Symptoms of Anxiety and Depression in Relation to Work Patterns During the First Wave of the COVID-19 Epidemic in Philadelphia PA: A Cross-Sectional Survey

OBJECTIVE

We investigated whether patterns of work during COVID-19 pandemic altered by effort to contain the outbreak affected anxiety and depression.

METHODS

We conducted a cross-sectional online survey of 911 residents of Philadelphia, inquiring about their working lives during early months of the epidemic, symptoms of anxiety and depression, plus demographics, perceived sources of support, and general health.

RESULTS

Occupational contact with suspected COVID-19 cases was associated with anxiety. Concerns about return to work, childcare, lack of sick leave, and loss/reduction in work correlated with anxiety and depression, even when there was no evidence of occupational contact with infected persons; patterns differed by sex.

CONCLUSIONS

Heightened anxiety and depression during COVID-19 pandemic can be due to widespread disruption of working lives, especially in "non-essential" low-income industries, on par with experience in healthcare.

Cancer-work management: Hourly and salaried wage women's experiences managing the cancer-work interface following new breast cancer diagnosis

OBJECTIVE

The purpose of this paper is to report the baseline characteristics of EMPOWER participants-a group of newly diagnosed breast cancer survivors-and describe differences in hourly and salaried wage women's experiences regarding cancer and work management in the three months following breast cancer diagnosis.

DESIGN AND SETTING

The EMployment and Potential Outcomes of Working through canceER (EMPOWER) project is a prospective longitudinal, mixed methods pilot study designed to evaluate how employment influences treatment decisions among women diagnosed with breast cancer. Participants were women diagnosed with new breast cancer and treated at one of two clinical sites of the University of Maryland Medical System. Women were enrolled in the study within three months of first breast cancer diagnosis. Study visits occurred every three months for one year. This paper reports data from for the baseline and three-month visit which had been completed by all enrollees.

METHODS

Trained research personnel collected demographic information, medical history and health status, social history, employment data, cancer-related data, psychosocial adjustment, and financial wellbeing at the baseline enrollment visit. A semi-structured qualitative interview was administered at the three-month study visit to assess employment decisions and the impact of job demands, cancer care, and cancer-work fit during the three months following diagnosis.

RESULT

Fifty women with new, primary diagnosis of breast cancer were enrolled in the study. Mean age of participants was 51 years, and 46% identified their race as Black or other. The majority of women disclosed their diagnosis to their employer and nearly all maintained some level of employment during the first three to six months of treatment. Women with hourly wage jobs were similar to those with salaried wage jobs with respect to demographic and social characteristics. Women with hourly wage jobs were more likely to report working in physically demanding jobs and taking unpaid leave. They were also more likely to experience side effects that required physical restrictions at work, to leave their jobs due to demands of treatment, and to report managing cancer and work concurrently as very difficult. Women in salaried wage jobs were more likely to report falling behind or missing work and working remotely as a cancer-management strategy. Women in hourly jobs more often reported difficulty managing the competing demands of cancer and work.

CONCLUSION

While further study is needed, these results suggest that women in hourly and salaried workers reported similar experiences managing cancer and work, with a few key exceptions. These exceptions pertain to the nature of hourly-wage work. Cancer survivors employed in hourly jobs may be more vulnerable to poor employment outcomes due to limited access to paid time off and workplace flexibility, and challenges related to managing physical aspects of cancer and employment.

Sickness absence trajectories following labour market participation patterns: a cohort study in Catalonia (Spain), 2012-2014

BACKGROUND

Previous studies have focused on the relationship between employment pathways and health-related outcomes based on cross-sectional or longitudinal approaches. However, little is known about the cumulative effects of employment status mobility on sickness absence (SA) over time. The aim of the present study was to examine the association between prior labour market participation (LMP) patterns and SA trajectories from a life-course perspective.

METHODS

This cohort study was based on a sample of 11,968 salaried workers living in Catalonia and affiliated with the Spanish Social Security system, who accumulated more than 15 days on SA in at least one quarter during 2012-2014. Individuals were grouped into three different working life stages: early (18-25 years), middle (26-35 years), and late (36-45 years). To identify LMP patterns, we applied sequence analysis and cluster analysis (2002-2011), and we used latent class growth modelling to identify SA trajectories (2012-2014). Finally, we applied multinomial logistic regression models to assess the relationship between LMP patterns and SA trajectories.

RESULTS

The analyses yielded six LMP patterns: stable employment (value range: 63-81%), increasing employment (5-22%), without long-term coverage (7-8%), decreasing employment (4-10%), fluctuant employment (13-14%), and steeply decreasing employment (7-9%). We also identified four SA trajectories: low stable (83-88%), decreasing (5-9%), increasing (5-11%), and high stable (7-16%). However, the only significant association we identified for LMP patterns and SA trajectories was among young men, for whom an increasing employment pattern was significantly associated with a lower risk for increased days on SA (adjusted odds ratio: 0.21; 95% confidence interval: 0.05-0.96).

CONCLUSIONS

SA trajectories are generally not related to prior 10-year LMP patterns at any stage of working life. To disentangle this relationship, future research might benefit from considering working life transitions with a quality-of-work approach framed with contextual factors closer to the SA course.

Comparison of the physical and mental health problems of unemployed with employees in South Korea

This study compared the physical and mental health problems of adults with standard and nonstandard employment with those who were unemployed. We used data from the Korean National Health and Nutrition Examination Survey to compare adult males and females with standard and nonstandard employment with those who were unemployed. Relative to adults with standard employment, higher proportions of unemployed individuals were women, older, had low monthly incomes, and had mental health problems. Compared to men and women with standard employment, unemployed men and women had greater risk of reporting depressive feelings (OR = 1.683, 95% CI = 1.298-2.183; OR = 1.419, 95% CI = 1.179-1.709) and suicidal ideation (OR = 2.218, 95% CI = 1.682-2.928; OR = 1.250, 95% CI = 1.020-1.530). Among workers with nonstandard employment, there were gender differences in the risk for arthritis. Unemployed individuals also had a higher risk of mental health problems than nonstandard workers. In conclusion, the unemployed were more vulnerable to mental health problems.

Prevalence of problem gambling in an employed population in Brittany, France

Some employees may have recourse to gambling, notably as an adaptive strategy. Although many studies have been performed on specific occupational groups (i.e. gambling industry, transportation or teaching), none have been conducted with workers followed-up by Occupational Health Services (OHS). Our aim was to evaluate the prevalence of problem gambling in an employed population and its links with work. We performed a cross-sectional study between November 2016 and April 2017, in an OHS in France. We evaluated the prevalence of gambling using the Lie or Bet questionnaire and the Canadian Problem Gambling Index. Among the 410 employees included, 138 (33.7%) had gambled in the previous year, 12 (2.9%) considered their gambling experience to be work-related, 13 (3.2%) were identified as problem gamblers. The influence of colleagues and the workplace hierarchy and ease of access to gambling (in tobacco shops, bars…) could be risk factors. Screening for gambling behavior could be offered by occupational health services, using the Lie or Bet, especially for employees exposed to readily available gambling opportunities at their workplace.

Decision support system for designing and assigning ergonomic workplaces to workers with disabilities

Workers with disabilities are still lagging in employment rates compared to the healthy workforce. Those workers are also more sensitive for stress at work and possible injuries that are usually connected with non-adequate workplace design. Generally, absenteeism presents high costs for companies and costs can be even higher if injuries at work occur. Therefore, companies face the problem of identifying a suitable workplace for workers with disabilities and supplying the needed requirements. The purpose of our research was to develop a decision support system that would aid in the process of identifying and categorising disabilities of workers, and assigning the most suitable workplace with needed requirements in an integrated work environment to ensure high safety, productivity and satisfaction. The developed decision support system is also a step toward prevention of injuries at work. The usefulness of the system has been shown in a case study of a large-sized production company. Practitioner summary: The purpose of our research was to develop a decision support system that would aid companies to identify a suitable workplace for workers with disabilities with needed requirements in an integrated work environment to ensure high safety, productivity and satisfaction with lower costs. Abbreviations: OSHA: occupational safety and health act; UN Convention: The United Nations Convention; EU Directive 89/654/EEC: European Union directive concerning the minimum safety and health requirements for the workplace; ICF: The International Classification of Functioning, Disability and Health; ICD: The International Statistical Classification of Diseases and Related Health Problems; RULA: rapid upper limb assessment; OWAS: ovaco working analysing system.

Work Hours and Difficulty in Leaving Work on Time in Relation to Work-to-Family Conflict and Burnout Among Female Workers in Taiwan

The present study explores the relations between work hours and the difficulty in leaving work on time to both work-to-family conflict (WFC) and burnout among female workers in Taiwan. A cross-sectional research design and questionnaire were employed to obtain the research data. In total, 738 full-time female workers took part in the study. The results of regression analyses showed that when age, marital status, economic status, occupation, parental status, and housework responsibilities were controlled, more work hours were positively associated with WFC and burnout. When the difficulty in leaving work on time was also considered in the analysis, long working hours were still significantly associated with burnout; however, the significant relation with WFC disappeared. It is surmised that if female employees work overtime voluntarily, the perception of WFC diminishes; nevertheless, the adverse effect of long working hours on health remains unabated. This study concludes that female employees who work overtime on a voluntary basis are at risk of health problems, which should be a focus of concern.

Work-Related Outcomes in Self-Employed Cancer Survivors: A European Multi-country Study

Purpose To describe: (i) patterns of self-employment and social welfare provisions for self-employed and salaried workers in several European countries; (ii) work-related outcomes after cancer in self-employed people and to compare these with the work-related outcomes of salaried survivors within each sample; and (iii) work-related outcomes for self-employed cancer survivors across countries. Methods Data from 11 samples from seven European countries were included. All samples had cross-sectional survey data on work outcomes in self-employed and salaried cancer survivors who were working at time of diagnosis (n = 22-261 self-employed/101-1871 salaried). The samples included different cancers and assessed different outcomes at different times post-diagnosis. Results Fewer self-employed cancer survivors took time off work due to cancer compared to salaried survivors. More self-employed than salaried survivors worked post-diagnosis in almost all countries. Among those working at the time of survey, self-employed survivors had made a larger reduction in working hours compared to pre-diagnosis, but they still worked more hours per week post-diagnosis than salaried survivors. The self-employed had received less financial compensation when absent from work post-cancer, and more self-employed, than salaried, survivors reported a negative financial change due to the cancer. There were differences between self-employed and salaried survivors in physical job demands, work ability and quality-of-life but the direction and magnitude of the differences differed across countries. Conclusion Despite sample differences, self-employed survivors more often continued working during treatment and had, in general, worse financial outcomes than salaried cancer survivors. Other work-related outcomes differed in different directions across countries.

Beyond the Employment Dichotomy: An Examination of Recidivism and Days Remaining in the Community by Post-Release Employment Status

Criminological research has tended to consider employment in a dichotomy of employed versus unemployed. The current research examines a sample of individuals 1-year post-release to assess the extent to which four distinct employment categories (full-time, part-time, disabled, and unemployed) are associated with reincarceration and days remaining in the community. Findings indicate disabled individuals remain in the community longer and at a higher proportion compared with other employment categories. Furthermore, unique protective and risk factors are found to be associated with each employment category while some risk factors (e.g., homelessness) highlight the importance of addressing reentry barriers regardless as to employment status.

Comparison of occupational health problems of employees and self-employed individuals who work in different fields

We used a representative sample of the working population of Korea to compare the occupational health problems of employees and self-employed individuals who performed different types of work. The Korean Working Conditions Survey (KWCS) of 2014 was used to compare the working conditions and occupational safety and health (OSH) issues of employees and self-employed individuals performing different types of work. Relative to paid employees, self-employed individuals were older, more likely to perceive their health as bad, and had less education, longer working hours, more exposure to workplace ergonomic hazards, more musculoskeletal problems, and poorer mental well-being. Relative to those performing "mental work" or "emotional work", individuals performing "physical work" were more vulnerable to OSH problems. In conclusion, self-employed individuals in the sample were more vulnerable to OSH problems.

Supporting the Transition into Employment: A Study of Canadian Young Adults Living with Disabilities

Objective To examine the job accommodation and benefit needs of young adults with disabilities as they transition into employment, and their perceived barriers to meeting support needs. Methods An online survey was conducted of 155 Canadian young adults with disabilities (mean age = 25.8 years). Respondents were either employed or seeking employment, and were asked about their need for health benefits, and soft (e.g., flexible scheduling) and hard accommodations (e.g., ergonomic interventions), and perceived accommodation barriers. Disability characteristics (e.g., disability type), demographic details and work context information were collected. Multivariable logistic analyses were conducted to examine the factors associated with a greater need for health benefits and hard and soft accommodations. Result Participants reported having a physical (79%), psychological (79%) or cognitive/learning disability (77%); 68% had > 1 disability. Over half (55%) were employed. Health benefits and soft accommodations were most needed by participants. Also, an average of six perceived accommodation barriers were indicated; difficulty with disability disclosure was most frequently reported. More perceived accommodation barriers were associated with a greater need for health benefits (OR 1.17, 95% CI 1.04-1.31) and soft accommodations (OR 1.13, 95% CI 1.01-1.27). A psychological disability was a associated with a greater need for health benefits (OR 2.91, 95% CI 1.09-7.43) and soft accommodations (OR 3.83, 95% CI 1.41-10.42). Discussion Employers can support the employment of young adults with disabilities through provision of extended health benefits and soft accommodations. Addressing accommodation barriers could minimize unmet workplace need, and improve employment outcomes for young adults with disabilities as they begin their career and across the life course.

Differences in Metabolic Syndrome Prevalence by Employment Type and Sex

Workers may sometimes do the same work, but differ in their risk of health-related problems depending on whether the employment type is standard or non-standard. Furthermore, even with similar job and employment types, there may be differences in risk factors for health-related problems depending on sex. This study aimed to determine the prevalence of metabolic syndrome (MetS) by employment type and sex using data from the Fifth Korean National Health and Nutrition Examination Survey (KNHANES Ⅴ) (2010–2012) and KNHANES Ⅵ (2013–2015) conducted by the Korea Centers for Disease Control and Prevention. Overall, 9523 adult wage workers (5523 standard workers and 4000 non-standard workers) aged ≥ 19 years were analyzed. To determine MetS prevalence odds ratios according to employment type, logistic regression analysis was performed disaggregated by sex. The prevalence of MetS significantly increased with age (p < 0.001), being married (p < 0.05), current smoking status (p < 0.05), and high-risk drinking (p < 0.001) among male subjects. The prevalence of MetS significantly increased among female manual workers (p < 0.001), those with lower educational level and household income (p < 0.001). Non-standard workers of either sex showed higher MetS prevalence than standard workers; only females showed significant difference (p < 0.001). Female non-standard workers showed 1.44, 1.33, and 1.34 (all p < 0.001) times higher odds of MetS prevalence in Models 1, 2, and 3, respectively, compared to standard workers, suggesting a difference in risk factors of MetS according to sex. Also, that employment type affects MetS prevalence suggests that employment pattern is an important risk factor especially in females. Therefore, to manage MetS in female non-standard workers, individual health care as well as social effort may be necessary.

Earnings of Employed and Self-employed US Health Care Professionals, 2001 to 2015

IMPORTANCE

Over the last 15 years, the health care practitioner landscape has changed significantly. Fewer practitioners are self-employed and more are employed by for-profit or nonprofit organizations. These shifts can have an impact on annual labor earnings.

OBJECTIVES

To examine trends in self-employment and employment and to assess the gap in annual labor earnings between self-employed and employed US health care professionals from 2001 to 2015.

DESIGN, SETTING, AND PARTICIPANTS

Survey study in which data on employment type (self-employed, employed by private sector, or employed by government) and annual labor earnings for 50 states and the District of Columbia were extracted from the 2001 to 2015 American Community Survey. The analyses were restricted to 175 714 self-identified dentists, physicians, pharmacists, optometrists, podiatrists, chiropractors, and physical therapists aged 30 years and older who worked at least 40 weeks per year and 20 hours per week. Controlling for age, sex, race/ethnicity, year, and state of residence, median regression models were used to measure the gap in annual labor earnings between self-employed and employed health care professionals.

MAIN OUTCOMES AND MEASURES

Annual labor earnings, defined as the sum of self-employment and wages or salary income.

RESULTS

Our sample of 175 714 respondents included 99 077 physicians, 20 008 dentists, 26 143 pharmacists, 4238 optometrists, 6076 chiropractors, 1164 podiatrists, and 19 008 physical therapists. The weighted percentage of self-employed physicians decreased from 35.2% (95% CI, 34.4%-36.1%; 6807 of 18 726 physicians) in 2001 through 2005 to 24.7% (95% CI, 24.2%-25.2%; 10 974 of 41 205 physicians) in 2011 through 2015. The percentage of self-employed dentists decreased from 73.0% (95% CI, 71.2%-74.8%; 3117 of 4153 dentists) in 2001 through 2005 to 65.1% (95% CI, 63.7%-66.4%; 5260 of 7820 dentists) in 2011 through 2015. Among physicians, the regression-adjusted earnings gap reversed from $19 679 (95% CI, $14 431-$24 927; P < .001) during 2001 through 2005 to -$10 623 (95% CI, -$14 547 to -$6699; P < .001) during 2011 through 2015. Among dentists, the regression-adjusted earnings gap narrowed from $30 448 (95% CI, $23 040-$37 855; P < .001) during 2001 through 2005 to $21 291 (95% CI, $15 723-$26 859; P < .001) during 2011 through 2015. From 2001 to 2015 the earnings gap also reversed among pharmacists, optometrists, and podiatrists. The regression-adjusted earnings gap narrowed among chiropractors and physical therapists.

CONCLUSIONS AND RELEVANCE

Since 2001, the percentage of health care professionals who are self-employed declined, and the gap in earnings between self-employed and employed health care professionals narrowed.

Dietary Differences in Male Workers among Smaller Occupational Groups within Large Occupational Categories: Findings from the Japan Environment and Children's Study (JECS)

Studies examining workers' diet according to smaller occupational groups within "large occupational categories" are sparse. The aim of this study was to examine the potential differences in workers' diets based on the classification of workers into smaller occupational groups that comprise "large occupational categories". The subjects of this study were working fathers who had participated in the Japan Environment and Children's Study (N = 38,656). Energy and nutrient intake were calculated based on data collected from the Food Frequency Questionnaire. Occupations were classified according to the Japanese Standard Occupational Classification. Logistic regression analyses were performed to examine the adherence to current dietary recommendations within smaller occupational groups. In particular, significant differences were observed among the categorical groups of "professional and engineering workers", "service workers", and "agricultural, forestry, and fishery workers". In "professional and engineering workers", teachers showed higher odds of adherence to calcium intake recommendations compared with nurses (OR, 2.54; 95% CI, 2.02⁻3.14; p < 0.001). In "agricultural, forestry, and fishery workers", agriculture workers showed higher odds of adherence to calcium (OR, 2.15; 95% CI, 1.46⁻3.15; p < 0.001) and vitamin C (OR 1.90, 95% CI 1.31⁻2.74, p = 0.001) intake recommendations compared with forestry and fishery workers. These findings may be beneficial from a research perspective as well as in the development of more effective techniques to improve workers' diet and health.

Sickness presenteeism: measurement and management challenges

Since work can be restorative to health, attending work when unwell should not be viewed as an inherently negative phenomenon. However, the functional benefits are likely to depend on the health condition, and the psychosocial quality of the work provided. The current study used a workforce survey to explore differences in the pattern of presenteeism and absenteeism by health condition, the association of psychosocial work factors with presenteeism compared to absenteeism, and their interaction to predict health. Findings indicate that instead of substituting absenteeism for presenteeism, the two tend to coincide, but the balance differs by health condition. Presenteeism is more likely to occur in poorer psychosocial environments, reinforcing the importance of ensuring work is designed and managed in ways that are beneficial rather than detrimental to health. The findings also highlight the methodological importance of differentiating between the act and impact of presenteeism in future research and practice. Practitioner Summary: Effective management of work-related health requires that practitioners manage both sickness absence and presence together, since employees tend to fluctuate between the two when unwell. Interventions should be tailored to the specific health concern, paying particular attention to the psychosocial environment in enabling employees to continue working without exacerbating health.

Foods, Dietary Patterns and Occupational Class and Leukocyte Telomere Length in the Male Population

Telomeres contain TTAGGG repetitive sequences and are located at the end of human chromosomes. Telomere dysfunction is associated with some age-related and chronic diseases, but its relationship with foods, dietary patterns, and occupational class in the young male population is not yet known. In this cross-sectional study, 300 healthy men, residents of Tehran, aged 25-40 years were enrolled from January to December 2016. We employed a cross-sectional study of 300 healthy people, residents of Tehran, aged 25-40 years. A food frequency questionnaire was used to obtain food intakes of all participants and converted into actual food intake (g/day). The principal components analysis was used to determine dietary patterns and other demographic characteristics. Leukocyte telomere length (TL) was measured by quantitative real-time polymerase chain reaction (PCR) to measure number of telomere repeat copy number (T) to the relative number of 36B4 copies (S) (T/S ratio). T/S in office-workers, waste recyclers, and other workers were 1.22 ± 0.4, 1.08 ± 0.3, and 1.094 ± 0.34, respectively. The results of multivariate linear regression adjusted for age, body mass index (BMI), and smoking were showed that whole grains (β = 0.02; p = .05), refined grains, fruits and vegetables, fish and dairy products were associated with an increase in log-T/S, but consumption of nuts and seeds (β = -0.00072; p = .06), meats (β = -0.00043; p = .9), produced meats (β = -0.00238; p = .03), oils and solid fats (β = -0.00146; p = .03) had a negative relationship with log-T/S in all studied occupational classes. A positive relationship was reported between the healthy (β = 0.017; p = .2) and traditional dietary pattern (β = 0.012; p = .4) with log-T/S, but western pattern identified negative relationship (β = -0.004; p = .7). Adherence to a healthy (with consumption whole grains, refined grains, dairy, and cereals) and then traditional pattern with increased consumption of fruits, vegetables and whole grains, fish and dairy products are necessary to prevent TL destruction in all studied occupational classes.

Informal care and long-term labor market outcomes

In this paper we estimate long-run effects of informal care provision on female caregivers' labor market outcomes up to eight years after care provision. We compare a static version, where average effects of care provision in a certain year on later labor market outcomes are estimated, to a partly dynamic version where the effects of up to three consecutive years of care provision are analyzed. Our results suggest that there are significant initial negative effects of informal care provision on the probability to work full-time. The reduction in the probability to work full-time by 4 percentage points (or 2.4-5.0 if we move from point to partial identification) is persistent over time. Short-run effects on hourly wages are zero but we find considerable long-run wage penalties.

Valuing productivity costs using the friction-cost approach: Estimating friction-period estimates by occupational classifications for the UK

The friction cost approach has been proposed as an alternative to the human capital approach in estimating productivity costs. However, it is difficult, in practice, to apply this approach due to limited availability of context-specific data. Using national and firm-level data on vacancy durations sourced from 4 organisations, we estimated vacancy durations, and consequently, length of friction period for the United Kingdom disaggregated by occupational classification. We found comparable estimates to previously reported friction periods elsewhere. The disaggregated friction period analysis confirmed occupational class has an effect on the estimated length of the friction period. The research presents estimates on vacancy durations and friction periods necessary to use the friction cost approach in a practical way in economic evaluations.

Why have relative rates of class mobility become more equal among women in Britain?

In a previous paper it has been shown that across three cohorts of men and women born in Britain in 1946, 1958 and 1970 a gender difference exists in regard to relative rates of class mobility. For men these rates display an essential stability but for women they become more equal. The aim of the present paper is to shed light on the causes of this trend-or, that is, of increasing social fluidity-among women. We begin by considering a refined version of the perverse fluidity hypothesis: that is, one that proposes that part-time work leads to increasing downward worklife mobility among women that also entails downward intergenerational mobility and thus promotes greater fluidity. We do in fact find that the increase in fluidity is very largely, if not entirely, confined to women who have had at least one period of part-time work. However, a more direct test of the hypothesis is not supportive. We are then led to investigate whether it is not that part-time working itself is the crucial factor but rather that women who subsequently work part-time already differ from those who do not at entry into employment. We find that eventual full- and part-timers do not differ in their class origins nor, in any systematic way, in their educational qualifications. But there is a marked and increasing difference in the levels of employment at which they make their labour market entry. Eventual part-timers are more likely than eventual full-timers to enter in working-class positions, regardless of their class origins and qualifications. Insofar as these women are from more advantaged origins, they would appear not to seek to exploit their advantages to the same extent as do full-timers in order to advance their own work careers. And it is, then, in the downward mobility accepted by these women-who increase in number across the cohorts-that we would locate the main source of the weakening association between class origins and destinations that is revealed among women at large.

The impact of participation in a Research/Writing Group on scholarly pursuits by non-tenure track clinical faculty

BACKGROUND AND PURPOSE

The purpose of this study was to evaluate the success of a faculty Research/Writing Group (RWG) by quantifying the amount of scholarly productivity from participants in the group compared with that of a matched cohort.

EDUCATIONAL ACTIVITY AND SETTING

The RWG meets monthly to discuss current projects, providing an assessment of their scholarly activity. Participants offer ideas on improvement, resources and possible platforms for presentations and/or publications.

FINDINGS

To evaluate the success of this model, scholarly production from the participants in the RWG was compared to a matched group of clinical non-tenure track faculty not participating in the group over a three year period. Faculty perception of RWG participation was evaluated by data collected through a survey using Qualtrics.

SUMMARY

Participation in the RWG provided these junior faculty the support system to feel confident in their pursuit of scholarly activities; and therefore, they outpaced their counterparts in dissemination of their research.

The effects of prospective mate quality on investments in healthy body weight among single women

This paper examines how a single female's investment in healthy body weight is affected by the quality of single males in her marriage market. A principle concern in estimation is the presence of market-level unobserved heterogeneity that may be correlated with changes in single male quality, measured as earning potential. To address this concern, we employ a differencing strategy that normalizes the exercise behaviors of single women to those of their married counterparts. Our main results suggest that when potential mate quality in a marriage market decreases, single black women invest less in healthy body weight. For example, we find that a 10 percentage point increase in the proportion of low quality single black males leads to a 5-10% decrease in vigorous exercise taken by single black females. Results for single white women are qualitatively similar, but not consistent across specifications. These results highlight the relationship between male and female human capital acquisition that is driven by participation in the marriage market. Our results suggest that programs designed to improve the economic prospects of single males may yield positive externalities in the form of improved health behaviors, such as more exercise, particularly for single black females.

The Impact of Early Retirement on Perceptions of Life at Work and at Home: Qualitative Analyses of British Civil Servants Participating in the Whitehall II Retirement Study

This study examined pathways to retirement and the role of circumstances at work and at home (including the introduction of financially-enhanced early retirement schemes) on retirement-related decision-making. In-depth qualitative interviews were conducted within 2 years of retirement with 59 British civil servants participating in the Whitehall II Study. Focusing on the experiences of 33 interviewees who spontaneously discussed “early retirement” we identified three pathways to retirement (non-applicants, successful applicants, and unsuccessful applicants for early retirement) each influenced by a range of complementary positive and negative factors at work and at home. The early retirement schemes influenced the balance between these factors in three ways: by encouraging participants to reflect on (and reconsider) existing retirement plans; by offering financial incentives to retire early; and because they were part of the ongoing process of restructuring and downsizing within the Civil Service which was accompanied by a perceived deterioration in conditions at work.

Obesity, job satisfaction and disability at older ages in Europe

This study investigates the interaction between obesity and disability and its impact on the levels of job satisfaction reported by older workers (aged 50-64) in ten European countries (Denmark, Sweden, Austria, Belgium, France, Germany, The Netherlands, Switzerland, Italy and Spain). Using longitudinal data from the Survey of Health, Ageing and Retirement in Europe for the years 2004, 2007 and 2011, we estimate a job satisfaction equation which includes a set of explanatory variables measuring worker's obesity and disability status (non-disabled, non-limited disabled, and limited disabled). The results show that, after controlling for other variables, obese workers are more likely to be satisfied with their jobs as compared to those workers with normal weight (0.066 points). In addition, being limited disabled or having poor health contribute to reducing (by 0.082 and 0.172 points, respectively) this positive effect of being obese on job satisfaction. However, we do not find any differential effect of obesity on job satisfaction by disability status, except for those underweight individuals who are not limited in their daily activities. Overall, these findings support the hypothesis of lower expectations about jobs for obese workers, especially if they also have poor health.

Health Status of Older US Workers and Nonworkers, National Health Interview Survey, 1997-2011

INTRODUCTION

Many US workers are increasingly delaying retirement from work, which may be leading to an increase in chronic disease at the workplace. We examined the association of older adults' health status with their employment/occupation and other characteristics.

METHODS

National Health Interview Survey data from 1997 through 2011 were pooled for adults aged 65 or older (n = 83,338; mean age, 74.6 y). Multivariable logistic regression modeling was used to estimate the association of socioeconomic factors and health behaviors with 4 health status measures: 1) self-rated health (fair/poor vs good/very good/excellent); 2) multimorbidity (≤1 vs ≥2 chronic conditions); 3) multiple functional limitations (≤1 vs ≥2); and 4) Health and Activities Limitation Index (HALex) (below vs above 20th percentile). Analyses were stratified by sex and age (young-old vs old-old) where interactions with occupation were significant.

RESULTS

Employed older adults had better health outcomes than unemployed older adults. Physically demanding occupations had the lowest risk of poor health outcomes, suggesting a stronger healthy worker effect: service workers were at lowest risk of multiple functional limitations (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.71-0.95); and blue-collar workers were at lowest risk of multimorbidity (OR, 0.84; 95% CI, 0.74-0.97) and multiple functional limitation (OR, 0.84; 95% CI, 0.72-0.98). Hispanics were more likely than non-Hispanic whites to report fair/poor health (OR, 1.62; 95% CI, 1.52-1.73) and lowest HALex quintile (OR, 1.21; 95% CI, 1.13-1.30); however, they were less likely to report multimorbidity (OR, 0.78; 95% CI, 0.73-0.83) or multiple functional limitations (OR, 0.82; 95% CI, 0.77-0.88).

CONCLUSION

A strong association exists between employment and health status in older adults beyond what can be explained by socioeconomic factors (eg, education, income) or health behaviors (eg, smoking). Disability accommodations in the workplace could encourage employment among older adults with limitations.

Do immigrants improve the health of natives?

This paper studies the effects of immigration on health. Specifically, we merge information on individual characteristics from the German Socio-Economic Panel (1984-2009) with detailed local labour market characteristics, and we then exploit the longitudinal component of the data to determine how immigration affects the health of both immigrants and natives over time. We find that immigrants to Germany are healthier than natives upon their arrival (the healthy immigrant effect) but that immigrants' health deteriorates over time. We show that the convergence in health is heterogeneous across immigrants and occurs more rapidly among those working in more physically demanding jobs. Because immigrants are significantly more likely to work in strenuous occupations, we investigate whether changes in the spatial concentration of immigrants affect the health of the native population. Our results suggest that immigration reduces the likelihood that residents will report negative health outcomes. We show that these effects are concentrated in blue-collar occupations and are stronger among low-educated natives. Improvements in natives' average working conditions and workloads help explain the positive effects of immigration on the health of the native population.

An examination of retention factors among registered practical nurses in north-eastern Ontario, Canada

INTRODUCTION

Literature from the past two decades has presented an insufficient amount of research conducted on the nursing practice environments of registered practical nurses (RPNs). The objective of this article was to investigate the barriers and facilitators to sustaining the nursing workforce in north-eastern Ontario (NEO), Canada. In particular, retention factors for RPNs were examined.

METHODS

This cross-sectional research used a self-administered questionnaire. Home addresses of RPNs working in NEO were obtained from the College of Nurses of Ontario (CNO). Following a modified Dillman approach with two mail-outs, survey packages were sent to a random sample of RPNs (N=1337) within the NEO region. Logistic regression analyses were used to determine intent to stay (ITS) in relation to the following factor categories: demographic, and job and career satisfaction.

RESULTS

Completed questionnaires were received from 506 respondents (37.8% response rate). The likeliness of ITS in the RPNs' current position for the next 5 years among nurses aged 46-56 years were greater than RPNs in the other age groups. Furthermore, the lifestyle of NEO, internal staff development, working in nursing for 14-22.5 years, and working less than 1 hour of overtime per week were factors associated with the intention to stay.

CONCLUSIONS

Having an understanding of the work environment may contribute to recruitment and retention strategy development. The results of this study may assist with addressing the nursing shortage in rural and northern areas through improved retention strategies of RPNs.

Education, mental health, and education-labor market misfit

Higher-educated people experience enhanced mental health. We ponder whether the mental health benefits of educational attainment are limitless. At the individual level, we look at the impact of job-education mismatch. At the societal level, we hypothesize that diminishing economic returns on education limit its mental health benefits. Using a subsample of individuals aged 20 to 65 years (N = 28,288) from 21 countries in the European Social Survey (ESS 2006), we estimate the impact on depressive symptoms of characteristics at both the employee level (years of education and job-education mismatch) and the labor market/country level (the gap between the nontertiary and tertiary educated in terms of unemployment risks and earnings). The results show that educational attainment produces mental health benefits in most European countries. However, in some of the countries, these benefits are limited or even completely eliminated by education-labor market misfit.

Job strain in the public sector and hospital in-patient care use in old age: a 28-year prospective follow-up

BACKGROUND

high job strain increases the risk of health decline, but little is known about the specific consequences and long-term effects of job strain on old age health.

OBJECTIVES

purpose was to investigate whether physical and mental job strain in midlife was associated with hospital care use in old age.

METHODS

study population included 5,625 Finnish public sector employees aged 44-58 years who worked in blue- and white-collar professions in 1981. The number of in-patient hospital care days was collected from the Finnish Hospital Discharge Register for the 28-year follow-up period.

RESULTS

rates of hospital care days per 1,000 person-years for men were 7.78 (95% confidence interval [CI] 7.71-7.84) for low, 9.68 (95% CI 9.50-9.74) for intermediate and 12.56 (95% CI 12.47-12.66) for high physical job strain in midlife. The corresponding rates for women were 6.63 (95% CI 6.57-6.68), 7.91 (95% CI 7.87-7.95) and 10.35 (95% CI 10.25-10.42), respectively. Rates were parallel but lower for mental job strain. Reporting high physical job strain in midlife increased the risk of hospital care in old age compared with those who reported low job strain, fully adjusted incidence rate ratio 1.17 (95% CI 1.00-1.38) for men and 1.42 (95% CI 1.25-1.61) for women. These associations were robust in analyses confined to hospital care that took place after the employees had turned 65 years.

CONCLUSION

exposure to high mental and, particularly, high physical job strain in midlife may set employees on a higher healthcare use trajectory which persists into old age.

Recognition of health informatics in Australian standard classifications for research, occupation and education

Work on building a strong research base, a skilled workforce and an accredited learning and development system in Australian Health Informatics is not mature. This paper aims to explore how such work is supported at a fundamental level, that is, within formal systems for identifying fields of research, occupation and education in Australia. The researchers examined the treatment of Health Informatics and related terms in a range of relevant Australian standards. We found that Health Informatics has somewhat inappropriate recognition in the formal systems defining research in Australia, a tenuous presence in those describing education, and none in those describing occupations. We argue that our findings provide the evidence base for decisive action to benefit not only individuals but also the wider Australian community.

Urban economies and occupation space: can they get "there" from "here"?

Much of the socioeconomic life in the United States occurs in its urban areas. While an urban economy is defined to a large extent by its network of occupational specializations, an examination of this important network is absent from the considerable body of work on the determinants of urban economic performance. Here we develop a structure-based analysis addressing how the network of interdependencies among occupational specializations affects the ease with which urban economies can transform themselves. While most occupational specializations exhibit positive relationships between one another, many exhibit negative ones, and the balance between the two partially explains the productivity of an urban economy. The current set of occupational specializations of an urban economy and its location in the occupation space constrain its future development paths. Important tradeoffs exist between different alternatives for altering an occupational specialization pattern, both at a single occupation and an entire occupational portfolio levels.

Cyclical absenteeism among private sector, public sector and self-employed workers

This research note analyzes differences in the number of absent working days and doctor visits and in their cyclicality between private sector, public sector and self-employed workers. For this purpose, I used large-scale German survey data for the years 1995 to 2007 to estimate random effects negative binomial (count data) models. The main findings are as follows. (i) Public sector workers have on average more absent working days than private sector and self-employed workers. Self-employed workers have fewer absent working days and doctor visits than dependent employed workers. (ii) The regional unemployment rate is on average negatively correlated with the number of absent working days among private and public sector workers as well as among self-employed men. The correlations between regional unemployment rate and doctor visits are only significantly negative among private sector workers.

Health care reform the hourly challenge

For those industries most likely to be transformed by the Patient Protection and Affordable Care Act (ACA), enacting the right strategy is the only strategy. A critical issue will be balancing cost and compliance factors with productivity concerns brought on by changes in the full- and part-time or hourly status of a given workforce. This article discusses industry perspectives in light of the ACA's 2014 implementation date, options for changing staffing models, and how the success of such changes depends on segmenting business units and locations while developing strategies for the different groups. Thus, the mix of full- and part-time employees becomes a more complicated strategy, but an achievable one.

Which aspects of health differ between working and nonworking women with fibromyalgia? A cross-sectional study of work status and health

BACKGROUND

Women with fibromyalgia (FM) describe great difficulties in managing work. Reported work ability in women with FM varies from 34 to 77 percent in studies from different countries. Many factors are suggested to affect the ability to work in women with FM, including pain, fatigue, impaired physical capacity and activity limitations. However, it is difficult to define to which extent symptom severity can be compatible with work. The aim of this study was to investigate which aspects of health differ between working women with FM and nonworking women with FM.

METHODS

A cross-sectional study of 129 women of working age with FM which included clinical assessment, structured interviews, questionnaires and performance-based tests. The women were categorized as working or nonworking. Aspects of health are presented according to the International Classification of Functioning, Disability and Health (ICF).

RESULTS

Working women with FM presented better health than nonworking women with FM in ratings of body function (FIQ pain p < 0.001, FIQ fatigue p = 0.006, FIQ stiffness p = 0.009, HADS-Depression p = 0.007). Ratings of overall health status were also significantly better in working women with FM than in nonworking women with FM (FIQ total, eight-item p = 0.001 and SF-36 PCS p < 0.001). No significant differences were found between working- and nonworking women in tests of physical capacity. FIQ pain was an independent explanatory factor for work in stepwise multiple logistic regression analysis (OR 0.95, CI 0.93- 0.98), p < 0.001.

CONCLUSION

Working women with FM reported better health than nonworking women with FM in terms of pain, fatigue, stiffness, depression, disease specific health status and physical aspects of quality of life, which represent body functions and overall health status. However, they were equally impaired in tests of physical capacity. Moderate pain levels were compatible with work, while severe pain appeared to compromise work. Fatigue was better tolerated, as women scoring severe levels of fatigue worked.

Self-reported hearing difficulties, main income sources, and socio-economic status; a cross-sectional population-based study in Sweden

BACKGROUND

Hearing difficulties constitute the most common cause of disability globally. Yet, studies on people with hearing difficulties regarding socio-economic status (SES), work, long-term unemployment, sickness absence, and disability pension are scarce. The aim of the present study was to investigate the main income sources of men and women of working ages with and without self-reported hearing difficulties and associations with gender, age, SES, type of living area, and country of birth.

METHODS

A cross-sectional population-based study, using information on self-reported hearing difficulties and SES of 19 045 subjects aged 20-64 years participating in Statistics Sweden's annual Living Conditions Surveys in any of the years 2004 through 2008. The information was linked to a nationwide database containing data on demographics and income sources. Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated, using binary logistic regression analysis.

RESULTS

Hearing difficulties increased with age and were more common in men (age-adjusted OR: 1.42 (95% CI: 1.30-1.56)) with an overall prevalence of 13.1% in men and 9.8% in women. Using working men as reference, the OR of having hearing difficulties was 1.23 (0.94-1.60) in men with unemployment benefits and 1.36 (1.13-1.65) in men with sickness benefits or disability pension, when adjusting for age and SES. The corresponding figures in women were 1.59 (1.17-2.16) and 1.73 (1.46-2.06). The OR of having sickness benefits or disability pension in subjects with hearing difficulties was 1.36 (1.12-1.64) in men and 1.70 (1.43-2.01) in women, when adjusting for age and SES and using men and women with no hearing difficulties as reference.

CONCLUSIONS

Hearing difficulties were more prevalent in men. After adjustment with age and SES as well as with type of living area and country of birth, a significant association with unemployment benefits was found only in women, and the associations with long-term sickness absence and disability pension tended to be stronger in women.

Sources of health insurance and characteristics of the uninsured: analysis of the March 2012 Current Population Survey

HEALTH COVERAGE RATE INCREASED, UNINSURED DOWN: The percentage of the nonelderly population (under age 65) with health insurance coverage increased to 82 percent in 2011, notable since increases in health insurance coverage have been recorded in only five years since 1994. EMPLOYMENT-BASED COVERAGE REMAINS DOMINANT SOURCE OF HEALTH COVERAGE, BUT CONTINUES TO ERODE: Employment-based health benefits remain the most common form of health coverage in the United States, though it represents a declining share. In 2011, 58.4 percent of the nonelderly population had employment-based health benefits, down from the peak of 69.3 percent in 2000, during the 1994-2011 period. PUBLIC PROGRAM COVERAGE IS EXPANDING: Public program health coverage expanded as a percentage of the population in 2011, accounting for 22.5 percent of the nonelderly population. Enrollment in Medicaid and the State Children's Health Insurance Program (S-CHIP) also increased to a combined 46.9 million in 2011, covering 17.6 percent of the nonelderly population, significantly above the 10.2 percent level of 1999. INDIVIDUAL COVERAGE STABLE: The percentage represented by individually purchased health coverage was unchanged in 2011 and has basically hovered in the 6-7 percent range since 1994. WHAT TO EXPECT IN 2012: The unemployment rate in 2012 has been about 8 percent since the beginning of the year, and remains high amidst a still-sluggish economy. As a result, the nation is likely to see a corresponding erosion of employment-based health benefits when the data for 2012 are released next year. Until the economy gains enough strength to have a substantial impact on the labor market, a rebound in employment-based coverage is unlikely.

Health, employment, and economic change, 1973-2009: repeated cross sectional study

OBJECTIVE

To see whether adverse relations between social class, health, and economic activity, observed between 1973 and 1993 and previously identified in a 1996 BMJ paper, were still apparent between 1994 and 2009 despite improvements in the general economic climate and overall population health.

DESIGN

Replication of repeated cross sectional analysis from the original paper, using the same source (the General Household Survey) and occupation coding scheme, but extended from the period 1973-93 to 1973-2009, and including women as well as men.

SUBJECTS

Men and women aged 20-59 years in each annual survey between 1973 and 2009.

MAIN OUTCOME MEASURES

Change over time in class specific rates of employment, unemployment, and economic inactivity within subgroups of respondents.

RESULTS

Overall employment rates have decreased for men of working age while increasing for working age women. For men in particular, the gradient of these changes seems to depend on occupational group. Over 37 years, the differences in occupational group specific economic inactivity and employment rates between people reporting and those not reporting a limiting long term illness has increased substantially.

CONCLUSION

Between 1973 and 2009, the relation between good health and securing and sustaining employment has strengthened for both men and women. For men, this has been due to employment rates decreasing and economic inactivity rates increasing among men with poor health. For women, this has largely been due to a general trend of increased employment and reduced economic inactivity occurring among healthier women but not in women of poorer health. Some evidence suggests that, since 2005, the relation between health, employment, and economic inactivity for women in the top two occupational groups has become more like that for men, with poor health becoming associated with reducing employment rates.

Gender analysis of musculoskeletal disorders and emotional exhaustion: interactive effects from physical and psychosocial work exposures and engagement in domestic work

The objective of this study was to assess the relationships between physical and psychosocial work exposures, engagement in domestic work and work-home imbalance in relation to symptoms of musculoskeletal disorders and emotional exhaustion in white- and blue-collar men and women. Three thousand employees from 21 companies were asked to answer a questionnaire on family structure, household and child care tasks, work exposure, work-home imbalance and symptoms of neck/shoulder disorders, low back disorders and emotional exhaustion. Women reported more musculoskeletal disorders and engagement in domestic work. Adverse at-work exposures were highest in blue-collar women. High engagement in domestic work was not separately associated with symptoms but paid work exposure factors were associated. High engagement in domestic work interacted with adverse work exposure and increased risk estimates for low back disorders and emotional exhaustion. Reported work-home imbalance was associated with neck/shoulder disorders in women and with emotional exhaustion in both women and men.

PRACTITIONER SUMMARY

The current article adds to earlier research by showing that high engagement in domestic work is not separately associated with increased symptoms, but interacts with psychosocial work exposure variables to produce emotional exhaustion in both women and men and low back disorders in women.

Inter-rater reliability of assessed prenatal maternal occupational exposures to solvents, polycyclic aromatic hydrocarbons, and heavy metals

Because direct measurements of past occupational exposures are rarely available in population-based case-control studies, exposure assessment of job histories by multiple expert raters is frequently used; however, the subjective nature of this method makes measuring reliability an important quality control step. We evaluated inter-rater reliability of 7729 retrospective jobs reported in the National Birth Defects Prevention Study. Jobs were classified as exposed, unexposed, or exposure unknown by two independent industrial hygienists; exposed jobs were further evaluated for intensity, frequency, and routes. Exposure prevalence ranged from 0.1-9.8%. Inter-rater reliability for exposure (yes/no), assessed by kappa coefficients, was fair to good for cadmium (κ = 0.46), chlorinated solvents (κ = 0.59), cobalt (κ = 0.54), glycol ethers (κ = 0.50), nickel compounds (κ = 0.65), oil mists (κ = 0.63), and Stoddard Solvent (κ = 0.55); PAHs (κ = 0.24) and elemental nickel (κ = 0.37) had poor agreement. After a consensus conference resolved disagreements, an additional 4962 jobs were evaluated. Inter-rater reliability improved or stayed the same for cadmium (κ = 0.51), chlorinated solvents (κ = 0.81), oil mists (κ = 0.63), PAHs (κ = 0.52), and Stoddard solvent (κ = 0.92) in the second job set. Inter-rater reliability varied by exposure agent and prevalence, demonstrating the importance of measuring reliability in studies using a multiple expert rater method of exposure assessment.

Employment-based retirement plan participation: geographic differences and trends, 2010

LATEST DATA: This Issue Brief examines the level of participation by workers in public- and private-sector employment-based pension or retirement plans, based on the U.S. Census Bureau's March 2011 Current Population Survey (CPS), the most recent data currently available (for year-end 2010). SPONSORSHIP RATE: Among all working-age (21-64) wage and salary employees, 54.2 percent worked for an employer or union that sponsored a retirement plan in 2010. Among full-time, full-year wage and salary workers ages 21-64 (those with the strongest connection to the work force), 61.6 percent worked for an employer or union that sponsors a plan. PARTICIPATION LEVEL: Among full-time, full-year wage and salary workers ages 21-64, 54.5 percent participated in a retirement plan. TREND: This is virtually unchanged from 54.4 percent in 2009. Participation trends increased significantly in the late 1990s, and decreased in 2001 and 2002. In 2003 and 2004, the participation trend flattened out. The retirement plan participation level subsequently declined in 2005 and 2006, before a significant increase in 2007. Slight declines occurred in 2008 and 2009, followed by a flattening out of the trend in 2010. AGE: Participation increased with age (61.4 percent for wage and salary workers ages 55-64, compared with 29.2 percent for those ages 21-24). GENDER: Among wage and salary workers ages 21-64, men had a higher participation level than women, but among full-time, full-year workers, women had a higher percentage participating than men (55.5 percent for women, compared with 53.8 percent for men). Female workers' lower probability of participation among wage and salary workers results from their overall lower earnings and lower rates of full-time work in comparison with males. RACE: Hispanic wage and salary workers were significantly less likely than both white and black workers to participate in a retirement plan. The gap between the percentages of black and white plan participants that exists overall narrows when compared across earnings levels. GEOGRAPHIC DIFFERENCES: Wage and salary workers in the South and West had the lowest participation levels (Florida had the lowest percentage, at 43.7 percent) while the upper Midwest, Mid-Atlantic, and Northeast had the highest levels (West Virginia had the highest participation level, at 64.2 percent).

OTHER FACTORS

White, more highly educated, higher-income, and married workers are more likely to participate than their counterparts.

Socioeconomic differences in cardiometabolic factors: social causation or health-related selection? Evidence from the Whitehall II Cohort Study, 1991-2004

In this study, the health-related selection hypothesis (that health predicts social mobility) and the social causation hypothesis (that socioeconomic status influences health) were tested in relation to cardiometabolic factors. The authors screened 8,312 United Kingdom men and women 3 times over 10 years between 1991 and 2004 for waist circumference, body mass index, systolic and diastolic blood pressure, fasting glucose, fasting insulin, serum lipids, C-reactive protein, and interleukin-6; identified participants with the metabolic syndrome; and measured childhood health retrospectively. Health-related selection was examined in 2 ways: 1) childhood health problems as predictors of adult occupational position and 2) adult cardiometabolic factors as predictors of subsequent promotion at work. Social causation was assessed using adult occupational position as a predictor of subsequent change in cardiometabolic factors. Hospitalization during childhood and lower birth weight were associated with lower occupational position (both P’s ≤ 0.002). Cardiometabolic factors in adulthood did not consistently predict promotion. In contrast, lower adult occupational position predicted adverse changes in several cardiometabolic factors (waist circumference, body mass index, fasting glucose, and fasting insulin) and an increased risk of new-onset metabolic syndrome (all P’s ≤ 0.008). These findings suggest that health-related selection operates at younger ages and that social causation contributes to socioeconomic differences in cardiometabolic health in midlife.

Resuming work after cancer: a prospective study of occupational register data

INTRODUCTION

Long-term employment rates have been studied in cancer survivors, but little is known about the return to work of cancer patients. This study investigated return to work (RTW) within 2 years after the diagnosis of different types of cancer.

METHODS

This prospective study investigated the associations of demographics (age, gender, socioeconomic status, and residential region) and occupational factors (occupation, duration of employment, and company size) of employees absent from work due to cancer with the time to partial RTW, defined as working at least 50% of the earnings before sickness absence. Likewise, the associations of demographics and occupational factors with full RTW at equal earnings as before sickness absence were investigated.

RESULTS

The cohort included 5,234 employees who had been absent from work due to cancer between January 2004 and December 2006. The time to partial RTW was shortest among employees with skin cancer (median 55 days) and longest among employees with lung cancer (median 377 days). There were no significant associations between RTW and demographics. With regard to the occupational factors, employees in high occupational classes started working earlier than those in low occupational classes, but the time to full RTW did not differ significantly across occupational classes. Employees working in large companies returned to work earlier than those working in small companies.

CONCLUSION

RTW after different types of cancer depended on occupational factors rather than demographics.

Sources of health insurance and characteristics of the uninsured: analysis of the March 2011 current population survey

LATEST CENSUS DATA: This Issue Brief provides historical data through 2010 on the number and percentage of nonelderly individuals with and without health insurance. Based on EBRI estimates from the U.S. Census Bureau's March 2011 Current Population Survey (CPS), it reflects 2010 data. It also discusses trends in coverage for the 1994-2010 period and highlights characteristics that typically indicate whether an individual is insured. HEALTH COVERAGE RATE CONTINUES TO DECREASE, UNINSURED INCREASE: The percentage of the nonelderly population (under age 65) with health insurance coverage decreased to 81.5 percent in 2010. Increases in health insurance coverage have been recorded in only three years since 1994, when 36.5 million nonelderly individuals were uninsured. The percentage of nonelderly individuals without health insurance coverage was 18.5 percent in 2010, up from 18.3 percent in 2009, and its highest level during the 1994-2010 period. EMPLOYMENT-BASED COVERAGE REMAINS DOMINANT SOURCE OF HEALTH COVERAGE, BUT CONTINUES TO ERODE: Employment-based health benefits remain the most common form of health coverage in the United States. In 2010, 58.7 percent of the nonelderly population had employment-based health benefits, down from 69.3 percent in 2000. SHIFTING COMPOSITION OF EMPLOYMENT-BASED COVERAGE: Between 2007 and 2010, the percentage of individuals under age 65 with employment-based coverage in their own name has dropped. In 2007, 54.2 percent had coverage in their own name. By 2010, it was down to 51.5 percent. Dependent coverage during this time period fell slightly from 17.5 percent to 17.1 percent, and increased slightly from 16.8 percent to 17.1 percent between 2009 and 2010. PUBLIC PROGRAM COVERAGE IS GROWING: Public program health coverage expanded as a percentage of the population in 2010, accounting for 21.6 percent of the nonelderly population. Enrollment in Medicaid and the State Children's Health Insurance Program increased, reaching a combined 45 million in 2010, and covering 16.9 percent of the nonelderly population, significantly above the 10.2 percent level of 1999. INDIVIDUAL COVERAGE STABLE: Individually purchased health coverage was unchanged in 2010 and has basically hovered in the 6-7 percent range since 1994. WHAT TO EXPECT IN 2011: 2010 is the most recent year for data on sources of health coverage. Unemployment in 2011 has been about 9 percent since the beginning of the year. While down from the 2010 average of 9.6 percent, it remains high and there is a continued threat of a double-dip recession increasing it even further. As a result, the nation is likely to see continued erosion of employment-based health benefits when the data for 2011 are released in 2012. Fewer working individuals translates into fewer individuals with access to health benefits in the work place, especially after COBRA subsidies have been exhausted.

An updated historical cohort mortality study of workers exposed to asbestos in a refitting shipyard, 1947-2007

PURPOSE

To evaluate the long-term health effects of occupational asbestos exposure, an updated historical cohort mortality study of workers at a refitting shipyard was undertaken.

METHODS

The cohort consisted of 249 male ship repair workers (90 laggers, 159 boiler repairers). To determine relative excess mortality, standardized mortality ratios (SMRs) were calculated using mortality rates among the Japanese male population. Mortality follow-up of study subjects was performed for the period from 1947 till the end of 2007.

RESULTS

We identified the vital status of 87 (96.7%) laggers and 150 (94.3%) boiler repairers. Of these, 63 (72.4%) and 95 (63.3%), respectively, died. Laggers, who had handled asbestos materials directly, showed a significantly elevated SMR of 2.64 (95% confidence interval [CI]: 1.06-5.44) for lung cancer and 2.49 (95% CI: 1.36-4.18) for nonmalignant respiratory diseases. Boiler repairers, who had many opportunities for secondary exposure to asbestos and a few for direct exposure, showed no significant elevation in SMR for lung cancer but a significantly elevated SMR of 1.78 (95% CI: 1.06-2.81) for nonmalignant respiratory diseases. In an analysis according to duration of employment, there was a significantly elevated SMR of nonmalignant respiratory diseases in the longer working years group. Among workers from both jobs, no deaths caused by mesothelioma in addition to those in the original study were found and no subject died from larynx cancer.

CONCLUSION

This updated study confirmed a significant excess of asbestos-related mortality from diseases such as lung cancer and nonmalignant respiratory diseases among workers in a refitting shipyard in Japan.

Disability pension by occupational class--the impact of work-related factors: the Hordaland Health Study Cohort

BACKGROUND

The social gradient in disability pension is well recognized, however mechanisms accounting for the gradient are largely unknown. The aim of this study was to examine the association between occupational class and subsequent disability pension among middle-aged men and women, and to what extent work-related factors accounted for the association.

METHODS

A subsample (N = 7031) of the population-based Hordaland Health Study (HUSK) conducted in 1997-99, provided self-reported information on health and work-related factors, and were grouped in four strata by Erikson, Goldthorpe and Portocareros occupational class scheme. The authors obtained follow-up data on disability pension by linking the health survey to national registries of benefit (FD-trygd). They employed Cox regression analysis and adjusted for gender, health (medical conditions, mental health, self-perceived health, somatic symptoms) and work-related factors (working hours, years in current occupation, physical demands, job demands, job control).

RESULTS

A strong gradient in disability pension by occupational class was found. In the fully adjusted model the risk (hazard ratio) ranged from 1.41 (95% CI 0.84 to 2.33) in the routine non-manual class, 1.87 (95% CI 1.07 to 3.27) in the skilled manual class and 2.12 (95% CI 1.14 to 3.95) in the unskilled manual class, employing the administrator and professional class as reference. In the gender and health-adjusted model work-related factors mediated the impact of occupational class on subsequent disability pension with 5% in the routine non-manual class, 26% in the skilled manual class and 24% in the unskilled manual class. The impact of job control and physical demands was modest, and mainly seen among skilled and unskilled manual workers.

CONCLUSIONS

Workers in the skilled and unskilled manual classes had a substantial unexplained risk of disability pension. Work-related factors only had a moderate impact on the disability risk. Literature indicates an accumulation of hazards in the manual classes. This should be taken into account when interpreting the gradient in disability pension.

Is there a relationship between periodontal disease and smoking after adjusting for job classification in Japanese employed males?

OBJECTIVES

The objective of this study is to examine whether the well-known association between periodontal disease and smoking persists after adjusting for job classification.

METHODS

A sample of 16,110 employed Japanese males aged 20-69 years was included in the study. Periodontal examinations were conducted using the Community Periodontal Index. The association between periodontal disease and smoking status was examined using logistic regression adjusting for age, diabetes and job classification. Job classification was based on criteria of the Japanese Ministry of Health, Labour and Welfare. There are nine major job groups: (1) Professional (professionals, specialists), (2) Managers, (3) Office workers (computer operators, clerks, secretaries), (4) Skilled worker (factory workers, construction workers), (5) Salesperson (shop assistants), (6) Service occupations (superintendents, cleaners or car park attendants), (7) Security (guards), (8) Farmers and fishermen, (9) Transport and telecommunication workers (truck drivers).

RESULTS

Current and former smokers were more likely to have periodontal disease than non-smokers. Adjusting for job classification attenuated the association between smoking and periodontal disease but did not eliminate the association. The odds ratios for the association between smoking and Community Periodontal Index score 3 or 4 attenuated from 2.25 to 2.04 and from 2.62 to 2.52 for individuals aged 20 to 39 and 40 to 69 years, respectively. The effect of job classification on the association between periodontal disease and smoking was higher among younger participants aged 20 to 39 years.

CONCLUSIONS

Smoking persisted as an important determinant of periodontal disease after adjusting for job classification in Japanese employed males.

Should I stay or should I go? Motivational profiles of Danish seafaring officers and non-officers

BACKGROUND

Other studies have shed light on specific types of seafarers' job stressors and job satisfaction. However, so far there have not been any systematic attempts to capture the motivational profile of seafarers when it comes to both work demands and work resources. The purpose of this study is to explore the motivational profiles of seafarers in the Danish merchant fleet by identifying factors which motivate or demotivate seafarers to stay in their specific profession. Furthermore, we examine if there is a difference in work motivators and demotivators between Danish seafaring officers and non-officers. Material and methods. A questionnaire was sent out to 560 Danish-speaking seafarers with a Danish postal address; 346 seafarers returned the questionnaire, equalling a 61% response rate.

RESULTS

The work motivators which were identified were: duration of home leave, level of responsibility, and level of challenge. The main demotivating factors that were identified were: being away from home, shipping company´s HRM, and regulatory requirements.

CONCLUSIONS

The results contribute to a deeper understanding of how seafarers perceive their occupation, and help to identify areas and aspects which might need change if employers want to retain their workforce in the long run. Overall, the results show that most of the job demands and job resources that seafarers perceive are psychosocial. When it comes to the best aspects of seafaring, over 70% of the answers were related to psychosocial factors rather than organizational or structural factors. In relation to the perceived worst aspects in seafaring, about 85% of the responses fell into psychosocial categories. The differences in the motivational profiles of officers and non-officers showed the importance of not only looking at the seafaring profession as a whole but also considering the different characteristics of various jobs onboard.

The negative health consequences of unemployment: the case of Poland

In the 1990s Poland began to make a transition to a free-market economy: a transition accompanied by a variety of negative socio-economic developments, most notably a rise in unemployment. The aim of this study is to shed light on the relationship between occupational status (including unemployment) and the risk of cardiovascular disease (CVD), by examining the experience of 542 men and 572 women between the ages of 40 and 50 of the town of Wroclaw in 2006. The Framingham Risk Score (FRS), which uses certain health and life-style parameters to predict the risk of major coronary problems over a 10-year period, was calculated, and the effect of occupational status on the FRS was assessed. The results showed that the FRS varied according to sex and to occupational status, with the highest FRS rating among unemployed men. Thus governmental policies to counter the adverse effects of unemployment should be developed to remedy the problem.