Racial patterns of heart rate in an employed adult population.

This study explored racial patterns of heart rate in a large population of employed Chicagoans: 39,665 adults screened in Chicago firms between late 1967 and early 1973. Of these, 30,876 were white or black adults age 18--64 with complete data, and not on drug therapy for hypertension. Mean heart rates of young black men and women were significantly lower than mean heart rates of young white men and women. This difference was not present for the age groups 35 and older. The difference was present in both smokers and non-smokers; in normotensives and in persons with elevated blood pressure; and could not be explained by differences in relative body weight. The difference persisted after simultaneous adjustment for differences in the mean values of systolic blood pressure, relative weight, serum cholesterol, post-loaded plasma glucose, and number of cigarettes smoked per day.     

Burden of illness for an employed population with chronic obstructive pulmonary disease

Abstract Chronic obstructive pulmonary disease (COPD) affects approximately 7% of Americans. COPD impacts productivity and forces 1 in 5 employees ages 45-65 years old to retire prematurely. Our objective was to quantify the direct and indirect costs of COPD in an employed population in the United States. A retrospective analysis using Thomson Reuters MarketScan commercial claims and Health and Productivity (HPM) databases (2000-2007) identified employees (ages 18-65 years) with ≥?1 COPD medical claim, ≥?6 month insurance eligibility pre and ≥?12 months post diagnosis, and ≥?12 months HPM data post diagnosis. COPD subjects were matched to non-COPD subjects using propensity scores to create a comparison group with similar characteristics. Differences in medical and pharmacy utilization and productivity (absence and short-term disability [STD] days) were examined using negative binomial regression, and cost differences using Heckman selection models. A total of 27,612 COPD patients were matched in a 1:1 ratio to 825,884 non-COPD patients; 80% were ages 36-65 years, and 59% were male. COPD employees had about twice the rate of emergency department visits and hospitalizations compared to non-COPD employees (P<0.0001). The rate of absence and STD days was approximately 1.5 times higher (P<0.0001) compared to non-COPD employees. Yearly direct and indirect expenditures were higher ($3609 and $909, respectively; P<0.0001) for COPD versus non-COPD employees. Excess utilization and associated costs of COPD to employers was quantified. By understanding these costs, employers may evaluate disease management programs and treatment to improve outcomes for employees with COPD. Improved treatment options may reduce the direct and indirect costs of COPD. (Population Health Management 2012;15:267-275).     

Substance abuse treatment client experience in an employed population: results of a client survey

Background  

Understanding client perspectives on treatment is increasingly recognized as key to improving care. Yet information on the perceptions and experiences of workers with private insurance coverage who receive help for substance use conditions is relatively sparse, particularly in managed behavioral health care organization (MBHO) populations. Furthermore, the role of several factors including prior service use has not been fully explored.     

Substance abuse treatment client experience in an employed population: results of a client survey

Background

Understanding client perspectives on treatment is increasingly recognized as key to improving care. Yet information on the perceptions and experiences of workers with private insurance coverage who receive help for substance use conditions is relatively sparse, particularly in managed behavioral health care organization (MBHO) populations. Furthermore, the role of several factors including prior service use has not been fully explored.

Methods

Employees covered by a large MBHO who had received substance abuse services in the past year were surveyed (146 respondents completed the telephone survey and self-reported service use).

Results

The most common reasons for entering treatment were problems with health; home, family or friends; or work. Prior treatment users reported more reasons for entering treatment and more substance use-related work impairment. The majority of all respondents felt treatment helped a lot or some. One quarter reported getting less treatment than they felt they needed.

Discussion and conclusions

Study findings point to the need to tailor treatment for prior service users and to recognize the role of work in treatment entry and outcomes. Perceived access issues may be present even among insured clients already in treatment.     

Exercising choice: the economic determinants of physical activity behaviour of an employed population

Lack of physical activity is a major contributing factor to the worldwide obesity epidemic, and to the overall burden of disease. The deindustrialisation of developed economies and move to more sedentary employment has impacted on the opportunities of working individuals to participate in physical activity. This can have negative effects on productivity and worker health potentially influencing economic growth. Thus, it is important to determine the factors influencing the frequency of participation in physical activity for employed individuals. This paper uses a modified time allocation framework to explore this issue. We use data from the first six waves of the Household Income and Labour Dynamics of Australia survey (HILDA). The analysis examines frequency of participation in physical activity using a generalised random effects ordered probit model. We control for non-parallel cut-points between the physical activity categories and individual heterogeneity, as well as exploring differences across gender. The results indicate that there is a time trade-off between non-market work, market work, and the frequency of physical activity participation. This effect is moderated by gender. For example, dependent children have a larger negative effect on the frequency of physical activity participation for women. Education and marriage have a larger negative effect on the frequency of participation for men. The findings suggests that policies which make exercise more convenient, and hence decrease the opportunity cost of exercise, will help to encourage more frequent participation in physical activity for working adults.     

Depression in the workplace: effects on short-term disability.

We analyzed data from two national surveys to estimate the short-term work disability associated with thirty-day major depression. Depressed workers were found to have between 1.5 and 3.2 more short-term work-disability days in a thirty-day period than other workers had, with a salary-equivalent productivity loss averaging between $182 and $395. These workplace costs are nearly as large as the direct costs of successful depression treatment, which suggests that encouraging depressed workers to obtain treatment might be cost-effective for some employers.     

中国精神残疾与伤害致残共患特征分析

目的 探讨精神残疾与伤害致残的关系, 以及我国两种残疾共患的多重残疾人群其残疾严重程度和卫生服务利用情况。方法 利用2006年第二次全国残疾人抽样调查和2009年残疾监测追踪调查数据, 提取精神残疾合并伤害致残的数据资料进行统计描述分析, 并加入权重使其结果推至全国。结果 我国2.7%的精神残疾共患因伤害导致的视、听、言语、肢体和/或智力残疾, 1.8%的伤害致残合并精神残疾, 高于普通人群伤害致残(0.94%)和精神残疾(0.63%)的现患率。>50%的共患残疾其严重程度为极重度, 46.32%共患残疾者的精神残疾和伤害致残为同年发生。需要精神科治疗的共患残疾中, 有56.25%未接受任何治疗。结论 精神疾病与伤害致残间可能存在密切关系。我国共患残疾者的治疗康复水平有待进一步提高。     

Assessing the burden of disease among an employed population: implications for employer-sponsored prevention programs

Escalating healthcare costs have led employers to identify ways to assess the actual burden of disease among their employees. One such measure is the use of disability-adjusted life-years (DALYs). DALYs were calculated for the General Motors (GM) population for 1994 through 1998 using data from GM's Mortality Registry, published life tables, and age- and sex-specific disease incidence and disability data from the U.S. Burden of Disease Study. Chronic diseases accounted for 45% (245,844 of 540,450) of total DALYs lost. Ischemic heart disease, stroke, lung cancer, and chronic obstructive pulmonary disease led the list for both men and women and accounted for 39% and 31%, respectively, of the top 10 DALYs lost. Disease burden among employees could be reduced through targeted interventions aimed at the risk factors associated with the leading causes of DALYs.     

Health status, health habits, utilization behaviour and health care utilization in an actively employed Japanese population

Healthcare utilization data from 1 February 1986 to 31 January1992 for 18601 local public service employees were analysedin relation to data on their perceived health status, healthhabits, health care utilization behaviour and health-relatedworries which were obtained from a questionnaire survey conductedin 1988. The results showed health care utilization behaviouras defined by the questionnaire responses to be the most importantpredictor of health care utilization as defined by claim rateand group utilization rate, followed by perceived health statusand certain health habits (ie caring about sleep, food and diet,watching body weight). Health-related worries, when used asa group variable, were not an independent predictor of utilization.The co-existence of ‘active’ utilization behaviouror the above-mentioned health habits with fair/poor perceivedhealth status was associated with the highest health care utilization.The implication of these findings is that if utilization behaviourmodification is incorporated into various worksite health programmesthat aim at improving employee health and containing healthcare utilization and costs, greater reduction can be achievedin employee health care utilization and costs.     

我国就业流动人口睡眠状况及影响因素分析

目的 了解我国18～59岁就业流动人口睡眠状况及其影响因素,为改善流动人口睡眠状况的相关政策提供依据。方法 利用2012年中国慢性病及其危险因素监测流动人口专题调查数据,该调查采用按行业分层多阶段整群抽样的方法在全国范围开展,以面对面访谈的方式,询问调查对象的人口学基本信息、行为危险因素、睡眠时间以及社会压力状况。对数据进行复杂加权后,采用多因素logistic回归模型,探讨就业流动人口睡眠状况及其影响因素。结果 共纳入43 521名研究对象,就业流动人口平均每天睡眠时间为7.77 h,女性（7.87 h）高于男性（7.69 h）。就业流动人口睡眠不足率为12.3%（95% CI：11.8%～12.7%）,45～59岁人群（21.2%）高于18～岁人群（11.2%）。多因素logistic回归分析发现,性别、年龄、婚姻状况、文化程度、职业、流入地区、行为危险因素、BMI、社会压力、自评健康状况和自报患有慢性病是影响流动人口睡眠不足率的主要因素。男性流动人口睡眠不足率是女性的1.18倍（95% CI：1.07～1.31）;吸烟人群是不吸烟人群的1.22倍（95% CI：1.11～1.33）;过量饮酒人群是正常人群的1.31倍（95% CI：1.16～1.49）;工作和生活压力较大的流动人口睡眠不足率是没有工作和生活压力人群的1.46倍（95% CI：1.29～1.65）和1.33倍（95% CI：1.18～1.50）。结论 我国就业流动人口睡眠不足率受多种因素的影响,政府有关部门应加强对流动人口睡眠状况的重视,不断提高流动人口的睡眠质量。     

The impact of body mass index on short-term disability in the workplace

OBJECTIVE: The objective of this study was to assess the association between body mass index and short-term disability in a working "white collar" population. METHODS: The authors collected cross-sectional data from 19,061 health risk appraisals completed by employees of a large financial services corporation from 2000-2002. The self-reported information for demographics and job satisfaction was combined with personnel and detailed information from short-term disability events (STD) taken during the same time period. RESULTS: After adjusting for multiple covariates, body mass index is an independent predictor for STD events. Body mass index categories of overweight and obese have odds ratios of 1.26 and 1.76 compared with normal weight (P < 0.0001). CONCLUSIONS: The improvement of employee health and wellness should be pursued by the employer in an effort to promote healthier weight among their workers. This in turn should reduce STD events that result in the loss of worker productivity and a major cost to companies.