Job Burnout, Work Health Management Interference, and Organizational Health Climate Among Employees with Varied Levels of Work Ability

PURPOSE

The presence of chronic health conditions (CHCs), without sufficient personal and job resources, can impede one's ability to effectively perform work tasks and manage job demands. The aim of this study was to evaluate the level of job burnout and perceptions of work health management interference (WHMI) and organizational health climate (OHC) among employees with varied levels of work ability (WA). We also examined relationships among these variables and with sociodemographic and job-related variables (e.g., age, number of physician-diagnosed conditions).

METHODS

A convenience sample of 878 adults living and working in the United States who responded to a recruitment message via professional listservs/email lists and social media participated in a non-experimental, cross-sectional online survey. Participants reported sociodemographic and job-related items, as well as measures to evaluate WA, burnout, WHMI, and OHC.

RESULTS

Statistically significant differences in burnout, WHMI, and OHC were observed across WA groups. Workers with poor WA reported the highest levels of overall burnout, WMHI, and the least supportive OHC. A more supportive OHC was associated with lower burnout. A strong inverse relationship between WA and the number of physician-diagnosed conditions was observed; weak relationships between WA and age, as well as WA and managerial status, were found.

CONCLUSION

Employees with lower levels of WA tended to report higher levels of burnout and WHMI and lower levels of OHC. Findings provide a foundation for future research to examine causal relationships among these variables and to inform actions to both preserve WA and support worker well-being.

The potential impact of tobacco use on female fertility and pregnancy outcomes: An invited scientific review by EBCOG

Tobacco use in pregnant women remains prevalent with an estimated prevalence of 8.1 % in the European region. In whatever form it is partaken, tobacco use is associated with significant short- and long-term consequences for both the mother and the progeny thus making the habit an important obstetric and public health concern. It is recommended that an active intervention policy should be adopted by healthcare providers to promote preconception smoking cessation and provide services for counselling with behavioural modification support, and the provision of smoking cessation pharmaceutical services. Women who continue to smoke should have closer antenatal surveillance throughout the whole of pregnancy.

How are hearing loss and physical activity related? Analysis from the English longitudinal study of ageing

Although cross-sectional studies suggest that hearing loss in middle- and older-aged adults is associated with lower physical activity, longitudinal evidence is limited. This study aimed to investigate the potential bi-directional association between hearing loss and physical activity over time. Participants were from the English Longitudinal Study of Ageing (N = 11,292) who were 50-years or older at baseline assessment (1998-2000). Individuals were followed-up biannually for up to 20-years (2018-2019) and were classified as ever reporting hearing loss (n = 4946) or not reporting hearing loss (n = 6346). Data were analysed with Cox-proportional hazard ratios and multilevel logistic regression. The results showed that baseline physical activity was not associated with hearing loss over the follow-up. Time (i.e., wave of assessment) by hearing loss interactions showed that physical activity declined more rapidly over time in those with hearing loss, compared to those without (Odds Ratios = 0.94, 95% Confidence Intervals; 0.92-0.96, p < .001). These findings highlight the importance of addressing physical activity in middle- and older-aged adults with hearing loss. As physical activity is a modifiable behaviour that can reduce the risk of developing chronic health conditions, individuals with hearing loss may need additional, tailored support to be more physically active. Mitigating the decline in physical activity could be essential to support healthy ageing for adults with hearing loss.

Identifying diverse forms of (un)healthy sleep: Sleep profiles differentiate adults' psychological and physical well-being

RATIONALE

Sleep health is best described by the co-occurrence of various dimensions (e.g., regularity, daytime alertness, satisfaction, efficiency, duration) but is rarely measured this way. Information is needed regarding common within-person patterns of sleep characteristics among adults and their relative healthiness.

OBJECTIVE

To deepen understanding of healthy and unhealthy sleep, the present study aimed to uncover multidimensional sleep profiles in adults and their associations with a variety of psychological and physical well-being outcomes.

METHODS

Survey data from 4622 adults who participated in the Midlife in the United States (MIDUS) project was used to identify latent sleep profiles across five core sleep dimensions. Adjusting for individual sleep dimensions and sociodemographic covariates, General Linear Models were used to test the associations of sleep profile membership with hedonic and eudemonic well-being and chronic physical conditions.

RESULTS

Four latent sleep profiles were revealed, good sleepers, sufficient but irregular sleepers, nappers, and short, dissatisfied, and inefficient sleepers. The profiles differentially related to well-being outcomes above and beyond individual sleep dimensions and sociodemographic covariates. Good sleepers generally reported the best outcomes, and short, dissatisfied, and inefficient sleepers generally reported the worst outcomes.

CONCLUSION

Four common sleep profiles describe adults' holistic sleep experiences and predict a variety of well-being outcomes beyond other known predictors. In adulthood, healthy sleep may involve sufficient sleep across all dimensions whereas unhealthy sleep may involve insufficient sleep across three key dimensions: duration, satisfaction, and efficiency.

Drinking water salinity is associated with hypertension and hyperdilute urine among Daasanach pastoralists in Northern Kenya

Water salinity is a growing global environmental health concern. However, little is known about the relation between water salinity and chronic health outcomes in non-coastal, lean populations. Daasanach pastoralists living in northern Kenya traditionally rely on milk, yet are experiencing socioecological changes and have expressed concerns about the saltiness of their drinking water. Therefore, this cross-sectional study conducted water quality analyses to examine how water salinity, along with lifestyle factors like milk intake, was associated with hypertension (blood pressure BP ≥140 mm Hg systolic or ≥90 mm Hg diastolic) and hyperdilute urine (urine specific gravity <1.003 g/mL, indicative of altered kidney function). We collected health biomarkers and survey data from 226 non-pregnant adults (46.9% male) aged 18+ from 134 households in 2019 along with participant observations in 2020. The salinity (total concentration of all dissolved salts) of reported drinking water from hand-dug wells in dry river beds, boreholes, and a pond ranged from 120 to 520 mg/L. Water from Lake Turkana and standpipes, which was only periodically used for consumption when no other drinking sources are available, ranged from 1100 to 2300 mg/L. Multiple logistic regression models with standard errors clustered on households indicate that each additional 100 mg/L of drinking water salinity was associated with 45% (95% CI: 1.09-1.93, P = 0.010) increased odds of hypertension and 33% (95% CI: 0.97-1.83, P = 0.075) increased odds of hyperdilute urine adjusted for confounders. Results were robust to multiple specifications of the models and sensitivity analyses. Daily milk consumption was associated with 61-63% (P < 0.01) lower odds of both outcomes. This considerable protective effect of milk intake may be due to the high potassium, magnesium, and calcium contents or the protective lifestyle considerations of moving with livestock. Our study results demonstrate that drinking water salinity may have critical health implications for blood pressure and kidney function even among lean, active pastoralists.

Inequality in hospitalization due to non-communicable diseases in Sweden: Age-cohort analysis of the Uppsala Birth Cohort Multigenerational Study

We aimed to investigate cohort differences in age trajectories of hospitalization due to non-communicable conditions, and if these varied by paternal socioeconomic position. We used the Uppsala Birth Cohort Multigenerational Study—including virtually complete information on medical diagnoses.

Our sample constituted 28,448 individuals (103,262 observations). The outcome was five-year prevalence of hospitalization due to major non-communicable conditions in 1989–2008. The exposures were age (19–91), year-of-birth (1915–1929; 1938–1972), gender (man vs woman), and parental socioeconomic position (low, medium, and high). We used multilevel logit models to examine associations between exposures and the hospitalization outcome.

Younger cohorts had a higher prevalence of hospitalization at overlapping ages than those born earlier, with inter-cohort differences emerging from early-adulthood and increasing with age. For instance, at age 40 predicted probability of hospitalization increased across birth-cohorts—from 1.2% (born in 1948-52) to 2.0% (born in 1963-67)—whereas at age 50 it was 2.9% for those born in 1938-42 compared with 4.6% among participants born in 1953-57. Those with medium and low socioeconomic position had 13.0% and 20.0% higher odds of experiencing hospitalization during the observation period, respectively—when age, year-of-birth and gender were accounted for.

We found that no progress was made in reducing the socioeconomic inequalities in hospitalization across cohorts born between 1915 and 1972. Hence, more effective policies and interventions are needed to reduce the overall burden of morbidity—particularly among the most vulnerable.

•

What is already known on this subject?

•

The evidence on trends in morbidity in Sweden is mainly cross-sectional and focused on individual conditions.

•

Rates of various indicators of morbidity (e.g. poor mobility, psychological distress, disability) have increased over time.

•

What this study adds.

•

Successively younger birth cohorts had a higher prevalence of hospitalization, with differences emerging in early-adulthood.

•

Those in medium and low parental socioeconomic position (vs high) had 13% and 20% higher odds of hospitalization.

•

No progress was made in reducing the socioeconomic inequalities across cohorts born between 1915 and 1972.

Beyond recent BMI: BMI exposure metrics and their relationship to health

Body mass index (BMI) is generally used to classify adiposity. Despite the fact that the consequences of adiposity for chronic health accumulate and manifest over time, most population health research exploring the implications of high BMI measures only its recent intensity. Some studies have used retrospective measures involving maximum weight, and even fewer have used BMI at multiple time points to estimate cumulative exposure to adiposity. The goal of this study was to compare BMI exposure metrics that captured different dimensions of body mass – intensity, history, and duration – in models of health indicators linked with adiposity. We used self-reported BMI of young adults (ages 18 – 33 years, n = 8,608) across 11 waves of data from the National Longitudinal Survey of Youth 1997 to evaluate eight BMI exposure metrics: most recent, maximum, mean, and median BMI, proportion of time with overweight/obesity, and excess BMI-years with overweight/obesity. We used these metrics in models of self-reported general health, chronic condition, and diabetes, and ascertained how most recent BMI performed when compared with other metrics that better capture the dynamics of BMI. The Akaike information criteria and Vuong tests were used for model comparison, and the strengths of associations were also compared. Most recent BMI was the best metric for explaining general health. Median BMI was best for explaining diabetes, with most recent BMI under-estimating the association by 13% relative to median BMI. For chronic condition, there was no clear best metric. We concluded that most recent BMI is useful for explaining health outcomes, though other metrics should also be given consideration, particularly for conditions that develop over time. Metrics that accounted for both intensity and history performed quite well, but the duration measures might be less useful.

•

BMI is dynamic, so researchers need to consider beyond BMI at the time of survey.

•

We calculated 8 BMI-based metrics accounting for intensity, history, and duration.

•

Most recent BMI was the best metric, based on AIC, for explaining general health.

•

Most recent BMI understated the association for diabetes, relative to median BMI.

Acute exposure and chronic retention of aluminum in three vaccine schedules and effects of genetic and environmental variation

Like the mechanisms of action as adjuvants, the pharmacodynamics of injected forms of aluminum commonly used in vaccines are not well-characterized, particularly with respect to how differences in schedules impact accumulation and how factors such as genetics and environmental influences on detoxification influence clearance. Previous modeling efforts are based on very little empirical data, with the model by Priest based on whole-body clearance rates estimated from a study involving a single human subject. In this analysis, we explore the expected acute exposures and longer-term whole-body accumulation/clearance across three vaccination schedules: the current US Centers for Disease Control and Prevention (CDC) schedule, the current CDC schedule using low aluminum or no aluminum vaccines, and Dr. Paul Thomas' "Vaccine Friendly Plan" schedule. We then study the effects of an implicit assumption of the Priest model on whether clearance dynamics from successive doses are influenced by the current level of aluminum or modeled by the assumption that a new dose has its own whole-body dynamics "reset" on the day of injection. We model two additional factors: variation (deficiency) in aluminum detoxification, and a factor added to the Priest equation to model the potential impact of aluminum itself on cellular and whole-body detoxification. These explorations are compared to a previously estimated pediatric dose limit (PDL) of whole-body aluminum exposure and provide a new statistic: %alumTox, the (expected) percentage of days (or weeks) an infant is in aluminum toxicity, reflecting chronic toxicity. We show that among three schedules, the CDC schedule results in the highest %alumTox regardless of model assumptions, and the Vaccine Friendly Plan schedule, which avoids >1 ACV per office visit results in the lowest (expected) %alumTox. These results are conservative, as the MSL is derived from data used by FDA to estimate safety of aluminum in adult humans. These results demonstrate high potential utility of modeling variation in patient responses to aluminum. More empirical data from individuals who are suspected of being intolerant of aluminum from vaccines, evidenced by high aluminum retention, neurodevelopmental disorders and/or a myriad of chronic illnesses would help answer questions on whether the model predictions can be used to estimate parameter values tied to genetic factors including genomic sequence variation and family history of chronic illnesses tied to aluminum exposure.

Effects of Perceived Discrimination and Length of Residency on the Health of Foreign-Born Populations

This study explores the relationship between chronic conditions, perceived discrimination, and length of residency among three racial groups of foreign-born respondents: Afro-Caribbean, Asian, and Latino Americans. Analysis utilized Collaborative Psychiatric Epidemiology Surveys (CPES) merged data from the National Latino and Asian American Study (NLAAS) and the National Survey of American Life (NSAL). Afro-Caribbean subgroups were more likely than Asian and Latino American subgroups to report perceived discrimination. Logistic regression analysis was conducted to determine which groups within the model were more likely to report chronic health conditions. Perceived discrimination was found to vary by race and was inversely associated with chronic respiratory conditions for Afro-Caribbeans. In general, years of US residency were associated with health across all chronic conditions where those in the USA longer were more likely to experience health-related problems. Perceived discrimination revealed mixed results.