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PubMed1999

The unemployment iceberg: what is beneath, behind, and ahead?

Unemployment is a complex issue, affected by many different factors, institutions, and policies. It can be viewed as the ultimate of four levels of institutional settings, each with its own options and processes: the potential working population; family/household patterns affecting labor force participation; the employment system, its working time regimens, and the allocation of paid and unpaid work; and finally, economic exclusion, by unemployment, poverty, or both. The author examines this complexity and describes the experiences of some OECD countries over the last few decades, then outlines some policy options for addressing the problem of unemployment. The article concludes with a discussion of some crucial tests confronting social democracy and the trade union movement.

Cross-Cultural Comparison↗
PubMed2000

A benefit of one's own: older women's entitlement to Social Security retirement.

This article explores differences in Social Security eligibility and benefit levels for older men and women using survey data from the Health and Retirement Study combined with administrative records on actual work histories and Social Security rules. We are able to determine the fully insured status of those persons, how close they are to meeting eligibility criteria when they are not fully insured, and their prospects for benefits. Around three-quarters of older women nearing retirement today will be fully insured for Social Security old-age benefits on the basis of their own accounts, but the rest would need substantial extra employment to rise above the eligibility threshold. Further, two-thirds of older married women who are fully insured have sufficient lifetime earnings to translate into an age-65 primary insurance amount worth at least half their husband's, but the other one-third can expect no additional retirement benefit from contributing to Social Security late in life. Finally, most wives will not be able to improve their benefits by working more under current rules. These results have mixed implications regarding the potential impact of women's rising labor force attachment on eventual retirement benefits. Working more years could increase women's chances of becoming eligible for Social Security benefits, but that effect is likely to be small. Furthermore, even when women do become fully insured according to the rules, not many wives will receive a higher benefit at the margin. The reason is that married women still receive higher Social Security benefits as a spouse than they do on the basis of their own work record. In fact, the net benefit from Social Security due to additional work is negative once one takes into account the Social Security contributions the women paid while employed. Benefits paid to widows are even more likely to be based on the spouse's work history rather than on the woman's. Hence, the rising labor market attachment of women in the future may increase their eligibility for benefits but will produce only modest (and often negative) impacts on their old-age Social Security benefits under current rules.

Aged↗
PubMed2026

Understanding psychosocial adjustment in military-to-civilian transition: A latent profile analysis of ex-serving Australian Defence Force members.

Military-to-civilian transition is a critical life stage that can expose veterans to elevated risks of psychological distress, social difficulties, and reduced wellbeing. Although psychosocial factors are central to successful reintegration, little is known about distinct patterns of needs among ex-serving Australian Defence Force (ADF) members. This study used latent profile analysis (LPA) to identify psychosocial needs profiles across five domains of the Military-Civilian Adjustment and Reintegration Measure (M-CARM) in a sample of 725 ex-serving ADF members. The optimal three-class solution identified: a Low Adjustment Need (LAN) group (20.7%) reporting minimal reintegration challenges; a Cultural Adjustment Need (CAN) group (42.9%) characterized by cultural adaptation difficulties, particularly beliefs about civilians and regimentation; and a Cultural and Psychological Need (CPN) group (36.4%) showing broader challenges across beliefs about civilians, purpose and connection, regimentation, and resentment and regret. The CAN group was more likely to be male, have lower educational attainment, and have no combat deployment history. The CPN group was similarly male dominated with lower education, and was additionally characterized by Navy service, unemployment or not being in the labor force, and medical discharge. Compared with the LAN group, both CAN and CPN groups reported higher levels of depression, anxiety, posttraumatic stress, and nightmare distress, as well as poorer quality of life and greater functional impairment. These findings highlight persistent reintegration challenges among veterans and support the need for stratified support models, ranging from psychoeducation to intensive multidisciplinary care, to better address diverse psychosocial needs of ex-serving ADF members.

Australian defense force↗
PubMed1998

Pregnancy and the working woman: a review.

The potential impact of employment on pregnancy is an important issue that merits assessment, given the increasing numbers of women entering the labor force and continuing employment throughout pregnancy. A review of the literature evaluating the effects of employment on pregnancy is presented, including a brief historical and legal perspective, as well as employment statistics in the USA. There is emerging evidence from various studies suggesting that long working hours and prolonged standing may place a pregnancy at risk. Thus, physicians need to counsel their patients about these potential risks and provide recommendations for early modification of employment activities, in order to have a positive impact on pregnancy outcome.

Attitude to Health↗
PubMed1985

The increasing proportion of men with low earnings in the United States.

This study has provided an examination of recent changes in the lower tail of the male earnings distribution. Data from the CPS for 1967 through 1978 were used to analyze the increasing proportion of male workers with annual and weekly earnings below a fixed low earnings threshold. Our central purpose was to assess the extent to which the growth in the probability of low earnings could be explained by the more salient changes in the structure of the male labor force over this period. To this end, logit analysis was used to examine the roles of education, experience, cyclical conditions, and cohort size in explaining variations in the probability of subthreshold earnings, conditional on experience and education. The estimates generally yielded the expected effects. However, the most important findings from our analysis concern the trends estimated net of education, experience, unemployment, and cohort size. These variables appear to explain satisfactorily the recent growth in the proportion of men with low earnings among those with at least sixteen years of education. For all other educational categories, our independent variables were unable to account for a major portion of the growth in the probability of low earnings. Our results supplement previous findings of positive trends for mean annual and weekly earnings net of a similar set of independent variables. Hence, we have provided substantial evidence of stagnation in the lower tail of the male earnings distribution--a stagnation not shared by the average worker nor fully explicable by education, experience, aggregate unemployment, or the entrance of the baby boom cohort into the labor market. Investigation of alternative explanations for this phenomenon, such as changes in female labor supply or the structure of labor demand, is clearly warranted.

Adolescent↗
PubMedDate not supplied

Punch out the time clocks.

Today's work environment is full of contradictions. On the one hand there aren't enough jobs to go around and on the other some people who have jobs would trade pay for time off. Some managers, at least managers of one-fifth of the labor force, are resolving this contradiction with an elegantly simple solution. They are installing some version of alternative work schedules: flexitime, permanent part-time jobs, job sharing, compressed workweeks, and work sharing, which give employees more control over their professional and personal lives and give employers, for instance in an economic downturn, a way, a way to keep experienced workers on the job without straining budgets. The authors of this article, both of whom have helped develop alternative work schedules, describe the five forms and how numerous employers across the country are adapting them to their purposes. They predict that eventually most U.S. employees will be working under some form of the new schedules.

California↗
PubMed2003

Depressive and anxiety symptoms among housemaids.

BACKGROUND: Housemaid, the most common occupation in the female labor force in Brazil, is known to be targeted by a generalized racial and job discrimination, which can generate mental suffering such as depressive and anxiety symptoms. In this cross-sectional study, the association between being a maid and having depressive and anxiety symptoms was evaluated. METHODS: Data for this study was taken from a former survey carried out in a random sample of 470 families living in a poor area of the city of Salvador, capital of the state of Bahia, Northeast Brazil. The study population comprised all women between the ages of 14 and 69, who reported having a paid occupation (n = 335). Data was collected by trained interviewers, using questionnaires. Psychological symptoms were identified using the Questionnaire for Psychiatric Morbidity among Adults, (QMPA), from which only those related to depression and anxiety (QMPA-SAD) were analyzed. RESULTS: Logistic regression showed that being a housemaid was positively associated with "sadness/tiredness" (adjusted prevalence ratio, PR(adj) = 1.64; 95% confidence interval, CI: 1.17-2.28), "poor concentration" (PR(adj) = 1.81; 95% CI: 1.13-2.90), "palpitations" (PR(adj) = 2.22; 95% CI: 1.28-3.84), and "aggressive behavior" (PR(aj) = 1.58; 95% CI: 1.01-2.46). CONCLUSIONS: Although cross-sectional designs are limited by causal inference, these results are in accordance with those obtained in qualitative studies. Advances in the Brazilian labor legislation with respect to domestic service may help to reduce social discrimination and contribute towards minimizing a possible mental burden resulting from this occupation.

Adolescent↗
PubMed2000

The determinants of time off work after childbirth.

Relatively little is known about the role that leave policies--family, parental, or maternity-leave policies--play in facilitating time off work after childbirth. Yet time off is a critical element of leave policies, as it facilitates the mother's recovery from childbirth and promotes maternal-infant attachment. Using data from Minnesota, the state with the highest rate of female labor force participation, we examine the extent to which policies, relative to personal, job, and workplace characteristics, determine the duration of women's childbirth-related leaves from work. A random sample of women identified from vital statistics records is used to estimate the relationship between leave policies and time off work after childbirth. Of our sample 85 percent had access to some paid leave benefits, although only 46 percent had paid maternity leave benefits. The difference in duration of leave between women with and without paid leave policies was approximately four weeks, a substantial difference for most women and their infants. Paid leave policies and spousal earnings as primary determinants of maternal time off work, suggest problems in the use of unpaid leave for economically vulnerable women.

Costs and Cost Analysis↗
PubMed2004

The economic impact of chronic prostatitis.

BACKGROUND: Little information exists on the economic impact of chronic prostatitis. The objective of this study was to determine the direct and indirect costs associated with chronic prostatitis. METHODS: Outcomes were assessed using a questionnaire designed to capture health care resource utilization. Resource estimates were converted into unit costs with direct medical cost estimates based on hospital cost-accounting data and indirect costs based on modified labor force, employment, and earnings data from the US Census Bureau. RESULTS: The total direct costs for the 3 months prior to entry into the cohort, excluding hospitalization, were $126 915 for the 167 study participants for an average of $954 per person among the 133 consumers. Of the men, 26% reported work loss valued at an average of $551. The average total costs (direct and indirect) for the 3 months was $1099 per person for those 137 men who had resource consumption with an expected annual total cost per person of $4397. For those study participants with any incurred costs, tests for association revealed that the National Institutes of Health Chronic Prostatitis Symptom Index (P<.001) and each of the 3 subcategories of pain (P =.003), urinary function (P =.03), and quality-of-life (P =.002) were significantly associated with resource use, although the quality-of-life subscale score from the National Institutes of Health Chronic Prostatitis Symptom Index was the only predictor of resource consumption. CONCLUSIONS: Chronic prostatitis is associated with substantial costs and lower quality-of-life scores, which predicted resource consumption. The economic impact of chronic prostatitis warrants increased medical attention and resources to identify and test effective treatment strategies.

Absenteeism↗
PubMed2001

Child health status and parental employment.

OBJECTIVE: To understand the relationship between several measures of child health status and the employment of parents. DESIGN: A cross-sectional study using 1994 National Health Interview Survey on Disability data. PARTICIPANTS: A nationally representative sample of children and their parents. OUTCOME MEASURES: Maternal and paternal employment (measured separately). INTERVENTION: We use a series of logistic regression models with maternal and paternal employment as the dependent variables and the health status of the child with the poorest health status in the family as the primary independent variable. Models additionally include sociodemographic correlates of employment. RESULTS: Having a child with poor health status, as measured by general reported health, hospitalizations, activity limitations, and chronic condition or disability status, is associated with reduced employment of mothers and fathers. For example, the odds ratios of being employed for having a child with an activity limitation are 0.75 for mothers (95% confidence interval, 0.67-0.85) and 0.66 for fathers (95% confidence interval, 0.53-0.82). CONCLUSIONS: Having a child with poor health status is associated with reduced maternal and paternal employment. Further studies are needed to determine whether poor child health status causes reductions in parental labor force participation. If such a causal relationship exists, it has important implications for social policy, employment policy, and clinical anticipatory guidance.

Adolescent↗
PubMed1985

The educational, vocational, and marital status of growth hormone-deficient adults treated with growth hormone during childhood.

The goal of growth hormone therapy in childhood is to increase stature, thereby facilitating normal psychosocial development. To determine the social outcome of patients with growth hormone deficiency (GHD), we interviewed 116 adults with GHD across Canada, including 86 men and 30 women 18 to 38 years of age who were treated with growth hormone during childhood. The education of the 96 patients who had completed their formal education was similar to their siblings and to the general population. Of the patients in the labor force, 35.4% were unemployed; the unemployment rates for those patients less than 25 years of age and those 25 years of age or older were 45% and 23%, respectively, compared with national rates of 21.2% and 9.4% for the same age groups, respectively. Of the 90 patients with GHD who were not attending school, 70 lived with their parents or relatives. Only 15 patients were married; one was divorced. The percentage of patients with GHD who were married was less than 30% of the expected age-adjusted rate. No difference in the rate of employment or marriage was found between the patients with idiopathic isolated GHD and organic hypopituitarism. In summary, the achievements of patients with GHD seem to be normal in the education system, but the rate of employment and marriage are much lower than expected. This poor outcome was unrelated to the response to growth hormone therapy and emphasizes the need to develop strategies that lead to more satisfactory psychosocial integration of patients with GHD in adult life.

Adolescent↗
PubMed2004

Significant correlation of trauma epidemiology with the economic conditions of a community.

HYPOTHESIS: Depressed economic conditions are associated with increased trauma and violent crime. DESIGN: Retrospective cohort study of prospectively collected data. SETTING AND INTERVENTIONS: Population and labor force data from 1992 to 2002 were obtained from the state Employment Development Department and the US Census Bureau. County data regarding the total number of trauma activations and mechanism of trauma were recorded. Crime statistics were obtained from the state Department of Justice and the Federal Bureau of Investigation. Correlation statistics were performed. Health care coverage for victims of penetrating trauma was also analyzed. MAIN OUTCOME MEASURES: Correlation between unemployment rate, trauma epidemiology, and crime indexes. RESULTS: The correlation between the percentage penetrating trauma and the unemployment rate was R = 0.92 (Orange County, California) and R = 0.95 (Los Angeles County, California) (P<.001). The unemployment rate was also tightly correlated with Federal Bureau of Investigation crime indexes in both counties and in the state (P<.001). The overall county population was positively correlated with the total number of trauma occurrences in both counties (P<.001) but was negatively correlated with the number of penetrating traumas and crime indexes (P<.001). Seventy-five percent of penetrating trauma victims had no health care coverage or had state or county aid only. CONCLUSIONS: The proportion of violent crime in a community is closely associated with the unemployment rate of that community and will vary longitudinally over time. The overall county population is less important. These data may be used for public policy initiatives regarding resource allocation to trauma centers, law enforcement planning, and programs aimed at crime prevention.

California↗
PubMed1997

Spondylolysis in prehistoric human remains from Guam and its possible etiology.

This study reports the findings of complete bilateral separation of the neural arch (spondylolysis) in 176 inhumations from the Hyatt Site, Tumon Bay, which is located on the west side of the island of Guam. Skeletons were excavated and analyzed by the Paul H. Rosendahl Inc. (PHRI) team in 1989-1990. The inhumations were associated with the pre-European Latte Period (circa 1,200-1,521 A.D.). This period was characterized by the use of large stone pillars, called latte sets, for the construction of houses. Of the 176 individuals, only 38 adult skeletons had complete spines, and 21% (8/38) of these had evidence of spondylolysis in their lumbar vertebrae, particularly in L-5. The age of the eight individuals range from 30 to 50 years. No children were found with spondylolysis. Of the males 29.4% (5/17) had spondylolysis, as did 14.3% (3/21) of the females. However, the difference between the sexes was not statistically significant. Though the sample is small, it is suggested that the high incidence of lumbar spondylolysis found in these ancient Chamorros was related to lower back traumatic events. The transport of latte stones, involving hyperextension and torque of the lower back, while dragging the stones, probably contributed to the development of microfractures in the spine and subsequent spondylolysis. If this hypothesis is correct, then both males and females appear to have been participants in an organized community labor force. It is predicted that similar frequencies of spondylolysis will be found at other Latte sites.

Bone and Bones↗
PubMed1996

Self-reported carpal tunnel syndrome: predictors of work disability from the National Health Interview Survey Occupational Health Supplement.

The objective of this study was to identify risk factors for work disability among persons with carpal tunnel syndrome (CTS). The study was designed to analyze data from the Occupational Health Supplement of the National Health Interview Survey, a nationwide, population-based survey. Subjects included 544 survey respondents with self-report of CTS and 32,688 survey respondents without CTS, all aged 18-64 years, and with a history of labor force participation. Measurements were as follows: Dependent variables were work disability, defined either as cessation of employment without attribution of cause or, alternatively, as cessation of employment or job change specifically attributed to CTS by the survey respondent. Independent variables were ergonomic risk of work disability, defined by minutes of workplace repetitive hand and wrist bending for the most recent job held. This measure was derived from responses categorized by an occupation and industry matrix independent of CTS status. Socio-demographic and health status risk factors for work disability were based on the respondent report. The main results were as follows: Among 544 persons with CTS, 58 (11%, CI 8-13%) reported work disability specifically attributed to CTS, representing an estimated national prevalence of 240,578 persons with this limitation. Workplace ergonomic risk, measured as repetitive hand or wrist bending in the occupation and industry of last employment, was a significant factor predictive of CTS-attributed work disability (per 120 min of daily exposure, OR 1.7, CI 1.1-2.6), even after taking into account socio-demographic factors and health status. The conclusions were that work disability among persons with CTS is common. For those with CTS, working conditions characterized by repetitive bending of the hand or wrist may increase the risk of work disability associated with this condition.

Adolescent↗
PubMed1998

The economic benefits of supported employment for persons with mental illness.

BACKGROUND: Policies and programs that emphasize employment for persons with mental illness are often promoted with the goals of improving economic self-sufficiency and reducing dependence on public welfare programs. At present, there is little empirical evidence about the actual effect of vocational interventions on economic self-sufficiency or on use of public benefits by persons with mental illness. STUDY AIMS: This study provides a preliminary look at how participating in supported employment, a form of vocational rehabilitation emphasizing ongoing support in competitive jobs, affects the amount that participants earn from work and the total amount of income they receive from all sources. Further, we examine the extent to which receiving public benefits affects the amount earned from private employment, taking into consideration other factors that might be associated with benefit status. METHODS: Data are from a randomized trial of supported employment interventions. This analysis followed 137 of those study participants with severe mental illness for 18 months after they enrolled in either of two supported employment programs. Income from various sources was estimated based on interviews with study participants upon study entry and at six-month intervals thereafter. Changes in income from work, government and other sources were analyzed using paired Wilcoxon matched-pairs signed-ranks tests and t-tests. Using ordinary least-squares regression, we analyzed the effect of benefit status on changes in earnings, taking into account diagnosis, work history, education, program type, site of program, psychiatric symptoms, global functioning and previous earnings. RESULTS: Estimated total income increased by an average of $134 (US) per month after enrolling in supported employment. More than three-quarters of this increase was from government sources, such as Social Security and educational grants. The increase in government income was largely due to participants applying for and getting cash benefits for the first time. Social Security payments for those receiving benefits before enrollment did not change significantly. A small group of persons (n = 22) who did not receive Social Security benefits before or after enrolment earned significantly more from competitive employment after enrolling than did those who received benefits. This finding persisted after taking into acount differences in work history, clinical and functional variables and education. LIMITATIONS: Because of the relatively small sample size and the lack of continuous measures of income these results should be considered preliminary. CONCLUSIONS: Supported employment, one of the more effective forms of vocational rehabilitation for persons with mental illness, did not reduce dependence on government support. Receiving government benefits was associated with lower earnings from work. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: These findings suggest that most persons in treatment for severe mental illness need continued public financial support even after enrolling in vocational rehabilitation programs. IMPLICATIONS FOR HEALTH POLICY FORMULATION: Undoubtedly increased labor force participation can benefit persons with mental illness in a number of ways. However, policy makers should be careful about justifying increased access to vocational programs on the basis of reduced spending for income support. Further, targeting such programs only to persons receiving income support may overlook the clients who can benefit most: those who are not currently receiving benefits. IMPLICATIONS FOR FURTHER RESEARCH: Policy makers need a better understanding of how vocational interventions and income support programs affect the income and well-being of persons with mental illness. Studies similar to this one should be repeated with larger, more diverse samples that will allow use of instrumental variables statistical techniques.

Journal Article↗
PubMed2000

Paths of reentry: employment experiences of injured workers.

BACKGROUND: An injury at work can result in a change in jobs or employers, unemployment, or withdrawal from the labor force. Substantial life changes can occur, often mediated by the initial attempt to return to employment. METHODS: This study uses ethnographic interviews of 204 workers injured in Florida. RESULTS: The study describes three paths to reemployment taken by the injured workers. The "welcome back" path provides workers with a sense of being valued by their preinjury employers. This positive effect remains, even for those who are unable to continue working because of limitations imposed by their injuries. Other paths cause workers to feel undervalued, as discarded or damaged goods, and generate hostility and resentment. Females in all groups are less likely to be currently working. White males were more likely than other groups to be employed in skilled jobs and are also the most likely to return to light-duty jobs and to remain in their preinjury jobs over time. CONCLUSIONS: Half of the workers in this study experience employer indifference or hostility in response to their attempts to return to work after an occupational back injury. After injury, there are both commonalities and meaningful disparities in post-injury experiences of White, Black, and Hispanic male and female workers.

Accidents, Occupational↗
PubMed2000

Mortality from six work-related cancers among African Americans and Latinos.

BACKGROUND: Ethnic minorities have been omitted from many occupational health studies, despite their substantial contributions to the labor force and documented cases of high exposures in some settings. To describe the occurrence of potentially work-related cancers among African American and Latino Workers, we conducted an epidemiologic study based on death certificate data. METHODS: Data were obtained from 21 states during 1985-1992. Directly adjusted proportionate mortality ratios (PMRs) and standardized mortality rate ratios (SRRs) for ages 20-64 years were computed for cancers of the lung, nasal cavity, pleura, and peritoneum, malignant melanoma and leukemia using the mortality data and population counts from the 1990 census. RESULTS: Proportionate mortality was generally low for both groups, but African Americans had higher than expected mortality rates for leukemia and cancers of the lung, nasal cavity, and peritoneum. Industry-specific analyses indicate excess leukemia among African American men in the rubber industry (PMR 2.08, 95% confidence interval (CI) 1.29 - 3.35), Latino men in textile (PMR 2. 31, 95% CI 0.81 - 5.13) and wood industries (PMR 2.03, 95% CI 0.81 - 5.13), and Latino women in the chemical industry (PMR 2.18, 95% CI 0.59 - 8.10), among other findings. Excess cancer of the pleura and peritoneum was observed among workers with a variety of usual occupations, consistent with widespread exposure to asbestos. CONCLUSIONS: This study demonstrates the utility of surveillance data bases for generating basic epidemiologic information on historically neglected workers. Leads about specific workplace exposure can be followed up in more detailed studies.

Adult↗