Work and health in a contemporary society: demands, control, and insecurity

OBJECTIVE: To examine independent associations of job strain (high demands and low control) and job insecurity with mental and physical health outcomes. DESIGN: Cross sectional general population study conducted in 2000 using a self completed questionnaire. SETTING: Two adjoining cities in south east Australia. SUBJECTS: 1188 employed professionals, aged 40-44 years, 55% (n = 655) male. MAIN OUTCOME MEASURES: Depression, anxiety, physical, and self rated health (SRH). RESULTS: Adverse job conditions were relatively prevalent as 23% of the sample reported high job strain, while 7.3% and 23% reported high and moderate job insecurity respectively. Associations between job conditions and health persisted after adjustment for gender, education, marital status, employment status, major life events, and negative affectivity (personality). When adjusted for job strain, high job insecurity was independently associated with a greater than threefold increase in odds for poor SRH, depression and anxiety (OR (95% confidence intervals) poor SRH: 3.72 (1.97 to 7.04) depression: 3.49 (1.90 to 6.41), anxiety: 3.29 (1.71 to 6.33)), and a twofold increase for physical health 2.19 (1.21 to 3.95). High job strain also showed significant independent associations with depression: 2.54 (1.34 to.4.75) and anxiety: 3.15 (1.48 to 6.70). CONCLUSION: In this relatively privileged socioeconomic group, insecure employment and high job strain showed independent, consistent, and strong associations with physical and mental health. These adverse job conditions are on the increase, particularly insecure employment, and the influence of these two work conditions are an important focus for future public health research and their prevalence and impact should be examined in other occupations.     

Association of obesity with anxiety, depression and emotional well-being: a community survey

OBJECTIVE: To investigate the association of obesity with anxiety, depression and emotional well-being (positive and negative affect) in three age groups. METHODS: A cross-sectional survey was carried out in Canberra and the neighbouring town of Queanbeyan, Australia, with a random sample from the electoral roll of 2,280 persons aged 20-24, 2,334 aged 40-44, and 2,305 aged 60-64. RESULTS: Self-reported height and weight were used to classify participants as underweight (body mass index of less than 18.5), acceptable weight (18.5 to less than 25), overweight (25 to less than 30) or obese (30 and over). Obesity in women was associated with more anxiety and depression symptoms and less positive affect, but there were only weak and inconsistent associations in men. When factors that might mediate any association were controlled (physical ill health, lack of physical activity, poorer social support, less education and financial problems), a different picture emerged, with the underweight women having more depression and negative affect and the obese and overweight women tending to have better mental health than the acceptable weight group. Controlling for physical ill health alone accounted for the association of obesity with anxiety and depression in women. CONCLUSIONS: Obesity has an association with anxiety, depression and lower well-being in women, but not in men. The results are consistent with physical ill health playing a mediating role. IMPLICATION: Reducing obesity in the population is unlikely to have any direct effect on mental health or emotional well-being.     

Zur Organisationsdiagnose psychischen Befindens in der Arbeitswelt

Along with the structural changes of the economy, the psychological well-being of employees becomes increasingly important for their performance. The reporting of mental well-being at the organizational level is an essential precondition for occupational health interventions. This article deals with the mental health of employees from ten different companies. These data show that almost 1?in 5?employees rate their mental well-being as poor. Most notably, women with lower status in the services sector are affected. Those who are temporarily in a bad mood are often affected by strong physical complaints and tend to assess the quality of their work as rather poor. Moreover, the data from 3,349 employees show that the extent of social capital of an organization highly correlates with the mental well-being of their employees. Our results show that work-related stress factors and (psychological) illnesses can be detected and prevented more often if the influence of social parameters on mental well-being are taken into consideration.     

Relationship between psychosocial job satisfaction and health in white collar workers

OBJECTIVE: To identify whether psychosocial satisfaction at work is associated with workers' health and to verify if sociodemographic characteristics have an impact on these associations. METHODS: A cross-sectional study was carried out in 224 employees of a private managed care and retirement savings company in S?o Paulo, Brazil. Four self-administered questionnaires on sociodemographic features, job satisfaction, and health (physical, mental, and work ability) were applied. Variables associations were analyzed using t-Student, Mann-Whitney and Kruskal-Wallis tests, Spearman correlation coefficient, and multiple linear regression analysis. RESULTS: Job satisfaction was associated with duration in the company (p <0.001) and job position (p=0.003), where greater satisfaction was observed among workers with shorter duration in the company and those in managing positions. Job satisfaction was associated with mental health and work ability (vitality: p<0.001; social aspects: p=0.055; emotional aspect: p=0.074; mental health: p<0.001; and work capacity: p=0.001). CONCLUSIONS: Job satisfaction is associated with workers' health regarding their "mental health" and "work ability", showing the importance of psychosocial factors for their health and well-being. Changes are suggested in work conception and organization to focus psychosocial factors. Longitudinal studies are recommended to investigate the causal direction of these associations.     

Work related well-being is associated with individual subjective well-being

This study utilizes Gallup-ShareCare Well-being Index data to investigate the association between work-related well-being, i.e., job satisfaction, and overall subjective well-being among US workers. Subjective well-being is measured by i) daily positive and negative emotional experiences - happiness, smiles, enjoyment, sadness, anger, worry, and stress (hedonic well-being); and ii) current and future life evaluation (evaluative well-being). The study finds significant positive relationships between job satisfaction and subjective well-being both in terms of higher odds of positive hedonic experiences and increased life evaluation scores after controlling for covariates and other nonwork-related contributors to well-being. Job satisfaction accounted for a 14% increase in current and an 8% increase in future life evaluation scores. The results emphasize that not only the income generated by work but the quality of work is also important for worker well-being. In fact, those without a job had higher well-being than those workers who are dissatisfied at work. This is probably the first study that relates work-related well-being to overall well-being, using a nationally representative sample of US workers. Further, this is one of the few instances where the subjective measure of well-being is used in the occupational safety and health literature.     

Characterizing self-rated health during a period of changing health status

Self-rated health (SRH) is among the most frequently assessed health perceptions. The purpose of this study was to assess the tenability of the recently proposed distinctions of SRH, as a spontaneous assessment of overall health, or as an enduring self-concept. Individuals (n = 449) undergoing total joint replacement for hip or knee osteoarthritis in Toronto, Canada were followed over 6 months of recovery. Health questionnaires, completed pre-surgery, and at 3 and 6 months post-surgery, included measures of pain, physical function, sports/recreation, fatigue, anxiety, depression, social participation, passive/active recreation, and community access. Structural equation modeling was used for the analyses. SRH was found to be responsive to current and changing mental well-being throughout the six months of recovery. Current SRH strongly predicted future SRH. In this clinical sample undergoing significant changes in health status, SRH displayed both enduring and spontaneous features; evidence is provided that both operate simultaneously. SRH may prove to be a simple yet critical health measure for identifying individuals who would benefit most from targeted interventions for improving overall health.     

Work-family spillover and health during midlife: is managing conflict everything?

PURPOSE: To examine the association between multiple dimensions of work-family spillover, and physical and mental health among working midlife adults. DESIGN: Cross-sectional analyses of self-reported data. SETTING: The National Survey of Midlife Development in the United States (MIDUS), 1995. SUBJECTS: Employed adults aged 35-65 years (n = 1547) who participated in the telephone interview and returned the mail-back questionnaires of the MIDUS (overall response rate of 60.8%). MEASURES: Independent variables included negative spillover from work to family, positive spillover from work to family, negative spillover from family to work, positive spillover from family to work. Self-rated physical health, chronic conditions, obesity, self-rated mental health, negative psychological well-being, and positive psychological well-being were outcomes. RESULTS: Independent of negative spillover between work and family, more positive spillover from work to family was associated with better physical health (odds ratio [OR] = 1.17, p < or = .05) and mental health (OR = 1.28, p < or = .01). More positive spillover from family to work was associated with less chronic conditions (OR = .85, p < or = .05), less negative well-being (OR = .67, p < or = .001), as well as better mental health (OR = 1.45, p < or = .01) and more positive well-being (OR 1.76, p < or = 001). CONCLUSIONS: Health promotion or employment programs and policies may need to focus on minimizing negative spillover between work and family and promoting positive spillover between work and family.     

Association of perceived family criticism with health behaviors

BACKGROUND: Criticism from family members has been implicated in psychiatric illnesses such as schizophrenia, depression, and eating disorders. Perceived family criticism has also been linked to primary health care use. In our study, we examined the association between perceived family criticism and health behaviors, as well as the potential mediating role of negative affect. METHODS: A questionnaire was mailed to patients receiving care at a family medicine center. Perceived family criticism was measured using the Family Emotional Involvement and Perceived Criticism Scale. Diet, regular exercise, smoking status, and levels of depression, hostility, and physical health were also assessed through self report. RESULTS: Nine hundred twenty-two (62%) active family medicine patients responded to our questionnaire. Complete data were available for 875 patients. In univariate analysis, a high level of perceived family criticism was associated with various demographic characteristics, poorer physical health, negative affect, higher fat intake, lack of exercise, and smoking. In multivariate analysis, the association between a high level of perceived criticism and health behavior was independent of demographic characteristics and physical health, for example, high-fat diet (odds ratio [OR] = 1.47; 95% confidence interval [CI], 1.11 - 1.95), no regular exercise (OR = 1.37; 95% CI, 1.02 - 1.84) and current smoking (OR = 1.38; 95% CI, 1.00 - 1.90). None of these associations was statistically significant after controlling for depression and hostility. CONCLUSIONS: A high level of perceived family criticism is associated with adverse health behaviors. This association appears to be explained by resultant depression and hostility.     

Perceived neighborhood social cohesion and subsequent health and well-being in older adults: An outcome-wide longitudinal approach

BackgroundGrowing research documents associations between neighborhood social cohesion with better health and well-being. However, other work has identified social cohesion's “dark side” and its ability to promote negative outcomes. It remains unclear if such diverging findings are attributable to differences in study design, or other reasons. To better capture its potential heterogeneous effects, we took an outcome-wide analytic approach to examine perceived neighborhood social cohesion in relation to a range of health and well-being outcomes.MethodsData were from 12,998 participants in the Health and Retirement Study—a large, diverse, prospective, and nationally representative cohort of U.S. adults age >50. Multiple regression models evaluated if social cohesion was associated with physical health, health behavior, psychological well-being, psychological distress, and social well-being outcomes. All models adjusted for sociodemographics, personality, and numerous baseline health and well-being characteristics. To evaluate the effects of change in cohesion, we adjusted for prior social cohesion. Bonferroni correction was used to account for multiple testing.ResultsPerceived neighborhood social cohesion was not associated with most physical health outcomes (except for reduced risk of physical functioning limitations and better self-rated health) nor health behavior outcomes (except for more binge drinking). However, it was associated with numerous subsequent psychosocial well-being (i.e., higher: positive affect, life satisfaction, optimism, purpose in life, mastery, health mastery, financial mastery; reduced likelihood of infrequent contact with friends) and psychological distress outcomes (i.e., lower depression, hopelessness, negative affect, loneliness) over the 4-year follow-up period.ConclusionsWith further research, these results suggest that perceived neighborhood social cohesion might be a valuable target for innovative policies aimed at improving well-being.     

Work-related life events, psychological well-being and cardiovascular risk factors in male Swedish automotive workers

AIMS: To analyse the relationship between life events, social support, psychological well-being and cardiovascular risk factors in blue- and white-collar Swedish automotive workers. METHODS: Baseline questionnaire regarding life events, social support, depressed mood and mental strain and smoking habits. Follow-up questionnaire after 5 years included the Psychological General Well-being Inventory to assess various health variables. At baseline and follow-up, anthropometric data were obtained. Blood pressure, blood glucose and serum lipids were measured and smoking habits were surveyed. RESULTS: The blue-collar workers showed a profile indicating increased cardiovascular risk with a higher proportion of smokers, a higher waist to hip ratio and higher triglycerides. They also reported themselves to have worse general health and less emotional self-control, but were less anxious than the white-collar workers. Negative life events, especially those related to work seemed to affect the well-being of the blue-collar workers more adversely than the white-collar workers. Being nervous and depressed at baseline increased the risk of poor psychological well-being at the follow-up. Social support within this 5-year perspective was a factor which predicted psychological well-being in both worker categories. Increase in cholesterol/high-density lipoprotein-cholesterol (HDL-C) ratio was the only cardiovascular risk factor associated with the strain of life events but not with work-related events. CONCLUSION: Over a 5-year period, men who experienced negative, strongly stressful and work-related life events displayed poorer psychological well-being at follow-up regardless of worker category. Social support was protective.     

Gender differences in the effects from working conditions on mental health: a 4-year follow-up

OBJECTIVES: The overall aim was to examine how working conditions in 1993 influenced the occurrence of poor mental health in 1997 among women and men from the general population. Also, the relative importance of other living conditions in relation to poor mental health in 1997 was examined. METHODS: A sample from the general Swedish population (originally examined in 1969) was followed up in 1993 and 1997. Data from these follow-ups were analysed, and both bivariate and multivariate analyses of associations between occupational and non-occupational conditions in 1993 and poor mental health in 1997 -- defined as sub-clinical depression, reduced psychological well-being and high alcohol consumption -- were performed. RESULTS: Several occupational risk indicators were identified for poor mental health among women, especially sub-clinical depression and high alcohol consumption. Occupational factors such as shift work, job strain, no education at the employer's expense, low occupational pride, low stimulation at work and poor social support were related to poor mental health among women. For poor mental health among men, mainly sub-clinical depression, shift work and low occupational pride were identified as risk indicators. Non-occupational factors related to poor mental health among women were poor quality of social contacts, demanding life events, physical inactivity, high perceived physical load outside work and inadequate coping strategies. Among men, smoking and inadequate coping strategies were related to poor mental health. CONCLUSIONS: The difference between women and men, regarding the numbers of identified occupational and non-occupational risk indicators, may partly be explained by the gender-segregated labour market, and partly by other explanations. In our study, we have not succeeded in collecting the relevant information about occupational conditions that is important for men's mental health.     

Self-rated Health Among Vulnerable Older Adults in Rural Appalachia

CONTEXT: Self-rated health (SRH) predicts service use, morbidity, and mortality. Additionally, SRH has been associated with indices of psychological well-being. PURPOSE: The main focus of the study was to investigate important differences among the lower spectrum of SRH (ie, fair and poor) on indices of well-being. METHODS: In-person interviews collected data from 207 (M age = 75.8) older rural adults. Data were used to examine differences between those reporting poor, fair, and good or excellent SRH on measures of demographics, and physical and psychological health. RESULTS: Significant differences emerged between levels of SRH in relation to measures of physical and psychological health. Specifically, individuals with poor SRH were significantly more likely to have (1) illnesses, (2) problems with basic and cognitive tasks of daily living, and (3) depressed affect than individuals reporting good or excellent health. Individuals with poor SRH were significantly more likely to have problems with basic and cognitive tasks of daily living than individuals with fair SRH. No significant differences were found between people reporting fair and good or excellent SRH on illnesses and depressed affect. CONCLUSIONS: Results suggest that future research should investigate the expansion of the lower-end of the SRH measure to more accurately assess SRH among vulnerable, rural older adults. Such efforts would better inform health care providers, practitioners, and policy makers in rural areas as to how SRH affects the well-being of vulnerable older adults.     

Perceived occupational stress,affective, and physical well-being among telecommunication employees in Greece

The present study examined four potential roles of work-related negative affectivity on the associations between self-reported occupational stress and physical well-being among telecommunication employees in Greece. Participants (764, predominantly male) completed a battery of self-report measures on perceived occupational stress, negative affectivity, and illness symptoms. In line with previous research, negative affectivity exerted a nuisance effect, by inflating the association between reported stressors and illness symptoms, and significantly predicted illness symptoms, over and above the effects of stressors. In addition, negative affectivity influenced reported illness symptom indirectly, through the effects of stressors, and moderated the relationship between interpersonal conflict at work and illness symptoms. The findings suggest that negative affectivity can largely explain and influence in different ways the associations between self-reported stress and physical strain. It is recommended that future studies of occupational stress should control for the effects of negative affectivity, and that health professionals should be cautious of its effects when interpreting relationships between self-reported occupational stress and physical well-being.     

Working conditions and health behaviours among employed women and men: the Helsinki Health Study

BACKGROUND: Working conditions influence health, but previous studies on the associations between work-related factors and health behaviours are scarce. The aim of this study was to analyse whether unfavourable working conditions are associated with diet, physical activity, alcohol consumption, and smoking. METHODS: The data derive from postal questionnaires collected in 2000-2001 from 40- to 60-year-old employees of the City of Helsinki (n=6243, response rate: 68%). Logistic regression analysis was used to examine health behaviours as outcomes. Job demands and job control, physically and mentally strenuous work, work fatigue, working overtime and satisfaction with work-home interface were independent variables, adjusted for age, education, occupational social class and marital status. RESULTS: Most of the examined associations between working conditions and health behaviours were not statistically significant. Among women, mentally strenuous work and high job control were associated with a healthy diet. Work fatigue was associated with physical inactivity, whereas physically strenuous work and satisfaction with work-home interface were more often reported by physically active women. Work fatigue was associated with high drinking among men. Low job strain was reported by nonsmoking women, whereas working overtime was associated with nonsmoking among men. CONCLUSIONS: Working conditions were only weakly associated with health behaviours, and the associations varied for different health behaviours.     

The association of subjective social status and health in low-income Mexican-origin individuals in Texas

There is only limited research on subjective social status (SSS) and its effect on health in general and in minority US populations in particular. This study first investigates the determinants of SSS and the relationship between SSS and objective social status. It then explores the relationships of SSS to self-reported physical health, self-reported mental health, and self-rated health (SRH). The study population consists of Mexican-origin individuals living in low-income neighborhoods in Texas and grouped into acculturation categories based on nativity and use of the Spanish language. We also investigate the role of reference groups. Results indicate that there is no disjuncture between subjective and objective status in this population but that the less acculturated groups rank their social status based on different criteria than the more acculturated. People compare themselves mainly with those similar to them and average subjective status in the different acculturation groups accurately reflects the objective status of the group. Sociocultural factors, in particular perceived differences in opportunities, explain differences between subjective and objective status. Subjective status was associated with all health outcomes. When controlling for objective status, subjective status was associated with mental health and SRH but not with physical health. Objective status indicators were consistently associated with all health outcomes, indicating the prominence of objective socioeconomic status in affecting health in this low-income minority population. Sociocultural characteristics appear to mediate the effect of SSS on health. In particular, perceived victimization might mediate the effect of SSS on mental health.     

An inquiry into the causal relationship among leisure vacation, depression, and absence from work

Depression is one of the most prevalent psychological health problems in occupational settings. Through literature review and the experience of previous investigations, it is now presumed that depression could mediate the association between workload and absence from work. In order to examine the above relationship, a follow-up investigation was conducted using male white-collar employees. The authors have been examining the association between work-related factors and employee health for some years, and vacation has become recognized as one of the important candidates for alleviating psychological problems in the workplace. In July 1996, the chance of leisure vacations within the past year and the presence of depression were examined by a self-administrated questionnaire. The subjects were followed-up for the rest of the year and absence from work was monitored. By analyzing 357 eligible subjects aged 20-59 years, the causal association between leisure vacation, depression, and absence from work was examined. Through correlation and log-linear analysis, the following findings were explored: The decrease of leisure vacation chances was correlated with the presence of depression, and depression contributed to an increase in the absence from work after adjustment was made for possible confounding factors. Leisure vacation could be independent of other work-related factors such as working hours, and it seemed to be significant to investigate positive effects of leisure vacation on psychological well-being in the workplace.     

Explaining the gender difference in self-rated health among university students in Egypt

ABSTRACT

In this study the authors assessed gender differences in the relationships between self-rated health (SRH) and demographic factors, physical health, health service use, infections, a variety of symptoms and health conditions, and wider well-being features. A self-administered questionnaire was administered to 3,271 students at Assiut University, Egypt during 2009–2010. Multiple logistic regression was used (with excellent/very good SRH as dependent variable) to assess the variables that might explain the gender difference in SRH. Females had more symptoms, infectious diseases/illness periods, substantially lower quality of life, and more burdens, although their health awareness and satisfaction with social support were higher than males. The unadjusted odds ratio (OR) suggested that females were less likely than males to rate their SRH as excellent/very good [OR 0.56, 95% confidence interval (CI) 0.47–0.68]. Adjusting only for relevant physical health and health service use variables, the OR for excellent/very good SRH for females increased, but nevertheless still remained significantly lower than that of males. With further adjustment for physical health, health service use, and also for wider well-being variables, the gender difference in SRH became no longer statistically significant. Poorer physical health indicators and a lower level of wider well-being features explained the lower SRH among female Egyptian university students. Health promotion and prevention programs should consider these factors in attempting to address gender health disparities.     

The prevalence of common mental disorders among hospital physicians and their association with self-reported work ability: a cross-sectional study

ABSTRACT: BACKGROUND: We studied the prevalence of common mental disorders among Dutch hospital physicians and investigated whether the presence of a mental disorder was associated with insufficient self-reported work ability. METHODS: A questionnaire was sent to all (n=958) hospital physicians of one academic medical center, using validated scales to assess burnout, work-related fatigue, stress, posttraumatic stress disorder (PTSD), anxiety and depression. Furthermore, respondents were asked to rate their current work ability against the work ability in their own best period (adapted version of the first WAI item). The prevalence of each common mental disorder was calculated. In addition, odds ratios of reporting insufficient work ability for subjects with high complaint scores compared to patients with low complaint scores were calculated for each mental disorder. RESULTS: The response rate was 51%, and 423 questionnaires were eligible for analysis. The mental disorder prevalence rates were as follows: work-related fatigue 42%, depression 29%, anxiety 24%, posttraumatic stress complaints 15%, stress complaints 15% and burnout 6%. The mean score for self-reported work ability was 8.1 (range 0-10), and 4% of respondents rated their own work ability as insufficient. Physicians with high mental health complaints were 3.5- for fatigue, 5.6- for PTSD, 7.1- for anxiety, 9.5- for burnout, 10.8- for depression and 13.6-fold more likely to report their work ability as insufficient. CONCLUSIONS: The prevalence of common mental disorders among hospital physicians varied from 6% for burnout to 42% for work-related fatigue. Those physicians with high complaints had significantly 4- to 14 times increased odds of reporting their own work ability as insufficient. This work suggests that to ensure future workers health and patients safety occupational health services should plan appropriate intervention strategies.     

大学生心理健康与应对方式及社会支持的相关分析

目的探讨大学生应对方式及社会支持与心理健康的关系,以便更好地开展心理健康教育。方法对临沂师范学院的216名大学生采用症状自评量表(SCL-90)、应对方式问卷和社会支持评定量表(SSRS)进行调查。结果主观支持与抑郁、焦虑、恐怖及精神病性呈显著负相关(P<0.05),自责与焦虑、抑郁,幻想与强迫、人际关系敏感,合理化与躯体化、人际关系敏感呈显著相关(P值均<0.05),幻想与焦虑、抑郁、敌对及精神病性,合理化与敌对、焦虑、精神病性呈非常显著正相关(P值均<0.01)。结论大学生存有较多的心理问题,更多使用不成熟或混合型应对方式,其心理健康状况与社会支持及应对方式密切相关。     

护理人员心理健康水平及与医院情境因素的相关分析

目的:探讨护理人员的心理健康水平及与医院情境因素的相关性;方法:采用症状自评量表和医院情境因素问卷对116名护理人员进行测评;结果:护理人员的SCL-90总分和强迫症状、人际关系敏感、焦虑、敌意、精神病性因子均分低于全国常模(P<0.05～0.01),精神科护理人员与综合科护理人员相比,前者的SCL-90症状总分和强迫症状、人际敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性、其他9个因子均低于后者(P<0.01),医院情境因素中的工作激励、待遇满意度、医院保健、心理保健、集体精神、信息沟通6个因素与SCL-90总分及躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性、其他10个因子呈不同程度的负相关;结论:护理人员的心理健康水平高于一般正常人群,尤其是精神科护士;优化医院情境因素有利于护士心理健康水平的提高。