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Fatal occupational injury rates: Quebec, 1981 through 1988.

OBJECTIVES: The purpose of the study was to estimate the death rates from occupational injuries in the province of Quebec for the period 1981 through 1988. METHODS: Worker's compensation files were used to ascertain numbers of deaths, which were used as the numerators in figuring the rates (it was estimated that these files reported 83% of the true number of deaths among men). Annual average estimates of the labor force were used as denominators. RESULTS: From 1981 through 1988, compensation was awarded for 1227 fatal work injuries. Among men (96% of the victims), rates declined from 1981 to 1988 (from 12.7 to 8.1 per 100,000); women's rates were stable (< or = 1.0 per 100,000). Compared with men, women had excess mortality from violent acts. Motor vehicle crashes accounted for 36% of all fatal injuries in 1984 and 1985 and declined thereafter. Fatal injury rates in forestry and mining rose to a 1987 maximum of 67.6 per 100,000. The construction sector had the largest number of deaths, despite a decline in rates from 1981 to 1988 (from 27.8 to 15.9 per 100,000). CONCLUSIONS: Except for construction and agriculture, reported fatal occupational injury rates in Quebec were similar to those in the United States. Motor vehicle crashes, falls, violent acts, and farming-related injuries were the most frequent causes of death.

Accidents, Occupational↗

Estimates of population smoking prevalence: self-vs proxy reports of smoking status.

OBJECTIVES: In the face of rising costs of surveillance systems, it is time to reexamine the feasibility of including proxy respondents in surveys designed to provide population estimates of smoking prevalence. METHODS: Data are from the California. Tobacco Surveys, which are random-digit dialed telephone surveys. One adult provided demographic information and smoking status for all household residents. Additionally, some adults were selected for in-depth interviews that also included smoking status questions. We matched information from proxy respondents and self-respondents and evaluated smoking status discrepancies between them relative to demographic and other factors (n = 2930 matched pairs) in 1992. We address the potential bias these discrepancies might introduce into the population estimate of smoking prevalence. RESULTS: Overall, the discrepancy between proxy report and self-report was 4.3%, and it increased particularly when the self-respondent reported nondaily smoking or recent quitting. Discrepancies acted in both directions, and the net bias was that the screener survey overestimated smoking prevalence by 0.1% in 1992 (0.3% in 1990). CONCLUSIONS: Smoking status questions can be added to ongoing surveys such as the census or labor force surveys; one adult could provide smoking status for all household members.

Adult↗

Emotional disability days: prevalence and predictors.

This study considered days missed from work or usual activities for emotional reasons associated with a range of specific psychopathologic disorders, psychosocial distress, and persons found to be asymptomatic. Analyses were performed with the presence or absence of emotional disability days as the dependent variable using logistic regression. The effects of specific mental disorders were compared with the effects of chronic physical conditions for labor force participants and for the total population. The odds ratio (and 95% confidence interval) for subjects with major depressive disorder was 27.8 (6.93, 108.96); for panic disorder, 21.1 (2.25, 198.44); and for schizophrenia, 17.8 (1.73, 182.99). Work-place adjustments for persons with psychopathology are encouraged.

Absenteeism↗

US mortality by economic, demographic, and social characteristics: the National Longitudinal Mortality Study.

OBJECTIVES: A large US sample was used to estimate the effects of race, employment status, income, education, occupation, marital status, and household size on mortality. METHODS: Approximately 530,000 persons 25 years of age or more were identified from selected Current Population Surveys between 1979 and 1985. These individuals were followed for mortality through use of the National Death Index for the years 1979 through 1989. RESULTS: Higher mortality was found in Blacks than in Whites less than 65 years of age; in persons not in the labor force, with lower incomes, with less education, and in service and other lower level occupations; and in persons not married and living alone. With occasional exceptions, in specific sex and age groups, these relationships were reduced but remained strong and statistically significant when each variable was adjusted for all of the other characteristics. The relationships were generally weaker in individuals 65 years of age or more. CONCLUSIONS: Employment status, income, education, occupation, race, and marital status have substantial net associations with mortality. This study identified segments of the population in need of public health attention and demonstrated the importance of including these variables in morbidity and mortality studies.

Adult↗

Maternal employment and breast-feeding: findings from the 1988 National Maternal and Infant Health Survey.

OBJECTIVES: This analysis uses nationally representative data from the 1988 National Maternal and Infant Health Survey to explore the factors, including employment, associated with breast-feeding initiation and duration. METHODS: Multiple logistic regression was used to model the determinants of breast-feeding initiation among 9087 US women. Multiple linear regression was used to model the duration of breast-feeding among women who breast-fed. RESULTS: Fifty-three percent of mothers initiated breast-feeding in 1988, and the decision to breast-feed was not associated with maternal employment. However, among breast-feeders, returning to work within a year of delivery was associated with a shorter duration of breast-feeding when other factors were controlled. Among employed mothers, the duration of maternity leave was positively associated with the duration of breast-feeding. CONCLUSIONS: The low rates of breast-feeding initiation in the United States are not attributable to maternal participation in the labor force. However, returning to work is associated with earlier weaning among women who breast-feed.

Adult↗

Mortality differentials among Israeli men.

OBJECTIVES: This study examined differentials in mortality among adult Israeli men with respect to ethnic origin, marital status, and several measures of social status. METHODS: Data were based on a linkage of records from a 20% sample of the 1983 census to records of deaths occurring before the end of 1992. The study population included 72,527 men, and the number of deaths was 17,378. RESULTS: Differentials is mortality by origin show that mortality was higher among individuals of North African origin than among those of Asian and European origin. After allowance for several socioeconomic indicators, the excess mortality among North African Jews was eliminated. Substantial and consistent differences in mortality were found according to education, occupation, income, possession of a car, housing, and household amenities. Differentials among the elderly were markedly narrower than those among men younger than 70 years. CONCLUSIONS: Some sectors of Israeli society have higher risks of death than others, including, among the male population, these who are poor, less educated, unmarried, unskilled, out of the labor force, and of North African origin.

Adult↗

The impact of welfare reform on parents' ability to care for their children's health.

OBJECTIVES: Most of the national policy debate regarding welfare assumed that if middle-income mothers could balance work while caring for their children's health and development, mothers leaving welfare for work should be able to do so as well. Yet, previous research has not examined the conditions faced by mothers leaving welfare for work. METHODS: Using data from the National Longitudinal Survey of Youth, this study examined the availability of benefits that working parents commonly use to meet the health and developmental needs of their children; paid sick leave, vacation leave, and flexible hours. RESULTS: In comparison with mothers who had never received welfare, mothers who had been on Aid to Families with Dependent Children were more likely to be caring for at least 1 child with a chronic condition (37% vs 21%, respectively). Yet, they were more likely to lack sick leave for the entire time they worked (36% vs 20%) and less likely to receive other paid leave or flexibility. CONCLUSIONS: If current welfare recipients face similar conditions when they return to work, many will face working conditions that make it difficult or impossible to succeed in the labor force at the same time as meeting their children's health and developmental needs.

Adolescent↗

Novel treatments for obesity and osteoporosis: targeting apoptotic pathways in adipocytes.

Obesity and osteoporosis have grave consequences for human health, quality of life, and even the efficiency of the labor force and economy. However, these pathologies share a common cell progenitor, revealing a surprising target for drug research and development. Recent findings show that high adipocyte count in bone marrow is directly related to bone loss, as fat cells replace osteoblasts (or bone-forming cells). The objective of this review is to examine the importance of adipocyte apoptosis in the treatment of obesity and/or osteoporosis, with special emphasis on natural products as promising leads for drug development. We have induced in vivo adipocyte apoptosis, using leptin, ciliary neurotrophic factor (CNTF), beta adrenergic agonists and conjugated linoleic acid (CLA) in rodents. The results of leptin treatments on rats are suppressed food intake, reduced body weight, reduced body fat, adipocyte apoptosis, and elevated energy expenditure. Further, leptin treatment of leptin-deficient (ob/ob) mice increases endosteal bone formation and bone mineral density. Adipocyte apoptosis has also been induced in vitro using tumor necrosis factor-alpha (TNF-alpha), (-)-epigallocatechin gallate (EGCG) from Camellia sinensis and ajoene, from Allium sativum. Natural products have potential for inducing apoptosis of adipose tissue, inhibiting bone marrow adipogenesis and increasing the expression of osteogenic factors in bone, thereby yielding effective treatments for obesity and osteoporosis.

Adipocytes↗

Gender, work control, and stress: a theoretical discussion and an empirical test.

Within the field of occupational stress research the theoretical orientation, the research instruments, and the populations studied have largely been standardized on and restricted to male subjects. This article discusses the threats that single-sex studies pose to the valid assessment of the health effects of working life. Following this critique, an empirical examination of the differential distribution of work control is examined within a random sample (n = 13,203) of Swedish working males and females. Results indicate that even in a socially progressive society the labor force continues to be highly sex-segregated. Males, as a group, were found to have access to a larger and more diverse set of jobs than do females, as a group. Work control was found to be consistently higher among men than among women. The highest level of control was found among white-collar men in male-segregated jobs, while the lowest was found among blue-collar women in male-segregated jobs. It was notable that men had a higher level of control than women even in jobs that are traditionally considered "women's work." The implications of these findings are discussed in terms of future directions in the psychosocial work environment field.

Adolescent↗

Life-span determinants of work in retirement years.

This article presents the results of a path analysis to clarify the life-span determinants of work effort in postretirement years. It was found that personal and structural characteristics are different between a group of retirees who did not work in the three years after retirement and those that worked more than 300 hours annually. Those that participated in the labor force after retirement experienced more successful employment histories before retirement. On the other hand, people with more marginal work histories were less likely to sustain work efforts after retirement, despite lower income.

Aged↗

Predictors of driving while intoxicated (DWI) among American Indians in the northwest.

This study compares DWI arrest records for American Indians to those of the general population in Washington State. Within the period January 1987 through December 1987, 1,067 American Indians were arrested for DWI. This sample was compared for age, gender, and occupational status to 28,130 total DWI arrestees during the same period. The data indicate that American Indians were the most over-represented population as they were two-and-one-half times as likely to be arrested for DWI, compared to overall DWI arrest population. The population of American Indians arrested for DWI was three times as likely to be unemployed as compared to the resident labor force of all American Indians. This research supports the conclusion that DWI arrests may be viewed as a symptom of alcohol misuse, abuse, or chemical dependency for American Indians, and that a DWI prevention approach should include education, prevention, intervention, treatment, aftercare, and law enforcement efforts that are sensitive to tribal diversity.

Adolescent↗

Women's emancipation and socialsm: the case of the People's Republic of Poland.

Determinants of occupational position in Poland, as elsewhere, include the socialization process, access to education, and the employment structure. The socialization process includes the domestic pattern of division of labor, occupational models encountered in person and in the various media, and parental and social pressures, including vocational counseling. Ecuational access is a critical determinant of the extent and type of participation in the labor force as well as attitudes toward work. Although Poland has made major attempts to improve the socialization process and acces by type of program, disparties are still encountered in pay received for similar work, and for work in positions that cannot be explained by differences in productivity or education. Employment policies being undertaken or considered include measures to improve working conditions and occupational position, to socialize a larger number of "domestic" tasks, and to provide more flexibility via part-time work and longer maternity leaves.

Attitude↗

Health and labor-power: a theoretical investigation.

In this historical materialist analysis of health and medical care, health is defined as a component of labor-power (capacity to work). Investment in health, including provision of medical services, represents part of the cost of maintaining the labor force. The primary determined of the level of health and medical care under capitalism is the tendency toward maximization of the rate of exploitation. The absolute level of health and medical care tends to decline as unemployment rises and individual workers become more "replaceable." Health differentials by socioeconomic status are similarly explained by the easier replacement of lesser-skilled workers. Medical care services in the context of the capitalist system constitute a drain on surplus-value. In periods of economic decline, attempts are made to conserve surplus-value through reductions in medical services ("social wages"). Institutional and ideological racism yields additional surplus-value savings and weakness public resistance to medical care retrenchment. The profits of health-related industries are shown to be merely partially recouped surplus-value losses. The social epidemiology of capitalism has been characterized as social murder. "Public health" measures appropriate to this systemic pathology are suggested.

Delivery of Health Care↗

Race, gender, and the retirement decisions of people ages 60 to 80: prospects for age integration in employment.

UNLABELLED: Demographic projections have prompted concerns about the potential economic burden of an aging population. This article, drawing on the 1998 Health and Retirement Study, explores ways in which race, gender, and age moderate the effects of various factors on labor force participation among people ages 60 to 80. Key findings center on health, education, and non-wage income. First, the effect of low non-wage income is weaker at older ages due to higher levels of functional disability. Second, the effect of low education is stronger for women, who perceive their chances of finding employment as low. Third, the effect of health is weaker for blacks, as they are less likely to find steady employment regardless of health. POLICY IMPLICATIONS: Employer flexibility in number of hours worked might make sense for workers close to retirement age, while job search and training programs might be preferable for workers past the typical retirement age.

Age Distribution↗

Health care administration in the United States and Canada: micromanagement, macro costs.

A decade ago, U.S. health administration costs greatly exceeded Canada's. Have the computerization of billing and the adoption of a more business-like approach to care cut administrative costs? For the United States and Canada, the authors calculated the 1999 administrative costs of health insurers, employers' health benefit programs, hospitals, practitioners' offices, nursing homes, and home care agencies; they analyzed published data, surveys of physicians, employment data, and detailed cost reports filed by hospitals, nursing homes, and home care agencies; they used census surveys to explore time trends in administrative employment in health care settings. Health administration costs totaled at least dollar 294.3 billion, dollar 1,059 per capita, in the United States vs. dollar 9.4 billion, dollar 307 per capita, in Canada. After exclusions, health administration accounted for 31.0 percent of U.S. health expenditures vs. 16.7 percent of Canadian. Canada's national health insurance program had an overhead of 1.3 percent, but overhead among Canada's private insurers was higher than in the U.S.: 13.2 vs. 11.7 percent. Providers' administrative costs were far lower in Canada. Between 1969 and 1999 administrative workers' share of the U.S. health labor force grew from 18.2 to 27.3 percent; in Canada it grew from 16.0 percent in 1971 to 19.1 percent in 1996. Reducing U.S. administrative costs to Canadian levels would save at least dollar 209 billion annually, enough to fund universal coverage.

Canada↗

Women and AIDS in Zimbabwe: the making of an epidemic.

As the AIDS epidemic in Africa assumes major proportions, the need to understand the social context in which heterosexual transmission occurs takes on urgent importance. In this article we explore how the intersection of traditional culture with the colonial legacy and present-day political economy has influenced family structure and sexual relations, and particularly the social position of women. Drawing on Zimbabwe's historical experience, we show how land expropriation, rural impoverishment, and the forcible introduction of male migrant labor fostered new patterns of sexual relations, characterized by multiple partners. Traditional patriarchal values reinterpreted in European law resulted in further subjugation of women as even limited rights to ownership were withdrawn. For many women, sexual relations with men, either within marriage (for the majority) or outside, become inextricably linked to economic and social survival. In this setting, all sexually transmitted diseases became rampant, including genital ulcer, which facilitates transmission of the human immunodeficiency virus (HIV). Intervention programs to halt the spread of AIDS need to take into the account the epidemic's historical roots and social nature. For example, efforts to reduce risk of HIV transmission should seek to expand women's limited options, both technically (e.g., by providing alternatives to condoms) and socially (e.g., by promoting employment).

Acquired Immunodeficiency Syndrome↗

New points of production: homework and shoemaking in Asia.

Globalization--and the manner in which it has been governed during the last decade--has harmed various public policy infrastructures of developing nations, but especially those in health, social, and environmental sectors. The poorest population suffers the most severe consequences, as production takes place in the "informal" economy and in homes. Work safety and health in the informal economy has not gained the attention it warrants and requires, considering that this "sector" constitutes the majority of the world's labor force. The purpose of this article is twofold: (i) to describe the working environment in home-based shoemaking--based on Indonesian and Philippines experience by Markkanen [1]; and (ii) to examine the research framework proposed by Levenstein and Tuminaro in The Political Economy of Occupational Disease [2] and further developed in Wooding and Levenstein, The Point of Production, 1999 [3]. The field investigation by Markkanen employed this approach to explore how hazardous working conditions and inadequate health protection are the product of complex, converging relationships among diverse "actors" or agents at international, national, community, and shoe industry levels.

Journal Article↗

Neoliberalism, "globalization," unemployment, inequalities, and the welfare state.

This analysis of "neoliberalism" and its economic and social consequences is presented in six sections. Section I begins by describing the impact of neoliberal public policies on economic growth and inflation, on business profits and business investments, on productivity, on business credit, on unemployment and social inequalities, on social expenditures, and on poverty and family debt. The author shows that, except in the area of business profits and control of inflation, neoliberal policies have not proved superior to those they replaced. Section II deals with unemployment and social polarization in the developed capitalist countries. The author criticizes some of the theories put forward to explain these social problems, such as the introduction of new technologies and globalization of the economy, and suggests that a primary reason for these problems is the implementation of neoliberal policies. Section III challenges the widely held neoliberal perception that the U.S. economy is highly efficient and the E.U. economies are "sclerotic" due to their "excessive" welfare states and "rigid" labor markets. The author shows that the U.S. economy is not so dynamic, nor the E.U. economies so sclerotic. Some developed countries with greater social protection and more regulated labor markets are shown to be more successful than the United States in producing jobs and lowering unemployment. The reasons for the growing polarization in developed capitalist countries, rooted in political rather than economic causes, are discussed in section IV--especially the enormous power of the financial markets and their influence on international agencies and national governments, and the weakness of the labor movements, both nationally and internationally. Section V questions the major theses of globalization. The author shows that rather than globalization of commerce and investments, we are witnessing a regionalization of economic relations stimulated by political considerations. He also analyzes the globalization of capital finance, criticizing the thesis that capital markets are determining public policies. The economic determinism that underlies the globalization position is questioned, uncovering the importance of political explanations for understanding major social problems such as unemployment. Finally, section VI shows that neoliberal public policies on the deregulation of labor markets are creating enormous instability in the labor force, worsening the living conditions of the majority of the populations.

Developed Countries↗