Effect of de-industrialisation on working conditions and self reported health in a sample of manufacturing workers

Does employment alter the course and outcome of schizophrenia and other severe mental illnesses? A systematic review of longitudinal research

INTRODUCTION

This review synthesized prospective evidence to assess whether achieving employment alters the course of schizophrenia-spectrum disorder.

METHOD

Researchers identified relevant analyses for review via PubMed, expert referral, and reference review and systematically applied two levels of screening to 1484 citations using seven a priori criteria.

RESULTS

A total of 12 analyses representing eight cohorts, or 6844 participants, compared illness course over time by employment status in majority schizophrenia-spectrum samples. Employment was consistently associated with reductions in outpatient psychiatric treatment (2 of 2 studies) as well as improved self-esteem (2 of 2 studies). Employment was inconsistently associated with positive outcomes in several other areas, including symptom severity, psychiatric hospitalization, life satisfaction, and global wellbeing. Employment was consistently unrelated to worsening outcomes.

DISCUSSION

Achieving employment does not cause harm among people with schizophrenia-spectrum disorder and other severe mental illnesses. Further detailed mechanistic analyses of adequately powered long-term follow-up studies using granular descriptions of employment are needed to clarify the nature of associations between employment and hypothesized benefit.

Occupational musculoskeletal and mental health: Significance of rationalization and opportunities to create sustainable production systems - A systematic review

This literature review aims to identify occupational musculoskeletal and mental health effects of production system rationalization as well as organizational-level measures that may improve health outcome ("modifiers" in this review). A short review of the effect of ergonomic interventions is included as background and rationalization is discussed as a theoretical concept. Indicator variables for occupational musculoskeletal and mental health and related risk factors are presented. Variables with a generalized format were allowed in the literature searches (e.g., job satisfaction and absenteeism were accepted as risk factor and health indicator, respectively), suitable for the research fields of work sociology, organization science, human resource management (HRM) and economics research. One hundred and sixty-two studies of rationalization effects on health and risk factors and 72 organization-level modifier results were accepted into the final database. Entries were sorted by rationalization strategy and work life sector, and trends in outcome (positive, mixed, no effect, or negative effect on health and risk factors) were determined. Rationalizations have a dominant negative effect on health and risk factors (57% negative, 19% positive); the most negative effects were found for downsizing and restructuring rationalizations in general (71 studies negative, 13 positive) and for the health care sector in particular (36 studies negative, 2 positive). The rationalization strategy High Performance Work System (HPWS) was associated with the highest fraction positive outcome studies (6 of 10 studies). Other rationalization strategies (lean practices, parallel vs. serial production and mechanization level) reported intermediate results, in part dependent on work life sector, but also on the year when studies were carried out. Worker participation, resonant management style, information, support, group autonomy and procedural justice were modifiers with favourable influence on outcome. It is concluded that production system rationalization represents a pervasive work life intervention without a primary occupational health focus. It has considerable and mostly negative influence on worker health, but this can be reduced by attention to modifiers. The results create a basis for new priorities in ergonomic intervention research.

Globalization and the Marginalization of Unskilled Labor: Potential Impacts on Health in Developed Nations

The objective of this investigation was to determine the impacts of economic globalization on labor markets and outline potential pathways for these changes to affect health status in industrialized nations. A systematic review of the economic globalization and health literature revealed that, under the impact of globalization and market deregulation, the past 25 years have witnessed de-industrialization, shifts to nontraditional, insecure work arrangements, and relatively high levels of unemployment in most developed nations. This has occurred in the context of hypermobility of capital, relative immobility of labor, and declining market position for unskilled labor. Such structural changes in the labor markets in conjunction with shifts in educational opportunities and requirements have resulted in the increasing marginalization of unskilled workers from the labor market. Aside from direct effects on health due to the threat and experience of unemployment, and given that income inequality within nations is a main driver of national health status, lowered relative wages for the unskilled will probably affect national health status through increased income inequality.

Cities of consumption: the impact of corporate practices on the health of urban populations

The increasing concentration of the world's population in cities and the growing accumulation of political and economic power by corporations create new threats to health and opportunities for improving global health. By considering the intersection of these two fundamental social determinants of well-being, we elucidate some of the mechanisms by which they influence the health of urban populations. After reviewing the changing historical impact of corporations on cities, we focus on the growth of consumption as a leading cause of mortality and morbidity and describe how the food, tobacco, automobile, and other industries promote unhealthy behaviors and lifestyles in urban settings. Cities are also sites for developing alternatives to unhealthy corporate practices, and we assess strategies used to modify practices that harm health.

An international perspective on worker mental health problems: who bears the burden and how are costs addressed?

OBJECTIVE

To discuss the burden of poor mental health in workers, who currently bears it, and how the associated rising costs are being addressed, from an international perspective.

METHOD

We identify the stakeholder groups and the costs they incur as a result of problems related to mental health in 6 different domains. In addition, we offer examples of programs, services, and strategies being used to either decrease costs or enhance benefits.

RESULTS

Mental illness is associated with a wide range of costs distributed across multiple stakeholders including government, employers, workers and their families, and the health care system. The costs incurred by the groups are interrelated; an attempt to decrease the burden for one group of stakeholders will inevitably affect other stakeholders. Thus the answer to the question of who bears the costs of poor mental health is "everyone."

CONCLUSIONS

Everyone could benefit from investment in improved mental health in the workplace. However, because the benefits associated with improved worker mental health are often distributed among several stakeholders, the incentives for any single stakeholder to pay for additional services for workers may be diluted. As a consequence, no one invests. Nevertheless, there is a role for all stakeholders, just as there are potential benefits for all. Along with government, employers, employees, and the health care system must invest in promoting good workplace health.

Factors associated with a positive attitude towards change among employees during the early phase of a downsizing process

Most research on organizational changes in working life, including downsizing, focuses on the negative attitudes and negative consequences of the change. The aim of this study was to evaluate if the employee's previous learning experience and characteristics of the working environment were associated with positive attitudes towards organizational change. The 467 employees (73.5% males) working in a global oil company in the early phases of a downsizing process were asked to answer a questionnaire with demographic variables, perception of the working environment, and attitude to change (93% response rate). Corporate social responsibility (CSR), involvement and participation, team leadership and team effectiveness were important factors related to positive attitudes towards organizational change. Non-leaders and older employees were positive to change. We conclude that employees' perceptions of their psychosocial working environment, in particular the CSR, were highly related to their attitude to organizational change.

Multivariate models of self-reported health often neglected essential candidate determinants and methodological issues

BACKGROUND AND OBJECTIVE

Self-reported health is an important indicator of overall well-being that may be influenced by diverse parameters. We intended to evaluate the variety of candidate determinants used in models of self-reported health (SRH) and to examine the methodological problems encountered in multivariate models used in recent studies in this field.

STUDY DESIGN AND SETTING

Medline searches identified articles published in 2002 in which SRH was included as an outcome, at least one other variable was used as a determinant of SRH, and the study population was not defined by the presence of specific diseases.

RESULTS

Of 1,991 initially identified reports, 56 were eligible. In 91% of the eligible articles, multivariate models were used. In total, 133 different determinants of SRH were considered (median 7 determinants considered per study with multivariate models). The proportions of studies with problems in multivariate modeling were: overfitting, 10%; nonconformity to a linear gradient, 29%; no report of tests for interactions, 63%; unspecified coding of variables, 49%; and unspecified selection of variables, 29%.

CONCLUSION

Models that try to identify what influences SRH should consider appropriate lists of candidate determinants, with proper attention to methodological aspects of multivariate modeling.

Self-esteem, stress and self-rated health in family planning clinic patients

Background

The independent effects of stress on the health of primary care patients might be different for different types of clinic populations. This study examines these relationships in a low-income female population of patients attending a family planning clinic.

Methods

This study investigated the relevance of different sources of personal stress and social support to self-rated health, adjusting for mental health, health behavior and demographic characteristics of subjects. Five hundred women who attended family planning clinics were surveyed and 345 completed the form for a response rate of 72 percent.

Results

Multiple logistic regression analysis revealed that liking oneself was related to good self-rated health (Odds ratio = 7.11), but stress or support from children, parents, friends, churches or spouses were not significant. White non-Hispanic and non-white non-Hispanic respondents had lower odds of reporting good self-rated health than Hispanic respondents (odds ratios were 2.87 and 2.81, respectively). Exercising five or more days per week also was related to good self-rated health. Smoking 20 or more cigarettes per day, and obese III were negatively related to good self-rated health (odds ratios were .19 and .22, respectively with corresponding p-values equal to .0043 and .0332).

Conclusions

Among younger low-income women, addressing low self-esteem might improve health status.

Unsafe neighborhoods, social group activity, and self-rated health

The purpose of this project was to assess the importance of stressors and social supports in influencing self-rated health in a community sample so that public health programs could be designed to address the root causes of poor health. The municipal health department in Amarillo, Texas, contracted for a Behavioral Risk Factor Surveillance survey in 2002. The dependant variable for the study was self-rated health. Results suggest that programs targeted at improving neighborhood safety and increasing involvement in organized social groups are needed. Public health agencies may need to collaborate with other governmental agencies in order to craft effective policies.