Sickness absence trajectories following labour market participation patterns: a cohort study in Catalonia (Spain), 2012-2014.

BACKGROUND: Previous studies have focused on the relationship between employment pathways and health-related outcomes based on cross-sectional or longitudinal approaches. However, little is known about the cumulative effects of employment status mobility on sickness absence (SA) over time. The aim of the present study was to examine the association between prior labour market participation (LMP) patterns and SA trajectories from a life-course perspective. METHODS: This cohort study was based on a sample of 11,968 salaried workers living in Catalonia and affiliated with the Spanish Social Security system, who accumulated more than 15 days on SA in at least one quarter during 2012-2014. Individuals were grouped into three different working life stages: early (18-25 years), middle (26-35 years), and late (36-45 years). To identify LMP patterns, we applied sequence analysis and cluster analysis (2002-2011), and we used latent class growth modelling to identify SA trajectories (2012-2014). Finally, we applied multinomial logistic regression models to assess the relationship between LMP patterns and SA trajectories. RESULTS: The analyses yielded six LMP patterns: stable employment (value range: 63-81%), increasing employment (5-22%), without long-term coverage (7-8%), decreasing employment (4-10%), fluctuant employment (13-14%), and steeply decreasing employment (7-9%). We also identified four SA trajectories: low stable (83-88%), decreasing (5-9%), increasing (5-11%), and high stable (7-16%). However, the only significant association we identified for LMP patterns and SA trajectories was among young men, for whom an increasing employment pattern was significantly associated with a lower risk for increased days on SA (adjusted odds ratio: 0.21; 95% confidence interval: 0.05-0.96). CONCLUSIONS: SA trajectories are generally not related to prior 10-year LMP patterns at any stage of working life. To disentangle this relationship, future research might benefit from considering working life transitions with a quality-of-work approach framed with contextual factors closer to the SA course.

Unemployment, employment precarity, and inflammation.

Unemployment has been associated with poorer health, but few studies have examined the biological mechanisms that confer these health decrements. Further, no studies to date have examined differences across employment groups to consider whether employment (in whatever means) is preferential in terms of health. The present study utilised secondary data from Understanding Society: The Household Longitudinal Survey during the aftermath of the recent global recession. Two markers of peripheral inflammation: C-reactive protein (CRP) and fibrinogen were assessed across employment groups (unemployed; permanent, temporary, and self-employed), controlling for individual, socio-demographic and health variables to give greater context to our understanding of how employment status influences health. After controlling for relevant confounds, unemployment was associated with higher levels of fibrinogen but not CRP. Subsequent analyses of employment subgroup revealed the temporary employed have similar levels of fibrinogen to the unemployed, and may therefore be at a similar health disadvantage. The findings confirm that unemployment is associated with increases in one marker of peripheral inflammation, but that this health protection is not conferred to those in precarious employment.

[Inequalities in health services access and use among formal, informal, and unemployed workers, based on data from the Brazilian National Household Sample Survey, 2008]. / Desigualdades no acesso e uso dos serviços de saúde entre trabalhadores informais e desempregados: análise da PNAD 2008, Brasil.

The aim of this study was to analyze whether job market status is associated with differences in health services access and use. Data from the Brazilian National Household Sample Survey (PNAD/2008) were used to study workers 18 to 64 years of age, both men and women (N = 152,233). Prevalence and crude and adjusted prevalence ratios for the worker's health characteristics were calculated using Poisson regression. When compared to formal workers (n = 76,246), informal workers (n = 62,612) and unemployed (n = 13,375) showed less schooling, lower monthly income, worse self-reported health status, more frequent reporting of have been "bedridden in the previous two weeks", greater difficulty in accessing health services, and lower health services seeking, even after controlling for sex, age bracket, region, schooling, and respondent. Health policies are needed to reduce inequalities in access to health services by informal workers and the unemployed.

Desigualdades no acesso e uso dos serviços de saúde entre trabalhadores informais e desempregados: análise da PNAD 2008, Brasil / Inequalities in health services access and use among formal, informal, and unemployed workers, based on data from the Brazilian National Household Sample Survey, 2008 / Desigualdades en el acceso y uso de los servicios de salud entre los trabajadores informales y desempleados: análisis de la PNAD 2008, Brasil

O objetivo do estudo foi analisar se o tipo de vínculo de trabalho está associado a diferenças no acesso e utilização dos serviços de saúde. Utilizando os microdados da Pesquisa Nacional por Amostra de Domicílios (PNAD/2008) foram estudados trabalhadores de 18 a 64 anos (N = 152.233), de ambos os sexos. Foram calculadas prevalências e razões de prevalência brutas e ajustadas das características de saúde dos trabalhadores por meio de regressão de Poisson. Em relação aos formais (n = 76.246), os informais (n = 62.612) e desempregados (n = 13.375) apresentaram menor escolaridade, menor renda mensal, pior estado de saúde autorreferido, maior frequência de "acamado nas duas últimas semanas", maior dificuldade de acesso e menor procura e uso dos serviços de saúde, mesmo após ajuste para sexo, faixa etária, região, escolaridade e informante. Há necessidade de políticas de saúde que diminuam a desigualdade no acesso aos serviços de saúde pelos trabalhadores informais e desempregados.

The aim of this study was to analyze whether job market status is associated with differences in health services access and use. Data from the Brazilian National Household Sample Survey (PNAD/2008) were used to study workers 18 to 64 years of age, both men and women (N = 152,233). Prevalence and crude and adjusted prevalence ratios for the worker's health characteristics were calculated using Poisson regression. When compared to formal workers (n = 76,246), informal workers (n = 62,612) and unemployed (n = 13,375) showed less schooling, lower monthly income, worse self-reported health status, more frequent reporting of have been "bedridden in the previous two weeks", greater difficulty in accessing health services, and lower health services seeking, even after controlling for sex, age bracket, region, schooling, and respondent. Health policies are needed to reduce inequalities in access to health services by informal workers and the unemployed.

El objetivo del estudio fue analizar si el tipo de situación en el empleo se asocia con diferencias en el acceso y utilización de los servicios de salud. Utilizando datos microeconómicos de la Encuesta Nacional por Muestra de Domicilio (PNAD/2008) se estudiaron trabajadores de 18 a 64 años (N = 152.233) de ambos sexos. Se calcularon prevalencias y razones de prevalencia ajustadas y características manifiestas de los trabajadores de la salud a través de regresión de Poisson. En situaciones de relación formal (n = 76.246), informal (n = 62.612) y desempleo (n = 13.375) contaban con menor educación; menores ingresos; peor percepción del estado de salud, una mayor incidencia de "postrado en cama las últimas dos semanas", de mayor dificultad de acceso y de disminución en la demanda y utilización de servicios de salud, incluso después de realizar ajustes por sexo, edad, región, educación, e informante. No es necesario que las políticas de salud reduzcan la desigualdad en el acceso a los servicios de salud para los trabajadores desempleados e informales.

Variables que afectan a la creatividad de las personas desempleadas / Variables affecting the creativity of people unemployed

En este artículo se analiza la relación entre el nivel de creatividad y variables que afectan al desempleo, como la edad, el género y la duración del desempleo. Se exploraron los niveles de creatividad de 140 personas desempleadas. Los resultados derivados de la aplicación de los diferentes análisis estadísticos, utilizando una metodología cuantitativa de carácter descriptivo, nos indican que las variables estudiadas no tienen una incidencia significativa en la creatividad de las personas desempleadas. Se discute la influencia que tienen las variables mediadoras en el estudio de la creatividad de las personas que no tienen empleo. El trabajo concluye con propuestas de intervención y futuras investigaciones en el área (AU)

In this article is evaluating the relationship between the level of creativity and variables which affect unemployment such as age, gender and period of unemployment. The creativity were explored using a sample consisted on 140 unemployed people. The results derived by application of different statistical analysis, using quantitative methodology of descriptive character, indicated that the studied mediating variables do not show any significant incidence in the creativity of people unemployed. The influence of mediating variables in the creativity of the unemployed is discussed. The work concludes with proposals for intervention and future research in the area (AU)

Mediated moderation or moderated mediation: relationship between length of unemployment, resilience, coping and health

The aim of the present research was to evaluate a model of mediated moderation vs. moderated mediation that could explain the relationship between length of unemployment, dispositional resilience, coping styles and depression and social functioning of Venezuelan unemployed individuals. Self-report measures were administered to a sample of 328 unemployed residents in Caracas, Venezuela. Results indicated that emotional coping acted as a mediator in the relationship between resilience and depression. Individuals with greater resilience used more detachment coping when unemployment was longer, while individuals with poorer resilience in the same situation used less avoidance coping. Resilience acted as a protective moderating factor between longer periods of unemployment and social functioning, a process mediated by detachment coping. Overall, results supported a mediated moderation model, with resilience as the moderating factor and coping as the mediator in the relation between stress due to the length of unemployment and well-being (AU)

El objetivo de la presente investigación fue evaluar un modelo de moderación mediada vs. mediación moderada que permitiera explicar la relación entre la duración del desempleo, una medida disposicional de resiliencia, los estilos de afrontamiento y la depresión y el funcionamiento social percibido en desempleados venezolanos. Para ello se administraron instrumentos de auto-informe a una muestra de 328 desempleados residentes en la ciudad de Caracas, Venezuela. Los resultados indicaron que el afrontamiento emocional operó como un factor mediador en la relación entre la resiliencia y la depresión. Asimismo, las personas más resilientes usan más el afrontamiento por desapego cuando tienen más tiempo desempleadas, mientras que las personas menos resilientes en esa misma condición hacen menos afrontamiento evitativo. La resiliencia operó como factor moderador del impacto de la duración del desempleo sobre el funcionamiento social, actuando como un factor protector, proceso que estuvo mediado por el afrontamiento por desapego emocional. En síntesis, los resultados apoyan un modelo de moderación mediada, siendo la resiliencia el factor moderador y el afrontamiento el factor mediador en el impacto del estrés por la duración del desempleado sobre la salud (AU)

[Medical research and vulnerable subjects: unemployed people]. / Badania na ludziach i szczególnie wrazliwe grupy osób: bezrobotni.

Although the importance of medical research for the diagnosis and treatment of human diseases is unquestionable, the use of human subjects, however, still presents a complex ethical problem. Moral difficulties occur in particular when the medical research deals with vulnerable subjects. Vulnerable individuals are defined as those who experience diminished actual autonomy. Among the groups which should be considered as being vulnerable are usually listed the following: children, pregnant women, mentally or emotionally disabled, physically disabled, homeless, and institutionalized people. This study addresses key concerns that gave rise to the question of whether unemployed people had to be recognized as vulnerable subjects. The term "vulnerability" was clarified and it was assumed that the "vulnerability" of medical research subjects' had to be understood as a form of continuum from potential, through the circumstantial, temporal, episodic, permanent to inevitable vulnerability. The conclusion was drawn that unemployed people were, at least, potentially vulnerable subjects. Research involving unemployed people presents important moral challenges to researchers and should be undertaken very carefully, following special ethical guidelines.

[Unemployment, job insecurity and their consequences for health in a sample of young adults]. / Gesundheitsfolgen von Arbeitslosigkeit und Arbeitsplatzunsicherheit bei jungen Erwachsenen.

BACKGROUND: Negative consequences of unemployment have been known for a long time. This study concerns the effect of unemployment and job insecurity in a large sample of young adults because little is known about this special age group. Methods : 420 persons (46.8% males, 52.2% females, mean age 29 years) were polled in the 16(th) wave of the Sächsische Längsschnittstudie in 2002. This longitudinal study accompanies an East German sample since 1987 i.e. some time before German reunification. We used standardised psychological questionnaires to assess the state of health (SCL-9, HADS, GBB, SWE). RESULTS: 120 (29%) persons were repeatedly unemployed, 143 (34%) once, and only 157 (37%) have never been unemployed. The period of unemployment lasted 1 to 76 months. According to the experience with unemployment we found differences in subgroups: persons having more experience with unemployment report on higher global distress, more anxiety and depression, feel less efficacious and are in a subjectively poorer state of health. Nearly one-third of the participants think they have an insecure job. Persons who perceive an insecure job feel significantly greater anxiety, depression, body complaints, mental distress and feel less efficacious. CONCLUSIONS: Unemployment is a big social problem for young and well-qualified persons. The experience of unemployment decreases the identification with the current social system and has a strong negative influence on the state of health. Specific offers of medical and psychosocial support are required. Even the feeling of job insecurity has explicitly negative effects on health. Further longitudinal research is necessary.

Health insurance for workers who lose jobs: implications for various subsidy schemes.

A number of proposals have been made to help laid-off workers purchase health insurance. We use data from the 1996 Medical Expenditure Panel Survey to profile the insurance status of workers who left a job. Our descriptive analysis suggests that it might be difficult to design policies that target those who would otherwise be uninsured and that large subsidies might be needed to help laid-off workers.

[The disabled worker. The course of job demands from September 1992 to September 1993 . Main characteristics of job applicants during the third trimester of 1993] trimester]. / Les travailleurs handicapés. Evolution des demandes d'emploi de Septembre 92 à Septembre 93--Principales caractéristiques des demandeurs au 3ème trimestre 93.

Official data show that among those who are seeking a job in France, 75,000 are disabled. Most of them have had a work accident. The period devoted to seeking a job is much longer as concerns the disabled: 723 days as compared to the average in all the French population (364 days). The disabled workers are mostly unskilled and this adds to their difficulties.