Dental caries disparities in early childhood: A study of kindergarten children in British Columbia.

OBJECTIVE: The objective of this paper was to describe results of a public health-administered, provincial dental survey of children aged 4-6 years old in British Columbia, and assess the changes in rates of dental caries geographically and by neighbourhood socio-economic status between baseline (2006/07) and follow-up data collection (2009/10). METHOD: The study design involved two retrospective cohorts of kindergarten children who received a public health-administered dental assessment in the years 2006/07 and 2009/10. Neighbourhood socio-economic status was measured by an index created from Canadian Census and Tax Filer data sets. The dental outcomes included previous decay experience, untreated visible decay, and urgent treatment needs. RESULTS: The analysis comprised dental outcomes for 35,602 kindergarten children in 2006/07 and 35,215 children in 2009/10. There was a modest decrease in dental decay rates between surveys, with rates of decay experience - previous and untreated - of 38.9% and 36.7% respectively. However, there were disparities, with almost 50% of children with dental decay in the most socio-economically disadvantaged neighbourhoods, and approximately 30% with dental decay in the least disadvantaged areas. CONCLUSION: The kindergarten dental survey had extensive coverage, was at the population level, and enabled analysis of change in early childhood dental decay rates over time and by geography. Although overall rates improved, dental health inequalities persisted in both survey years at both regional and neighbourhood levels.

Stakeholder perceptions of job stress in an industrialized country: implications for policy and practice.

We used a secondary, qualitative analysis of stakeholder perceptions of work stress in Australia to characterize the context for policy and practice intervention. Themes included: Individual versus contextual descriptions of stress; perceived 'gender' differences in manifesting and reporting of stress; the work/home interface; and perceived sectoral and occupational differences in compensation claim rates. We found that people often still perceive stress as an individual rather than organizational problem and view work stress as a stereotypically feminine weakness that affects only certain people. Organizations downplay and overlook risks, increasing worker reluctance to report stressors, creating barriers to job stress interventions. Our study may be relevant to other industrial countries where researchers currently study job stress interventions to improve their effectiveness. Comprehensive approaches can increase knowledge and decrease stigma about job stress and mental illness, and target both work- and non-work-related influences on mental health.

Psychosocial and other working conditions: variation by employment arrangement in a sample of working Australians.

BACKGROUND: The evidence linking precarious employment with poor health is mixed. Self-reported occupational exposures in a population-based Australian sample were assessed to investigate the potential for differential exposure to psychosocial and other occupational hazards to contribute to such a relationship, hypothesizing that exposures are worse under more precarious employment arrangements (EA). METHODS: Various psychoscial and other working conditions were modeled in relation to eight empirically derived EA categories with Permanent Full-Time (PFT) as the reference category (N = 925), controlling for sex, age, and occupational skill level. RESULTS: More precarious EA were associated with higher odds of adverse exposures. Casual Full-Time workers had the worst exposure profile, showing the lowest job control, as well as the highest odds of multiple job holding, shift work, and exposure to four or more additional occupational hazards. Fixed-Term Contract workers stood out as the most likely to report job insecurity. Self-employed workers showed the highest job control, but also the highest odds of long working hours. CONCLUSIONS: Psychosocial and other working conditions were generally worse under more precarious EA, but patterns of adverse occupational exposures differ between groups of precariously employed workers.

Unwanted sexual advances at work: variations by employment arrangement in a sample of working Australians.

OBJECTIVE: We tested the hypothesis that the risk of experiencing unwanted sexual advances at work (UWSA) is greater for precariously-employed workers in comparison to those in permanent or continuing employment. METHODS: A cross-sectional population-based telephone survey was conducted in Victoria (66% response rate, N=1,101). Employment arrangements were analysed using eight differentiated categories, as well as a four-category collapsed measure to address small cell sizes. Self-report of unwanted sexual advances at work was modelled using multiple logistic regression in relation to employment arrangement, controlling for gender, age, and occupational skill level. RESULTS: Forty-seven respondents reported UWSA in our sample (4.3%), mainly among women (37 of 47). Risk of UWSA was higher for younger respondents, but did not vary significantly by occupational skill level or education. In comparison to Permanent Full-Time, three employment arrangements were strongly associated with UWSA after adjustment for age, gender, and occupational skill level: Casual Full-Time OR = 7.2 (95% Confidence Interval 1.7-30.2); Fixed-Term Contract OR = 11.4 (95% CI 3.4-38.8); and Own-Account Self-Employed OR = 3.8 (95% CI 1.2-11.7). In analyses of females only, the magnitude of these associations was further increased. CONCLUSIONS: Respondents employed in precarious arrangements were more likely to report being exposed to UWSA, even after adjustment for age and gender. IMPLICATIONS: Greater protections from UWSA are likely needed for precariously employed workers.

A systematic review of the job-stress intervention evaluation literature, 1990-2005.

Ninety reports of systematic evaluations of job-stress interventions were rated in terms of the degree of systems approach used. A high rating was defined as both organizationally and individually focused, versus moderate (organizational only), and low (individual only). Studies using high-rated approaches represent a growing proportion of the job-stress intervention evaluation literature. Individual-focused, low-rated approaches are effective at the individual level, favorably affecting individual-level outcomes, but tend not to have favorable impacts at the organizational level. Organizationally-focused high- and moderate-rated approaches are beneficial at both individual and organizational levels. Further measures are needed to foster the dissemination and implementation of systems approaches to examining interventions for job stress.

Psychosocial and other working conditions in relation to body mass index in a representative sample of Australian workers.

BACKGROUND: The aim of the study was to examine the relationship between psychosocial and other working conditions and body-mass index (BMI) in a working population. This study contributes to the approximately dozen investigations of job stress, which have demonstrated mixed positive and negative results in relation to obesity, overweight and BMI. METHODS: A cross-sectional population-based survey was conducted among working Australians in the state of Victoria. Participants were contacted by telephone from a random sample of phone book listings. Information on body mass index was self-reported as were psychosocial work conditions assessed using the demand/control and effort/reward imbalance models. Other working conditions measured included working hours, shift work, and physical demand. Separate linear regression analyses were undertaken for males and females, with adjustment for potential confounders. RESULTS: A total of 1101 interviews (526 men and 575 women) were completed. Multivariate models (adjusted for socio-demographics) demonstrated no associations between job strain, as measured using the demand/control model, or ERI using the effort/reward imbalance model (after further adjustment for over commitment) and BMI among men and women. Multivariate models demonstrated a negative association between low reward and BMI among women. Among men, multivariate models demonstrated positive associations between high effort, high psychological demand, long working hours and BMI and a negative association between high physical demand and BMI. After controlling for the effort/reward imbalance or the demand/control model, the association between physical demand and working longer hours and BMI remained. CONCLUSION: Among men and women the were differing patterns of both exposures to psychosocial working conditions and associations with BMI. Among men, working long hours was positively associated with higher BMI and this association was partly independent of job stress. Among men physical demand was negatively associated with BMI and this association was independent of job stress.