Income loss after a cancer diagnosis in Germany: An analysis based on the socio-economic panel survey.

BACKGROUND AND AIMS: Cancer treatments often require intensive use of healthcare services and limit patients' ability to work, potentially causing them to become financially vulnerable. The present study is the first attempt to measure, on the German national level, the magnitude of absolute income loss after a cancer diagnosis. METHODS: This study analyzes data from the Socio-Economic Panel (SOEP) survey, one of the largest and most comprehensive household surveys in Germany, consisting of approximately 20,000 individuals, who are traced annually. The empirical strategy consists of ordinary least squares (OLS) and multinomial logistic estimators to measure changes in job income, work status, working hours, and pension as a result of reporting a cancer diagnosis for the period between 2009 and 2015. Sample consistency checks were conducted to limit measurement error biases. RESULTS: Our results show that job incomes dropped between 26% and 28% within the year a cancer diagnosis was reported. The effect persisted for two years after the diagnosis and was no longer observable after four years. The finding was linked to an increased likelihood of unemployment and a reduction of working hours by 24%. Pension levels, on the other hand, were not affected by a cancer diagnosis. CONCLUSIONS: These findings suggest that many cancer patients are exposed to financial hardship in Germany, particularly when the cancer diagnosis occurs during their working age and before requirements to obtain a pension are met. Further research seems warranted to identify particularly vulnerable patient groups.

Risk for unemployment at 10 years following cancer diagnosis among very long-term survivors: a population based study.

PURPOSE: To clarify the association between cancer diagnosis and subsequent risk of being unemployed at 10 years after diagnosis among very long-term survivors. METHODS: A historical cohort study using prospectively collected data was done which included baseline measurements from the Israeli national census. Only patients who were 50 years old or younger at the time of diagnosis were included in the current study. Binary logistic regression analyses were used to assess odds ratios for unemployment at 10 years following diagnosis, while controlling for socioeconomic measurements and employment status at 2 years prior to diagnosis. RESULTS: The final study population included 2493 patients who were diagnosed with cancer and 7360 persons without a history of cancer, after excluding individuals who died before the end of 2015. After controlling for confounders, positive associations were found between cancer and increased risk for unemployment at 10 years (OR = 1.31, 95% CI 1.17-1.47). Analysis by cancer type revealed that patients who were diagnosed with CNS malignancies (OR = 2.71, 95% CI 1.80-4.07), followed by patients who were diagnosed with lymphoma (OR = 1.66, 95% CI 1.16-1.28) showed the greatest magnitude of effect, while the association between unemployment at 10 years following diagnosis and breast cancer was found to weaken and actually lose significance (adjusted OR = 1.22, 95% CI 0.99-1.50). CONCLUSIONS: Cancer survivors have an increased risk for long-term unemployment among very long-term survivors, mainly among patients diagnosed with CNS malignancies and lymphoma. IMPLICATIONS FOR CANCER SURVIVORS: The current study emphasizes the need for tailored intervention in order to mitigate the long-term risk of unemployment.

The Effect of the Economic Crisis on Adolescents' Perceived Health and Risk Behaviors: A Multilevel Analysis.

BACKGROUND: Previous studies have analyzed the impact of economic crises on adult's health and lifestyles, but evidence among children and adolescents is limited. The objective of this study was to analyze the impact of the economic crisis on self-perceived health and some risk behaviors in the Spanish adolescent population. METHODS: We used data from four waves (2002, 2006, 2010, 2014) of the Health Behavior in School-Aged Children (HBSC) survey in Spain. Separate multilevel logistic and linear regression models were applied for health complaints, self-rated health, life satisfaction, smoking, alcohol consumption, and breakfast skipping. Annual change in Spanish regional unemployment rates was used as a proxy of the economic crisis. An increasing set of control variables were included, consisting of individual, socioeconomic, and family and peer relationships indicators. Median odds ratios were estimated to quantify the cross-region and cross-school variation. RESULTS: Increases in unemployment rates were linked to a higher risk of poorer health and bad habits in the simplest models. The effect was no longer statistically significant when indicators of family and peer relationships were included, suggesting a protective effect against the impact of the economic crisis. Our findings also show that schools had a larger effect on health and lifestyles than regions. CONCLUSION: The child's social context-family, peers, school, and region-play an important role on the effects of the economic crisis on health and risk behaviors.

Health and socioeconomic circumstances over three generations as predictors of youth unemployment trajectories.

BACKGROUND: Youth unemployment is a critical life event, which may trigger other labour market-related disadvantages and detrimental health implications. To better understand the processes causing unemployment, we study how socioeconomic circumstances of successive generations and familial and health factors in adolescence predict youth unemployment trajectories between ages 16 and 28 in Finland from 2000 to 2009. METHODS: We used survey data from 1979 to 1997 on 12- to 18-year-old Finns (n = 43 238) linked with 1970-2009 registry-based data of their grandparents, parents and themselves. Growth mixture modelling and multivariate logistic regression analyses were used. RESULTS: Three latent youth unemployment trajectories emerged; low (46%), decreasing (38%) and high (16%) risk groups. Of adolescent factors, low school achievement was the most important predictor of youth unemployment followed by smoking, stress symptoms and poor self-rated health. Grandparents' education predicted their grandchildren's unemployment but the effects of other grandparental socioeconomic circumstances mediated through parents' socioeconomic status (SES). Parents' low SES and education, and long-term unemployment increased the risk of the child's unemployment. Youth unemployment was related to low education at the age of 29. CONCLUSION: Grandparents' education, family socioeconomic circumstances and adolescents' health and school achievement predict the developmental trajectory of youth unemployment. Youth unemployment is also related to low education in early adulthood. Our findings suggest that the health selection of unemployment works already in adolescence.

Employment status of workers with a diagnosed occupational disease in Croatia: a 10-year trend (2005-2014).

Occupational diseases (ODs) often have a chronic, progressive course, resulting in reduced work capacity and quality of life, prolonged sick leaves, unemployment, early retirements, and disability claims. The aim of this retrospective study was to see how diagnosed ODs affected the employment of 95 Croatian workers between 2005 and 2014. To do that, we reviewed archived data and made a telephone survey. The lowest age at which an OD was diagnosed was 20 years in women and 22 in men, while the shortest duration of work before OD diagnosis was one year for both genders. The most common ODs were overuse syndromes on the arms, carpal tunnel syndrome in particular, diagnosed mostly in textile and office workers. Of the 95 participants, 12 lost their jobs since the OD diagnosis, 46 retired, and 37 continued to work. Significantly more participants became unemployed after OD diagnosis in the period 2010-2014 than 2005-2009 (9 out of 43, 21 %, vs. 3 out of 52, 6 %, P<0.05). Only five participants were included in an occupational rehabilitation programme. Our findings warn against the deterioration in care for workers diagnosed with OD in Croatia.

Factors influencing job loss and early retirement in working men with prostate cancer-findings from the population-based Life After Prostate Cancer Diagnosis (LAPCD) study.

PURPOSE: To investigate factors associated with job loss and early retirement in men diagnosed with prostate cancer (PCa) 18-42 months previously. METHODS: Men ≤ 60 years at diagnosis who completed the Life After Prostate Cancer Diagnosis (LAPCD) survey were identified. Men who moved from employment at diagnosis to unemployment (EtoU) or retirement (EtoR) at survey (18-42 months post-diagnosis) were compared to men remaining in employment (EtoE). Sociodemographic, clinical and patient-reported factors were analysed in univariable and multivariable analysis. RESULTS: There were 3218 men (81.4%) in the EtoE, 245 (6.2%) in EtoU and 450 (11.4%) in the EtoR groups. Men with stage IV disease (OR = 4.7 95% CI 3.1-7.0, relative to stage I/II) and reporting moderate/big bowel (OR = 2.5, 95% CI 1.6-3.9) or urinary problems (OR = 2.0, 95% CI 1.4-3.0) had greater odds of becoming unemployed. Other clinical (≥ 1 comorbidities, symptomatic at diagnosis) and sociodemographic (higher deprivation, divorced/separated), living in Scotland or Northern Ireland (NI)) factors were predictors of becoming unemployed. Men who were older, from NI, with stage IV disease and with caring responsibilities had greater odds of retiring early. Self-employed and non-white men had lesser odds of retiring early. CONCLUSION: PCa survivors who retire early following diagnosis do not report worse urinary or bowel problems compared to men remaining in employment. However, we identified clinical and sociodemographic factors which increased unemployment risk in PCa survivors. IMPLICATIONS FOR CANCER SURVIVORS: Targeted support and engagement with PCa survivors at risk of unemployment, including their families and employers, is needed.

Transformações e tendências do mercado de trabalho no Brasil entre 2001 e 2015: paradoxo do baixo desemprego? / Transformations and tendencies of the labor market in Brazil between 2001 and 2015: paradox of the low unemployment? / Cambios y tendencias en el mercado de trabajo en Brasil entre 2001 y 2015: la paradoja bajo nivel de desempleo?

Resumo A economia brasileira, favorecida pelos superciclo das commodities, teve uma década de crescimento e relativa estabilidade macroeconômica, em que o mercado de trabalho apresentou um desempenho bastante favorável. Contudo, houve uma desaceleração do Produto Interno Bruto (PIB), seguida de forte recessão em 2015 e 2016. Houve uma defasagem grande entre o início da desaceleração da economia e seus primeiros efeitos sobre o mercado de trabalho, o chamado paradoxo do baixo desemprego. O objetivo deste artigo é analisar tal fenômeno, utilizando as duas principais pesquisas que abordam o tema emprego no âmbito do Instituto Brasileiro de Geografia e Estatística: a Pesquisa Nacional por Amostra de Domicílios e a Pesquisa Mensal de Emprego. Recorrendo à metodologia de decomposições da variação da taxa de desocupação, constatou-se que a parcela mais expressiva tanto da redução anterior da taxa de desocupação, quanto do seu aumento atual, ocorreu nas metrópoles, e que grande parte de seu comportamento pode ser explicado pela redução da participação dos mais jovens, das pessoas menos instruídas e pela redução no ritmo de inserção das mulheres no mercado de trabalho. O perfil etário da desocupação no país tornou-se mais jovem, o que traz preocupações quanto à emergência de uma “geração perdida”.

Abstract The Brazilian economy, boosted by the commodities super-cycle, had a decade of growth and macroeconomic stability, in which the labor market performed very favorably. However, there was a slowdown in the GDP, followed by a strong recession in 2015 and 2016. There was a large gap between the beginning of the economic slowdown and its first effects on the labor market, the so called paradox of low unemployment. The objective of this paper is to analyze this phenomenon using the two main surveys carried out by the Brazilian Geography and Statistics Institution (IBGE) that deals with this subject, the Pesquisa Nacional por Amostra de Domicílios (PNAD) and the Pesquisa Mensal de Emprego (PME). Using the unemployment rate variation decomposition methodology, the results show that the most expressive part of both, the previous reduction and the current increase of the rate, took place in the metropolitan areas, and that a great part of this behavior can be explained by the reduction of the participation of both young and less educated workers and the reduction in the pace of women’ insertion in the labor market. The age profile of unemployment in Brazil has become younger, raising concerns of an emerging “lost generation”.

Resumen La economía brasileña, favorecida por el superciclo de las comodities, tuvo una década de crecimiento y estabilidad macroeconómica, en la cual el mercado laboral mostró un relativo comportamiento favorable. Sin embargo, hubo una desaceleración del producto interno bruto (PIB) seguida de una profunda recesión en 2015 y 2016. En este período, hubo un profundo desfasaje entre el inicio de la crisis económica y sus primeros efectos en el mercado de trabajo —la llamada paradoja de la baja tasa de desempleo—. El objetivo de este artículo es analizar este fenómeno, utilizando las dos encuestas principales del Instituto Brasileño de Geografía y Estadística (IBGE) que abordan el tema de empleo: la Pesquisa Nacional por Amostra de Domicílios (PNAD) y la Pesquisa Mensal de Emprego (PME). Utilizando la metodología de descomposición de la variación de la tasa de desempleo, se encontró que la porción más significativa, tanto de la reducción previa de la tasa de desempleo cuanto de su actual aumento, se produjo en las regiones metropolitanas y que gran parte de su comportamiento puede ser explicado por la reducción de la participación de los más jóvenes, de los menos educados y por la reducción de la tasa de participación de las mujeres en el mercado laboral. El perfil de edad de desempleo en el país se ha rejuvenecido, lo que plantea preocupaciones acerca de la aparición de una “generación perdida”.

Delayed Workforce Entry and High Emigration Rates for Recent Canadian Radiation Oncology Graduates.

PURPOSE: To determine the employment status and location of recent Canadian radiation oncology (RO) graduates and to identify current workforce entry trends. METHODS AND MATERIALS: A fill-in-the-blank spreadsheet was distributed to all RO program directors in December 2013 and June 2014, requesting the employment status and location of their graduates over the last 3 years. Visa trainee graduates were excluded. RESULTS: Response rate from program directors was 100% for both survey administrations. Of 101 graduates identified, 99 (98%) had known employment status and location. In the December survey, 5 2013 graduates (16%), 17 2012 graduates (59%), and 18 2011 graduates (75%) had permanent staff employment. Six months later, 5 2014 graduates (29%), 15 2013 graduates (48%), 24 2012 graduates (83%), and 21 2011 graduates (88%) had secured staff positions. Fellowships and temporary locums were common for those without staff employment. The proportion of graduates with staff positions abroad increased from 22% to 26% 6 months later. CONCLUSIONS: Workforce entry for most RO graduates was delayed but showed steady improvement with longer time after graduation. High emigration rates for jobs abroad signify domestic employment challenges for newly certified, Canadian-trained radiation oncologists. Coordination on a national level is required to address and regulate radiation oncologist supply and demand disequilibrium in Canada.

Recessions, healthy no more?

Over the 1976-2010 period, total mortality shifted from strongly procyclical to being weakly or unrelated to macroeconomic conditions. The association is likely to be poorly measured when using short (less than 15 year) analysis periods. Deaths from cardiovascular disease and transport accidents continue to be procyclical; however, countercyclical patterns have emerged for fatalities from cancer mortality and external causes. Among the latter, non-transport accidents, particularly accidental poisonings, play an important role.

O impacto da crise econômica espanhola na mão de obra imigrante / The impact of the Spanish economic crisis on immigrant labor in Spain / El impacto de la crisis económica española en la mano de obra inmigrante

Artigo tem o objetivo de analisar a situação da mão de obra imigrante na Espanha nos últimos dez anos, vinculando-a com as transformações econômicas e sociais pelas quais o país tem passado desde meados da década de 1990, com ênfase no panorama gerado pela crise econômica que eclodiu a partir do final de 2008 e o seu impacto na situação dos imigrantes, coletivo que mais tem sofrido com o novo quadro econômico e social estabelecido com a crise. Diante da situação que a Espanha atravessa, com notável aumento do desemprego e de deterioração dos indicadores sociais, nota-se o retorno considerável de imigrantes para os seus países de origem depois de esgotarem todas as vias alternativas de permanência na Espanha. O fundamento para o desenvolvimento deste trabalho foram os dados proporcionados pelo Instituto Nacional de Estadística (INE) da Espanha, utilizando a EPA (Encuesta de Población Activa), além dos dados do Eurostat e das fontes bibliográficas citadas...

This paper aims to analyze the situation of immigrant labor in Spain over the last ten years, linking it to social and economic transformations, which the country has undergone since the mid-1990s, with emphasis on the scenario generated by the economic crisis that erupted at the end of 2008 and its impact on the situation of immigrants, the people who have been most deeply affected by the new economic and social setting resulting from the crisis. Faced with the situation in Spain, with a remarkable increase in unemployment and deterioration of social indicators, immigrants have been returning to their countries of origin after exhausting all alternative ways to remain in Spain. The development of this paper is based on data provided by the Instituto Nacional de Estadística (INE - National Statistics Institute), of Spain, which used the Encuesta de Población Activa (EPA - Active Population Survey), in addition to data from Eurostat and the bibliographical references cited...

Este artículo tiene por objetivo analizar la situación de la mano de obra inmigrante en España en los últimos diez años, vinculándola con las transformaciones económicas y sociales por las que ha atravesado el país desde mediados de la década de 1990, con énfasis en el panorama generado por la crisis económica que eclosionó a fines de 2008 y su impacto en la situación de los inmigrantes, colectivo que más ha sufrido con el nuevo escenario económico y social establecido con la crisis. Ante la situación por la que atraviesa España, con un notable aumento del desempleo y del deterioro de los indicadores sociales, se observa un considerable retorno de los inmigrantes hacia sus países de origen, después de agotar todas las vías alternativas para su permanencia. El fundamento para el desarrollo de este trabajo han sido los datos proporcionados por el Instituto Nacional de Estadística (INE) de España, utilizando la Encuesta de Población Activa (EPA), además de los datos de Eurostat y de las fuentes bibliográficas citadas...

Unemployment, public-sector healthcare spending and stomach cancer mortality in the European Union, 1981-2009.

OBJECTIVES: We sought to determine the association between changes in unemployment, healthcare spending and stomach cancer mortality. METHODS: Multivariate regression analysis was used to assess how changes in unemployment and public-sector expenditure on healthcare (PSEH) varied with stomach cancer mortality in 25 member states of the European Union from 1981 to 2009. Country-specific differences in healthcare infrastructure and demographics were controlled for 1- to 5-year time-lag analyses and robustness checks were carried out. RESULTS: A 1% increase in unemployment was associated with a significant increase in stomach cancer mortality in both men and women [men: coefficient (R)=0.1080, 95% confidence interval (CI)=0.0470-0.1690, P=0.0006; women: R=0.0488, 95% CI=0.0168-0.0809, P=0.0029]. A 1% increase in PSEH was associated with a significant decrease in stomach cancer mortality (men: R=-0.0009, 95% CI=-0.0013 to -0.005, P<0.0001; women: R=-0.0004, 95% CI=-0.0007 to -0.0001, P=0.0054). The associations remained when economic factors, urbanization, nutrition and alcohol intake were controlled for, but not when healthcare resources were controlled for. Time-lag analysis showed that the largest changes in mortality occurred 3-4 years after any changes in either unemployment or PSEH. CONCLUSION: Increases in unemployment are associated with a significant increase in stomach cancer mortality. Stomach cancer mortality is also affected by public-sector healthcare spending. Initiatives that bolster employment and maintain public-sector healthcare expenditure may help to minimize increases in stomach cancer mortality during economic downturns.

Trajectories of cigarette smoking from adolescence to adulthood as predictors of unemployment status.

INTRODUCTION: This longitudinal study examined the association between trajectories of cigarette smoking and unemployment across a 29-year time period from mean age 14 to mean age 43. METHODS: Participants came from a community-based random sample of residents in 2 upstate New York counties. Data were collected at 7 timepoints. RESULTS: Using growth mixture modeling, 5 trajectory groups of cigarette smokers were identified. The trajectory groups were as follows: heavy/continuous smokers, occasional smokers, late-starting smokers, quitters/decreasers, and nonsmokers. Multivariate logistic regression analysis was used to study the relationship between the participant's trajectory group membership and unemployment in the fifth decade of life. The association was determined with controls for age, gender, current cigarette use, current alcohol use, current marijuana use, physical diseases, occupation, educational level, past unemployment experience, socioeconomic status measures of family of origin, depressive mood, and self-control from adolescence through the early 40s. The findings indicate that patterns of adolescent and young adult cigarette smoking have implications for later unemployment. Overall, the results showed that people who fell into the categories of heavy/continuous smokers (adjusted odds ratio [AOR] = 3.84) and occasional smokers (AOR = 4.03) were more likely to be unemployed at mean age 43 when compared with nonsmokers. There was no significant difference between the quitters/decreasers and the nonsmokers with respect to unemployment. CONCLUSIONS: Intervention programs designed to deal with unemployment should consider focusing on heavy/continuous and occasional cigarette smokers as risk factors for unemployment.

O efeito trabalhador adicional para filhos no Brasil / /The added worker effect for children in Brazil / /El efecto trabajador adicional para hijos en Brasil

O objetivo deste trabalho é testar a hipótese da existência do efeito trabalhador adicional para filhos no Brasil, procurando identificar se a situação de desemprego do chefe de família fará com que algum membro da família, cuja condição seja filho, transite para a População Economicamente Ativa - PEA. A base de dados utilizada foi a Pesquisa Mensal de Emprego - PME realizada pelo IBGE, que permite a construção de painéis para análise longitudinal de dados. A hipótese foi testada para pelo menos um filho com idade de 10 a 18 anos, entre 2002 e 2013, para as regiões metropolitanas de Belo Horizonte, Salvador, Porto Alegre, São Paulo, Rio de Janeiro e Recife, que compõem a área de abrangência da PME. Este trabalho admite a existência de diferencial por sexo do chefe para o efeito trabalhador adicional de filhos de 10 a 18 anos. Os resultados mostraram haver um efeito positivo maior para chefes homens do que para chefes mulheres, sendo que a variável de transição do filho para a atividade não apresentou significância estatística que permitisse assumir a existência do efeito. Corroborou-se a hipótese da existência de diferencial por sexo, contudo no sentido oposto ao da hipótese assumida...

The aim of this paper was to test the hypothesis of the existence of the effect of the added worker for children in Brazil. The paper aims to identify whether a situation of unemployment of the head of the household will lead some daughter or son in the family to enter the economically active population (EAP). The database used was the Monthly Employment Survey conducted by IBGE, which allows the construction of panels for longitudinal data analysis. The hypothesis was tested for at least one child aged 10 to 18, between 2002 and 2013, for the metropolitan areas of Belo Horizonte, Salvador, Porto Alegre, Sao Paulo, Rio de Janeiro and Recife, which make up the area covered by the Monthly Employment Survey (PME). This study accepts the existence of differential by gender of the head of the household for the added worker effect for children ages 10-18. The results showed that there was a greater positive effect for male heads of household than for female heads of household. The variable of transition of the son or daughter to employed activity showed no statistical significance that would allow us to assume the existence of the effect. The hypothesis of the existence of a differential by gender was confirmed, but in the opposite direction from the original hypothesis...

El objetivo de este artículo es probar la hipótesis de la existencia del efecto trabajador adicional para hijos en Brasil, tratando de identificar si la situación de desempleo del jefe de familia hará que algún miembro de la familia, cuya condición sea de hijo, transite hacia la Población Económicamente Activa - PEA. La base de datos utilizada fue la Pesquisa Mensal de Emprego - PME, realizada por IBGE, que permite la construcción de paneles para el análisis longitudinal de datos. La hipótesis fue probada para por lo menos un hijo con edad de 10 a 18 años, entre 2002 y 2013, para las regiones metropolitanas de Belo Horizonte, Salvador, Porto Alegre, São Paulo, Rio de Janeiro y Recife, que conforman el área de alcance de la PME. Este trabajo admite la existencia de diferencial por sexo del jefe para el efecto trabajador adicional de hijos de 10 a 18 anos. Los resultados mostraron que hay un efecto positivo mayor para jefes hombres que para jefas mujeres, siendo que la variable de transición del hijo hacia la actividad no presentó significancia estadística que permitiera asumir la existencia del efecto. Se corroboró la hipótesis de la existencia de diferencial por sexo, pero en el sentido opuesto al de la hipótesis asumida...

Otolaryngology - Head and Neck Surgeon unemployment in Canada: a cross-sectional survey of graduating Otolaryngology - Head and Neck Surgery residents.

OBJECTIVE: Recently graduated Otolaryngology - Head and Neck Surgeons (OTO-HNS) are facing an employment crisis. To date, there has been no systematic evaluation of the factors contributing to this situation, graduating OTO-HNS trainee employment rates, nor the employment concerns of these graduating residents. This investigation sought to empirically evaluate prospective OTO-HNS graduate employment, identify factors contributing to this situation, and provide suggestions going forward. METHODS: A cross-sectional survey of the 2014 graduating cohort of OTO-HNS residents was conducted 6-months prior to graduation, and immediately following residency graduation. Surveyed items focused on the demographics of the graduating cohort, their future training and employment plans, and their concerns relative to the OTO-HNS employment situation. RESULTS: All twenty-nine Canadian medical school graduated OTO-HNS residents completed the initial survey, with 93% responding at the completion of residency. Only 6 (22%) indicated confirmed employment following residency training. 78% indicated that they were pursuing fellowship training. 90% identified the pursuit of fellowship training as a moderately influenced by limited job opportunities. The ability to find and secure full-time employment, losing technical skills if underemployed/unemployed, and being required to consider working in a less-desired city/province were most concerning. 34% of the residents felt that they were appropriately counseled during their residency training about employment. 90% felt that greater efforts should be made to proactively match residency-training positions to forecasted job opportunities. CONCLUSIONS: Canadian OTO-HN Surgeons lack confirmed employment, are choosing to pursue fellowship training to defer employment, and are facing startling levels of under- and unemployment. A multitude of factors have contributed to this situation and immediate action is required to rectify this slowly evolving catastrophe.

Washington State cancer patients found to be at greater risk for bankruptcy than people without a cancer diagnosis.

Much has been written about the relationship between high medical expenses and the likelihood of filing for bankruptcy, but the relationship between receiving a cancer diagnosis and filing for bankruptcy is less well understood. We estimated the incidence and relative risk of bankruptcy for people age twenty-one or older diagnosed with cancer compared to people the same age without cancer by conducting a retrospective cohort analysis that used a variety of medical, personal, legal, and bankruptcy sources covering the Western District of Washington State in US Bankruptcy Court for the period 1995-2009. We found that cancer patients were 2.65 times more likely to go bankrupt than people without cancer. Younger cancer patients had 2-5 times higher rates of bankruptcy than cancer patients age sixty-five or older, which indicates that Medicare and Social Security may mitigate bankruptcy risk for the older group. The findings suggest that employers and governments may have a policy role to play in creating programs and incentives that could help people cover expenses in the first year following a cancer diagnosis.

Exempting casinos from the Smoke-free Illinois Act will not bring patrons back: they never left.

OBJECTIVE: The Smoke-free Illinois Act was implemented in January 2008, one month after the beginning of a national recession. In December 2010, the Illinois legislature proposed new legislation that would provide an exemption for casinos from the act until neighbouring states also implement smoke-free casino policies. Lobbyists and gaming commission representatives argued that Illinois casinos were losing patrons to casinos in neighbouring states that allow smoking. This study examined the influence of the act on casino admissions in Illinois and neighbouring states in light of the economy. METHODS: A multilevel model was developed to examine monthly casino admissions from January 2007 to December 2008. RESULTS: There was no difference in changes in admissions across the four states over time after accounting for the economic downturn. CONCLUSIONS: The Smoke-Free Illinois Act did not have a detectable effect on Illinois casino admissions.

Disponíveis no trabalho, disponíveis para a vida? Saúde-doença, trabalho e relações pessoais de servidores públicos postos em disponibilidade no governo Collor / Available at work, available for life? Health and illness, work and personal relationships of public servants made ​​available at the Collor government

Esta dissertação objetiva analisar as repercussões sobre as relações pessoais, o trabalho e o binômio saúde-doença determinados pela disponibilidade a que servidores públicos federais foram submetidos, durante o governo Collor (1990-1992).A opção foi pela modalidade artigo. No texto que o antecede, após introdução, o referencial teórico foi organizado em quatro etapas: a) As relações saúde-trabalho: trabalho, não trabalho, desemprego e o desconhecimento de suas consequências no período Collor; b) O contexto neoliberal do período Collor, na cena internacional (cuja influência foi decisiva para as medidas tomadas nacionalmente); c) O processo político-administrativo da reforma administrativa, daquele período; e, d) A disponibilidade dos servidores públicos federais. No artigo, são apresentados os resultados de entrevistas e discussões com onze servidores. O único critério utilizado para a escolha dos sujeitos da pesquisa foi seu local de lotação, durante o período de disponibilidade, que foi definido como o estado do Rio de Janeiro. As entrevistas foram previamente agendadas e realizadas em um centro de estudos de um hospital local. Os questionários utilizados nas entrevistas foram elaborados com questões abertas, apresentadas em três tempos: antes, durante e após a disponibilidade. As entrevistas foram realizadas de 01 de julho a 31 de outubro de 2010. A análise qualitativa dos dados utilizou o referencial de Bardin (1977). Os resultados mostraram que os sentimentos preponderantes a afetarem os trabalhadores foram medo, insegurança, baixa autoestima, tipificando processos de violência e assédio moral capitaneados pelo próprio governo. Pôde-se observar destrato por chefes e colegas, pouca participação em movimentos organizados contra a disponibilidade e agregação em busca de locais para trabalhar. No retorno às atividades, os pesquisados foram bem recebidos...

This dissertation aims to analyze the effects on personal relationships, work and health-disease dyad determined by the compulsory away of work of federal civil servants determined during the Collor government (1990-1992).The option was for the article mode. In the article preceding text, after introduction, the theoretical framework was organized into four steps: a) the health and work relationship: work, not work, unemployment and ignorance of its consequences during Collor time b) The context of the neoliberal Collor period taking into account the international scene (whose influence was decisive for the measures taken nationally) c) The administrative-political process of administrative reform on that time, and d) The compulsory away of work of federal civil servants of federal public servants. The article presents the results of interviews and discussions with eleven servers. The unique criteria for the choice of research subjects was your working place during the period of compulsory away of work of federal civil servants, which was defined as the state of Rio de Janeiro. The interviews were scheduled in advance and carried out in a study center at a local hospital. The questionnaires used in the interviews were made with semi-structured questions, presented in three stages: before, during and after compulsory away of work of federal civil servants. The interviews were conducted from July 1 to October 31, 2010. The qualitative data analysis used the benchmark of Bardin (1977). The results showed that the predominant feelings affect workers were fear, insecurity, low self-esteem, typifying processes of bullying and violence spearheaded by the government. It was observed mistreatment by bosses and colleagues, low participation in organized movements against the compulsory away of work of federal civil servants and aggregation in search of places to work...

Decline in the United States black preterm/low birth weight rate in the 1990s: can the economic boom explain it?

PURPOSE: Macroeconomic improvements have been posited as an explanation of the decline in the Black preterm birth rate during the 1990s. This study assessed whether decreasing unemployment explained the decline in preterm, low birth weight births (PT-LBW) for Black women. METHODS: United States singleton births to non-Hispanic Black women ages 18 and over, conceived between 1990 and 2001, were pooled to examine PT-LBW trends by level of social advantage (approximated by education and marital status). The impact of the state-level unemployment rate in the first and second trimester of pregnancy was evaluated in multiple logistic regression models. RESULTS: During the 1990s, PT-LBW declined 11% among disadvantaged (unmarried, less than high school educated) Black women. Although the unemployment rate and PT-LBW were positively related, decreases in unemployment did not explain the decline in PT-LBW. Instead, improvements in prenatal care utilization and smoking behavior largely accounted for the temporal trend. CONCLUSIONS: Macroeconomic improvements, measured by unemployment, only marginally contributed to the Black PT-LBW trend in the 1990s. To effect further reductions, future studies should investigate other possible determinants of the proximate behavioral changes that did explain the trend (e.g., Earned Income Tax Credit expansions, increased, cigarette taxes/smoking legislation).