Artificial intelligence and the work-health interface: A research agenda for a technologically transforming world of work.

The labor market is undergoing a rapid artificial intelligence (AI) revolution. There is currently limited empirical scholarship that focuses on how AI adoption affects employment opportunities and work environments in ways that shape worker health, safety, well-being and equity. In this article, we present an agenda to guide research examining the implications of AI on the intersection between work and health. To build the agenda, a full day meeting was organized and attended by 50 participants including researchers from diverse disciplines and applied stakeholders. Facilitated meeting discussions aimed to set research priorities related to workplace AI applications and its impact on the health of workers, including critical research questions, methodological approaches, data needs, and resource requirements. Discussions also aimed to identify groups of workers and working contexts that may benefit from AI adoption as well as those that may be disadvantaged by AI. Discussions were synthesized into four research agenda areas: (1) examining the impact of stronger AI on human workers; (2) advancing responsible and healthy AI; (3) informing AI policy for worker health, safety, well-being, and equitable employment; and (4) understanding and addressing worker and employer knowledge needs regarding AI applications. The agenda provides a roadmap for researchers to build a critical evidence base on the impact of AI on workers and workplaces, and will ensure that worker health, safety, well-being, and equity are at the forefront of workplace AI system design and adoption.

The impact of social assistance programs on population health: a systematic review of research in high-income countries.

BACKGROUND: Socioeconomic disadvantage is a fundamental cause of morbidity and mortality. One of the most important ways that governments buffer the adverse consequences of socioeconomic disadvantage is through the provision of social assistance. We conducted a systematic review of research examining the health impact of social assistance programs in high-income countries. METHODS: We systematically searched Embase, Medline, ProQuest, Scopus, and Web of Science from inception to December 2017 for peer-reviewed studies published in English-language journals. We identified empirical patterns through a qualitative synthesis of the evidence. We also evaluated the empirical rigour of the selected literature. RESULTS: Seventeen studies met our inclusion criteria. Thirteen descriptive studies rated as weak (n = 7), moderate (n = 4), and strong (n = 2) found that social assistance is associated with adverse health outcomes and that social assistance recipients exhibit worse health outcomes relative to non-recipients. Four experimental and quasi-experimental studies, all rated as strong (n = 4), found that efforts to limit the receipt of social assistance or reduce its generosity (also known as welfare reform) were associated with adverse health trends. CONCLUSIONS: Evidence from the existing literature suggests that social assistance programs in high-income countries are failing to maintain the health of socioeconomically disadvantaged populations. These findings may in part reflect the influence of residual confounding due to unobserved characteristics that distinguish recipients from non-recipients. They may also indicate that the scope and generosity of existing programs are insufficient to offset the negative health consequences of severe socioeconomic disadvantage.

Inflation hardship, gender, and mental health.

Inflation hit a 40 year high in the United States in 2022, yet the impact of inflation related hardships on distress is poorly understood, particularly the impact on women, whose income is already more limited. Using data from the US Household Pulse Survey (September-November 2022), we test whether exposure to inflation hardships is associated with greater distress and whether this association is moderated by gender (n = 119,531). We draw on a list of eighteen inflation related hardships (e.g., purchasing less food, working additional jobs, delaying medical treatment) to construct an ordinal measure of exposure to inflation hardship ranging from "no inflation hardship" to "five or more inflation hardships." We observe that an increasing number of inflation hardships is associated with higher levels of distress. We find no evidence of gender differences in the magnitude of that association at lower levels of inflation hardship (four inflation hardships or less). However, our findings suggest that exposure to five or more inflation hardships is more strongly associated with distress among men compared to women. The current study provides new insights into the cumulative burden of inflation hardships on mental health and the role that gender plays in this association.

Understanding income-related differences in distribution of child growth, behaviour and development using a cross-sectional sample of a clinical cohort study.

OBJECTIVES: Children from low-income households are at an increased risk of social, behavioural and physical health problems. Prior studies have generally relied on dichotomous outcome measures. However, inequities may exist along the range of outcome distribution. Our objective was to examine differences in distribution of three child health outcomes by income categories (high vs low): body mass index (BMI), behaviour difficulties and development. DESIGN AND SETTING: This was a cross-sectional study using data from a primary care-based research network with sites in three Canadian cities, and 15 practices enrolling participants. PARTICIPANTS, INDEPENDENT VARIABLE AND OUTCOMES: The independent variable was annual household income, dichotomised at the median income for Toronto (<$C80 000 or ≥$C80 000). Outcomes were: (1) growth (BMI z-score (zBMI) at 5 years, 1628 participants); (2) behaviour (Strengths and Difficulties Questionnaire (SDQ) at 3-5 years, 649 participants); (3) development (Infant Toddler Checklist (ITC) at 18 months, 1405 participants). We used distributional decomposition to compare distributions of these outcomes for each income group, and then to construct a counterfactual distribution that describes the hypothetical distribution of the low-income group with the predictor profile of the higher-income group. RESULTS: We included data from 1628 (zBMI), 649 (SDQ) and 1405 (ITC) children. Children with lower family income had a higher risk distribution for all outcomes. For all outcomes, thecounterfactual distribution, which represented the distribution of children with lower-income who were assigned the predictor profile of the higher-income group, was more favourable than their observed distributions. CONCLUSION: Comparing the distributions of child health outcomes and understanding different risk profiles for children from higher-income and lower-income groups can offer a deeper understanding of inequities in child health outcomes. These methods may offer an approach that can be implemented in larger datasets to inform future interventions.

Social inequalities in protective behaviour uptake at the start of the COVID-19 pandemic: results from a national survey.

OBJECTIVES: We aimed to assess social patterns of handwashing, social distancing, and working from home at the start of the COVID-19 pandemic in Canada, and determine what proportions of the overall prevalence and social inequalities in handwashing and social distancing are related to inequalities in the opportunity to work from home, to guide pandemic preparedness and response. METHODS: Using cross-sectional data from the Canadian Perspectives Survey Series, collected between March 29 and April 3, 2020, among Canadian adults (N=4455), we assessed prevalence of not working from home, social distancing in public, or practicing frequent handwashing, according to age, sex, marital status, immigration, education, chronic disease presence, and source of COVID-19 information. Multivariate regression, population attributable fraction estimation, and generalized product mediation analysis were applied. RESULTS: Absence of frequent handwashing and distancing was more common among those working outside than within the home (prevalence differences of 7% (95% CI: 4, 10) and 7% (95% CI: 3, 10), respectively). Inequalities in handwashing and distancing were observed across education and immigration status. Over 40% of the prevalence of non-uptake of handwashing and distancing was attributable to populations not being able to work from home. If all worked from home, over 40% (95% CI: 8, 70) of education-based inequalities in handwashing and distancing could be eliminated, but differences by immigration status would likely remain. CONCLUSION: For pandemic response, both workplace safety initiatives and mechanisms to address the inequitable distribution of health risks across socio-economic groups are needed to reduce broader inequalities in transmission risk.

RéSUMé: OBJECTIFS: Nous avons cherché à évaluer les habitudes sociales en matière d'hygiène des mains, de distanciation physique et de travail à domicile au début de la pandémie de la COVID-19 au Canada, et à déterminer quelles proportions de la prévalence globale et des inégalités sociales en matière d'hygiène des mains et de distanciation physique sont liées aux inégalités dans la possibilité de travailler à domicile (le télétravail), afin de guider la préparation et la réponse à la pandémie. MéTHODES: À l'aide des données transversales de la Série d'enquêtes sur les perspectives canadiennes 1, recueillies entre le 29 mars et le 3 avril 2020 auprès d'adultes canadiens (N=4 455), nous avons évalué la prévalence du travail hors du domicile, de la non-distanciation physique en public et de l'absence de lavage fréquent des mains, en fonction de l'âge, du sexe, de l'état civil, de l'immigration, de l'éducation, de la présence de maladies chroniques et de la principale source déclarée d'information sur la COVID-19. Une régression multivariée, une estimation de la fraction attribuable dans la population et une analyse de médiation par produit généralisé ont été appliquées. RéSULTATS: L'absence de lavage fréquent des mains et de distanciation physique étaient déclarées plus fréquemment chez les personnes travaillant à l'extérieur qu'à l'intérieur du domicile (différences de prévalence de 7 % (IC 95 % : 4, 10) et 7 % (IC 95 % : 3, 10), respectivement). Des inégalités en matière de lavage fréquent des mains et de la pratique de distanciation physique ont été observées en fonction du niveau d'éducation et du statut d'immigration. Plus de 40 % de la prévalence de la non-pratique du lavage fréquent des mains et de la distanciation physique était attribuable au fait que les populations ne pouvaient pas travailler à domicile. Si toutes les personnes travaillaient à domicile, plus de 40 % (IC 95 % : 8, 70) des inégalités liées au niveau d'éducation en matière de lavage des mains et distanciation physique pourraient être éliminées, mais les inégalités au niveau du statut d'immigration en matière de ces deux comportements subsisteraient probablement. CONCLUSION: Pour la répondre à la pandémie, il faut à la fois des initiatives de sécurité au travail, ainsi que des mécanismes visant à remédier à la répartition inéquitable des risques sanitaires entre les groupes socio-économiques pour réduire les inégalités plus larges en matière de risque de transmission.

Assessing the Psychosocial Work Environment in Relation to Mental Health: A Comprehensive Approach.

OBJECTIVES: Prevailing job stress models encourage a multidimensional view of the psychosocial work environment and highlight the role that multiple co-occurring stressors play in the aetiology of mental health problems. In this study, we develop a latent typology of psychosocial work environment profiles to describe how a comprehensive array of job stressors are clustered in the Canadian labour market. We also examine the association between these latent psychosocial work environment profiles and several indicators of mental health. METHODS: Data were collected from 6408 workers who completed the Canadian National Psychosocial Work Environment Survey. Psychosocial work exposures were measured using standard items from the Copenhagen Psychosocial Questionnaire. We employed latent profile analyses to identify groups of individuals with similar psychosocial work environment profiles. We used log-linear regression models to examine the association between latent psychosocial work environment profiles and burnout, stress, and cognitive strain. RESULTS: Four distinct groups with highly divergent psychosocial work environment profiles were identified. Adjusting for a range of demographic and socioeconomic factors, latent psychosocial work environment profiles were strongly related to mental health. Individuals who reported exposure to a comprehensive array of psychosocial job stressors (11% prevalence) reported the highest probability of burnout (PR: 7.51, 95% confidence interval [CI]: 5.56-10.15), stress (PR: 8.98, 95% CI: 6.20-13.0), and cognitive strain (PR: 7.29, 95% CI: 5.02-10.60). CONCLUSIONS: Findings suggest that psychosocial work stressors are tightly clustered in the Canadian labour market, and that the clustering of work stressors is strongly associated with adverse mental health outcomes. Future scholarship may benefit from adopting a more comprehensive approach to the assessment of psychosocial job quality as a determinant of health and well-being.

Impacts of the COVID-19 pandemic on health, financial worries, and perceived organizational support among people living with disabilities in Canada.

BACKGROUND: Individuals with physical or mental health disabilities may be particularly vulnerable to the impact of COVID-19 on their health and employment. OBJECTIVES: We examined COVID-19-related concerns for health, finances, and organizational support among workers with no disability, a physical, mental health, or both physical and mental health disability, and factors associated with COVID-19 perceptions. METHODS: An online, cross-sectional survey was administered to a sample of Canadians in the first wave of the COVID-19 pandemic. Questions asked about COVID-19 perceptions, demographics (gender, age, education), work context (e.g., sector, contract work) and employment conditions (e.g., job stress, control, accommodation needs). Descriptive, multivariable, and nested regression analyses examined factors associated with COVID-19 perceptions. RESULTS: A total of 3066 participants completed the survey. Workers with both a physical and mental health disability reported significantly greater health and financial concerns and less organizational support than those with no disability. Workers with a physical disability reported more health concerns and those with a mental health disability reported more financial concerns and less organizational support. Respondents with disabilities also reported significant differences in employment conditions (e.g., more contract work, stress, unmet accommodation needs) than those with no disability. Employment conditions were consistently significant predictors of COVID-19 perceptions and attenuated the significance of disability type in analyses. CONCLUSIONS: Concerns about the impact of COVID-19 on one's health, finances, and organizational support reflected existing disability inequities in employment conditions and highlight the importance of creating more inclusive employment opportunities for people living with physical and mental health disabilities.

The effect of welfare reform on the health of the unemployed: evidence from a natural experiment in Germany.

BACKGROUND: Over the past several decades, governments have enacted far-reaching reforms aimed at reducing the generosity and coverage of welfare benefits. Prior literature suggests that these policy measures may have deleterious effects on the health of populations. In this study, we evaluate the impact of one of the largest welfare reforms in recent history-the 2005 Hartz IV reform in Germany-with a focus on estimating its effect on the health of the unemployed. METHODS: We employed a quasi-experimental difference-in-differences (DID) design using population-based data from the German Socio-Economic Panel Study, covering the period between 1994 and 2016. We applied DID linear probability modelling to examine the association between the Hartz IV reform and poor self-rated health, adjusting for a range of demographic and socioeconomic confounders. RESULTS: The Hartz IV reform was associated with a 3.6 (95% CI 0.9 to 6.2) percentage point increase in the prevalence of poor self-rated health among unemployed persons affected by the reform relative to similar but unaffected controls. This negative association appeared immediately following the implementation of the reform and has persisted over time. CONCLUSION: Governments in numerous European and North American jurisdictions have introduced measures to further diminish the generosity and coverage of welfare benefits. In line with growing concerns over the potential consequences of austerity and associated policy measures, our findings suggest that these reform efforts pose a threat to the health of socioeconomically disadvantaged populations.