Working conditions, adverse events and mental health problems in a sample of 949 German teachers

Objectives: The aim of this study was (1) to explore in detail the working load of teachers, (2) to analyse the extent of negative or threatening school-related events teachers are confronted with, and (3) to evaluate mental health strain by applying the general health questionnaire (GHQ). Methods A sample of 949 teachers in 10 grammar schools (German: Gymnasien) and 79 secondary modern schools (German: Hauptschulen) was investigated applying (1) a questionnaire covering different aspects of the occupational burden and threatening school-associated events and (2) the general health questionnaire (GHQ-12). Results Based on what teachers indicated in the questionnaire, full-time teachers work more than 51 h weekly. More than 42% of our sample indicated verbal insults, almost 7% deliberate damage of personal belongings, and 4.4% threat of violence by pupils during the past 12 months. When applying the GHQ-12, we found that 29.8% of the sample report significant mental health problems. With respect to school types, teachers in secondary modern schools indicated more of such problems, while no effects regarding age, gender, or full/part-time teaching were observed. Conclusions To be a teacher is a hard work and requires coping of considerable amount of adverse events. Based on the GHQ, nearly 30% of teachers suffer from significant mental health problems.     

Working conditions and weight gain: a 28-year follow-up study of industrial employees

Longitudinal studies observing working conditions and weight gain are rare. We aimed to study whether weight gain can be predicted by working conditions or changes in them in a 28-year follow-up. The study population consisted of working-aged industrial employees (n = 449). Data on height and weight were collected in clinical examinations in 1973, 1983 and 2001, and information on working conditions by questionnaires. We analysed the impact of changes in physical strain, temporal requirements and indicators of mental strain at work in 1973 and 1983 on weight changes using analysis of variance, logistic regression analysis and linear mixed longitudinal growth model. The latter was done to account for individual variation in temporal weight change over the study period. Weight gain was prominent in the data and about a third of the participants gained at least 15 kg by the final survey. Changes in physical strain and temporal requirements including working overtime hours among men, and experiencing increased working pace among women, were associated with greater mean weight gain and major weight gain. Job efforts and increasing mental strain showed weak associations with weight gain in men. Changes in the physical strain and temporal requirements seem to predict weight gain but working conditions were in general mostly weakly associated with weight gain in this cohort of initially young adults. The results highlight the importance of stable working hours and reasonable workload on healthy weight.     

Occupational class inequalities in health across employment sectors: the contribution of working conditions

Objective  While health inequalities among employees are well documented, their variation and determinants among employee subpopulations are poorly understood. We examined variations in occupational class inequalities in health within four employment sectors and the contribution of working conditions to these inequalities. Methods  Cross-sectional data from the Helsinki Health Study in 2000–2002 were used. Each year, employees of the City of Helsinki, aged 40–60 years, received a mailed questionnaire (n = 8,960, 80% women, overall response rate for 3 years 67%). The outcome was physical health functioning measured by the overall physical component summary of SF-36. The socioeconomic indicator was occupational social class. Employment sectors studied were health care, education, social welfare and administration (n = 6,557). Physical and mental workload, and job demands and job control were explanatory factors. Inequality indices from logistic regression analysis were calculated. Results  Occupational class inequalities in physical health functioning were slightly larger in education (1.47) than in the other sectors (1.43–1.40). Physical workload explained 95% of inequalities in social welfare and 32–36% in the other sectors. Job control also partly explained health inequalities. However, adjusting for mental workload and job demands resulted in larger health inequalities. Conclusion  Inequalities in physical health functioning were found within each employment sector, with minor variation in their magnitude. Physical workload was the main explanation for these inequalities, but its contribution varied between the sectors. In contrast, considering psychosocial working conditions led to wider inequalities. Improving physical working conditions among the lower occupational classes would help reduce health inequalities within different employment sectors.     

Working capital management policy in health care: The effect of leverage

Hospitals, which are mainly capital intensive, require large amounts of financial resources to render high-quality services. Accordingly, health care managers and policy makers should take into account the level of debt in managing working capital. This study, therefore, aims to explore whether the financial leverage moderates the relationship between the working capital and profitability for the publicly-listed European Hospitals. The data set including 52 hospitals with 468 observations was solicited from the ORBIS. A regression analysis was carried out. The results reveal that increasing the length of the cash conversion cycle for hospitals with high financial leverage decreases profitability. On the contrary, increasing the length of the cash conversion cycle for the ones having low leverage boosts profitability. The findings of this study suggest that since leverage influences the relationship between the cash conversion cycle and profitability, the degree of financial leverage is an important indicator to be considered by health care managers and policy makers in managing working capital. In addition, by clarifying the effect of leverage, this study helps policy makers understand and estimate the possible impact of working capital changes on profitability. This study also helps managers and decision makers not only apply a tight working capital policy but also decide whether to increase or decrease the length of cash conversion cycle to improve hospital profitability.     

Interaction of working conditions, job satisfaction, and sickness absences: evidence from a representative sample of employees

We study the predictors of sickness absences among 2800 Finnish workers responding to the cross-sectional Quality of Work Life Survey in 1997. The data contain detailed information on the prevalence of adverse working conditions at the workplace from a representative sample of wage and salary earners. We show by using recursive multivariate models that the prevalence of harms at the workplace is associated with job dissatisfaction and dissatisfaction with sickness absences. The policy lesson is that the improvement of working conditions should be an integral part of any scheme aimed at decreasing sickness absence.     

5岁以下儿童腹泻与家庭卫生行为和卫生条件的关系

目的探讨陵水县农村5岁以下儿童腹泻与家庭卫生行为和卫生条件的相关性,为今后儿童腹泻病的预防与控制提供参考资料。方法于2015年7月采用多阶段随机整群抽样方法,对陵水县4个乡镇413名5岁以下儿童进行入户调查,分析儿童腹泻相关因素。结果陵水农村5岁以下儿童2周内腹泻患病率为23.5%;随着年龄的增加,5岁以下儿童2周内腹泻患病率下降(χ~2=17.786,P=0.000)。对饮用水不进行处理的家庭儿童2周内腹泻患病率高于对饮用水进行处理的家庭(χ~2=4.152,P=0.042);无厕所的家庭儿童2周内腹泻患病率高于有厕所的家庭(χ~2=4.563,P=0.033);厕所类型是粪坑的家庭儿童腹泻患病率最高;卫生间不清洁的家庭儿童腹泻患病率高于卫生间清洁的家庭(χ~2=4.778,P=0.029)。垃圾处理方式为填埋和院内处理的家庭儿童2周内腹泻患病率较高。结论本次调查地区5岁以下儿童2周内腹泻病的患病率较高,且与家庭卫生行为和卫生条件有关。     

The mental and physical health of miners following the 1992 national pit closure programme: a cross sectional survey using General Health Questionnaire GHQ-12 and Short Form SF-36

Background: In the twelve months following the announcement of the UK pit closure programme in October 1992, 22 500 miners were made redundant. In 1994 we undertook a cross-sectional survey to determine whether the mental and physical health of men who had been employed in the Nottinghamshire mining industry differed from that of the general population.Methods: A postal questionnaire was designed incorporating the General Health Questionnaire (GHQ-12), and six domains from SF-36. Questionnaires were sent to 1064 miners and ex-miners and 2097 other men in Nottinghamshire. Non-responders were sent two reminders.Results: The final response rate was 51%. The percentage of responders with GHQ-12 scores of three or more (suggesting psychological disorder) was 46% for those still employed in the mining industry, 52% for unemployed former miners and 22% for working non-miners (odds ratios: 3.0 [95% C.I. 2.2–4.1] for current miners and 3.9 [95% C.I. 2.6–5.7] for unemployed miners compared with working non-miners). The miners and ex-miners also had lower scores (suggesting greater morbidity) for each of the SF-36 domains tested. When stratifying for age in respondents of social classes IIIM-V the scores of current miners were significantly lower than those of working non-miners (P < 0.01).Conclusions: This study suggests that when surveyed in 1994, men who had been employed in three Nottinghamshire collieries in 1992 were psychologically and physically disadvantaged compared with working non-miners. Whether these findings are a result of pit closures is uncertain. However, significant potential health needs have been demonstrated.     

Working conditions and mental health: Results from the CARESUN study

The authors conducted a work-related stress surveillance study in 2013 on 6,558 public-sector employees in Italy, examining how they perceived their jobs, via the Job Content Questionnaire, and their mental health status, via the General Health Questionnaire 12 (GHQ-12). Of the 2,094 employees completing the questionnaires, 60% were male, 52% had a medium-level education, and 76% had a medium-level job. Three hundred and eighty-five employees (18%) had a GHQ-12 score >3 and were classified as GHQ-12 cases: these were more often female (54%), medium-to-highly educated (54%), and had more often reported health problems over the previous year (51%). Thus, GHQ-12 cases represented a significant percentage of the examined population, indicating that work-related stress surveillance programs are needed for the planning of psychosocial interventions aimed at the reintegration of individuals with mental health problems.     

Jails, prisons, and the health of urban populations: A review of the impact of the correctional system on community health

This review examined the interactions between the correctional system and the health of urban populations. Cities have more poor people, more people of color, and higher crime rates than suburban and rural areas; thus, urban populations are overrepresented in the nation's jails and prisons. As a result, US incarceration policies and programs have a disproportionate impact on urban communities, especially black and Latino ones. Health conditions that are overrepresented in incarcerated populations include substance abuse, human immunodeficiency virus (HIV) and other infectius diseases, perpetration and victimization by violence, mental illness, chronic disease, and reproductive health problems. Correctional systems have direct and indirect effects on health. Indirectly, they influence family structure, economic opportunities, political participation, and normative community values on sex, drugs, and violence. Current correctional policies also divert resources from other social needs. Correctional systems can have a direct effect on the health of urban populations by offering health care and health promotion in jails and prisons, by linking inmates to community services after release, and by assisting in the process of community reintegration. Specific recommendations for action and reseach to reduce the adverse health and social consequences of current incarceration policies are offered.     

Gender differences in health: a Canadian study of the psychosocial, structural and behavioural determinants of health

Gender-based inequalities in health have been frequently documented. This paper examines the extent to which these inequalities reflect the different social experiences and conditions of men's and women's lives. We address four specific questions. Are there gender differences in mental and physical health? What is the relative importance of the structural, behavioural and psychosocial determinants of health? Are the gender differences in health attributable to the differing structural (socio-economic, age, social support, family arrangement) context in which women and men live, and to their differential exposure to lifestyle (smoking, drinking, exercise, diet) and psychosocial (critical life events, stress, psychological resources) factors? Are gender differences in health also attributable to gender differences in vulnerability to these structural, behavioural and psychosocial determinants of health? Multivariate analyses of Canadian National Population Health Survey data show gender differences in health (measured by self-rated health, functional health, chronic illness and distress). Social structural and psychosocial determinants of health are generally more important for women and behavioural determinants are generally more important for men. Gender differences in exposure to these forces contribute to inequalities in health between men and women, however, statistically significant inequalities remain after controlling for exposure. Gender-based health inequalities are further explained by differential vulnerabilities to social forces between men and women. Our findings suggest the value of models that include a wide range of health and health-determinant variables, and affirm the importance of looking more closely at gender differences in health.     

北京市3类职业人群健康状况与生活方式调查

目的了解北京市公务员、科技人员和企业人员3类职业人群的健康状况和生活方式,为今后在职业人群中开展健康教育活动提供参考依据。方法采用分层整群抽样,自填式问卷调查的方法进行调查。结果 3种职业人群亚健康的检出率为5.0%;慢性病患病率居前5位的分别是:高血压(11.8%)、高脂血症(6.9%)、胃溃疡(3.0%)、贫血(2.8%)和心脏病(2.7%)。超重者占31.5%,肥胖者占10.4%,公务员中超重和肥胖者所占的比例高于其他两类人群(P<0.05)。3种职业人群总体的吸烟率为24.6%,其中公务员人群的吸烟率最高(33.4%),科技人员的吸烟率最低(22.4%)。经常吃早餐的人占78.3%,公务员最高(82.8%);3种职业人群每天摄入新鲜水果频率的差异无统计学意义(P>0.05)。企业人员的睡眠时间高于公务员和科技人员,睡眠时间大于7小时者占75.2%。结论 3类职业人群在生活行为、饮食习惯和健康状况等方面不容乐观,应该尽快采取有针对性的干预措施。     

Determinants of health policy impact: comparative results of a European policymaker study

Summary Objectives: This article will use a new theoretical framework for the analysis of health policy impact introduced by Rütten et al. (2003). In particular, it will report on a comparative European study of policymakers perception and evaluation of specific determinants of the policy impact, both in terms of output (implemented measures) and outcome (health behaviour change). Policy determinants investigated are goals, resources, obligations and opportunities as related to the policymaking process. Methods: Theory is applied to a comparative analysis of prevention and health promotion policy in Belgium, Finland, Germany, The Netherlands, Spain and Switzerland. The study is MED2-part of a project that has developed a Methodology for the Analysis of the Rationality and Effectiveness of Prevention and Health Promotion Strategies (MAREPS) within the EU-BIOprogram. A mail survey of 719 policymakers on the executive and administrative level selected by a focused sample procedure was conducted. This survey used policymakers experience and evaluative expertise to analyse determinants of policy output and outcome. Results: Regression analyses reveal differential predictive power of policy goals, resources, obligations, as well as of political, organisational and public opportunities. For instance, whereas resources, concreteness of goals, and public opportunities have significant importance for health outcome of policy, obligations and organisational opportunities significantly predict policy output. Conclusions: Results are discussed in terms of rationality and effectiveness of health policy. They indicate that six sensitising constructs derived from the theoretical framework represent equivalent structures across nations. They comprise a validated instrument that can be used for further comparative health policy research.     

Changes in job stress,musculoskeletal symptoms,and complaints of unfavorable working conditions among nurses after the adoption of a computerized order communication system

Objectives Order communication system (OCS) is a real-time computerized hospital information system that supports communication of orders from the ward users to the service departments. The adoption of an OCS may profoundly alter the service patterns of healthcare workers. As a result, job stress, musculoskeletal symptoms, and complaints of unfavorable working conditions can be expected to increase. This study investigated changes in job stress, musculoskeletal symptoms, and complaints of unfavorable working conditions among nurses after an OCS had been adopted and whether adoption of the system affected the changes.Methods A group of nurses employed in a university hospital in Korea was surveyed 1 month before and 3 months after the OCS had been adopted. We used Karaseks job contents questionnaire (JCQ) to evaluate job stress. The cumulative trauma disorder (CTD) questionnaire was used to assess the presence of musculoskeletal symptoms. The presence of unfavorable working conditions was also assessed. Next, we evaluated whether non-work factors (such as demographic factors and life events) had influence on job stress, musculoskeletal symptoms, and complaints of unfavorable working conditions after adoption of the OCS.Results One hundred thirty nurses from the hospital (51.2%) responded to both surveys. Several JCQ scales were notably altered after OCS adoption; psychological job demand was significantly decreased (P<0.01), although subjective assessment for hazardous conditions was significantly increased (P<0.01). There was a significant increase in back complaints (P<0.05). There was considerable decrease in the number of nurses who complained of increase in work intensity (P<0.05), increase of staying time to deal with remaining duties (P<0.05), and abrupt change of duties (P<0.01). According to the analysis for the associations between non-work factors and significantly changed variables, only two non-work factors, tenure and conflicts with friend(s), showed statistical significance with complaints of increase in work intensity (P<0.05)Conclusions This study suggests that a newly adopted computerized system might have provoked changes in job stress, musculoskeletal symptoms, and the complaints of unfavorable working conditions. It was found that, despite the overall favorable changes, complaints of hazardous conditions and back symptoms increased.     

Back to the future: Sweatshop conditions on the Mexico-U.S. border. I. Community health impact of maquiladora industrial activity

Present working conditions in one of the most active areas of the maquiladora system along the Mexico-U.S. border are reminiscent of nineteenth-century U.S. sweatshops. This conclusion was reached after evaluating two separate but interrelated surveys among Mexican nationals living near the Mexico-U.S. border, one of community leaders (Paper I), and one of workers in maquiladora enterprises in the towns of Matamoros and Reynosa, Mexico (Paper II). Paper I evaluates the results of the community leaders' survey. Criteria for selection of the leaders were: level of responsibility in the community; knowledge of the industry in the region, and length of residence in the area (more than 3 years). Representatives from government, maquiladora industry management, labor union leadership, labor union activists, and community improvement activists were interviewed. Structured questionnaires with opportunities for open-ended answers were used by trained Spanish speaking interviewers. The questions covered community demographics, health care structures, governance of the region, knowledge of working conditions, and knowledge of environmental impact on the region and the community. Community leaders were ambivalent on the purported benefits of the development of these types of industries in their communities. A substantial majority (21 of 25) thought that the maquiladoras brought few positive developments, other than creating jobs. Serious concerns about overextending weak social infrastructures and about environmental deterioration were voiced. Immediate (preventive) measures appear necessary to develop community infrastructures and to protect environmental health. © 1994 Wiley-Liss, Inc.     

The impact of changes in different aspects of social capital and material conditions on self-rated health over time: A longitudinal cohort study

Individual aspects of social capital have been shown to have significant associations with health outcomes. However, research has seldom tested different elements of social capital simultaneously, whilst also adjusting for other well-known health determinants over time. This longitudinal individual-level study investigates how temporal changes in social capital, together with changes in material conditions and other health determinants affect associations with self-rated health over a six year period. We use data from the British Household Panel Survey, a randomly selected cohort which is considered representative of the United Kingdom's population, with the same individuals (N = 9303) providing responses to identical questions in 1999 and 2005. Four measures of social capital were used: interpersonal trust, social participation, civic participation and informal social networks. Material conditions were measured by total income (both individual and weighted household income), net of taxation. Other health determinants included age, gender, smoking, marital status and social class. After the baseline sample was stratified by health status, associations were examined between changes in health status and changes in all other considered variables. Simultaneous adjustment revealed that inability to trust demonstrated a significant association with deteriorating self-rated health, whereas increased levels of social participation were significantly associated with improved health status over time. Low levels of household and individual income also demonstrated significant associations with deteriorating self-rated health. In conclusion, it seems that interpersonal trust and social participation, considered valid indicators of social capital, appear to be independent predictors of self-rated health, even after adjusting for other well-known health determinants. Understandably, how trust and social participation influence health outcomes may help resolve the debate surrounding the role of social capital within the field of public health.     

我国乡镇卫生院卫生人力资源配置现状分析——基于6省18县的调查

目的:分析我国乡镇卫生院卫生人力资源配置的现状和问题。方法:采用典型抽样的方法选择6省18县296所乡镇卫生院的在岗职工作为研究对象,并访谈了20名分管农村卫生的政府官员和乡镇卫生院院长;利用描述性统计分析对定量数据进行分析,对访谈数据进行归纳、总结和主题分析。结果:乡镇卫生院卫生人力资源总量和分布不均衡,中部地区卫生人力资源配置标准较低,乡镇卫生院空编和编外用人并存现象普遍存在。乡镇卫生院内部的卫生人力资源配置不尽合理,专业卫生技术人员配置比例低于国家规定,高级职称比例较低,部分地区存在人才断档的隐忧。乡镇卫生院人力资源建设仍存在一些障碍,医学生的培养与乡镇卫生院的需求错位,乡镇卫生院人员招聘政策不合理,卫生技术人员待遇偏低、晋升职称困难、职业发展受限。建议:优化乡镇卫生院人力资源结构;调整乡镇卫生院人才招聘政策;畅通乡镇卫生院卫生技术人员的晋升通道,拓展其职业发展空间;提升卫生技术人员的待遇,增强乡镇卫生院的岗位吸引力。     

The impact of the Citibank, NA, health management program on changes in employee health risks over time

This study estimated the impact of the Citibank Health Management Program on changes in health risks among Citibank employees. McNemar chi-squared tests compared the probability of being at high risk for poor health when the first and last health-risk appraisal surveys were taken. Logistic regression controlled for baseline differences in subsequent analyses when those who participated in more intensive program features were compared with those who participated in less intensive features. Declines in risk were noted for 8 of 10 risk categories. Most changes were small, except those related to exercise habits, seatbelt use, and stress levels. For nine health risk categories, those who participated in more intensive program services were significantly more likely than others to reduce their health risks. Thus, the Citibank Health Management Program was associated with significant reductions in health risk.     

Risk and resilience: health inequalities,working conditions and sickness benefit arrangements: an analysis of the 2010 European Working Conditions survey

In this article we ask whether the level of sickness benefit provision protects the health of employees, particularly those who are most exposed to hazardous working conditions or who have a little education. The study uses the European Working Condition Survey that includes information on 20,626 individuals from 28 countries. Health was measured by self‐reported mental wellbeing and self‐rated general health. Country‐level sickness benefit provision was constructed using spending data from Eurostat. Group‐specific associations were fitted using cross‐level interaction terms between sickness benefit provision and physical and psychosocial working conditions respectively, as well as those with little education. The mental wellbeing of employees exposed to psychosocial job strain and physical hazards, or who had little education, was better in countries that offer more generous sickness benefit. These results were found in both men and women and were robust to the inclusion of GDP and country fixed effects. In the analyses of self‐reported general health, few group‐specific associations were found. This article concludes that generous sickness benefit provision may strengthen employee's resilience against mental health risks at work and risks associated with little education. Consequently, in countries with a generous provision of sickness benefit, social inequalities in mental health are smaller.