How do employment types and job stressors relate to occupational injury? A cross-sectional investigation of employees in Japan

Objective

This study investigated whether 1) the risk of occupational injury differs among permanent employees and specific types of temporary workers, 2) the risk of occupational injury differs across different employment types depending on the degree of job stressors.

Study design

A cross-sectional study design based on self-report survey data.

Methods

A total of 36,688 full-time workers (28,868 men and 7820 women; average age = 35.4) were surveyed by means of a self-administered questionnaire. Employment types consisted of permanent employment and two forms of temporary employment: direct-hire and temporary work agent (TWA). Job characteristics including job demands, job control, and social support at work were measured. Occupational injury was measured by asking whether the participant had an injury on the job in the past 12 months that required a medical treatment. To investigate the relationships between employment types, job stressors, and occupational injury, hierarchical moderated logistic regression tests were conducted.

Results

High job demands (OR = 1.44) and low job control (OR = 1.21) were significantly associated with an increased risk of occupational injury, while controlling for demographic, life style, health, and occupational factors. In addition, direct-hires (OR = 1.85) and temporary agent workers (OR = 3.26) had a higher risk of occupational injury compared with permanent employees. However, the relationship between employment types and the risk of occupational injury depended on the levels of job demands and job control. Specifically, the magnitude of the relationship between job demands and the risk of occupational injury was substantially greater for temporary work agents than for permanent employees when they reported low levels of job control. Such an interaction effect between job demands and job control on the risk of occupational injury was not observed between permanent employees and direct-hire temporary workers.

Conclusion

The current study indicated that temporary workers might be more vulnerable to occupational injury than permanent employees. High levels of job demands and low levels of job control might also add to temporary workers' risk of occupational injury, particularly for TWAs.     

How do life style factors relate to general health and overweight?

In this study we examined the associations between on the one hand the life style factors: Sports, Alcohol, Nutrition, Overweight and Smoking (SANOS), the eating styles of dietary restraint, external- and emotional eating and on the other hand overweight, energy at work and perceived general health. Using a web-based life style questionnaire, responses were obtained from 3272 employees (1254 women and 2018 men) in a large banking corporation. These data were subjected to principal component factor analysis. In both sexes, the SANOS life style factors loaded on a factor that stood for good general health and energy at work, and that, in women, additionally comprised high dietary restraint. Overweight, in contrast, loaded in both sexes on a factor that comprised: restrained eating, emotional eating (highest loading) and external eating, and, in the women, additionally general health (negative loading) and energy at work (negative loading). It is concluded that the attempt made in life style programs to elevate general health perception and lower body weight may be more successful for the latter if the program is also targeted at improvement of eating behavior.     

How do economic downturns affect the mental health of children? Evidence from the National Health Interview Survey

Research linking economic conditions and health often does not consider children's mental health problems, which are the most common and consequential health issues for children and adolescents. We examine the effects of unemployment rates and housing prices on well‐validated child and adolescent mental health outcomes and use of special education services for emotional problems in the 2001–2013 National Health Interview Survey. We find that the effects of economic conditions on children's mental health are clinically and economically meaningful; children's mental health outcomes worsen as the economy weakens. The effects of economic conditions on child and adolescent mental health are pervasive, found in almost every subgroup that we examine. The use of special education services for emotional problems also rises when economic conditions worsen. Our analyses of possible mechanisms that link economic conditions to child mental health suggest that parental unemployment cannot fully explain the relationship between economic conditions and child mental health.     

Welfare to work? Impact of maternal health on employment

OBJECTIVES: This study investigated whether health problems among poor mothers of chronically ill children affect their ability to obtain and maintain employment. METHODS: Mothers of children with chronic illnesses were surveyed at clinical and welfare agency sites in San Antonio, Tex. RESULTS: There were distinct health differences according to mothers' TANF and employment status. Mothers without TANF experience reported better physical and mental health and less domestic violence and substance use than did those who had TANF experience. Those not currently working had higher rates of physical and mental health problems. CONCLUSIONS: Poor maternal health is associated with need for cash assistance and health insurance. Policymakers must recognize that social policies promoting employment will fail if they do not address the health needs of poor women and children.     

How should the post-2015 response to AIDS relate to the drive for universal health coverage?

The drive for universal health coverage (UHC) now has a great deal of normative impetus, and in combination with the inauguration of the sustainable development goals, has come to be regarded as a means of ensuring the financial basis for the struggle against HIV and AIDS. The argument of this paper is that such thinking is a case of ‘the right thing at the wrong time’: it seriously underestimates the scale of the work against HIV and AIDS, and the speed with which we need to undertake it, if we are to consolidate the gains we have made to date, let alone reduce it to manageable proportions. The looming ‘fiscal crunch’ makes the challenges all the more daunting; even in the best circumstances, the time required to establish UHCs capable of providing both essential health services and a very rapid scale-up of the fight against HIV and AIDS is insufficient when set against the urgency of ensuring that AIDS does not eventuate as a global health catastrophe.     

How do perceptions of local neighborhood relate to adolescents' walking and cycling?

PURPOSE: To examine how perceptions of the local neighborhood relate to adolescents' walking and cycling. DESIGN: Exploratory cross-sectional study. SETTING: Birth cohort from the Nepean Hospital, Sydney, Australia. SUBJECTS: Three hundred forty-seven adolescents (79.1% response rate; 49.6% boys; mean age = 13.0 +/- 0.2 years) and their parents. MEASURES: Self-report and parental-report questionnaires. RESULTS: Multiple linear regressions, adjusted for level of maternal education, revealed that boys who reported having many peers to hang out with locally, cycled for recreation (beta = 0.242, p = .006) or for transport (beta = 0.141, p = .046) more often, and walked for transport for longer (beta = 0.129, p = .024) on weekdays. For girls this variable was related to cycling for recreation on weekends (beta = 0.164, p = .006) and walking to school (beta = 0.118, p = .002). Adolescents who waved/talked to neighbors walked for transport more often (boys, beta = 0.149, p = .037; girls, beta = 0.119, p = .012). Girls who perceived local roads to be safe spent more time walking for transport on weekdays (beta = 0.183, p = .007) and for exercise on weekends (beta = 0.184, p = .034). Parents' perception of heavy traffic was negatively associated with boys' walking for transport (beta = -0.138, p = .037) and many aspects of girls' walking and cycling. CONCLUSION: Social interaction and road safety may be important predictors of adolescents' walking and cycling in their neighborhood. Limitations are the use of self-report and cross-sectional data. Longitudinal studies may clarify these relations.     

Health from the patient's point of view. How does it relate to the physician's judgement?

OBJECTIVES: The purpose of this study was to evaluate the relationship of self-rated health to a measure of physical status, based on a professional rating of the individual's health from a strictly physical point of view. METHODS: A random selection of 407 people over the age of 20 from the north-western catchment area of greater Stockholm were invited in 1995 to a physical examination, including a self-report questionnaire with questions about self-rated health, lifestyle, psychosocial factors and quality of life. A measure of physical health on a 5-point graded scale was constructed using the information from the records of the physical examination as a base. RESULTS: Self-rated health and the professional ratings of health coincided in approximately 60% of the cases. There were a relatively large number of cases where the ratings were contradictory. The correlation between the scales was 0.45. Comparison between the two ratings with respect to association with potential determinants showed that physical factors naturally explained most of the variances in physical health, whereas social and mental well-being and somatic conditions (women) were the most important explanatory variables for self-rated health. Irrespective of whether they had "favourable" or "unfavourable" health, those with "poor" self-rated health also had perceived lower social and mental well-being, less appreciation, more somatic conditions (women) and worse coping abilities (men). CONCLUSIONS: With mental, psychosocial and social problems becoming more pronounced in sickness patterns for primary care patients, self-rated health could be a helpful device, especially when time resources for consultations are short. This measure could also give a more global view of the patient's situation when effectivity and rationality can be a threat to a holistic view of the patient.     

Does health predict the reporting of racial discrimination or do reports of discrimination predict health? Findings from the National Longitudinal Study of Youth

Racial discrimination may contribute to diminished well-being, possibly through stress and restricted economic advancement. Our study examines whether reports of racial discrimination predict health problems, and whether health problems predict the reporting of racial discrimination. Data come from years 1979 to 1983 of the US National Longitudinal Study of Youth, focusing on respondents of Black (n = 1851), Hispanic (n = 1170), White (n = 3450) and other (n = 1387) descent. Our analyses indicate that reports of racial discrimination in seeking employment predict health-related work limitations, although these limitations develop over time, and not immediately. We also find that reports of discrimination at two time-points appear more strongly related to health-related work limitations than reports at one time-point. A key finding is that these limitations do not predict the subsequent reporting of racial discrimination in seeking employment. These findings inform our knowledge of the temporal ordering of racial discrimination in seeking employment and health-related work conditions among young adults. The findings also indicate that future research should carefully attend to the patterns and timing of discrimination.     

How do price minimizing behaviors impact smoking cessation? Findings from the International Tobacco Control (ITC) Four Country Survey

This paper examines how price minimizing behaviors impact efforts to stop smoking. Data on 4,988 participants from the International Tobacco Control Policy Evaluation (ITC) Four-Country Survey who were smokers at baseline (wave 5) and interviewed at a 1 year follow-up were used. We examined whether price minimizing behaviors at baseline predicted: (1) cessation, (2) quit attempts, and (3) successful quit attempts at one year follow up using multivariate logistic regression modeling. A subset analysis included 3,387 participants who were current smokers at waves 5 and 6 and were followed through wave 7 to explore effects of changing purchase patterns on cessation. Statistical tests for interaction were performed to examine the joint effect of SES and price/tax avoidance behaviors on cessation outcomes. Smokers who engaged in any price/tax avoidance behaviors were 28% less likely to report cessation. Persons using low/untaxed sources were less likely to quit at follow up, those purchasing cartons were less likely to make quit attempts and quit, and those using discount cigarettes were less likely to succeed, conditional on making attempts. Respondents who utilized multiple behaviors simultaneously were less likely to make quit attempts and to succeed. SES did not modify the effects of price minimizing behaviors on cessation outcomes. The data from this paper indicate that the availability of lower priced cigarette alternatives may attenuate public health efforts aimed at to reduce reducing smoking prevalence through price and tax increases among all SES groups.     

How do countries regulate the health sector? Evidence from Tanzania and Zimbabwe

The health sectors in many low- and middle-income countries have been characterized in recent years by extensive private sector activity. This has been complemented by increasing public-private linkages, such as the contracting-out of selected services or facilities, development of new purchasing arrangements, franchising and the introduction of vouchers. Increasingly, however, experience with the private sector has indicated a number of problems with the quality, price and distribution of private health services, and thus led to a growing focus on the role of government in regulation. This paper presents the existing network of regulations governing private activity in the health sectors of Tanzania and Zimbabwe, and their appropriateness in the context of emerging market realities. It draws on a comparative mapping exercise reviewing the complexity of the variables currently being regulated, the level of the health system at which they apply, and the specific instruments being used. Findings indicate that much of the existing regulation occurs through legislation. There is still very much a focus on the 'social' rather than 'economic' aspects of regulation within the health sector. Recent changes have attempted to address aspects of private health provision, but some very key gaps remain. In particular, current regulations in Tanzania and Zimbabwe: (1) focus on individual inputs rather than health system organizations; (2) aim to control entry and quality rather than explicitly quantity, price or distribution; and (3) fail to address the market-level problems of anti-competitive practices and lack of patient rights. This highlights the need for additional measures to promote consumer protection and address the development of new private markets such as for health insurance or laboratory and other ancillary services.     

Do green areas affect health? Results from a Danish survey on the use of green areas and health indicators

The article presents the result from a Danish survey on access and use of green areas and the impact on experienced stress and obesity. The statistical results indicate that access to a garden or short distances to green areas from the dwelling are associated with less stress and a lower likelihood of obesity. The number of visits cannot explain the effects of green areas on the health indicators. It is suggested that the significance of distance to green areas is mainly derived from its correlation with the character of the neighbourhood and its conduciveness to outdoor activities and "healthy" modes of travel.     

How to do the correct discard of medicine residues?

The final destination of medicine residues is a relevant subject to the public health due to the pharmacological properties of each medicine, that in future will become a residue and will need to be treated. In Brazil, the correct discard of the solid medicine residues is regulated by the Ministry of Health and also by the Ministry of Environment, that aim to provide the producers of medicine residues with instruments that enable them to correctly discard those residues. However, there are some obstacles that can only be overcome through the integration of all agents involved in this process. The purpose of this article is to make a critical survey of the legal instruments offered by the regulatory institutions, locating each agent and its responsibilities concerning the protection of public health and the environment.     

How do nurses perceive their role on health councils?

This study is part of a Master's thesis on the participation of nurses on Health Councils and aims to analyze the perception nurses have of their role in these forums. A qualitative approach is used with a theoretical referential of Discourse Analysis. The subjects are nurses who have been members of Local and Municipal Health Councils in Goiania, Goiás State, since 1995. The perceptions expressed are related to their concerns about not monopolizing the councils, about councils--especially local ones--being used for party political purposes, about avoiding corporate positions, about council autonomy, lack of infrastructure, political interference, lack of preparation on the part of professionals and the necessity of training for political quality, the contributions that they can make to discussion, reflection, group analysis, interventions and technical support. Hopeful perspectives refer to continued change in order to qualify a greater number of councilors, to the growing emancipation of people for citizenship and to the reliability of present administrations.     

How do directors of public health perceive leadership?

This study examines how directors of public health (DsPH) perceive effective leadership. Kelly's repertory grid technique is used. A total of 13 out of a possible 14 DsPH in one NHS region of England were interviewed. Qualitative and quantitative analysis were carried out. The findings show that male DsPH (n = 8) rate their leadership ability more highly than do female DsPH (n = 5). Qualitative analysis produced a number of categories of constructs, some of which are perceived to be indicative of effective leadership, these being "working for others", "personal attributes", "vision and innovation" and "courage and integrity" Some categories appear to be applicable only to the UK (or to public health) and not to the existing dominant US models of leadership. In general, DsPH perceptions of effective leadership converge with current theories; most specifically the UK-based theories. This study therefore refutes any simple extrapolation of US theories of leadership to UK health organisations.     

How should governments respond to the social determinants of health?

The notion of the social determinants of health is now prominent in international and national health policy discussions. However, action on the social determinants primarily lies outside the sphere of influence of Ministries of Health. Here it is proposed that Ministries of Health use part of their budgets to sponsor initiatives by other government departments that address the social determinants of health, and, in particular, reduce chronic stress or improve individual prospects of healing.     

Inpatient reimbursement system in Italy: How do tariffs relate to costs?

In 1995 the Italian National Health Service begun to fund its hospitals on a per case basis, classified according to a DRGs system. Five out of 21 Italian regions developed a regional DRG tariff system, while the majority adopted the system set at national level. The article presents how tariffs are set by the national government and by the Lombardy Region. Production cost (mainly assessed according to a top-down, gross-costing approach) is only one of the variables used for setting tariffs. Microcosting is not used and, apparently, is not deemed as an appropriate methodology. After 10 years since their introduction national and regional tariffs are still not derived from explicit algorithms.