Working longer hours and body weight: An Australian study using household panel data (with measures of paid and unpaid time) to provide gender-specific estimates.

Time is a resource for health, and when time is constrained, people have less opportunity to maintain good health. This study focuses on the relationship between paid work hours (with a focus on long hours) and body weight for Australian men and women. Time is conceptualised as a 24-hour system, including time in paid work, time in unpaid work, and discretionary time (available for health promoting activities). We propose that to accurately estimate the relationship between long paid work hours and body weight, analyses need to take account of unpaid work hours, and that this is particularly important for women. Analyses utilised 16 waves of data from the Household, Income and Labour Dynamics in Australia (HILDA) panel study, with data on hours in paid and unpaid work and BMI at all waves (n = 113,084 observations, 54,664 from women and 58,424 from men). We used Mixed Effects models with a Two Stage Residual Inclusion (2SRI) approach to account for time unobserved heterogeneity and the reciprocity between time uses (paid and unpaid) and body weight. The results showed that for every 10 hours worked above the gender-specific average, women weighed 762 grms more and men weighed 1.34 kgs more. When the analyses were restricted to sedentary jobs this increased to 938 grms for women and 1.68 kgs for men. We contribute new evidence highlighting the importance of including unpaid work hours in research that aims to understand working time and health.

Depression and anxiety in early adulthood: consequences for finding a partner, and relationship support and conflict.

AIMS: Mental health problems in early adulthood may disrupt partner relationship formation and quality. This prospective study used four waves of Australian data to investigate the effects of depression and anxiety in early adulthood on the quality of future partner (i.e. marriage or cohabiting) relationships. METHODS: A representative community sample of Australian adults aged 20-24 years was assessed in 1999, 2003, 2007 and 2011. Analyses were restricted to those who at baseline had never entered a marriage or cohabiting relationship with no children (n = 1592). Associations were examined between baseline depression and anxiety levels (using the Goldberg Depression and Anxiety scales) and (a) future relationship status and (b) the quality of marriage or cohabiting relationships recorded at follow-up (up to 12 years later) (partner social support and conflict scales). RESULTS: Depression in early adulthood was associated with never entering a partner relationship over the study period. For those who did enter a relationship, both depression and anxiety were significantly associated with subsequently lower relationship support and higher conflict. Supplementary analyses restricting the analyses to the first relationship entered at follow-up, and considering comorbid anxiety and depression, strongly supported these findings. CONCLUSIONS: Depression and anxiety in early adulthood is associated with poorer partner relationship quality in the future. This study adds to evidence showing that mental health problems have substantial personal and inter-personal costs. The findings support the need to invest in prevention and early intervention.

Change and stability in work-family conflict and mothers' and fathers' mental health: Longitudinal evidence from an Australian cohort.

Work-family conflict (WFC) occurs when work or family demands are 'mutually incompatible', with detrimental effects on mental health. This study contributes to the sparse longitudinal research, addressing the following questions: Is WFC a stable or transient feature of family life for mothers and fathers? What happens to mental health if WFC increases, reduces or persists? What work and family characteristics predict WFC transitions and to what extent are they gendered? Secondary analyses of 5 waves of data (child ages 4-5 to 12-13 years) from employed mothers (n = 2693) and fathers (n = 3460) participating in the Longitudinal Study of Australian Children were conducted. WFC transitions, across four two-year intervals (Waves 1-2, 2-3, 3-4, and 4-5) were classified as never, conscript, exit or chronic. Significant proportions of parents experienced change in WFC, between 12 and 16% of mothers and fathers for each transition 'type'. Parents who remained in chronic WFC reported the poorest mental health (adjusted multiple regression analyses), followed by those who conscripted into WFC. When WFC was relieved (exit), both mothers' and fathers' mental health improved significantly. Predictors of conscript and chronic WFC were somewhat distinct for mothers and fathers (adjusted logit regressions). Poor job quality, a skilled occupation and having more children differentiated chronic fathers' from those who exited WFC. For mothers, work factors only (skilled occupation; work hours; job insecurity) predicted chronic WFC. Findings reflect the persistent, gendered nature of work and care shaped by workplaces, but also offer tailored opportunities to redress WFC for mothers and fathers. We contribute novel evidence that mental health is directly influenced by the WFC interface, both positively and negatively, highlighting WFC as a key social determinant of health.

Common mental disorders, unemployment and psychosocial job quality: is a poor job better than no job at all?

BACKGROUND: Employment is associated with health benefits over unemployment, but the psychosocial characteristics of work also influence health. There has, however, been little research contrasting the prevalence of psychiatric disorders among people who are unemployed with those in jobs of differing psychosocial quality. METHOD: Analysis of data from the English Adult Psychiatric Morbidity Survey (APMS) considered the prevalence of common mental disorders (CMDs) among 2603 respondents aged between 21 and 54 years who were either (i) employed or (ii) unemployed and looking for work at the time of interview in 2007. Quality of work was assessed by the number of adverse psychosocial job conditions reported (low control, high demands, insecurity and low job esteem). RESULTS: The prevalence of CMDs was similar for those respondents who were unemployed and those in the poorest quality jobs. This pattern remained after controlling for relevant demographic and socio-economic covariates. CONCLUSIONS: Although employment is thought to promote mental health and well-being, work of poor psychosocial quality is not associated with any better mental health than unemployment. Policy efforts to improve community mental health should consider psychosocial job quality in conjunction with efforts to increase employment rates.

The psychosocial quality of work determines whether employment has benefits for mental health: results from a longitudinal national household panel survey.

OBJECTIVES: Although employment is associated with health benefits over unemployment, the psychosocial characteristics of work also influence health. We used longitudinal data to investigate whether the benefits of having a job depend on its psychosocial quality (levels of control, demands and complexity, job insecurity, and unfair pay), and whether poor quality jobs are associated with better mental health than unemployment. METHOD: Analysis of seven waves of data from 7,155 respondents of working age (44,019 observations) from a national household panel survey. Longitudinal regression models evaluated the concurrent and prospective association between employment circumstances (unemployment and employment in jobs varying in psychosocial job quality) and mental health, assessed by the MHI-5. RESULTS: Overall, unemployed respondents had poorer mental health than those who were employed. However the mental health of those who were unemployed was comparable or superior to those in jobs of the poorest psychosocial quality. This pattern was evident in prospective models: those in the poorest quality jobs showed greater decline in mental health than those who were unemployed (B = 3.03, p<0.05). The health benefits of becoming employed were dependent on the quality of the job. Moving from unemployment into a high quality job led to improved mental health (mean change score of +3.3), however the transition from unemployment to a poor quality job was more detrimental to mental health than remaining unemployed (-5.6 vs -1.0). CONCLUSIONS: Work of poor psychosocial quality does not bestow the same mental health benefits as employment in jobs with high psychosocial quality.

A systematic review of telephone-based interventions for mental disorders.

To assess the effectiveness of telephone-based interventions for mental illness, a systematic search of the literature was conducted using the databases PsycINFO and PubMed, and the search engine Google Scholar. The search identified 14 studies evaluating telephone-based interventions in the areas of depression (n = 6), anxiety (n = 3), eating disorders (n = 3), substance use (n = 1) and schizophrenia (n = 1). Although these studies provide evidence that telephone interventions can be effective, the few studies conducted, small sample sizes and lack of randomized controlled trial methodology prevent firm conclusions from being drawn. The articles reviewed suggest that an effective telephone intervention includes clearly structured therapy sessions and homework tasks. However, further evidence using large-scale, randomized controlled trials must be obtained in order to inform government and telephone counselling agencies about the efficacy of telephone interventions.

Outcomes among orthopedic patients in skilled nursing facilities: does managed care make a difference?

The use of rehabilitative care has increased greatly. This study evaluates whether managed care affects health outcomes among Medicare orthopedic patients receiving rehabilitative treatments. Managed care versus fee-for-service patients had better outcomes at four months following discharge from skilled nursing facilities. It is important to address predictive factors, such as age, length of hospital stay, debilitation and social living arrangements, which can also influence health outcomes when planning rehabilitative treatment for older patients.