we define structures, address the needs of the involved persons, and communicate foreseeable areas of conflict influences whether the implementation of the intervention succeeds.
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Affiliation(s)
- Eva Rothermund
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
| | - Tim Pößnecker
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
| | - Andreas Antes
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Reinhold Kilian
- Department of Psychiatry II, Ulm University Medical Center at BKH Günzburg, Lindenallee 2, 89312 Günzburg, Germany
| | - Franziska Kessemeier
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
| | - Jörn von Wietersheim
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Dorothea Mayer
- Health and Safety Sindelfingen, Daimler AG, Bela-Barenyi-Straße, 71059 Sindelfingen, Germany
| | - Monika A. Rieger
- Institute for Occupational and Social Medicine and Health Services Research, University Clinic Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
| | - Michael Hölzer
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
- Sonnenbergklinik, ZfP Südwürttemberg, Christian-Belser-Straße 79, 70597 Stuttgart, Germany
| | - Elisabeth M. Balint
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
| | - Kathrin Mörtl
- Faculty of Psychotherapy Science, Sigmund Freud University, Freudplatz 1, 1020 Vienna, Austria
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Hotel housekeepers and occupational health: experiences and perceived risks. Ann Occup Environ Med 2022; 34:e29. [DOI: 10.35371/aoem.2022.34.e29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/08/2022] [Accepted: 09/25/2022] [Indexed: 11/09/2022] Open
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Bergin AJ, Tucker MK, Jimmieson NL. Praise and recognition from supervisors buffers employee psychological strain: A two-sample investigation with tourism workers. Work 2021; 70:531-546. [PMID: 34657863 DOI: 10.3233/wor-213590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Focusing on employees with psychological strain, this research draws on Fredrickson's 'undoing hypothesis' to examine praise and recognition from one's supervisor as an organizational resource. OBJECTIVE A model is tested in which psychological strain is a mediator in the positive relationship between role demands and employees' intentions to take sick leave and seek medical advice, and positions supervisor praise and recognition as a buffer of psychological strain on such intentions. METHODS The model was tested using two Australian samples in the tourism sector, consisting of motel workers (n = 104) and museum workers (n = 168). RESULTS For museum workers, but not motel workers, there was a positive indirect effect of each role demand on sick leave intentions through psychological strain that weakened as a function of supervisor praise and recognition. The proposed moderated mediated model was supported for both samples in regards to intentions to seek medical advice. CONCLUSIONS This research contributes new evidence regarding the antecedents of employees' intentions to take sick leave and seek medical advice for work stress-related problems. It also contributes to the limited evidence regarding supervisor praise and recognition as a protective factor for employees exhibiting the symptoms of psychological strain.
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Affiliation(s)
- Adele J Bergin
- School of Management, Queensland University of Technology, Queensland, Australia
| | - Michelle K Tucker
- School of Management, Queensland University of Technology, Queensland, Australia
| | - Nerina L Jimmieson
- School of Management, Queensland University of Technology, Queensland, Australia
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Adverse Pregnancy Outcomes Following the Assassination of John F. Kennedy in 1963. Matern Child Health J 2021; 25:1455-1464. [PMID: 34021436 DOI: 10.1007/s10995-021-03139-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Women exposed to stressful events during pregnancy are thought to be at increased risk of adverse birth outcomes. However, studies investigating stressful events are often unable to control for important confounders, such as behavioral and genetic characteristics, or to isolate the impact of the stressor from other secondary effects. We used a discordant-sibling design, which provides stronger inferences about causality, to examine whether a widespread stressor with limited impact on day-to-day life (John F. Kennedy assassination) resulted in an increased risk of adverse birth outcomes. METHODS Data were obtained from the Collaborative Perinatal Project, a prospective, multi-site cohort study conducted in the US from 1959 to 1965. Our analysis was restricted to singleton live births ≥24 weeks born before the assassination (n = 24,406) or in utero at the time (n = 5833). We also evaluated associations within siblings discordant for exposure (n = 1144). We used survival analysis to evaluate associations between exposure and preterm birth and marginal models to evaluate associations with birthweight and placental pathology. RESULTS First trimester exposure was associated with preterm birth (hazard ratio (HR): 1.17; 95% CI: 1.05, 1.31). In the discordant-sibling model, the point estimate was similar (HR: 1.22; 95% CI: 0.36, 4.06). Third trimester exposure was associated with increased odds of fetal acute inflammation in the placenta (odds ratio (OR): 1.34, 95% CI: 1.05, 1.71). CONCLUSIONS FOR PRACTICE First trimester exposure to an acute stressor was associated with preterm birth. We did not observe increased odds of placental pathology with first trimester exposure; however, stress may increase preterm birth risk through chronic placental inflammation, which was not evaluated in this sample.
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Allwang C, Marten-Mittag B, Dinkel A, Mauss D, Lahmann C. Effectiveness of a Brief Psychotherapeutic Intervention for Employees With Psychosomatic and Psychosocial Complaints-Pilot Study of a Consultation Off the Workplace. Front Psychiatry 2020; 11:00867. [PMID: 33101069 PMCID: PMC7507600 DOI: 10.3389/fpsyt.2020.00867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 08/10/2020] [Indexed: 12/22/2022] Open
Abstract
Employees' mental health impairments are a leading reason for sickness-leave and early retirement. This is why a large number of different intervention programmes have evolved in recent years with the aim of counteracting this development. Our study evaluates a short-term cognitive-behavioral psychotherapeutic intervention off the workplace. We investigated improvement of mental and physical health in psychologically strained employees of a white collar company. Depressive symptoms (PHQ-9), anxiety symptoms (GAD-7), somatic symptoms (PHQ-15), and perceived stress (PSQ-20) were assessed at the beginning and after the intervention. Patient satisfaction (recommendation - likeliness) was also measured after the intervention. In a second step, we have looked at potential determinants of therapy outcome. Changes in the symptom measures were assessed using t-tests, MANOVA, and Chi²-tests. Cohen's d was computed as effect size measure. One-hundred twenty-seven participants completed the assessment before, and 66 participants post intervention. Mean age of the participants was 44.6 (SD = 9.8) years, 54% were men. 89.7% of the patients attended one to five sessions. Depressive, anxiety, somatic symptoms, and perceived stress significantly declined from baseline to end of intervention. Effect sizes ranged from d = 0.49 (perceived stress) to d = 0.72 (depressive symptoms). Moreover, 93% of the patients stated that they were satisfied with the intervention and would recommend it to a friend. Previous uptake of psychiatric/psychotherapeutic treatment moderated the effect of the intervention on depressive symptoms, i.e., patients without previous experience showed a stronger reduction in symptoms of depression. The results tentatively suggest that the intervention is effective in reducing a broad range of psychological symptoms. Future research could investigate preferences and different outcomes of on-site and off-site work place interventions.
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Affiliation(s)
- Christine Allwang
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Birgitt Marten-Mittag
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Daniel Mauss
- Medical Faculty Mannheim, Mannheim Institute of Public Health, Social and Preventive Medicine, Heidelberg University, Heidelberg, Germany
| | - Claas Lahmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
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Hajek A, König HH. Are perceived bad working conditions and perceived workplace bullying associated with doctor visits? Results of the nationally representative German General Social Survey. BMC Health Serv Res 2019; 19:697. [PMID: 31615523 PMCID: PMC6794812 DOI: 10.1186/s12913-019-4570-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 09/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The reason for doctor visits associated with bad working conditions (and workplace bullying) remains unknown. Therefore, the aim of this study was to examine the association between perceived working conditions as well as workplace bullying and the number of doctor visits as well as the reason for seeing a doctor. METHODS Data were derived from the German General Social Survey, a representative cross-section of the population in the year 2014. Self-reported doctor visits in the last 3 months were used as outcome measure. Self-rated working conditions (noise, bad air; time/performance pressure; bad working atmosphere; overtime; shifts/night work; hard physical labour) and workplace bullying were assessed. The reason for seeing a doctor was also recorded (acute illness; chronic illness; feeling unwell; requesting advice; visit to the doctor's office without consulting the doctor (e.g., need to get a prescription); preventive medical check-up/vaccination). Regression analysis stratified by sex was conducted. RESULTS Adjusting for various potential confounders, Poisson regressions showed that workplace bullying was associated with increased doctor visits in men, but not in women. Contrarily, time/performance pressure at work was only associated with increased doctor visits in women, but not in men. Furthermore, the probability of visiting the doctor for reasons of acute illness or feeling unwell increased with workplace bullying in men. The probability of visiting the doctor because of feeling unwell increased with time/performance pressure in women. CONCLUSIONS Our findings stress the association between adverse working conditions (workplace bullying as well as time/performance pressure at work) and doctor visits, with remarkable gender differences. Longitudinal studies are required to confirm the present findings and to obtain further insights into this relationship.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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Kerr DC, Ornelas IJ, Lilly MM, Calhoun R, Meischke H. Participant Engagement in and Perspectives on a Web-Based Mindfulness Intervention for 9-1-1 Telecommunicators: Multimethod Study. J Med Internet Res 2019; 21:e13449. [PMID: 31219045 PMCID: PMC6607772 DOI: 10.2196/13449] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 04/09/2019] [Accepted: 05/05/2019] [Indexed: 11/21/2022] Open
Abstract
Background Demanding working conditions and secondary exposure to trauma may contribute to a high burden of stress among 9-1-1 telecommunicators, decreasing their ability to work effectively and efficiently. Web-based mindfulness-based interventions (MBIs) can be effective in reducing stress in similar populations. However, low engagement may limit the effectiveness of the intervention. Objective The aim of this study was to assess participant engagement in a Web-based MBI designed for 9-1-1 telecommunicators. Specifically, we sought to describe the following: (1) participant characteristics associated with intervention engagement, (2) participant perspectives on engaging with the intervention, and (3) perceived challenges and facilitators to engaging. Methods We used qualitative and quantitative data from participant surveys (n=149) that were collected to assess the efficacy of the intervention. We conducted descriptive and bivariate analyses to identify associations between demographic, psychosocial, and workplace characteristics and engagement. We conducted a thematic analysis of qualitative survey responses to describe participant experiences with the MBI. Results We found that no individual participant characteristics were associated with the level of engagement (low vs high number of lessons completed). Participant engagement did vary by the call center (P<.001). We identified the following overarching qualitative themes: (1) the participants perceived benefits of mindfulness practice, (2) the participants perceived challenges to engage with mindfulness and the intervention, and (3) intervention components that facilitated engagement. The participants expressed positive beliefs in the perceived benefits of practicing mindfulness, including increased self-efficacy in coping with stressors and increased empathy with callers. The most commonly cited barriers were work-related, particularly not having time to participate in the intervention at work. Facilitators included shorter meditation practices and the availability of multiple formats and types of intervention content. Conclusions The findings of this study suggest that efforts to improve intervention engagement should focus on organizational-level factors rather than individual participant characteristics. Future research should explore the effect of mindfulness practice on the efficiency and effectiveness of 9-1-1 telecommunicators at work. Trial Registration ClinicalTrials.gov NCT02961621; https://clinicaltrials.gov/ct2/show/NCT02961621
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Affiliation(s)
- Darragh C Kerr
- Department of Health Services, University of Washington, Seattle, WA, United States
| | - India J Ornelas
- Department of Health Services, University of Washington, Seattle, WA, United States
| | - Michelle M Lilly
- Department of Psychology, Northern Illinois University, DeKalb, IL, United States
| | - Rebecca Calhoun
- Northwest Center for Public Health Practice, University of Washington, Seattle, WA, United States
| | - Hendrika Meischke
- Department of Health Services, University of Washington, Seattle, WA, United States.,Northwest Center for Public Health Practice, University of Washington, Seattle, WA, United States
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O'Donovan MA, McCallion P, McCarron M, Lynch L, Mannan H, Byrne E. A narrative synthesis scoping review of life course domains within health service utilisation frameworks. HRB Open Res 2019; 2:6. [PMID: 32296746 PMCID: PMC7140772 DOI: 10.12688/hrbopenres.12900.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Current thinking in health recognises the influence of early life experiences (health and otherwise) on later life outcomes. The life course approach has been embedded in the work of the World Health Organisation since the Ageing and Health programme was established in 1995. Yet there has been limited debate on the relevancy of a life course lens to understanding health service utilisation. Aim: The aim of the review was twofold. Firstly, identify existing healthcare utilisation frameworks other than the dominant Andersen's behavioural model currently in use. Secondly, to identify if current frameworks incorporate the advocated life course perspective in understanding health service utilisation. Methods: A scoping review of PubMed, Cinahl Plus, Emerald, PsycINFO, Web of Knowledge and Scopus was conducted. Data extraction used a framework approach with meta-synthesis guided by the four domains of the life course proposed by Elder (1979): human agency, location, temporality and relationships, and interdependencies. Results: A total of 551 papers were identified, with 70 unique frameworks (other than Andersen's Behavioural Model) meeting the inclusion criteria and included in the review. Conclusion: To date there has been limited explicit discussion of health service utilisation from a life course perspective. The current review highlights a range of frameworks that draw on aspects of the life course, but have been used with this perspective in mind. The life course approach highlights important gaps in understanding and assessing health service utilisation (HSU), such as utilisation over time. HSU is a complex phenomenon and applying a structured framework from a life course perspective would be of benefit to researchers, practitioners and policy makers.
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Affiliation(s)
- Mary-Ann O'Donovan
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Phillip McCallion
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Mary McCarron
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Louise Lynch
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Hasheem Mannan
- School of Nursing and Midwifery, University College Dublin, Dublin, Ireland
| | - Elaine Byrne
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
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Milner A, Petrie D, LaMontagne AD, Butterworth P. Do psychosocial job stressors influence mental health service use? Evidence from an Australian cohort. Occup Environ Med 2019; 76:295-301. [PMID: 30852492 DOI: 10.1136/oemed-2018-105440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 01/23/2019] [Accepted: 02/10/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVES There is strong evidence of a relationship between psychosocial job stressors and mental health at the population level. There has been no longitudinal research on whether the experience of job stressors is also associated with greater mental health service use. We seek to fill this gap. METHODS The Household Income Labour Dynamics in Australia survey cohort was used to assess the relationship between exposure to self-reported psychosocial job quality and reporting attendance at a mental health professional during the past 12 months. We adjusted for time-varying and time-invariant confounders. The study was conducted in 2009 and 2013. RESULTS In the random effects logistic regression model, increasing exposure to psychosocial job stressors was associated with an increased odds of mental health service use after adjustment (one stressor: OR 1.26, 95% CI 1.01 to 1.56; two stressors: OR 1.33, 95% CI 1.02 to 1.73; three stressors: OR 1.82, 95% CI 1.28 to 2.57). However, once the between person effects were controlled in a fixed effects model, the within-person association between change in job stressors and change in mental health service use was estimated to be close to zero and not significant. CONCLUSIONS More work is needed to understand the relationship between job stressors and service use. However, when taken with past findings on job stressors and mental health, these findings highlight the importance of considering policy and clinical practice responses to adverse working contexts.
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Affiliation(s)
- Allison Milner
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Dennis Petrie
- Monash University Centre For Health Economics, Clayton, Victoria, Australia
| | - Anthony D LaMontagne
- Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Peter Butterworth
- Research School of Population Health, The Australian National University, Canberra, ACT, Australia.,Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Melbourne, Victoria, Australia
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Faremi FA, Olatubi MI, Adeniyi KG, Salau OR. Assessment of occupational related stress among nurses in two selected hospitals in a city southwestern Nigeria. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2019. [DOI: 10.1016/j.ijans.2019.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Bronkhorst B. How 'healthy' are healthcare organizations? Exploring employee healthcare utilization rates among Dutch healthcare organizations. Health Serv Manage Res 2017; 30:156-167. [PMID: 28669234 DOI: 10.1177/0951484817715031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Occupational health and safety research rarely makes use of data on employee healthcare utilization to gain insight into the physical and mental health of healthcare staff. This paper aims to fill this gap by examining the prevalence of two relevant types of healthcare utilization among staff working in healthcare organizations: physical therapy and mental healthcare utilization. The paper furthermore explores what role employee and organizational characteristics play in explaining differences in healthcare utilization between organizations. A Dutch healthcare insurance company provided healthcare utilization records for a sample of 417 organizations employing 136,804 healthcare workers in the Netherlands. The results showed that there are large differences between and within healthcare industries when it comes to employee healthcare utilization. Multivariate regression analyses revealed that employee characteristics such as age and gender distributions, and healthcare industry, explain some of the variance between healthcare organizations. Nevertheless, the results of the analyses showed that for all healthcare utilization indicators there is still a large amount of unexplained variance. Further research into the subject of organizational differences in employee healthcare utilization is needed, as finding possibilities to influence employee health and subsequent healthcare utilization is beneficial to employees, employers and society as a whole.
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A Web-Based Mindfulness Stress Management Program in a Corporate Call Center: A Randomized Clinical Trial to Evaluate the Added Benefit of Onsite Group Support. J Occup Environ Med 2017; 58:254-64. [PMID: 26949875 PMCID: PMC4768630 DOI: 10.1097/jom.0000000000000680] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objective: The objective of this study is to determine the effectiveness of an 8-week web-based, mindfulness stress management program (WSM) in a corporate call center and added benefit of group support. Methods: One hundred sixty-one participants were randomized to WSM, WSM with group support, WSM with group and expert clinical support, or wait-list control. Perceived stress, burnout, emotional and psychological well-being, mindfulness, and productivity were measured at baseline, weeks 8 and 16, and 1 year. Results: Online usage was low with participants favoring CD use and group practice. All active groups demonstrated significant reductions in perceived stress and increases in emotional and psychological well-being compared with control. Group support improved participation, engagement, and outcomes. Conclusion: A self-directed mindfulness program with group practice and support can provide an affordable, effective, and scalable workplace stress management solution. Engagement may also benefit from combining web-based and traditional CD delivery.
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Rothermund E, Kilian R, Rottler E, Mayer D, Hölzer M, Rieger MA, Gündel H. Improving Access to Mental Health Care by Delivering Psychotherapeutic Care in the Workplace: A Cross-Sectional Exploratory Trial. PLoS One 2017; 12:e0169559. [PMID: 28056101 PMCID: PMC5215922 DOI: 10.1371/journal.pone.0169559] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 12/16/2016] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE Common mental disorders like mood and anxiety disorders and somatoform disorders have high costs, yet under-treatment is still frequent. Many people with common mental disorders are employed, so the workplace is potentially a suitable context in which to provide early treatment. Our study investigates whether a change of setting (workplace versus standard care) improves access to treatment for common mental disorders. METHODS Conditional latent profile analysis was applied to identify user profiles for work ability (WAI), clinical symptoms like depression (patient health questionnaire depression, PHQ-9), health-related quality of life (QoL, SF-12), and work-related stress (Maslach Burnout Inventory, irritation scale). Patients were recruited consecutively, via psychotherapeutic consultation in the workplace (n = 174) or psychotherapeutic consultation in outpatient care (n = 193). RESULTS We identified four user profiles in our model: 'severe' (n = 99), 'moderate I-low QoL' (n = 88), 'moderate II-low work ability' (n = 83), and 'at risk' (n = 97). The 'at risk' profile encompassed individuals with reduced work ability (36.0, 34.73 to 37.37), only mild clinical symptoms (PHQ-9 5.7, 4.92 to 6.53), no signs of work-related stress and good quality of life. A higher proportion of the 'at risk' group than of the 'severe' group sought help via the psychotherapeutic consultation in the workplace (OR 0.287, P < 0.01); this effect remained after controlling for gender. CONCLUSIONS Offering secondary mental health care in the workplace is feasible and accepted by users. Offering treatment in the workplace as an alternative to standard outpatient settings is a viable strategy for improving access to treatment for common mental disorders.
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Grants
- Young scientists program of the German network "Health Services Research Baden-Wuerttemberg" of the Ministry for Science, Research and Arts in collaboration with the Ministry for Work and Social Affairs, Family, Women, and Senior Citizens, Baden-Wuerttemberg. In addition, the company CASSIDIAN, now Airbus, supported the evaluation of the psychosomatic consultation in the context of company health management. The work of the Institute of Occupational and Social Medicine and Health Services Research Tuebingen is supported by an unrestricted grant of the employers' association of the metal and electric industry Baden-Wuerttemberg (Suedwestmetall). Suedwestmetall provided support in the form of partial salary for authors [MAR], Daimler AG provided support in the form of salary for authors [DM]. This does not alter our adherence to PLOS ONE policies on sharing data and materials. The funders did not have any role in analysis, decision to publish, or preparation of the manuscript. The specific roles of the authors MAR and DM are articulated in the 'author contributions' section.
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Affiliation(s)
- Eva Rothermund
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Reinhold Kilian
- Department of Psychiatry II, University Hospital Ulm, BKH Günzburg, Germany
| | - Edit Rottler
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | | | | | - Monika A. Rieger
- Institute for Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Competence Centre Health Services Research, Medical Faculty Tübingen, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
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15
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Bronkhorst B, Vermeeren B. Safety climate, worker health and organizational health performance. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2016. [DOI: 10.1108/ijwhm-12-2015-0081] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to investigate the relationship between organizational safety climate and organizational health performance outcomes (i.e. absenteeism, presenteeism, health care utilization) mediated by individual worker health. The authors used three pathways to examine this relationship: a physical pathway starting with physical safety climate and mediated by musculoskeletal disorders (MSDs), a psychosocial pathway starting with psychosocial safety climate and mediated by emotional exhaustion, and a combined pathway starting with psychosocial safety climate and mediated by both MSDs and emotional exhaustion.
Design/methodology/approach
Three mediational multilevel analyses were conducted using a sample of 8,761 employees working in 177 health care organizations.
Findings
Although the findings did not support the hypothesized physical pathway, they showed that the psychosocial pathway worked satisfactorily for two of the three health performance outcomes (absenteeism and presenteeism). The combined physical and psychosocial pathway explained differences in the third outcome: health care utilization.
Originality/value
This is one of the few studies to include both physical and psychosocial pathways that lead to employee health and organizational performance. The results underscore the importance of paying attention to psychological health and safety in the health care workplace. Not only for the psychological health of employees, but also to improve their physical health and subsequent organizational health performance.
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16
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O'Keefe LC, Brown KC, Frith KH, Heaton KL, Maples EH, Phillips JA, Vance DE. Obesity, Prediabetes, and Perceived Stress in Municipal Workers. Workplace Health Saf 2016; 64:453-461. [PMID: 27026274 DOI: 10.1177/2165079916632771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The primary cause of death for men and women in the United States is heart disease. Obesity and diabetes are major contributors to heart disease, and the risk is worsened in the presence of stress. It is clinically useful to identify predictors of obesity and prediabetes in a working population. The purpose of this current cross-sectional, correlational study was to examine relationships among obesity, prediabetes, and perceived stress in municipal workers using a subset of worksite wellness program data from employees screened in 2010 and 2011. Multiple regression models indicated that age, gender, race, HA1c, shift schedule, physical activity, and occupation were significant predictors of obesity in municipal workers ( p < .01). Prediabetes in municipal workers was predicted by age, Black race, and body mass index (BMI; p < .01). Perceived stress was not a significant predictor of obesity or prediabetes in municipal workers. Overall, the findings of this study provide guidance to occupational health nurses when evaluating individuals in an occupational health setting. Further research is needed to examine relationships among the variables and validate the models.
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17
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Reeuwijk KG, Robroek SJW, Hakkaart L, Burdorf A. How work impairments and reduced work ability are associated with health care use in workers with musculoskeletal disorders, cardiovascular disorders or mental disorders. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:631-639. [PMID: 24390780 PMCID: PMC4229647 DOI: 10.1007/s10926-013-9492-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE The aim of this study was to explore how work impairments and work ability are associated with health care use by workers with musculoskeletal disorders (MSD), cardiovascular disorders (CVD), or mental disorders (MD). METHODS In this cross-sectional study, subjects with MSD (n = 2,074), CVD (n = 714), and MD (n = 443) were selected among health care workers in 12 Dutch organizations. Using an online questionnaire, data were collected on individual characteristics, health behaviors, work impairments, work ability, and consultation of a general practitioner (GP), physiotherapist, specialist, or psychologist in the past year. Univariate and multivariate logistic regression analyses were performed to explore the associations of work impairments and work ability with health care use. RESULTS Lower work ability was associated with a higher likelihood of consulting any health care provider among workers with common disorders (OR 1.05-1.45). Among workers with MSD work impairments increased the likelihood of consulting a GP (OR 1.55), specialist (OR 2.05), and physical therapist (OR 1.98). Among workers with CVD work impairments increased the likelihood of consulting a specialist (OR 1.94) and physical therapist (OR 2.73). Among workers with MD work impairments increased the likelihood of consulting a specialist (OR 1.79) and psychologist (OR 1.82). CONCLUSION Work impairments and reduced work ability were associated with health care use among workers with MSD, CVD, or MD. These findings suggest that addressing work-related problems in workers with common disorders may contribute in reducing health care needs.
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Affiliation(s)
- Kerstin G. Reeuwijk
- Department of Public Health, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Suzan J. W. Robroek
- Department of Public Health, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Leona Hakkaart
- Institute of Health Policy and Management (iBMG), Institute for Medical Technology Assessment, Erasmus University, PO Box 1738, 3000 DR Rotterdam, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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18
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Jung D, Kang Y, Kim MY, Ma RW, Bhandari P. Zero-Inflated Poisson Modeling of Fall Risk Factors in Community-Dwelling Older Adults. West J Nurs Res 2014; 38:231-47. [PMID: 25315901 DOI: 10.1177/0193945914553677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study was to identify risk factors for falls among community-dwelling older adults. The study used a cross-sectional descriptive design. Self-report questionnaires were used to collect data from 658 community-dwelling older adults and were analyzed using logistic and zero-inflated Poisson (ZIP) regression. Perceived health status was a significant factor in the count model, and fall efficacy emerged as a significant predictor in the logistic models. The findings suggest that fall efficacy is important for predicting not only faller and nonfaller status but also fall counts in older adults who may or may not have experienced a previous fall. The fall predictors identified in this study--perceived health status and fall efficacy--indicate the need for fall-prevention programs tailored to address both the physical and psychological issues unique to older adults.
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Affiliation(s)
| | | | | | - Rye-Won Ma
- Ewha Womans University, Seoul, South Korea
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19
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Morledge TJ, Allexandre D, Fox E, Fu AZ, Higashi MK, Kruzikas DT, Pham SV, Reese PR. Feasibility of an online mindfulness program for stress management--a randomized, controlled trial. Ann Behav Med 2014; 46:137-48. [PMID: 23632913 PMCID: PMC3775158 DOI: 10.1007/s12160-013-9490-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Chronic stress affects many Americans. Stress management programs may be prohibitively expensive or have limited access. Purpose This study aims to determine feasibility of an 8-week Internet-based stress management program (ISM) based on mindfulness principles in reducing stress in a 12-week, parallel, randomized, controlled trial. Methods Participants were randomly allocated to ISM, ISM plus online message board (ISM+), or control groups. Perceived stress, mindfulness, self-transcendence, psychological well-being, vitality, and quality of life were measured at baseline, week 8, and week 12 using standard validated questionnaires. Results ISM and ISM+ groups demonstrated statistically significant improvements compared with control on all measures except vitality and physical health. Conclusions The ISM program effectively and sustainably reduced measures of stress. The magnitude of improvement is comparable to traditional mindfulness programs, although fewer participants were engaged. This feasibility study provides strong support for online stress management programs, which increase access at a fraction of cost of traditional programs.
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Affiliation(s)
| | - Didier Allexandre
- Cleveland Clinic, Cleveland, OH USA
- Kessler Foundation, West Orange, NJ USA
- Human Performance and Engineering Lab, Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ 07052 USA
| | | | - Alex Z. Fu
- Cleveland Clinic, Cleveland, OH USA
- Georgetown University Medical Center, Washington, DC USA
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20
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O'Keefe LC, Brown KC, Christian BJ. Policy Perspectives on Occupational Stress. Workplace Health Saf 2014; 62:432-8; quiz 439. [PMID: 25139784 DOI: 10.3928/21650799-20140813-02] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 07/14/2014] [Indexed: 11/20/2022]
Abstract
Occupational stress is a major physical and mental hazard for many workers and has been found to contribute to cardiovascular disease, musculoskeletal disorders, mood disturbances, workplace injuries, and mental health problems. Health care utilization related to these physical and mental health problems costs employers billions of dollars annually. To combat this problem, employers should adopt a preventive approach and institute organizational and administrative changes that require the participation of both management and workers. This article reviews policies that could impact the quality of work life and influence organizational changes needed to achieve occupational health and safety. Occupational health nurses play a vital role in designing and implementing policies to improve work environments and reduce occupational stress.
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21
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Jang MH, Park CG. [Risk factors influencing probability and severity of elder abuse in community-dwelling older adults: applying zero-inflated negative binomial modeling of abuse count data]. J Korean Acad Nurs 2013; 42:819-32. [PMID: 23364037 DOI: 10.4040/jkan.2012.42.6.819] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE This study was conducted to identify risk factors that influence the probability and severity of elder abuse in community-dwelling older adults. METHODS This study was a cross-sectional descriptive study. Self-report questionnaires were used to collect data from community-dwelling Koreans, 65 and older (N=416). Logistic regression, negative binomial regression and zero-inflated negative binomial regression model for abuse count data were utilized to determine risk factors for elder abuse. RESULTS The rate of older adults who experienced any one category of abuse was 32.5%. By zero-inflated negative binomial regression analysis, the experience of verbal-psychological abuse was associated with marital status and family support, while the experience of physical abuse was associated with self-esteem, perceived economic stress and family support. Family support was found to be a salient risk factor of probability of abuse in both verbal-psychological and physical abuse. Self-esteem was found to be a salient risk factor of probability and severity of abuse in physical abuse alone. CONCLUSION The findings suggest that tailored prevention and intervention considering both types of elder abuse and target populations might be beneficial for preventative efficiency of elder abuse.
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Affiliation(s)
- Mi Heui Jang
- College of Nursing Science and East-West Nursing Research Institute, Kyung Hee University, Seoul, Korea.
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22
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The relationship between job stress and body mass index using longitudinal data from Canada. Int J Public Health 2012; 57:807-15. [DOI: 10.1007/s00038-012-0348-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 01/26/2012] [Accepted: 02/08/2012] [Indexed: 10/28/2022] Open
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23
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Azagba S, Sharaf MF. The association between workplace smoking bans and self-perceived, work-related stress among smoking workers. BMC Public Health 2012; 12:123. [PMID: 22329920 PMCID: PMC3296657 DOI: 10.1186/1471-2458-12-123] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 02/13/2012] [Indexed: 11/15/2022] Open
Abstract
Background There is substantial empirical evidence on the benefits of smoking bans; however, the unintended consequences of this anti-smoking measure have received little attention. This paper examines whether workplace smoking bans (WSB's) are associated with higher self-perceived, work-related stress among smoking workers. Methods A longitudinal representative sample of 3,237 individuals from the Canadian National Population Health Survey from 2000 to 2008 is used. Work-related stress is derived from a 12-item job questionnaire. Two categories of WSB's, full and partial, are included in the analysis, with no ban being the reference category. Analysis also controls for individual socio-demographic characteristics, health status, provincial and occupational fixed-effects. We use fixed-effects linear regression to control for individual time-invariant confounders, both measured and unmeasured, which can affect the relationship between WSB's and work-related stress. To examine the heterogeneous effects of WSB's, the analysis is stratified by gender and age. We check the robustness of our results by re-estimating the baseline specification with the addition of different control variables and a separate analysis for non-smokers. Results Multivariate analysis reveals a positive and statistically significant association between full (β = 0.75, CI = 0.19-1.32) or partial (β = 0.69, CI = 0.12-1.26) WSB's, and the level of self-perceived, work-related stress among smoking workers compared to those with no WSB. We also find that this association varies by gender and age. In particular, WSB's are significantly associated with higher work stress only for males and young adults (aged 18-40). No statistically significant association is found between WSB's and the level of self-perceived work-related stress among non-smoking workers. Conclusion The results of this study do not imply that WSB's are the main determinant of self-perceived, work-related stress among smokers but provides suggestive evidence that these may be positively related.
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Affiliation(s)
- Sunday Azagba
- Department of Economics, Concordia University, 1455 de Maisonneuve Blvd. West, Montréal, Quebec H3G 1M8, Canada.
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24
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Azagba S, Sharaf MF. The effect of job stress on smoking and alcohol consumption. HEALTH ECONOMICS REVIEW 2011; 1:15. [PMID: 22827918 PMCID: PMC3403311 DOI: 10.1186/2191-1991-1-15] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 09/30/2011] [Indexed: 06/01/2023]
Abstract
This paper examines the effect of job stress on two key health risk-behaviors: smoking and alcohol consumption, using data from the Canadian National Population Health Survey. Findings in the extant literature are inconclusive and are mainly based on standard models which can model differential responses to job stress only by observed characteristics. However, the effect of job stress on smoking and drinking may largely depend on unobserved characteristics such as: self control, stress-coping ability, personality traits and health preferences. Accordingly, we use a latent class model to capture heterogeneous responses to job stress. Our results suggest that the effects of job stress on smoking and alcohol consumption differ substantially for at least two "types" of individuals, light and heavy users. In particular, we find that job stress has a positive and statistically significant impact on smoking intensity, but only for light smokers, while it has a positive and significant impact on alcohol consumption mainly for heavy drinkers. These results provide suggestive evidence that the mixed findings in previous studies may partly be due to unobserved individual heterogeneity which is not captured by standard models.
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Affiliation(s)
- Sunday Azagba
- Department of Economics, Concordia University, 1455 de Maisonneuve Blvd. West Montréal, Quebec, H3G 1M8, Canada
| | - Mesbah F Sharaf
- Department of Economics, Concordia University, 1455 de Maisonneuve Blvd. West Montréal, Quebec, H3G 1M8, Canada
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