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PubMed1995

Smaller socioeconomic inequalities in health among women: the role of employment status.

BACKGROUND: Socioeconomic inequalities in health are smaller among women than among men. In this paper, it is hypothesized that this is due to a gender difference in employment status. METHODS: We used data from the baseline of a Dutch longitudinal study. The socioeconomic indicators were educational level of the respondent and occupational level of the main breadwinner. Logistic regression was used to assess the size of socioeconomic inequalities in the prevalence of chronic conditions and less than 'good' perceived general health. RESULTS: The smaller socioeconomic inequalities in health among women were partly due to a less pronounced concentration among women than among men of relatively unhealthy employment status categories (unemployed, long-term work-disabled) in lower socioeconomic groups. The smaller inequalities in perceived general health among women could also partly be explained by the smaller overall size of the group of unemployed/long-term disabled/early retired among women than among men, a group which is characterized by relatively large inequalities in health. CONCLUSION: These findings suggest that in the Netherlands the low proportion of women in paid employment, and thereby the low proportion of the unemployed/long-term disabled/early retired, explains part of the smaller socioeconomic inequalities in health among women. The more pronounced concentration of those with a long-term work disability in lower socioeconomic groups among men, also points at the importance of working conditions for the gender difference in the size of socioeconomic inequalities in health.

Adult↗
PubMed2003

Role of workplace safety: a revisit of the relationship between job satisfaction and employment status.

This study evaluated the relationship between employment status (i.e., part- and full-time) and job satisfaction, with the focus on the moderating roles of perceived injury risk and injury incidence. The results found that the level of job satisfaction for full-time workers was about the same regardless of the level of injury risk they perceived. In contrast, job satisfaction of part-time workers was significantly higher when they perceived low injury risk rather than high injury risk. The findings also supported the potential adverse impact of injury incidence and injury risk on job satisfaction for both part- and full-time workers. This study highlighted the importance of understanding both workplace safety and job satisfaction when attempting to understand the differences between part-time and full-time workers.

Adult↗
PubMed2004

Parental employment status and neural-tube defects and folic acid/multivitamin supplementation in Hungary.

OBJECTIVE: To study the role of parental employment status as indicator of socio-economic status (SES) in the origin of neural-tube defect (NTD) and in the use of periconceptional folic acid/multivitamin supplementation. MATERIALS AND METHODS: One thousand two hundred and two cases with neural-tube defects, 38,151 population controls without any defects and 22,475 patient controls with other defects were compared in the population-based data set of the Hungarian case-control surveillance of congenital abnormalities, 1980-1996. RESULTS: The proportion of professionals was lower, while the proportion of semi- and unskilled workers was higher in the neural-tube defect group compared with the population control group. However, the comparison of neural-tube defect and patient control groups showed a lower socio-economic status in the patient control group. In addition, the socio-economic status of fathers in the neural-tube defect group seemed to be better than in the population and patient control groups. The higher periconceptional folic acid supplementation and the higher use of multivitamins during pregnancy occurred in the professional and managerial categories in all the three study groups. CONCLUSION: The occurrence of neural-tube defect shows a slight socio-economic dependence in the mothers at the comparison with population control group, however, patient control group had the lowest socio-economic status. The higher maternal education goes together with a higher proportion of periconceptional folic acid supplementation.

Adult↗
PubMed1994

Employment status and depressive symptoms in middle-aged women: a longitudinal investigation.

OBJECTIVES: This study investigated the psychological effects of paid employment and nonemployment, cross-sectionally and longitudinally, in 541 middle-aged women. METHODS: Women were seen for an extensive baseline evaluation and were reevaluated in an identical manner 3 years later. They were divided into four "synthetic" cohorts, based upon employment status at these two assessments. RESULTS: At baseline, nonemployed women reported higher levels of depressive symptoms than employed women, with nonemployed women with less education, low support from family and friends, or low marital satisfaction the most symptomatic. Symptoms decreased in women who were nonemployed initially but employed at the later exam; in all other groups, symptoms increased. Unlike the cross-sectional findings, however, the longitudinal findings showed that women who were nonemployed at baseline and had low levels of education, social support, or marital satisfaction did not benefit more from subsequent employment than did their counterparts who had high levels of these factors. CONCLUSIONS: New paid work may have a positive effect on mood for middle-aged women. However, given the contradictions between our cross-sectional and longitudinal results, caution should be exercised in drawing conclusions from cross-sectional studies that likely confound employment status, symptoms, and moderating variables.

Adult↗
PubMed2006

Mortality in relation to employment status during different levels of unemployment.

AIMS: The aim of this study was to estimate whether the risk for total and cause-specific mortality was related to employment status, and whether mortality in different non-employed groups differed during high and low levels of unemployment. METHODS: Structured interviews were used from the Swedish Survey of Living Conditions in 1984-89 and 1992-97, including women and men aged 18 to 64, classified as unemployed (n = 2,067), retired or on temporary disability pension (n = 2,674), economically inactive for other reasons (n = 1,373), and employed (n = 38,293). Data were linked to death certificates, as registered in the Cause of Death Register. Cox proportional hazards models were performed for the mortality risk up until eight and a half years following the interview. RESULTS: Being unemployed (OR = 1.43), retired, or on temporary disability pension (OR = 2.28) or being economically inactive for other reasons (OR = 1.63) was related to a risk for total mortality, after considering the level of unemployment, sociodemographic factors and longstanding illness. The risk of death due to external causes was excessive among the unemployed and among those retired or on temporary disability pension, and resulted to a large extent from suicide. The interaction between employment status and level of unemployment was not significant. CONCLUSIONS: The level of unemployment seems to have no major influence on the mortality risk. Future interventions for the non-employed groups should focus on preventing avoidable mortality, such as injury and suicide.

Adolescent↗
PubMedDate not supplied

The effects of a cognitive-behavioral pain management programme on the quality of work and employment status of severely impaired chronic pain patients.

This study examined changes in employment status and quality of work in 109 chronic pain patients who underwent a cognitive-behavioural pain management course; 68% of patients were female, mean age was 45 years, mean pain chronicity 10.7 years, 70% had spinal pain, and mean impairment on the Sickness Impact Profile was 26%. Twenty-six per cent of patients were employed at pre-treatment; the remaining 74% had been unemployed for 4.3 years on average. Measures of work status and quality, mood, pain, self-efficacy and walking performance were taken before admission, and at 1-, 6-, and 12-month follow-ups. Among employed patients quality of work scores improved by 35% from pre- to post-treatment (p < 0.01). Thirty per cent of previously unemployed patients returned to work during the 1-year follow-up, although employment status fluctuated greatly during this period. Non-workers were generally more impaired than workers on most measures, but the same measures did not differentiate between those who successfully returned to work and those who remained unemployed.

Affect↗
PubMed1992

The effect of employment status and household composition on health care utilisation in a general practice.

OBJECTIVE: to investigate the effect of employment status and family composition on general practice and secondary health care utilisation rates of a New Zealand general practice population. METHODS: the study practice's health care records were electronically interrogated and pooled data on utilisation rates was obtained for a 12 month period. Individual records were grouped according to the number of people in the family and families were further categorised according to the employment status of the adults in the family. Comparisons were made between family groups in rates of general practice and secondary care activities. Costs were attributed to each activity and a cost analysis undertaken. RESULTS: families of four or more people depending on government benefits had a lower primary care cost per person than equivalent families where an adult was in paid employment, but higher costs in secondary care resulted in a higher total health care cost. Overall, for the year reviewed, the mean cost per person for public health care was $365 for people in families where at least one person was in the paid workforce, $568 for those in families depending on government support, and $1438 for people over 60 years of age. CONCLUSION: in this practice the increased use of secondary care facilities by those who have lower rates of general practice activity resulted in a higher overall cost of health care to those patients. This study indicates the need for further analyses of activities by differing patient groupings to facilitate rational and equitable health care planning.

Adult↗
PubMedDate not supplied

Factors related to maternal employment status following the premature birth of an infant.

A sample of 110 two-parent families whose preterm infants were less than 37 weeks gestation, appropriate for gestational age, and free of major congenital anomalies were recruited from two level-III intensive care nurseries. At 3 months postpartum, 40 mothers (36.4%) were employed, 15 (13.6%) stated they were on a leave of absence, and the remaining 55 mothers (50%) were not employed. Although not significantly different on demographic or infant morbidity variables, employed mothers were significantly more employment-oriented and reported less choice and satisfaction with employment status than nonemployed mothers. In addition, employed mothers were employed more hours prenatally and reported prenatal plans to be employed sooner after the infant's birth than nonemployed mothers. Employed mothers also perceived more support from others for their employment and greater financial necessity and availability of child care than nonemployed mothers. Higher scores on employment orientation were correlated with higher maternal education level, fewer children, more hours employed, higher total support for their employment, higher financial necessity, and less choice and satisfaction with employment status.

Adult↗
PubMed1983

Predictors of employment status after cardiac surgery.

Preoperative predictors of postoperative employment status were studied in 228 patients (aged 25 to 64 years) who underwent cardiac surgery. Of the 150 patients working in the year before surgery, 73% returned within six months. Of those not so employed, 18% started working. Patients who expected preoperatively to return to work did so at an 82% rate compared with 39% of the others. This was a strong predictor in the multiple regression analysis. Educational level and family income were stronger predictors than occupation or level of physical exertion required. Rates of return were higher in patients with less severe angina and less fatigue preoperatively, but did not differ significantly by sex, surgical procedure, or duration of illness. Seven variables predicted work status correctly for 86% of persons. These results suggest that determinants of return to work are largely present before surgery and that patients' attitudes and expectations play an important role.

Adult↗
PubMed1998

Physician employment status and practice patterns.

BACKGROUND: Many physicians today are employed by another physician, group, hospital, HMO, or other organization. However, the differences in the characteristics, practice patterns, and patient outcomes of self-employed and employed physicians are not well understood. METHODS: The practices of 108 community family physicians in northeast Ohio were assessed using a multimethod cross-sectional design. Physician characteristics were assessed by questionnaire. Direct observation of 3536 consecutive patient visits was used to measure time use and the delivery of preventive services recommended by the US Preventive Services Task Force. Patient satisfaction was assessed with the Medical Outcomes Study (MOS) 9-item Visit Rating Form. RESULTS: Employed physicians were more likely to be female, in group practice, work fewer hours, and see fewer patients. Job satisfaction was similar between the two groups, but employed physicians reported greater satisfaction with leisure and family time. Employed physicians spent more time per patient visit, scheduled a larger percentage of well-care visits, and were more likely to refer to specialists. Employed physicians also spent a greater proportion of their patients' visit time performing history-taking and eliciting family information, and a lesser proportion of time on physical examination, planning treatment, providing health education, and chatting. Recommended screening and health habits counseling preventive services were more likely to be delivered by employed physicians. Patient satisfaction was similar for the two groups. CONCLUSIONS: Primary care physician characteristics and practice patterns differ by employment status. The consequences of the trend toward a largely employed physician workforce as reported in this study should be carefully considered.

Adult↗
PubMed1996

Inequalities in health related to women's marital, parental, and employment status--a comparison between the early 70s and the late 80s, Norway.

Studies indicate that inequalities in women's health are associated with women's marital, parental and employment status. The causal mechanisms which generate these inequalities are linked to social change at the macro level. The present study asks whether patterns of ill-health according to women's statuses have changed during recent decades in Norway. Five national surveys 1968-91 are analyzed, using number of long-standing diseases as an indicator of health. The results indicate that health differences between full-time employed women and other employment statuses have increased during the 70s and 80s. As regards marital and parental status, the observed changes are not significant. The findings suggest that important causal mechanisms generating health differences related to marital status are located in the private sphere. The interpretation of the widening health gap between employed and non-employed women focuses both on developments which have made it easier to combine employment and family duties, on new norms which favour the self-esteem of employed women, and on health selection processes connected to welfare state developments.

Adult↗
PubMed1987

Wife's employment status and marital duration in a population filing for divorce.

This study analyzes data from a 2% random sample of all couples who filed for divorce/dissolution in California in each of the 6 years, 1966-1971, in order to examine the relationship between wife's employment status and marital duration to separation. Using exchange theory, anomie theory, and role conflict as basic theoretical perspectives, the elaboration analysis of the zero order relationship is discussed vis a vis the findings that housewives are likely to be married longer before separation than employed wives, except when they marry very young. The analysis shows the enhancement of our zero order relationship for housewives marrying in their 20's, having an education of high school or above, and having been previously married. Furthermore, a causal linkage is posited between wife's employment status, presence of children, and marital duration to separation, which shows the zero order relationship to be non-spurious through the interpretation that occurred when controlling on presence of children.

Black or African American↗
PubMed1986

Clinical and social characteristics of male parasuicides: variation by employment status and duration of unemployment.

In this study employed and unemployed male parasuicides were compared on a number of clinical, sociodemographic and other characteristics in order to establish which, if any, were significantly related to employment status. A further analysis examined variation in personal attributes by duration of unemployment. The unemployed group was found to contain a higher proportion of individuals who were unmarried, living outside the family, of lower social class, given a diagnosis of abnormal personality, misusing drugs habitually, in trouble with the police and with a criminal record. Comparisons within the unemployed group showed that age and civil state varied significantly by duration of unemployment, but no linear trend was evident. Longer durations of unemployment were associated significantly with personality diagnosis and receipt of psychotropic drug treatment. Within the limits dictated by the study design (cross-sectional, without general population controls), the findings are discussed in terms of their compatibility with the causal or self-selection models of the unemployment-parasuicide relationship.

Adult↗
PubMed2000

The impact of rheumatoid arthritis on employment status in the early years of disease: a UK community-based study.

OBJECTIVE: To establish the prevalence of work disability and predictors of change in employment status in patients with early rheumatoid arthritis (RA). SETTING: The Norfolk Arthritis Register (NOAR), a primary-care based inception cohort of patients with recent-onset inflammatory arthritis. METHODS: Two cohorts of patients notified to NOAR, who satisfied the 1987 ACR criteria for RA at the time of notification (baseline) and who were economically active at the time of RA symptom onset, were identified. Cohort 1 consisted of 160 patients with an onset of RA between 1989 and 1992, and was followed for a mean of 8.6 yr from symptom onset. For 110 of these cases, a control group, matched for age, gender and employment status at baseline, was identified from the local population. Their employment histories were compared in 1995. Cohort 2 consisted of 134 patients with an onset of RA between 1994 and 1997, and was followed for a mean of 4.1 yr from symptom onset. RESULTS: One-third of RA cohort 1 had stopped working on the grounds of ill health by 1995. The baseline health assessment questionnaire (HAQ) score was the most important predictor of work disability. These patients were 32 times more likely to stop work on health grounds than the matched controls. The rates for work disability for the RA cases 1, 2, 5 and 10 yr after symptom onset were 14, 26, 33 and 39% respectively. For cohort 2, the rates for work disability 1 and 2 yr from onset were 23 and 33% respectively. CONCLUSION: Work disability is an important outcome in RA patients of working age. Many people stop working very early in the disease process, often before they are referred to hospital or started on disease-modifying anti-rheumatic drugs. Although the peak rates for work disability are in the early years, people with RA continue to leave the work force several years after onset. Thus, the recent move to earlier, more aggressive treatment has had no effect on the rates of work disability.

Adult↗
PubMed2002

Prediction of employment status following traumatic brain injury using a behavioural measure of frontal lobe functioning.

OBJECTIVE: To examine whether a behavioural measure of frontal lobe functioning, the Brock Adaptive Functioning Questionnaire (BAFQ), could predict employment status following traumatic brain injury (TBI). DESIGN: A discriminant function analysis was conducted to determine the ability of the BAFQ, along with other factors, to predict occupational status post-injury. METHODS: Sixty-one TBI survivors completed a background information questionnaire, the BAFQ, and an employment status rating scale. RESULTS: A factor analysis of the BAFQ sub-scales revealed two factors, one related to functioning in the orbitofrontal area, and one related to dorsolateral frontal lobe functioning. These two factors, along with background information, were entered into a discriminant function analysis, revealing a 77.4% accuracy rate in predicting occupational status post-injury. CONCLUSIONS: Demographic variables were found to differentiate employed from unemployed survivors. The BAFQ appeared useful in differentiating survivors who may return to their pre-injury employment level from those who may require modified employment.

Adolescent↗
PubMedDate not supplied

Employment status and perceptions of control of adults with cognitive and developmental disabilities.

This study was designed to examine the relationship between individual perceptions of control and employment status among adults with cognitive and developmental disabilities. The literature implies that one factor influencing perceptions of quality of life is the amount of control the person experiences across various domains. It was hypothesized that individuals employed in competitive work situations would evidence more positive perceptions of control than would their peers currently unemployed or employed in sheltered settings. Surveys containing the Adult version of the Nowicki-Strickland Internal-External Scale and requesting information about age, gender, and employment status were mailed to self-advocacy groups. For the more than 200 respondents, there were significant differences in locus of control scores among individuals employed competitively, individuals employed full-time, respondents in sheltered environments, individuals currently unemployed, and all other groups. Individuals unemployed and employed in sheltered settings perceived themselves as having less control than individuals employed competitively. These results are examined in light of quality of life findings, focusing on the need to include choice and control in programming for people with cognitive and developmental disabilities.

Adult↗
PubMed2001

Employment status of pregnant women in central Poland and the risk of preterm delivery and small-for-gestational-age infants.

BACKGROUND: Unemployment is one of the consequences of the ongoing transformation of the Polish economy. The main objective of the present study was to investigate the relationship between women's employment status and preterm delivery (PD) and/or small-for-gestational-age (SGA) infants, in Central Poland during the socio-economic transition. METHODS: The study population comprised 8% random sample of 2,080 women from the Lodz macro region who gave birth to a child during a one-year period (1996-1997). Based on the employment status, three groups were distinguished: the employed (n = 1238), the unemployed (n = 128)--women who lost their job before pregnancy (at least 12 months prior to delivery) and were actively seeking employment, and the housewives (n = 714). Women with chronic medical problems diagnosed before pregnancy were excluded from the study. RESULTS: The rates of preterm delivery were found to be 6.3%, 11.7% and 4.9%, respectively for the employed, unemployed, and housewives. After adjustment for age, marital status, education, maternal height, smoking, own apartment, presence of cervical insufficiency and uterine irritability, an excess risk of PD was observed among the unemployed women (OR = 1.92, 95% CI: 1.01-3.64). Unemployment was associated, though not significantly, with higher rates of SGA births. CONCLUSION: In Central Poland, the unemployed pregnant women are characterised by an excess risk of preterm delivery. The impact of unemployment on the community's health, which seems to be underestimated, should be given more consideration in the national and local policies for public health.

Adult↗
PubMed2007

Employment status and frequent mental distress among adults with disabilities.

BACKGROUND: It has been postulated that poor mental health can lead to disability and disability can lead to unemployment. However, the association between poor mental health and employment status among adults with disabilities has not been well characterized in population-based studies. AIM: To examine the association between employment status and frequent mental distress (FMD; 14 or more mentally unhealthy days during the previous 30 days) among adults with disabilities. METHODS: Cross-sectional data were analysed for 47,377 community-dwelling US adults aged 25-64 years with disabilities that participated in the 2001 and 2003 Behavioural Risk Factor Surveillance System. Logistic regression analysis was applied. RESULTS: Among adults with disabilities, the unadjusted prevalence of FMD was 18% (SE 0.4) among those employed, 40% (SE 1.3) among those unemployed and 44% (SE 0.8) among those unable to work. After adjustments were made for age, sex and race/ethnicity, the results indicated that adults with disabilities who were unemployed or unable to work were significantly more likely than those employed to have FMD (adjusted prevalence: 39 and 45%, respectively, versus 18%; P < 0.001). These associations persisted after further adjusting for education, marital status, health risk behaviours, body mass index, health care coverage and self-rated general health (34 and 36%, respectively, versus 19%; P < 0.001). CONCLUSION: These findings demonstrate the need for research and development of public health interventions to reduce the toll of mental distress among all adults with disabilities.

Adult↗