Job insecurity and its association with health among employees in the Taiwanese general population

As employers respond to intensive global competition through the deregulation of labor, job insecurity has become a widespread problem. It has been shown to have significant health impacts in a growing number of workers, but less is known about its social distribution, the mechanisms through which it may act, and the moderating effects of gender, socioeconomic position, and company size. Utilizing data from a national survey of a representative sample of paid employees in Taiwan, we examined the prevalence of job insecurity and its associations with psychosocial work characteristics and health status. A total of 8705 men and 5986 women aged between 25 and 65 years old were studied. Information on perceived job insecurity, industrial and occupational types, psychosocial work characteristics as assessed by the Job Strain model, and various measures of health status were obtained by a self-administered questionnaire. The overall prevalence of job insecurity was high (50%). Job insecurity was more prevalent among employees with lower education attainment, in blue-collar and construction workers, those employed in smaller companies, and in older women. Insecure employees also reported lower job control, higher job demands, and poor workplace social support, as compared with those who held secure positions. Regression analyses showed that job insecurity was strongly associated with poor health, even with adjustment of age, job control, job demands, and work place social support. The deleterious effects of job insecurity appeared to be stronger in men than women, in women who held managerial or professional jobs than women in other employment grades, and in those working in larger companies than smaller ones. The findings of this study suggest that perceived job insecurity is an important source of stress, and it is accompanied with adverse psychosocial work conditions and poor health. High-risk groups were identified for further investigation.     

The effects of workplace flexibility on health behaviors: a cross-sectional and longitudinal analysis

OBJECTIVE: To examine the cross-sectional and longitudinal associations between workplace flexibility and health behaviors, and estimate the potential importance of flexibility for effective worksite health promotion programs. METHOD: Cross-sectional and longitudinal health risk appraisal data were obtained from US based employees of a multinational pharmaceutical company (n = 3193). Examined health behaviors were hours of sleep, physical activity frequency, health education seminar attendance, frequency of practicing personal resilience techniques, and self-appraised lifestyle. Self-reported flexibility in the workplace was the primary independent variable. RESULTS: Each health behavior, except regular attendance in health education seminars, was positively related to perceived flexibility in cross-sectional analyses. Sleep and self-appraised lifestyle were significantly related to changes in perceived flexibility over time. CONCLUSIONS: Workplace flexibility may contribute to positive lifestyle behaviors, and may play an important role in effective worksite health promotion programs.     

Relationship between an interview-based health promotion program and cardiovascular risk factors at Japanese companies

The present study investigated the relationship between an interview-based health promotion program and cardiovascular risk factors at manufacturing companies. Excluding insufficient data and the workers who took medication prescribed by a physician in 1993, the subjects were six hundred and twenty-nine 18-55-yr-old employees who had been working at two manufacturing companies in Kyushu from 1993 to 1997. The intervention company introduced an interview-based health promotion program from 1993. The program consisted of health measuring, group education, and health interviewing all employees to help with their behavioral change. We subdivided the subjects into younger (18-34-yr-old) and older (35-55-yr-old) groups. We defined changing degree (Delta) with (the following data in 1997) minus (the initial data in 1993). With agreement of the subject companies, we compared the Delta of each item, including body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum total cholesterol (T-cho), serum aspartate aminotransaminase (AST), serum alanine aminotransferase (ALT), and serum gammaglutamyl transpeptidase (GGTP), in the intervention with that in the reference. BMI and SBP decreased significantly after the program in the under 35-yr-old intervention group. On the other hand, T-cho, AST, ALT, and GGTP decreased and HDL increased significantly after the program in the over 34-yr-old intervention group. Our results showed that the worksite health promotion had the potential to improve cardiovascular risk factors of Japanese employees.     

Issues related to participation in worksite health promotion: a preliminary study

PURPOSE. The purpose of this study was to identify characteristics associated with participation in worksite-based health promotion activities. DESIGN. Follow-up interviews were used to identify demographic, attitudinal, and behavioral differences among three employee groups. Reasons employees chose not to participate in health promotion activities were also explored. SETTING. All respondents were employed at a large midwestern university and were eligible to participate in free onsite health fairs and health promotion programs. SUBJECTS. A stratified random sample of 89 nonparticipants, health fair participants, and behavior change program participants was interviewed. MEASURES. The interview was comprised of questions related to demographic information, personal health habits, physical activity, perceived health status, perceived self-efficacy, worksite norms, health promoting lifestyle factors, and knowledge about health promotion activities. RESULTS. ANOVA and chi-squared comparisons revealed few group differences. Graduate students and employees with advanced degrees were most likely to take part in health fairs. Behavior change program participants were older, clerical-technical staff members, and women. Faculty members were least likely to participate. A lack of time was the most often cited reason for nonparticipation. CONCLUSIONS. The study was retrospective and the analyses limited due to low statistical power. The results suggest that different groups of employees are attracted to different types of health promotion activities.     

Worksite health promotion programs in the U.S.: factors associated with availability and participation

PURPOSE: To examine how the availability of and participation in worksite health promotion programs varies as a function of individual (e.g., age), organizational (e.g., occupation), and health (e.g., high blood pressure) characteristics. Availability of worksite programs was also compared to that reported in two previous national surveys of private companies. DESIGN: Data analyzed were from the 1994 National Health Interview Survey (NHIS), a national cross-sectional probability sample of the U.S. civilian population. SUBJECTS: Five thousand two hundred nineteen NHIS respondents met the inclusion criteria of (1) being currently employed in a company of at least 50 employees, and (2) completing the NHIS section on worksite health promotion. MEASURES: Employees indicated the availability of, and their participation in, 33 different types of worksite programs. National Health Interview Survey data were also available regarding general health, blood pressure, body mass index, and medical conditions. RESULTS: Smoking cessation programs had the highest mean availability (43%), followed by health education programs (31%) and screening tests (31%). Overall, availability of worksite programs appeared comparable to that reported in a recent national survey. Participation ranged from 32% for health education programs to 5% for smoking cessation programs. Compared to availability, participation depended less on individual and organizational characteristics. Healthy employees were not consistently more likely to participate in worksite health promotion programs than nonhealthy employees. CONCLUSIONS: Although availability of worksite health promotion programs remains high, participation by employees in specific types of programs can vary widely. Attempts to increase participation should look beyond individual, health, and organizational variables, to specific features of the work environment that encourage involvement in health promotion activities.     

Style of management and the relevance for workplace health promotion in small and medium sized enterprises

In a small company, the whole company culture, including the management style, is dominated by the owner. The management culture in small companies and above all the management style of the owner determine the chances of successfully introducing workplace health promotion (WHP). For this reason a typology was developed that describes the management personalities who affect the company culture in small enterprises. This provides a guide to the possible success of WHP in connection with the management style. Although a summary of the management and corporate culture of small companies in a few categories cannot show the variety of social reality, it can provide orientation. The typical categories of company social order (a mixture of ownership and leadership) in small and medium-sized enterprises are given below. Furthermore, there is an assessment of what the chances of realising workplace health promotion are in each type of company. Small and medium-sized companies (SME) have a number of organisational characteristics which are just ideal for the introduction and implementation of workplace health promotion. The work of the employer and employees is often the same. Information in the company is generally comprehensive and easily available. The lack of information which employees often complain about in large companies is not a problem. There is a good flow of communication. Small companies have a flat hierarchy that enables participation, the essential requirement for WHP. There is a close social relationship between the company head and the workforce, although it must be said that this closeness can be dangerous, particularly if it is misused as complete social control. The readiness to implement Workplace Health Promotion (WHP) in SME and the degree of success depends largely on the personality of the company manager and the style of leadership. Considering the importance of a manager’s personality for WHP in SME, modules and instruments to assist company owners and managers in SME are to be developed. On behalf of and in co-operation with the Austrian Network for Workplace Health Promotion several modules have been introduced to assist owners and managers of SMEs.     

Methods of the National Check Bus Project

OBJECTIVES: Prevention at the worksite is considered increasingly important. This paper describes the methods used in a nationwide prevention campaign performed at a large Swiss bank and a Swiss industrial company. The aim of this project was to encourage general health awareness among company employees. We also aimed to provide the companies with general health analyses of their staff as a basis for future health promotion. Furthermore, new screening methods were evaluated in the field of research. METHODS: Participation in the programme was voluntary and free of charge. The programme targeted all 25,243 employees of the two companies in all regions of Switzerland. A mobile unit was available on site. The programme included a written health questionnaire and medical examinations (e.g., blood pressure, blood tests, ultrasound of the common carotid artery, osteodensitometry, examinations of the eye, etc). Analysis of individual test results, information brochures, and a telephone information service were also provided. Based on the data of the individuals, the "health status" of the employees of the two companies was analysed. The companies did not have access to the data of the individuals. The programme ran from August 1996 to August 1998. RESULTS: With a total of 10,321 persons taking part in the project, the participation rate was 41%. For the different examinations offered, patterns of participation were identifiable that varied with age, hierarchical status within the concern, body mass index, and number of physical complaints of the employee. Some of the variables showed the same trend for different tests, while others showed opposite trends. CONCLUSIONS: Participation in worksite health promotion programmes is dependent on a complex system of individual and structural variables that need to be considered when planning worksite health promotion programmes. Consideration of specific target population characteristics, including motivations and incentives as well as structural constraints is likely to improve participation rates in worksite health promotion programmes among employees.     

大庆油田员工心理健康促进方案构建的研究

目的探讨适用于油田企业的员工心理健康促进方案的运作模式及其内容,了解员工生活与心理压力的来源与类型,规划构建有关心理健康教育课程。方法采用问卷调查方法,自行设计调查问卷,在大庆油田有限责任公司员工内采用分层抽样方法抽取3 000人作为调查对象。收集调查对象对心理健康促进的看法及需求并对资料进行统计分析。结果有效问卷2 760份,全体研究对象都认为现代企业关注员工心理健康很重要;受调查对象压力总体感觉比较大及以上者占33.59%,员工压力来源的排序依次为经济压力、生活压力、人际关系压力、职业发展压力、婚姻情感压力及内部竞争压力;员工需要获得的专业帮助依次为情绪管理、压力管理、有效沟通技巧、适应技巧、子女教育与亲子关系、心理调整技巧及职业规划设计;大庆油田员工心理健康促进方案以员工心理健康评价、心理卫生教育训练为主,辅以员工个别心理咨询。结论对大庆石油员工进行心理卫生教育是必要的。     

Health promotion programs sponsored by California employers

A survey of California employers with more than 100 employees at one or more sites was undertaken to determine: 1) the nature and extent of health promotion activities; 2) plans for continuation and/or expansion of these activities; 3) plans for initiation of new activities; and 4) the relationship between reported health promotion activities and other characteristics of employers. Of 511 employers with whom interviews were attempted, 49 possible respondents could not be reached and 38 respondents refused to be interviewed, leaving 424 or 83 per cent. Almost one-half of the sites where interviews were conducted had fewer than 200 employees. A total of 332 (78.3 per cent) of employers offered one or more health promotion activities. The most frequent activities provided were accident prevention (64.9 per cent) and CPR (52.8 per cent) with other frequent programs including alcohol/drug abuse (18.6 per cent), mental health counseling (18.4 per cent), stress management (13.0 per cent), fitness (11.6 per cent), hypertension screening (10.1 per cent), and smoking cessation (8.3 per cent). Employers with at least one activity averaged 2.8 activities. The likelihood of having health promotion activities increased with company size. Establishment of new programs appeared to accelerate rapidly in recent years.     

Occupational Stress in Special Education: A Challenge for School Health Professionals

Results of this study support the hypothesis that the majority of special educators, their support personnel, and general education administrators do not experience more job dissatisfaction than comparable occupational groups. However, they do report lower levels of subjective well-being when compared with normal populations. Furthermore, 18% of the educators in the study perceived themselves as failing to cope with their job, experienced more frequent symptoms of poor physical health, and reported significantly poorer subjective well-being. Health promotion programs for public school personnel should initiate prevention-oriented health education programs for all employees. For those identified as more vulnerable to stress-related mental and physical health problems, therapeutic approaches may be necessary. However, self-help and mutual support groups may offer both groups a social support system to help meet human needs in addition to offering the potential for reducing perceived occupational stress. School health personnel may be in the best position to influence policies, procedures, and practices in schools that would support the work-related needs of all employees.     

学习成绩不良初中生心理卫生的干预研究

目的研究学习成绩不良初中生心理健康教育的内容、方法、途径,为制定具有较强针对性和可操作性的学校心理健康教育模式提供参考依据.方法整群抽取太原市某中学初一和初二年级学生358名为研究对象,以学习成绩不良学生为目标人群,对其进行心理健康教育的干预实验.用自拟心理健康问卷进行评价.结果干预后干预组对家庭和父母的感受、对自己的认识和感受得分和心理健康问卷总分接近中等组和/或优生组,且该组学生对自己的认识和感受问卷得分及心理健康问卷总得分干预前后变化不显著,而2个对照组干预后得分较干预前显著降低.与对照组相比,干预组干预后学习成绩提高显著.结论心理干预健康教育有助于改善学习成绩不良学生的心理健康状况和学习成绩.     

The psychiatric patient at work.

Psychiatric consultations and job performance of 135 IBM employees were studied. Psychiatric referrals were made by management and the company medical department or were self-referred. The consulting psychiatrist conducted interviews, met with management, personnel representatives and other physicians to coordinate treatment with job requirements. Every effort was made to retain employees and improve performance. After a two-three year follow-up period, 82 employees (61.7 per cent) were with the company; ten were rated outstanding, 38 exceeded job requirements, 25 were meeting job requirements, and four were not. Performance data for five employees were not available. Forty-nine of 83 employees (59.0 per cent) rated unsatisfactory in job performance at the initial referral were performing satisfactorily at follow-up. The results support an optimistic attitude toward the working patient with psychiatric disease and highlight the value of a full-time medical department with consultation facilities leading to secondary and tertiary prevention.     

影响某电脑公司员工参与体力活动相关因素的定性研究

[目的]了解电脑从业人员的体力活动相关情况,为进一步开展干预活动提供参考依据.[方法]对上海某电脑公司49名员工进行一对一的非正式访谈,在atlas/ti软件支持下应用内容分析法对资料进行分析归纳.访谈内容包括基本健康状况、目前体力活动情况、体力活动相关知识了解情况、进行体力活动的障碍和促进体力活动的意见与建议.[结果]该电脑公司员工不仅大多以静态生活方式为主,而且不能正确描述促进健康体力活动的要求.缺乏运动的时间、无人结伴锻炼、锻炼的场地与设施的不便利,以及个人心理认知因素是影响其体力活动相关行为的主要因素.结果还显示,在公司开展电子邮件为载体的体力活动干预的同时,结合组织其他体育活动是该公司员工易于接受的体力活动干预形式.[结论]该人群不仅体力活动水平明显不足,而且缺乏体力活动健康促进的相关知识,以电子邮件为载体的促进体力活动的干预方式是该公司可行的选择.     

Schulung von Krankenkassenmitarbeiterinnen zur Gesundheitsförderung im Rahmen des §20 Sozialgesetzbuch (SGB) Fünftes Buch (V)

As of l January 1989, health promotion and disease prevention, in particular in the form of § 20 and -for trial purposes - of §§ 67 and 68 SGB V, fall into the area of responsibility of the statutory health insurances (GKV). In this connection, the basic conditions fixed by two reform laws include both an obligatory and a voluntary aspect. This enables the insurance companies to adequately combine health promotion with economical aspects and quality control within the framework of a consolidation and cost containment policy and thereby strengthen their position with regard to those who offer original services. For this purpose, however, implementation strategies have to be developed. Against the background of stronger competition resulting from the GSG and hence greater endeavours by the individual health insuran-ces to strengthen their efforts for self presentation and the creation of an image of their own, the following article describes a recently carried out measure for qualifying employees of an important health insurance company working in the field of health promotion.     

Eating habits, health status, and concern about health: a study among 1641 employees in the German metal industry

BACKGROUND: Nutrition has been found to be associated with sociodemographic characteristics and concern about health. There is limited knowledge, however, of associations between blue-collar worker's diet, morbidity, and health care utilization. METHODS: We conducted a survey on eating habits, physical symptoms, health care utilization, health status, and concern about health in two German metal companies. A self-administered questionnaire was mailed to employees of whom 1641 participated in the study (response rate 54. 7%). RESULTS: Most employees were characterized by a combination of healthy and unhealthy eating elements. Using linear regression analyses adjusted for age, gender, and occupational status, healthy eating was negatively associated with stomach aches and headaches, but not with cardiovascular disease. Restricted activity days and days in hospital were associated with healthy eating, but self-assessed health status and physician consultations were not. Using stepwise multiple regression analysis, age, gender, and concern about health were strongly and morbidity was weakly related to diet. Occupational status, marital status, and number of children were not associated with nutrition. CONCLUSIONS: Health promotion programs should motivate younger and male employees to participate in and aim toward increasing concern about health.     

Life-style related health promotion needs in oil refinery employees

This report describes the screening procedure used in the assessmentof health promotion needs in a group of oil refinery employees(n=885). The aim of the study was to assess the life-style relatedhealth promotion needs before initiating an intervention programmestudy. The frequency of different health promotion needs andtheir distribution according to age, gender and employee groupwere examined, as well as the factors explaining different healthpromotion needs. The assessment was based on laboratory testsand questionnaires covering the target areas of physical activityand fitness, dietary habits, overweight, blood pressure, serumlipids, smoking, alcohol consumption, sleep, mental health,and musculoskeletal symptoms. Life-style related health promotionneeds were frequent. Self-assessed health was strongly associatedwith health promotion needs in most of the ten target areasand also with the total number per person of areas with healthpromotion needs. Health promotion needs were also associatedwith such demographic variables as age, gender, basic education,and vocational training, If health promotion activities areprovided to employees in a company, assessment of individualneeds is necessary to find the employees with the greatest needof health promotion actions. This study presents one methodof screening, although certain simplification is needed to makeit fit into the daily routines. The contents of health promotionactivities could also vary according to the differences relatedto age and gender observed in health promotion needs of thetarget population.     

The shape up challenge: a community-based worksite exercise competition

PURPOSE: To assess organizational and employee participation during three community-wide worksite exercise competitions in two communities. DESIGN: A one-group, posttest-only design was used. Lack of controls, exercise baseline, and the short-term nature of the interventions were limitations. SETTING: The Minnesota Heart Health Program conducted annual exercise campaigns between 1982 and 1989 within three intervention communities to reduce behavioral risk for cardiovascular disease. The Shape Up Challenge was a worksite exercise competition designed, in conjunction with other campaign activities, to increase levels of physical activity. SUBJECTS: A total of 119 participating companies in two Minnesota communities, and 17,626 employees within these worksites, composed the subjects in this study. INTERVENTION: Eligible worksites were invited to participate in a month-long competition during which employees recorded minutes spent daily in aerobic activities. Incentives were established to promote intragroup cooperation and intergroup competition. Companies competed for awards that were based on average minutes of exercise per employee versus per participant. MEASURES: Numbers of companies recruited and participating, campaign activities, minutes of exercise, and costs were recorded on implementation logs. Companies completed surveys describing business type, number and sex of employees, existing health promotion programs, and perceived benefits of participation. RESULTS: Of the 365 companies invited to participate, 33% participated (range 15% to 50%). Participating companies were more likely than nonparticipating companies to offer other health promotion programs and perceived greater benefits from participation. Women and smaller companies had significantly greater participation rates than men and larger companies. Average employee participation rates ranged from as high as 84% in smaller organizations to as low as 16% as organization size increased. CONCLUSIONS: Community-based worksite exercise competitions appear to be a viable strategy for promoting employee exercise, particularly in smaller companies. Group-based contingencies applied in natural work units may facilitate employee participation. Further research is needed to assess the relative efficacy of this approach, compare alternative incentives, and identify strategies to enhance exercise maintenance after the intervention has ceased.     

The effects of a workplace health promotion program in small and middle-sized companies: a pre–post analysis

Aim

Employees have to deal with work-related problems like a sedentary work style or musculoskeletal disorders. Moreover, psychological factors like time pressure can lead to the inability to work. The Fit for Business-program started in order to provide health promotion interventions for small and middle-sized companies. This study analyzed data concerning the infrastructure, activity levels and critical factors of success to increase physical activity levels.

Subject and methods

A total of N?=?342 employees filled out standardized questionnaires about the infrastructure needed for health promotion, their workload, their physical and mental well-being, their resources and their health-related behavior. Statistical pre–post analysis included chi²-tests and multivariate tests. Qualitative interviews identified factors necessary for a successful implementation.

Results

There were differences concerning employees’ specific health conditions and infrastructures established for health promotion. The number of physically active employees increased significantly (p? = 0.015, Z?=?–3.67). This increase in sporting activity was due to participation in sports in fitness centers (+16.5 %, p?<?0.001, Z? =?5.217), company sports (+8.7 %, p?= 0.002, Z?=?–3.024) and sports clubs (+6.4 %, p?=?0.048, Z =?–1.976). Moreover, when the specific needs of the employees were considered, the number of people involved in several kinds of sports increased.

Conclusions

The implementation of health promotion programs in small and middle-sized companies is successful if the following factors are considered: a responsible key person or a linkage group and a marketing platform for the programs (e.g. a trail course) exists, an assessment of the employees’ demands for health promotion takes place and the interventions are geographically close to the company and compatible with working hours. Additionally, there might be a relationship between the company-specific infrastructure for health promotion and resulting workloads or physical complaints.