Availability of and Participation in Workplace Health Promotion Programs by Sociodemographic, Occupation, and Work Organization Characteristics in US Workers.

PURPOSE: To examine how the availability of and participation in workplace health promotion programs (WHPPs) vary as a function of sociodemographic, occupation, and work organization characteristics. DESIGN: Cross-sectional study. SETTING: 2015 National Health Interview Survey and Occupational Health Supplement. PARTICIPANTS: The study sample included 17 469 employed adults who completed the WHPP questions. MEASURES: The 2 dependent outcome measures were availability of WHPPs and participation in these programs when available. Independent variables included occupation and 8 work organization and employment characteristics: company size, hours worked, supervisory responsibility, hourly pay, paid sick leave, health insurance offered by employer, work schedule, and work arrangement. ANALYSIS: Poisson regression analyses were conducted with SUDAAN 11.0.1. RESULTS: Overall, 57.8% of 46.6% employees who have WHPPs available reported participating in these programs. This study found that adults who worked ≤20 h/wk, worked regular night shifts, were paid by the hour, or worked for temporary agencies were less likely to participate in WHPPs. Workers who supervised others were 13% more likely to participate than nonsupervisors. Borderline associations were seen for having access to employer-sponsored health insurance and working at a site with <10 employees. CONCLUSION: Despite the potential for improving physical and mental health, only 58% of US workers participated in WHPPs. Since barriers to WHPP participation (eg, time constraints, lack of awareness, and no perceived need) may vary across occupations and work organization characteristics, employers should tailor WHPPs based on their specific work organization characteristics to maximize participation.

Job Characteristics Associated With Self-Rated Fair or Poor Health Among U.S. Workers.

INTRODUCTION: Approximately 60% of the U.S. adult population is employed. Many aspects of a person's job may influence health, but it is unclear which job characteristics are most strongly associated with health at a population level. The purpose of this study was to identify important associations between job characteristics and workers' self-rated health in a nationally representative survey of U.S. workers. METHODS: Data from the 2010 National Health Interview Survey were used to calculate weighted prevalence rates for self-reported fair/poor health for five categories of job characteristics: occupation; pay/benefits (economic); work organization; chemical/environmental hazards; and psychosocial factors. Backward elimination methods were used to build a regression model for self-reported health with the significant job characteristics, adjusting for sociodemographic variables and health behaviors. Data were collected in 2010 and analyzed in 2012-2016. RESULTS: After adjusting for covariates, workers were more likely to have fair/poor health if they were employed in business operations occupations (e.g., buyers, human resources workers, event planners, marketing specialists; adjusted prevalence ratio [APR]=1.85, 95% CI=1.19, 2.88); had no paid sick leave (APR=1.35, 95% CI=1.11, 1.63); worried about becoming unemployed (APR=1.43, 95% CI=1.22, 1.69); had difficulty combining work and family (APR=1.23, 95% CI=1.01, 1.49); or had been bullied/threatened on the job (APR=1.82, 95% CI=1.44, 2.29). CONCLUSIONS: Occupation, lack of paid sick leave, and multiple psychosocial factors were associated with fair/poor health among U.S. workers at the population level in 2010. Public health professionals and employers should consider these factors when developing interventions to improve worker health.

Evaluating Job Demands and Control Measures for Use in Farm Worker Health Surveillance.

Workplace stress likely plays a role in health disparities; however, applying standard measures to studies of immigrants requires thoughtful consideration. The goal of this study was to determine the appropriateness of two measures of occupational stressors ('decision latitude' and 'job demands') for use with mostly immigrant Latino farm workers. Cross-sectional data from a pilot module containing a four-item measure of decision latitude and a two-item measure of job demands were obtained from a subsample (N = 409) of farm workers participating in the National Agricultural Workers Survey. Responses to items for both constructs were clustered toward the low end of the structured response-set. Percentages of responses of 'very often' and 'always' for each of the items were examined by educational attainment, birth country, dominant language spoken, task, and crop. Cronbach's α, when stratified by subgroups of workers, for the decision latitude items were (0.65-0.90), but were less robust for the job demands items (0.25-0.72). The four-item decision latitude scale can be applied to occupational stress research with immigrant farm workers, and potentially other immigrant Latino worker groups. The short job demands scale requires further investigation and evaluation before suggesting widespread use.

Prevalence rates for depression by industry: a claims database analysis.

PURPOSE: To estimate and interpret differences in depression prevalence rates among industries, using a large, group medical claims database. METHODS: Depression cases were identified by ICD-9 diagnosis code in a population of 214,413 individuals employed during 2002-2005 by employers based in western Pennsylvania. Data were provided by Highmark, Inc. (Pittsburgh and Camp Hill, PA). Rates were adjusted for age, gender, and employee share of health care costs. National industry measures of psychological distress, work stress, and physical activity at work were also compiled from other data sources. RESULTS: Rates for clinical depression in 55 industries ranged from 6.9 to 16.2 %, (population rate = 10.45 %). Industries with the highest rates tended to be those which, on the national level, require frequent or difficult interactions with the public or clients, and have high levels of stress and low levels of physical activity. CONCLUSIONS: Additional research is needed to help identify industries with relatively high rates of depression in other regions and on the national level, and to determine whether these differences are due in part to specific work stress exposures and physical inactivity at work. CLINICAL SIGNIFICANCE: Claims database analyses may provide a cost-effective way to identify priorities for depression treatment and prevention in the workplace.

Job control, psychological demand, and farmworker health: evidence from the national agricultural workers survey.

OBJECTIVE: Improve understanding of the potential occupational health impact of how agricultural jobs are organized. Exposure to low job control, high psychological demands, and high job strain were hypothesized to have greater risk for poor self-rated physical health and elevated depressive symptoms. METHODS: Cross-sectional data (N = 3691) obtained using the Work Organization and Psychosocial Factors module of the US National Agricultural Workers Survey fielded in 2009-2010. RESULTS: More than one fifth (22.4%) of farmworkers reported fair/poor health, and 8.7% reported elevated depressive symptoms. High psychological demand was associated with increased risk of fair/poor health (odds ratio, 1.73; 95% confidence interval, 1.4 to 2.2) and elevated depressive symptoms (odds ratio, 2.6; 95% confidence interval, 1.9 to 3.8). CONCLUSIONS: The organization of work in field agriculture may pose risks for poor occupational health outcomes among a vulnerable worker population.

Racial and ethnic disparities in work-related injuries and socio-economic resources among nursing assistants employed in US nursing homes.

BACKGROUND: We aimed to estimate the proportion of nursing assistants (NAs) in the US with work-related injuries and insufficient socio-economic resources by race/ethnicity. METHODS: Data from the 2004 National Nursing Assistant Survey (NNAS), a nationally representative sample survey of NAs employed in United States nursing homes, were analyzed accounting for the complex survey design. RESULTS: Among 2,880 participants, 44% reported "scratch, open wounds, or cuts" followed by "back injuries" (17%), "black eyes or other types of bruising" (16%), and "human bites" (12%). When compared to non-Hispanic white NAs, the adjusted rate ratio (RR) for wound/cut was 0.74 for non-Hispanic black NAs (95% confidence interval [CI]: 0.65-0.85). RRs for black eyes/bruises were 0.18 for non-Hispanic black NAs (95% CI: 0.12-0.26), and 0.55 for Hispanic NAs (95% CI: 0.37-0.82). CONCLUSIONS: Minority racial and ethnic groups were less likely to report having experienced injuries compared with non-Hispanic white NAs. Future research should focus on identifying preventable risk factors, such as differences by race and ethnicity in the nature of NA jobs and the extent of their engagement in assisting patients with activities of daily living.

Examining associations between job characteristics and health: linking data from the Occupational Information Network (O*NET) to two U.S. national health surveys.

OBJECTIVE: To determine whether the Occupational Information Network (O*NET) database can be used to identify job dimensions to serve as proxy measures for psychosocial factors and select environmental factors, and to determine whether these factors could be linked to national health surveys to examine associations with health risk behaviors and outcomes. METHODS: Job characteristics were obtained from O*NET 98. Health outcomes were obtained from two national surveys. Data were linked using Bureau of Census codes. Multiple logistic regression was used to examine associations between O*NET factors and cardiovascular disease, depression, and health risk factors. RESULTS: Seven of nine work organization or psychosocial factors were significantly associated with health risk behaviors in both the National Health and Nutrition Examination Survey III and National Health Interview Survey. CONCLUSIONS: This study demonstrates a method for linking independently obtained health and job characteristic data based on occupational code.

Race, occupation, and lung cancer: detecting disparities with death certificate data.

OBJECTIVES: To determine whether the analysis of death certificate data would reveal the same relationship among race, occupational exposure, and lung cancer mortality observed by a large cohort study. METHODS: An occupation-specific mortality odds ratio (MOR) for lung cancer (ICD-162) versus all other causes was calculated for 218,341 black men and white men who had been employed in the metal industries. RESULTS: Black men were at increased risk for lung cancer mortality when compared with white men among the 4668 oven workers (MOR = 1.38, 95% CI = 1.10 to 1.73), but not among the 33,605 white-collar workers (MOR = 0.95, 95% CI = 0.74 to 1.23). CONCLUSIONS: Our findings corroborate a previously demonstrated association among exposure to carcinogenic coke oven emissions, race, and lung cancer mortality, and support the use of death certificate data to help identify occupations with racial disparities in lung cancer mortality.