RESUMEN
INTRODUCTION: The goal of this study was to examine potential disparities in positive mental health (PMH) among adults in Canada by sexual orientation and gender modality. METHODS: Using 2019 Canadian Community Health Survey (CCHS) Annual Component data (N = 57 034), we compared mean life satisfaction and the prevalence of high self-rated mental health (SRMH), happiness and community belonging between heterosexual and sexual minority adults, and between cisgender and gender minority adults. We used 2019 CCHS Rapid Response on PMH data (N = 11 486) to compare the prevalence of high psychological well-being between heterosexual and sexual minority adults. Linear and logistic regression analyses examined the between-group differences in mean life satisfaction and the other PMH outcomes, respectively. RESULTS: Sexual minority (vs. heterosexual) adults reported lower mean life satisfaction (B = -0.7, 95% CI: -0.8, -0.5) and were less likely to report high SRMH (OR = 0.4, 95% CI: 0.3, 0.5), happiness (OR = 0.4, 95% CI: 0.3, 0.5), community belonging (OR = 0.6, 95% CI: 0.5, 0.7) and psychological well-being (OR = 0.4, 95% CI: 0.3, 0.6). Differences were not always significant for specific sexual minority groups in sexstratified analyses. Gender minority adults reported lower mean life satisfaction and were less likely to report high SRMH and happiness than cisgender adults. CONCLUSION: Future research could investigate how these PMH disparities arise, risk and protective factors in these populations, how other sociodemographic factors interact with sexual orientation and gender identity to influence PMH and changes in disparities over time.
Asunto(s)
Salud Mental , Minorías Sexuales y de Género , Humanos , Masculino , Femenino , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Canadá/epidemiología , Adulto , Salud Mental/estadística & datos numéricos , Persona de Mediana Edad , Satisfacción Personal , Disparidades en el Estado de Salud , Encuestas Epidemiológicas , Felicidad , Adulto Joven , Heterosexualidad/estadística & datos numéricos , Heterosexualidad/psicología , Adolescente , AncianoRESUMEN
OBJECTIVE: We assessed the impact of key population variables (age, gender, income and education) on perceptions of governmental effectiveness in communicating about COVID-19, helping meet needs for food and shelter, providing physical and mental healthcare services, and allocating dedicated resources to vulnerable populations. DESIGN: Cross-sectional study carried out in June 2020. PARTICIPANTS AND SETTING: 13 426 individuals from 19 countries. RESULTS: More than 60% of all respondents felt their government had communicated adequately during the pandemic. National variances ranged from 83.4% in China down to 37.2% in Brazil, but overall, males and those with a higher income were more likely to rate government communications highly. Almost half (48.8%) of the respondents felt their government had ensured adequate access to physical health services (ranging from 89.3% for Singapore to 27.2% for Poland), with higher ratings reported by younger and higher-income respondents. Ratings of mental health support were lower overall (32.9%, ranging from 74.8% in China to around 15% in Brazil and Sweden), but highest among younger respondents. Providing support for basic necessities of food and housing was rated highest overall in China (79%) and lowest in Ecuador (14.6%), with higher ratings reported by younger, higher-income and better-educated respondents across all countries. The same three demographic groups tended to rate their country's support to vulnerable groups more highly than other respondents, with national scores ranging from around 75% (Singapore and China) to 19.5% (Sweden). Subgroup findings are mostly independent of intercountry variations with 15% of variation being due to intercountry differences. CONCLUSIONS: The tendency of younger, better-paid and better-educated respondents to rate their country's response to the pandemic more highly, suggests that government responses must be nuanced and pay greater attention to the needs of less-advantaged citizens as they continue to address this pandemic.
Asunto(s)
COVID-19/prevención & control , Programas de Gobierno , Pandemias/legislación & jurisprudencia , Factores de Edad , COVID-19/epidemiología , Estudios Transversales , Estatus Económico , Gobierno , Humanos , Masculino , SARS-CoV-2 , Factores Sexuales , Factores SocioeconómicosRESUMEN
BACKGROUND: Research has suggested ideal combinations of sleep, physical activity (PA) and sedentary time (ST) (i.e., optimal sleep/high PA/low ST) are associated with better overall health. Previous research has shown nurses spend more than half their day sedentary, do not generally meet PA guidelines and have difficulty obtaining adequate sleep. There has been no known work to examine how combinations of sleep, PA and ST relate to the work performance and mental health of nurses. Our objective was to assess the associations of sleep, PA and ST with absenteeism, mood states and shift work disorder (SWD) in a sample of Canadian nurses. METHODS: A total of 342 nurses from the Champlain Nurses' Study (mean age ± SD = 43 ± 12 years, 94% women) wore an ActiGraph GT3X accelerometer for ≥ 4 days for ≥ 10 h/day to derive time spent in moderate-to-vigorous intensity physical activity (MVPA) and ST and reported sleep time for ≥ 4 days using daily activity logs. Behavioural patterns were categorized into four groups for comparison based on opposing combinations of sleep, MVPA and ST (e.g., optimal sleep/high MVPA/low ST vs. non-optimal sleep/low MVPA/high ST). Self-reported absenteeism, mood states and SWD as measured by the Profile of Mood States (POMS) and Shift Work Disorder Screening questionnaires, respectively, were compared across combinations of high versus low MVPA and ST, and optimal vs. non-optimal sleep. RESULTS: Nurses spent an average of 444 ± 11 min/day sedentary, 14 ± 15 min/day in bouts ≥ 10 minutes of MVPA (23% met PA guidelines) and reported an average of 8 h and 39 min ± 1 h 6 min of sleep/24-h. Significant associations between behaviour groups and the POMS score and its vigor subscale, as well as SWD were observed, however, none were observed for absenteeism. The healthiest behaviour group had a significantly lower mood disturbance compared to 2/3 unhealthy behaviours and greater vigor compared to 2/3 and 3/3 unhealthy behaviours. SWD trended toward being higher amongst the group with 2/3 unhealthy behaviours. Meeting PA guidelines was associated with significantly lower total mood disturbance versus not meeting guidelines (median [IQR] = 0.4 [4.5] vs. 1.3 [4.4], Z = - 2.294, df = 1, p = 0.022), as well as lower anger, higher vigor and lower fatigue. Low ST was associated with lower POMS total mood disturbance scores versus higher ST (0.6 [4.4] vs. 1.4 [4.3], Z = 2.028, df = 1, p = 0.043), as well as higher vigor and lower fatigue. CONCLUSIONS: In this sample of hospital nurses, the combined effects of sleep, PA and ST are associated with total mood disturbance and SWD. Achieving the recommended levels in all three behaviours may be beneficial in decreasing total mood disturbance and minimizing the effects of SWD. Future work is needed to address the low PA and high ST levels of nurses and to better understand how these behaviours can be improved to optimize the mental health of the health workforce.