JOB INSECURITY, MENTAL AND GENERAL HEALTH OVER TIME: A LONGITUDINAL UPDATE OF A CROSS-SECTIONAL STUDY.

OBJECTIVE: To test the relationship between different conceptualizations of job insecurity and health over time by applying a longitudinal design. METHODS: 543 workers were re-interviewed after one year to check if being exposed to job insecurity affected their general and mental health. Robust Poisson regressions were fitted to calculate the incidence rate ratio between job insecurities and two health outcomes. RESULTS: Cognitive job loss insecurity increases the risk of poor mental and general health. Other expressions of job insecurity such as labor market insecurity and working conditions insecurity, as well as affective job insecurity, are not significantly related to health across time. CONCLUSIONS: Caution is needed when interpreting cross-sectional results. Protection against the threat of losing a job would prevent mental health issues and poor general health.

Implementation of web-based respondent driven sampling in epidemiological studies.

BACKGROUND: Respondent-driven sampling (RDS) is a peer chain-recruitment method for populations without a sampling frame or that are hard-to-reach. Although RDS is usually done face-to-face, the online version (WebRDS) has drawn a lot of attention as it has many potential benefits, despite this, to date there is no clear framework for its implementation. This article aims to provide guidance for researchers who want to recruit through a WebRDS. METHODS: Description of the development phase: guidance is provided addressing aspects related to the formative research, the design of the questionnaire, the implementation of the coupon system using a free software and the diffusion plan, using as an example a web-based cross-sectional study conducted in Spain between April and June 2022 describing the working conditions and health status of homecare workers for dependent people. RESULTS: The application of the survey: we discuss about the monitoring strategies throughout the recruitment process and potential problems along with proposed solutions. CONCLUSIONS: Under certain conditions, it is possible to obtain a sample with recruitment performance similar to that of other RDS without the need for monetary incentives and using a free access software, considerably reducing costs and allowing its use to be extended to other research groups.

Sickness Presenteeism and Psychosocial Risk Factors According to Inequality Axes.

OBJECTIVE: To assess the association between psychosocial risk factors (PSRs) and sickness presenteeism (SP) and examine possible differences according to the major axes of inequality in the labor market. Methods: Cross-sectional study based on a representative sample of the Spanish salaried population. Results: Although nearly all PSR show crude associations with SP, when adjusted for every other PSR, only the workers exposed to lack of role clarity (adjusted prevalence ratio [aPR], 1.30; 95% confidence interval [CI], 1.01 to 1.68), having role conflicts (aPR, 1.45; 95% CI, 1.19 to 1.77) and lack of sense of community at work (aPR, 1.30; 95% CI, 1.06 to 1.59) show a significant association. Conclusions: After adjusting for all PSR, those significantly associated to SP belong to the interpersonal relationships domain. Some of the PSR effects change according to the segmentation axes analyzed.

Delegation and consultation on operational and tactical issues: Any difference in their potentialities for a healthier psychosocial work environment?

BACKGROUND: Despite the growing number of studies on direct participation labor-management practices, little is known about the role of their different discretionary degrees (delegation or consultation) and topics in their relationship with the psychosocial work environment by occupational groups. METHODS: Cross-sectional study on the relationship between direct participation and work-related psychosocial risks (using COPSOQ-ISTAS21 v3) on a representative sample of the salaried and wage-earning employees in Spain (n = 1807). Prevalence ratios were calculated using adjusted Poisson regression models, controlling for 10 other labor-management practices, sex, and age, and stratified by occupational group. RESULTS: The use of direct participation was either associated consistently with a healthier psychosocial work environment (mostly in manual occupations, which presented twice as many positive associations as nonmanual occupations, and of greater strength, mostly in the control and social support dimensions) or there were no significant associations (mostly among nonmanual occupations and in relation to work pace). More frequent and stronger associations were observed when consultation and delegation were used in combination. If used separately, consultation achieved better results among manual occupations and delegation among nonmanual occupations. Direct participation topics were not important for results in manual occupations whereas results were better on tactical (vs. operational) issues in nonmanual occupations. CONCLUSIONS: Direct participation does not change power structure, but it may be a useful intervention at the company level to reduce work-related psychosocial exposures and associated diseases among workers in manual occupations, and consequently for decreasing occupational exposures and health inequalities.

[Relationship between psychosocial risks exposure and health: a cohort study using the COPSOQ-Istas21]. / Relación entre exposición a riesgos psicosociales y salud: un estudio de cohorte mediante el COPSOQ-Istas21.

OBJECTIVE: To estimate the prospective relationships between exposure to psychosocial risks dimensions included in the COPSOQ-Istas21 and the deterioration of general and mental health and sleep problems among workers residing in Spain. METHOD: Cohort whose baseline corresponds to the 2016 Psychosocial Risks Survey with a new measurement after one year. RESULTS: Social capital and interpersonal relations and leadership dimensions, as well as work̶life conflict, were related to all health variables. Dimensions of work organization and job contents did it especially with the mental health, the quantitative demands with the general health and the emotional ones with the mental health. The dimensions related to job insecurity did not show relationships with health. CONCLUSIONS: The results obtained reinforce the role of the COPSOQ-Istas21 as a useful instrument for the evaluation and prevention of psychosocial risks at work.

[The third version of COPSOQ-Istas21. An updated international instrument for the workplace.] / La tercera versión de COPSOQ-Istas21. Un instrumento internacional actualizado para la prevención de riesgos psicosociales en el trabajo.

OBJECTIVE: The Copenhagen Psychosocial Questio-nnaire (COPSOQ) is one of the most widely used in research and psychosocial risk assessment in the workplace. The adaptation of the third international COPSOQ version to Spain is described and the evidence of its validity and reliability presented. METHODS: Most of the items were already part of the previous versions I and II. The translation of the new items was done by means of translation/reverse translation. The questionnaire was included in the Psychosocial Risk Survey 2016, a cross-sectional study of a representative sample of the wage-earning population in Spain (N=1,807). Descriptive statistics, internal consistency, floor and ceiling effects and factor structure were analysed. Prevalence Ratios adjusted by age, sex and occupational class (aPR) to mental health, general health and job satisfaction were calculated. Finally, population reference values were calculated for all dimensions of the instrument. RESULTS: The questionnaire showed an excellent factorial structure. All scales, except one, showed α of Cronbach >0.70. Comparing the COPSOQ-Istas21 III scales with their international references, Cronbach's α were higher and the ceiling and floor effects were lower; i.e. Organisational Justice: α=0.85 vs 0.74, ceiling and floor 1.6 and 9.4 vs 3.3 and 12.8. The aPR between all the psychosocial dimensions and the Mental Health, General Health and Job Satisfaction were in the expected direction and showed an association gradient. CONCLUSIONS: COPSOQ-Istas21 version III presents psychometric properties analogous or better than the original in English language, and good indicators of validity and reliability, to be used in research and psychosocial risk assessment at the workplace in Spain.

OBJETIVO: El Copenhagen Psychosocial Questionnaire (COPSOQ) es uno de los más utilizados en investigación y evaluación de riesgos psicosociales en el trabajo. En este artículo se describió la adaptación de la tercera versión internacional a España y se presentaron las pruebas de su validez y fiabilidad. METODOS: La mayoría de los ítems ya formaban parte de las versiones anteriores I y II. La traducción de los nuevos ítems fue realizada mediante traducción/traducción inversa. El cuestionario se incluyó en la Encuesta de Riesgos Psicosociales de 2016, estudio transversal de una muestra representativa de la población asalariada en España (N=1.807). Se analizaron los estadísticos descriptivos, consistencia interna, efectos suelo y techo y estructura factorial. Se calcularon las Razones de Prevalencia ajustadas por edad, sexo y clase ocupacional (aRP) con salud mental, salud general y satisfacción laboral. Finalmente, se calcularon los valores de referencia poblacionales para todas las dimensiones del instrumento. RESULTADOS: El cuestionario mostró una excelente estructura factorial. Todas las escalas, excepto una, mostraron α de Cronbach >0,70. Comparando las escalas de COPSOQ-Istas21 III con sus referentes internacionales, las α de Cronbach fueron más altas y los efectos techo y suelo menores (por ejemplo, Justicia organizacional: α=0,85 vs 0,74, techo y suelo 1,6 y 9,4 vs 3,3 y 12,8). Las aRP entre todas las dimensiones psicosociales y las dimensiones de Salud mental, Salud general y Satisfacción, fueron en la dirección esperada y mostraron un gradiente de asociación. CONCLUSIONES: COPSOQ-Istas21 versión III presenta propiedades psicométricas análogas o mejores al original en lengua inglesa y buenos indicadores de validez y fiabilidad para ser usado en investigación y evaluación de riesgos psicosociales laborales en España.

Job insecurity, economic hardship, and sleep problems in a national sample of salaried workers in Spain.

OBJECTIVE: To check for associations between various types of job insecurity and self-reported sleeping problems. DESIGN: A population-based, cross-sectional study. SETTING: Spain, 2016. PARTICIPANTS: Salaried workers included in the third Psychosocial Risks Survey (n = 1807). MEASUREMENTS: We investigated the association between 6 subjective and 2 attributed indicators of job insecurity (exposure) with 5 sleep problem variables (difficulty falling sleep, difficulty sleeping through the night, waking up too early, sleeping restlessly, and a composite variable summing all the sleeping problems) using Poisson regression, and controlling for socioeconomic, occupational, and demographic factors. RESULTS: Anticipating a salary decrease or working at a company where staff restructuring had occurred in the preceding year were associated with sleeping problems. Having a temporary or informal employment contract and most domains of perceived job insecurity were not a significant factor in adjusted models. CONCLUSIONS: Recent or anticipated economic hardship within a worker's household was the main predictor of sleeping problems. More research is needed to elucidate the exact mechanisms through which the experience of aspects of downsizing might manifest in disruptions to employees' sleep. Sleep health should be an active part of all employee wellness programs.

A comparison between cognitive and affective job insecurities.

BACKGROUND: Cognitive and affective job insecurity are compared in six aspects related to employment: job loss, worsening of tasks, schedule, salary and workplace, and difficulties over finding an alternative job (also known as labor market insecurity). Methods: Cross-sectional study. Data comes from the third Spanish Psychosocial Risks Survey (2016) which is a representative sample of the Spanish salaried population. Results: Affective responses are more variable than cognitive ones resulting in a low degree of answer concordance (IC95% Kappa = 0.08-0.13 to 0.18-0.23). There is a significant percentage of workers (22.5-50.3%) highly concerned about their future despite perceiving low probabilities of experiencing the specific insecurity threat, except for the labor market insecurity question. Conclusion: The differences observed in the degree of insecurity between the affective and the cognitive forms confirm that they are measuring different components of the insecurity construct. These differences are partly due to the economic situation of their households.

Sickness presenteeism: Are we sure about what we are studying? A research based on a literature review and an empirical illustration.

BACKGROUND: There has been an increasing interest in studying sickness presenteeism (SP). An ever-increasing amount of scientific literature is published using this term, yet there appears to be considerable heterogeneity in how it is assessed, which could result in substantial differences in the definition and interpretation of the phenomenon really being studied. We aim to discuss what really is being studied, depending on how the phenomenon is operationalized, measured, and analyzed. METHODS: A study based on a literature review and an empirical illustration using data of the third Spanish Psychosocial Risks Survey (2016). RESULTS: Differences are observed based on the population in which SP is measured, the cut-off points used to define a worker as presenteeist, the reasons for an SP episode and even an analysis of the phenomenon treated as a count or as a dichotomous. CONCLUSIONS: Without being completely exclusive, it seems that restricting the population of analysis to only those workers who consider that they should not have gone to work due to their health, and/or establishing low cut-off points to define someone as presenteeist, would more clearly delimit the study of SP to the exercise of a right to sick leave. In contrast, working with the entire population or using high cut-off points appears to relate the study of SP more with health status and less with the exercise of rights. On the other hand, taking the reasons for SP into account would probably help to improve interpretation of the phenomenon.

Cognitive and Affective Insecurity Related to Remaining Employed and Working Conditions: Their Associations With Mental and General Health.

OBJECTIVE: The present study aims to tackle in detail the associations of insecurity with mental and self-rated health by using cognitive and affective measures of insecurity that focus on different aspects such as job loss, difficulties in finding an alternative job, and worsening the working conditions. METHODS: Data come from a representative sample of the Spanish salaried working population (n = 1807) obtained by the 2016 Psychosocial Risks Survey. RESULTS: Cognitive measures yield stronger associations between job loss and labor market insecurity and health, whereas the association between insecurity over worsening job conditions and health is stronger when using affective measures, the associations with mental health being stronger in both cases than those involving self-rated health. CONCLUSION: Association with health varies, in strength and at times in direction, depending on how insecurity is measured and conceptualized.

Prevalence, associated factors and reasons for sickness presenteeism: a cross-sectional nationally representative study of salaried workers in Spain, 2016.

OBJECTIVES: The aim of this study was to estimate the prevalence of sickness presenteeism (SP), its associated factors and the reasons given for SP episodes, among the overall salaried population and excluding the 'healthy' workers. DESIGN: Population-based cross-sectional study. SETTING: Salaried population in Spain. PARTICIPANTS: Data were obtained from the third Spanish Psychosocial Risks Survey (2016), carried out between October and December 2016, n=1615. MAIN OUTCOME MEASURES: Self-reported episodes of SP and their reasons. RESULTS: 23.0% (95% CI 19.2 to 26.8) of the workers exhibit SP, whereas among those manifesting having had some health problem in the preceding year, the figure was 53.0% (95% CI 46.9 to 59.1). The factors associated with SP when we study all workers are age, seniority, salary structure, working more than 48 hours, the contribution of worker's wage to the total household income and downsizing; factors among the 'unhealthy' workers are working more than 48 hours and not having a contract. The most common reason for SP is 'did not want to burden my colleagues', 45.7% (95% CI 37.3 to 54.4), whereas 'I could not afford it for economic reasons' ranked third, 35.9% (29.4% to 42.9%), and 27.5% (21.3% to 34.6%) of the workers report 'worried about being laid off' as a reason for going to work despite being ill. CONCLUSIONS: The estimated frequency of SP in Spain is lower than certain other countries, such as the Scandinavian countries. The factors associated vary depending on the population analysed (all workers or excluding 'healthy' workers). The reason 'I was worried about being laid off' was much more common than the estimates for Sweden or Norway.

Perceptions and beliefs of public policymakers in a Southern European city.

INTRODUCTION: Socio-economic inequalities in health are large in urban areas; however, local municipal governments may plan, manage and provide services and policies which can reduce these. The objective of this study was to describe the beliefs and perceptions of public policymakers in a European city, Barcelona. They are the key actors in designing and implementing urban public policies. METHODS: A qualitative research study describing policymakers' beliefs on health inequalities. The study population were twelve policymakers. These were politicians or officers from the city council. Informant profiles were selected using a theoretical sample. Semi-structured individual interviews were performed to collect the data and a thematic content analysis was carried out. RESULTS: Politicians were aware of health inequalities in their city and identified diverse social causes. They viewed reducing inequalities as a priority for the city's government. Officers were less knowledgeable and described less efforts in addressing health inequalities. It was stated by some that reducing inequalities in non-health sectors helped to reduce health inequalities indirectly and there was some collaboration between two sectors. The most frequent barriers encountered when implementing policies were funding and the cities' limited authority. CONCLUSIONS: Officers and policymakers had different levels of awareness and access to information on health and its social determinants. Officers referred to specific causes of health inequalities and policies which related to their sectors and politicians were more familiar with upstream determinants and policies. Some participants explained that policies and programmes needed to be evaluated and very little intersectoral action was said to be carried out. More efforts should be made to provide all policymakers with information on the social determinants of health inequalities. Research on health inequalities and policy should engage with policymakers and promote health as a cross cutting issue in the city council in liaison with the third sector.

Social and health policies or interventions to tackle health inequalities in European cities: a scoping review.

BACKGROUND: Health inequalities can be tackled with appropriate health and social policies, involving all community groups and governments, from local to global. The objective of this study was to carry out a scoping review on social and health policies or interventions to tackle health inequalities in European cities published in scientific journals. METHODS: Scoping review. The search was done in "PubMed" and the "Sociological Abstracts" database and was limited to articles published between 1995 and 2011. The inclusion criteria were: interventions had to take place in European cities and they had to state the reduction of health inequalities among their objectives. RESULTS: A total of 54 papers were included, of which 35.2% used an experimental design, and 74.1% were carried out in the United Kingdom. The whole city was the setting in 27.8% of them and 44.4% were based on promoting healthy behaviours. Adults and children were the most frequent target population and half of the interventions had a universal approach and the other half a selective one. Half of the interventions were evaluated and showed positive results. CONCLUSIONS: Although health behaviours are not the main determinants of health inequalities, the majority of the selected documents were based on evaluations of interventions focusing on them.