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1.
Artigo em Inglês | MEDLINE | ID: mdl-32055895

RESUMO

PURPOSE: We aimed to understand how much of the gender difference in mental health service use could be due to the joint mediation of employment, behavioural and material factors, social support and mental health need. METHODS: We used data from employed individuals aged 18-65 years who participated in the 2015-2017 waves of the Household, Income and Labour Dynamics in Australia survey. The exposure (male, female) and confounders were measured in 2015, mediators in 2016 and the outcome-whether a person had seen a mental health professional in the previous year-was measured in 2017. We estimated natural mediation effects using weighted counterfactual predictions from a logistic regression model. RESULTS: Men were less likely to see a mental health care provider than women. The total causal effect on the risk difference scale was - 0.045 (95% CI - 0.056, - 0,034). The counterfactual of men taking the mediator values of women explained 28% (95% CI 1.7%, 54%) of the total effect, with the natural direct effect estimated to represent an absolute risk difference of - 0.033 (95% CI - 0.048, - 0.018) and the natural indirect effect - 0.012 (95% CI - 0.022, - 0.0027). CONCLUSION: Gendered differences in the use of mental health services could be reduced by addressing inequalities in health, employment, material and behavioural factors, and social support.

2.
Health Promot Int ; 35(1): 27-41, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31916577

RESUMO

This systematic review sought to evaluate the impact of gender equality on the health of both women and men in high-income countries. A range of health outcomes arose across the 48 studies included. Gender equality was measured in various ways, including employment characteristics, political representation, access to services, and with standard indicators (such as the Global Gender Gap Index and the Gender Empowerment Measure). The effects of gender equality varied depending on the health outcome examined, and the context in which gender equality was examined (i.e. employment or domestic domain). Overall, evidence suggests that greater gender equality has a mostly positive effect on the health of males and females. We found utility in the convergence model, which postulates that gender equality will be associated with a convergence in the health outcomes of men and women, but unless there is encouragement and support for men to assume more non-traditional roles, further health gains will be stymied.

3.
Crisis ; 41(1): 54-63, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31310165

RESUMO

Background: Suicide rates are higher among unemployed men as well as those employed in male-dominated occupations such as construction. There has been less research on whether these patterns are similar for suicide ideation and attempt. Aims: In a cohort of 13,892 Australian males, this study examined the relationship between employment status and occupational gender ratio on reported thoughts of suicide and suicide attempts. Method: Men reporting suicide ideation or attempts at Wave 1 were removed from the sample. Logistic regression was used to examine Wave 1 employment status and occupational gender ratio and Wave 2 reported suicide ideation and attempts, controlling for confounders (measured in Wave 1). We conducted a sensitivity analysis controlling for mental health status. Results: Those who were unemployed or not in the labor force had elevated rates of suicide ideation (unemployed OR = 1.91, 95% CI [1.30, 2.82], p = .001; not in the labor force OR = 1.68, 95% CI [1.09, 2.60], p = .020). Those who were not in the labor force had greater odds of attempts (OR = 2.32, 95% CI [1.05, 5.12], p = .037). There was no association between occupational gender ratio and suicide ideation or attempt. Limitations: We only had single item measures of ideation and attempts. Conclusion: There is a need for further investigation into risk factors for suicide among males, both when they are in and out of employment.

4.
SSM Popul Health ; 9: 100464, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31453312

RESUMO

Disability is a key social identity or social category that is associated with significant social disadvantage. For men, having a disability can be discordant with their masculine identity. Self-reliance is one component of masculinity that is known to be important to men with disabilities, however it is also known to be associated with adverse mental health outcomes in the broader adult male population. Intersectionality approaches offer a means of examining the way that the effect of self-reliance on mental health might vary between those with and without a disability. Among a sample of 12,052 men aged 18-55 years from the Ten-to-Men study, we used effect measure modification (EMM) to examine the way that self-reliance modifies the relationship between disability and depressive symptoms. Disability was assessed using the Washington Group Short Set of questions, which capture functional limitations. Results showed that men with disabilities who reported higher conformity to self-reliance norms had much worse mental health than non-disabled men with low conformity to self-reliance, as measured in terms of depressive symptoms (PRR: 9.40, 95%CI 7.88, 11.22, p-value<0.001). We found evidence of positive EMM of depressive symptoms by conformity to self-reliance on the additive scale (RERI: 2.84, 95%CI 1.26, 4.42, p-value<0.001). These results provide evidence that high conformity to self-reliance norms exerts a particularly damaging effect on the mental health of men with disabilities. Given that men with disabilities are more likely to rely on help and support from others, these results provide important insights for the delivery of services to men with disability.

5.
Artigo em Inglês | MEDLINE | ID: mdl-30939787

RESUMO

Both gender and employment are critical and intersecting social determinants of mental and physical health. This paper describes the protocol used to conduct a systematic literature review of the relationship between "gendered working environments" and mental health. Gendered working environments (GWE) are conceptualised as involving: (1) differences in selection into work, and more specifically, occupations; (2) variation in employment arrangements and working hours; (3) disparities in psychosocial exposures at work, and; (4) differences in selection out of work. Methods/design: The review will adhere to a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search procedure. Key words will be identified that are specific to each of the four domains of GWE. The databases used for the search will be Scopus, Pubmed, Proquest, and Web of Science. Keywords will be adapted for the specific requirements of each electronic database. Inclusion criteria are: Using a validated scale to measure mental health (outcome); including exposures related to the four domains of GWE; reporting estimates for both men and women; and use of a cohort, case-control, or cross-sectional design. Studies will be excluded if they were published more than 10 years ago, are not in English or do not present extractable data on the relationship between GWE and mental health. Discussion: The proposed review will provide evidence about the numerous and complex ways in which employment and gender intersect (and are reinforced) to influence mental health over the life course.


Assuntos
Emprego/psicologia , Disparidades nos Níveis de Saúde , Saúde Mental , Fatores Sexuais , Revisão Sistemática como Assunto , Feminino , Humanos , Masculino
6.
J Epidemiol Community Health ; 73(6): 569-576, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30914444

RESUMO

BACKGROUND: There is good evidence that job stressors are prospectively related to mental health problems, particularly depressive symptoms. This review aimed to examine whether job stressors were also related to use of psychotropic medications. METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, we examined seven electronic databases that indexed literature from a wide range of disciplines. Inclusion criteria were (1) the study included a job stressor or psychosocial working condition as an exposure, and (2) psychotropic medication was an outcome. All effect-size estimates were considered but needed to present either a SE or 95% CIs to be included in meta-analyses. Data were pooled between studies using the relative risk (RR) or odds ratio (OR) and 95% CIs. RESULTS: There were 18 unique studies with non-overlapping exposures eligible for inclusion in the quantitative meta-analysis. High job demands were associated with a statistically significant increased risk of psychotropic medication use (RR 1.16, 95% CI 1.02 to 1.31). There was also an elevated RR in relation to work-family conflict (RR 1.26, 95% CI 1.03 to 1.48). In studies reporting OR, high job demands were associated with an OR of 1.39 (95% CI 1.06 to 1.71). CONCLUSIONS: The findings of this review highlight the need for policy and programme attention to reduce harmful exposure to psychosocial job stressors. Health-service use measures should be considered as outcomes and may represent more severe mental health conditions.

7.
Prev Med Rep ; 14: 100826, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30886814

RESUMO

The health and human care workforce comprise a substantial and increasing proportion of the employed population in high income countries. This diverse workforce is comprised of high skilled workers, such as doctors and nurses, as well as lower skilled workers such as carers and support workers. This paper assessed psychosocial working conditions among health and human care workers compared to other workers. We also examined the effects of psychosocial working conditions on mental health. The data source was 16 waves of the Household Income Labour Dynamics in Australia survey. The exposure was a multidimensional, previously validated psychosocial job quality index. The outcome was changes in the Mental Health Inventory-5 (MHI-5). The effect modifier was a multicategory health and human care occupational variable. Random and fixed effects linear regression models were used to unpack between- versus within- person differences. Time varying confounders were controlled for. We found evidence of effect modification. Carers and support workers experienced a 4.90-point decline (95% CI -6.23 to 3.57) on the MHI-5 when reporting 3 or more job stressors compared to no stressors. These workers also reported lower levels of mental health than other occupational groups and had greater exposure to poor psychosocial working environments. Health workers also reported substantial declines on the MHI-5 when exposed to 3 or more job stressors (-3.50, 95% CI -5.05 to -1.94). Understanding the quality of employment in this workforce, and consequent impacts of this employment on mental health is critical to ensuring sustainable individual, organizational and client-related outcomes.

8.
J Adolesc Health ; 65(1): 72-78, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30833116

RESUMO

PURPOSE: There is evidence that traditional gender-role attitudes are associated with poor mental health outcomes in adults; however, few studies have examined associations among adolescents. We sought to test associations between gender-role attitudes and mental health among Australian adolescents. METHODS: Data were drawn from the Longitudinal Study of Australian Children, a nationally representative Australian study. Participants were 3,059 adolescents with complete data for Waves 5-6 (years 2012-2014, aged 12/13 and 14/15 years). Analyses were stratified by sex and controlled for parental education, household income, area socioeconomic position, ethnicity, religiousness, and household type. Multivariable linear regression analyses were conducted to test associations. RESULTS: Egalitarian gender-role attitudes were associated with fewer conduct problems for adolescent males (ß -.04, 95% confidence interval [CI] -.08 to .00; p = .048) and females (ß -.06, 95% CI -.11 to -.01; p = .014), and for females, less hyperactivity (ß -.15, 95% CI -.20 to -.09; p < .001), better prosocial behavior (ß .08, 95% CI .03 to .13; p = .003), and better overall mental health (ß -.27, 95% CI -.43 to -.11, p = .001). There were no associations for peer problems or emotional problems. Associations were more apparent for females than for males, and analyses using adolescent- and teacher-reported mental health supported the main findings. CONCLUSIONS: Egalitarian gender-role attitudes among adolescents are associated with better outcomes on some dimensions of adolescent mental health, suggesting that establishing egalitarian gender attitudes in adolescence could help impart mental health benefits among this population group.

9.
Artigo em Inglês | MEDLINE | ID: mdl-30736304

RESUMO

Suicide is a leading cause of death among young men. Help-seeking is known to be poor among this group, and little is known about what interventions are most successful in improving suicide prevention literacy among young men. This research aims to examine: (1) age differences in beliefs related to suicide prevention literacy and attitudes to the workplace in addressing mental health among male construction workers; (2) age differences in response to a workplace suicide prevention program. Pre- and post-training survey data of 19,917 male respondents were obtained from a workplace training program database. Linear regression models and predictive margins were computed. Mean differences in baseline beliefs, and belief change were obtained for age groups, and by occupation. Young men demonstrated poorer baseline suicide prevention literacy but were more likely to consider that mental health is a workplace health and safety issue. There was also evidence that young men employed in manual occupations had poorer suicide prevention literacy than older men, and young men employed in professional/managerial roles. The youngest respondents demonstrated the greatest intervention-associated change (higher scores indicating more favourable belief change) to People considering suicide often send out warning signs (predicted mean belief change 0.47, 95% CI 0.43, 0.50 for those aged 15⁻24 years compared to 0.38, 95% CI 0.36, 0.41 for men aged 45 years and over), and to The construction industry must do something to reduce suicide rates (predicted mean belief change 0.17, 95% CI 0.15, 0.20 for those aged 15⁻24 years compared to 0.12, 95% CI 0.10, 0.14 among men aged 45 years and over). Results indicate that while suicide prevention literacy may be lower among young men, this group show amenability to changing beliefs. There were some indications that young men have a greater propensity to regard the workplace as having a role in reducing suicide rates and addressing mental health, highlighting opportunity for workplace interventions.


Assuntos
Indústria da Construção/estatística & dados numéricos , Emprego/psicologia , Alfabetização em Saúde/estatística & dados numéricos , Promoção da Saúde/estatística & dados numéricos , Suicídio/prevenção & controle , Suicídio/psicologia , Local de Trabalho/psicologia , Adolescente , Adulto , Fatores Etários , Austrália/epidemiologia , Indústria da Construção/educação , Emprego/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Suicídio/estatística & dados numéricos , Inquéritos e Questionários , Local de Trabalho/estatística & dados numéricos , Adulto Jovem
10.
Eur Child Adolesc Psychiatry ; 28(9): 1231-1240, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30759281

RESUMO

Adolescence is a period of elevated stress for many young people, and it is possible that the challenges of adolescence are different for vulnerable groups. We aimed to document the depressive and anxiety symptoms, emotional-behavioural difficulties and suicidal/self-harming behaviours among adolescents with borderline intellectual functioning (BIF) or a disability, compared to those with neither disability nor BIF. Data were drawn from the nationally representative Longitudinal Study of Australian Children. Participants were 2950 adolescents with complete data for waves 3-6 (years 2008-2014), aged 14-15 years in 2014. Anxiety and depression symptoms and self-harming/suicidal thought/behaviours were self-reported. Emotional-behavioural difficulties items came from the Strengths and Difficulties Questionnaire, and were parent-, and adolescent-reported. Results of logistic regression analyses indicate that the emotional-behavioural difficulties of adolescents with either a disability or BIF, were worse than for those with neither disability nor BIF. While adolescents with a disability reported more anxiety symptoms, no clear associations were observed for self-harming/suicidal thoughts/behaviours or depressive symptoms for those with either BIF or a disability. Adolescents with BIF or a disability are at higher risk of poor mental health than those with neither disability nor BIF, and it is vital that factors contributing to these differences are identified in order to reduce these mental health inequalities.


Assuntos
Deficiência Intelectual/psicologia , Saúde Mental/normas , Adolescente , Feminino , Humanos , Estudos Longitudinais , Masculino
11.
Health Promot Int ; 2018 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-30534989

RESUMO

This systematic review sought to evaluate the impact of gender equality on the health of both women and men in high-income countries. A range of health outcomes arose across the 48 studies included. Gender equality was measured in various ways, including employment characteristics, political representation, access to services, and with standard indicators (such as the Global Gender Gap Index and the Gender Empowerment Measure). The effects of gender equality varied depending on the health outcome examined, and the context in which gender equality was examined (i.e. employment or domestic domain). Overall, evidence suggests that greater gender equality has a mostly positive effect on the health of males and females. We found utility in the convergence model, which postulates that gender equality will be associated with a convergence in the health outcomes of men and women, but unless there is encouragement and support for men to assume more non-traditional roles, further health gains will be stymied.

12.
Artigo em Inglês | MEDLINE | ID: mdl-30257471

RESUMO

Suicide is a significant health problem that is known to disproportionately affect those employed in manual occupations, including construction workers and tradespeople. Universal General Awareness Training (GAT) was part of a multi-component suicide prevention program in the Australian construction industry. The program's aims were to increase awareness of mental health and suicide, reduce stigma, and encourage help-seeking and help-offering behaviours. This paper sought to examine the effectiveness of the GAT program in shifting suicide beliefs. Pre- and post-training survey data of 20,125 respondents was obtained from a database of GAT evaluation results between 2016 and 2018. Generalized estimating equation (GEE) models were fitted to examine belief changes, and predictive margins and their SEs were computed. Mean differences in belief change were obtained for the overall sample, and by occupation. Modest but significant favourable shifts in three of the four beliefs assessed were observed following GAT. Managers and professionals showed greater propensity to shift beliefs, and Labourers and Machinery Operators and Drivers showed least. Results suggest that GAT can successfully shift some beliefs regarding suicide and mental health at least in the short term, but highlight the need to tailor communication to vulnerable occupational groups.


Assuntos
Indústria da Construção/educação , Doenças Profissionais/prevenção & controle , Saúde do Trabalhador/estatística & dados numéricos , Ocupações/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Suicídio/prevenção & controle , Adolescente , Adulto , Austrália , Indústria da Construção/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/psicologia , Ocupações/classificação , Suicídio/psicologia , Inquéritos e Questionários , Adulto Jovem
13.
BMJ Open ; 6(2): e008878, 2016 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-26883235

RESUMO

OBJECTIVES: Little is known about how the distribution of destinations in the local neighbourhood is related to body mass index (BMI). Kernel density estimation (KDE) is a spatial analysis technique that accounts for the location of features relative to each other. Using KDE, this study investigated whether individuals living near destinations (shops and service facilities) that are more intensely distributed rather than dispersed, have lower BMIs. STUDY DESIGN AND SETTING: A cross-sectional study of 2349 residents of 50 urban areas in metropolitan Melbourne, Australia. METHODS: Destinations were geocoded, and kernel density estimates of destination intensity were created using kernels of 400, 800 and 1200 m. Using multilevel linear regression, the association between destination intensity (classified in quintiles Q1(least)-Q5(most)) and BMI was estimated in models that adjusted for the following confounders: age, sex, country of birth, education, dominant household occupation, household type, disability/injury and area disadvantage. Separate models included a physical activity variable. RESULTS: For kernels of 800 and 1200 m, there was an inverse relationship between BMI and more intensely distributed destinations (compared to areas with least destination intensity). Effects were significant at 1200 m: Q4, ß -0.86, 95% CI -1.58 to -0.13, p=0.022; Q5, ß -1.03 95% CI -1.65 to -0.41, p=0.001. Inclusion of physical activity in the models attenuated effects, although effects remained marginally significant for Q5 at 1200 m: ß -0.77 95% CI -1.52, -0.02, p=0.045. CONCLUSIONS: This study conducted within urban Melbourne, Australia, found that participants living in areas of greater destination intensity within 1200 m of home had lower BMIs. Effects were partly explained by physical activity. The results suggest that increasing the intensity of destination distribution could reduce BMI levels by encouraging higher levels of physical activity.


Assuntos
Índice de Massa Corporal , Planejamento Ambiental , Atividade Motora , Características de Residência , Adolescente , Adulto , Idoso , Austrália , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , População Urbana , Caminhada , Adulto Jovem
14.
PLoS One ; 10(9): e0137402, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26355848

RESUMO

BACKGROUND: Local destinations have previously been shown to be associated with higher levels of both physical activity and walking, but little is known about how the distribution of destinations is related to activity. Kernel density estimation is a spatial analysis technique that accounts for the location of features relative to each other. Using kernel density estimation, this study sought to investigate whether individuals who live near destinations (shops and service facilities) that are more intensely distributed rather than dispersed: 1) have higher odds of being sufficiently active; 2) engage in more frequent walking for transport and recreation. METHODS: The sample consisted of 2349 residents of 50 urban areas in metropolitan Melbourne, Australia. Destinations within these areas were geocoded and kernel density estimates of destination intensity were created using kernels of 400m (meters), 800m and 1200m. Using multilevel logistic regression, the association between destination intensity (classified in quintiles Q1(least)-Q5(most)) and likelihood of: 1) being sufficiently active (compared to insufficiently active); 2) walking≥4/week (at least 4 times per week, compared to walking less), was estimated in models that were adjusted for potential confounders. RESULTS: For all kernel distances, there was a significantly greater likelihood of walking≥4/week, among respondents living in areas of greatest destinations intensity compared to areas with least destination intensity: 400m (Q4 OR 1.41 95%CI 1.02-1.96; Q5 OR 1.49 95%CI 1.06-2.09), 800m (Q4 OR 1.55, 95%CI 1.09-2.21; Q5, OR 1.71, 95%CI 1.18-2.48) and 1200m (Q4, OR 1.7, 95%CI 1.18-2.45; Q5, OR 1.86 95%CI 1.28-2.71). There was also evidence of associations between destination intensity and sufficient physical activity, however these associations were markedly attenuated when walking was included in the models. CONCLUSIONS: This study, conducted within urban Melbourne, found that those who lived in areas of greater destination intensity walked more frequently, and showed higher odds of being sufficiently physically active-an effect that was largely explained by levels of walking. The results suggest that increasing the intensity of destinations in areas where they are more dispersed; and or planning neighborhoods with greater destination intensity, may increase residents' likelihood of being sufficiently active for health.


Assuntos
Algoritmos , Atividade Motora/fisiologia , Características de Residência , Caminhada/fisiologia , Adolescente , Adulto , Idoso , Austrália , Bases de Dados como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Análise Multinível , Razão de Chances , Adulto Jovem
15.
Int J Behav Nutr Phys Act ; 9: 115, 2012 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-22989176

RESUMO

BACKGROUND: Using two different measures of park area, at three buffer distances, we sought to investigate the ways in which park area and proximity to parks, are related to the frequency of walking (for all purposes) in Australian adults. Little previous research has been conducted in this area, and results of existing research have been mixed. METHODS: Residents of 50 urban areas in metropolitan Melbourne, Australia completed a physical activity survey (n = 2305). Respondents reported how often they walked for ≥10 minutes in the previous month. Walking frequency was dichotomised to 'less than weekly' (less than 1/week) and 'at least weekly' (1/week or more). Using Geographic Information Systems, Euclidean buffers were created around each respondent's home at three distances: 400metres (m), 800 m and 1200 m. Total area of parkland in each person's buffer was calculated for the three buffers. Additionally, total area of 'larger parks', (park space ≥ park with Australian Rules Football oval (17,862 m2)), was calculated for each set of buffers. Area of park was categorised into tertiles for area of all parks, and area of larger parks (the lowest tertile was used as the reference category). Multilevel logistic regression, with individuals nested within areas, was used to estimate the effect of area of parkland on walking frequency. RESULTS: No statistically significant associations were found between walking frequency and park area (total and large parks) within 400 m of respondent's homes. For total park area within 800 m, the odds of walking at least weekly were lower for those in the mid (OR 0.65, 95% CI 0.46-0.91) and highest (OR 0.65, 95% CI 0.44-0.95) tertile of park area compared to those living in areas with the least amount of park area. Similar results were observed for total park area in the 1200 m buffers. When only larger parks were investigated, again more frequent walking was less likely when respondents had access to a greater amount of park area. CONCLUSIONS: In this study we found that more park area in residential environments reduced the odds of walking more frequently. Other area characteristics such as street connectivity and destinations may underlie these associations by negatively correlating with park area.


Assuntos
Planejamento Ambiental , Logradouros Públicos/estatística & dados numéricos , Recreação/psicologia , Caminhada , Adolescente , Adulto , Idoso , Austrália , Estudos Transversais , Exercício/psicologia , Feminino , Sistemas de Informação Geográfica , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , População Urbana/estatística & dados numéricos , Caminhada/psicologia , Caminhada/estatística & dados numéricos , Adulto Jovem
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