Construction of early and midlife work trajectories in women and their association with birth weight

Women’s Occupational Patterns and Later Life Physical Functioning

Objective: Timing and accumulation of work-related exposures may influence later life health. This study evaluates the association between women’s work patterns and physical functioning. Method: Work history and physical functioning information was collected at baseline for U.S. women ages 50 to 79 years in the Women’s Health Initiative Observational Study ( N = 75,507). We estimated life course workforce participation patterns using latent class analysis. Associations between work patterns and physical limitations were explored using modified Poisson regression. Results: Compared with working continuously, women who left the workforce early had 8% increased risk and women who worked intermittently had 5% reduced risk of physical limitations later in life. The negative association with intermittent workforce participation was stronger for women with substantively complex work (9% reduced risk) than for women with nonsubstantively complex work (2% reduced risk). Discussion: Life course work patterns and characteristics may contribute to physical functioning later in life among women.

Association of Birthweight With Maternal Trajectories of Effort-Reward Imbalance and Demand-Control Across Pregnancy

OBJECTIVES

We assessed longitudinal patterns of effort-reward imbalance (ERI) and demand-control (DC) scores in pregnancy, and their association with newborn birthweight (BW).

METHODS

Sixty-one women were surveyed four times across pregnancy using the ERI and DC questionnaires. Trajectories of change in ERI and DC scores across pregnancy were constructed using growth mixture modeling, and their associations with BW were examined with generalized linear regression.

RESULTS

Declining ERI (diminishing effort with stable/increasing reward) was associated with higher BW (408 g; P = 0.015), and was robust to other work factors. DC trajectory was not significantly associated with BW.

CONCLUSIONS

Declining ERI may reflect improved work psychosocial climate across pregnancy, or a conscious reduction in effort. The ERI model may represent more flexible work characteristics, whereas job control may be less amenable to short-term alteration. Surveys in more diverse pregnant working populations could be recommended.

Longitudinal Assessment of Effort-Reward Imbalance and Job Strain Across Pregnancy: A Preliminary Study

OBJECTIVES

To assess longitudinal changes in occupational effort-reward imbalance (ERI) and demand-control (DC) scores across pregnancy and examine associations with blood pressure (BP) during pregnancy.

METHODS

A pilot repeated-measures survey was administered four times to a sample of working women across pregnancy using the ERI and DC instruments. Demographic data and blood pressure measurements were collected at each interval. Growth mixture modeling was used to examine trajectories of change in occupational characteristics. Associations with BP were examined using repeated-measures linear regression models.

RESULTS

ERI model components (effort, reward, and overcommitment) all declined across pregnancy while job control remained stable. Increasing ERI trajectory was associated with higher systolic BP (b = 8.8; p < 0.001) as was high overcommitment; declining ERI also showed a lesser association with higher BP. Associations between DC trajectories and BP were much smaller, and non-significant once controlled for overcommitment.

CONCLUSIONS

Self-assessed efforts, rewards, and overcommitment at work decline across pregnancy in our participants, while job control remains stable. Replication in a more diverse pregnant working population is warranted to confirm these results. These preliminary data suggest that further investigation into the factors that may be linked with improved work psychosocial climate during pregnancy may be useful in order to improve pregnancy outcomes.

A review of recent literature on materialist and psychosocial models for racial and ethnic disparities in birth outcomes in the US, 2000-2014

OBJECTIVE

Material and psychosocial factors exacerbate racial disparities in health outcomes. This review sought to ascertain recent knowledge of the effects of materialist and psychosocial factors on differences in low birthweight (LBW) and preterm delivery (PTD) outcomes between Black and White mothers.

DESIGN

Search and review was conducted for studies that examined: (a) neighborhood-level deprivation as an indicator of material conditions, and (b) racial discrimination or occupational stressors as indicators of psychosocial stress. The outcomes of interest were LBW and PTD.

RESULTS

Material and psychosocial factors significantly and negatively affected Blacks more than Whites, and were associated with increased adverse outcomes. Of five studies with a homogeneous Black study sample, three reported no effect on outcomes in women exposed to material or psychosocial factors.

CONCLUSION

Through this review we find that in comparison to White women, Black women are at higher risk of adverse outcomes due to both psychosocial stress and meso-level deprivation, after accounting for personal factors. A better understanding of effects on health outcomes of material and psychosocial factors in Black women is needed. Further investigation into materialist and psychosocial factors, will allow us to better understand the factors driving PTD and LBW disparities in the US.

Enhancing women's health: A call for social work research

This article presents a critical synthesis of the social work empirical literature on women's health. In light of recent policy changes that directly affect women's health and social work, the authors conducted a literature review of recent publications (2010-2015) regarding social work and women's health nationally. Despite frequent accounts cited in the literature, there has been no comprehensive review of issues involving women's health and social work in the United States. The purpose of this review is to examine the current social work literature addressing women's health at the national (U.S.) level. This research presents a summary description of the status of the social work literature dealing with women's health, specifically 51 articles published between 2010 and 2015. Our search highlights the need for social work research to fill gaps and more fully address the needs of women across the lifespan.

Association Between Sedentary Work and BMI in a U.S. National Longitudinal Survey

INTRODUCTION

Technological advancements have made life and work more sedentary, and long hours of sitting are known to be associated with many health concerns. Several studies have reported an association between prolonged sitting time at work and weight gain, but the results are inconsistent. This study examined the relationship between sitting time at work and BMI using data from a large prospective cohort of U.S. men and women from 2002 to 2010. Initial analyses were performed in 2013, with additional analyses in 2014 and 2015.

METHODS

The sample size at the base year (2002) was 5,285 and the age range 38-45 years. The outcome, BMI, was based on self-reported measures of height and weight. Estimates of workplace sitting time were linked from an external database (Occupational Information Network), and the occupation-wide rating for sitting time was linked to survey participants by occupation. Fixed-effects models controlling for time-invariant effects of all time-invariant characteristics were employed to examine the association, controlling for age, education, work hours, and hours of vigorous and light/moderate physical activities.

RESULTS

Longer sitting time was significantly associated with higher BMI for the overall sample (β = 0.054; p<0.05) and men (β = 0.086; p<0.01). For women, the association was not statistically significant.

CONCLUSIONS

The findings provide further support for initiatives to reduce workplace sitting time as a means of reducing the risk of weight gain and related health conditions.