The Key Role of Work in Population Health Inequities

Landsbergis, Paul; Choi, BongKyoo; Dobson, Marnie; Sembajwe, Grace; Slatin, Craig; Delp, Linda; Siqueira, Carlos Eduardo; Schnall, Peter L.; Baron, Sherry

doi:10.2105/ajph.2017.304288

Cited by 26 publications

(22 citation statements)

References 6 publications

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“…The last four decades have been marked by drastic changes to work and employment conditions in the U.S. and globally [1]. In turn, American workers are working longer hours, encountering upsurges in shift work experiences, facing increasing burdens of psychosocial job stressors, and suffering significant work-life imbalances [2,3,4].…”

Section: Introductionmentioning

confidence: 99%

“…In turn, American workers are working longer hours, encountering upsurges in shift work experiences, facing increasing burdens of psychosocial job stressors, and suffering significant work-life imbalances [2,3,4]. Considering the poorer health outcomes in the U.S. compared with most other developed nations, it is becoming increasingly urgent to examine work as a major social determinant of health [1,5,6,7].…”

Section: Introductionmentioning

confidence: 99%

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Work-Life Conflict among U.S. Long-Haul Truck Drivers: Influences of Work Organization, Perceived Job Stress, Sleep, and Organizational Support

Hege

Lemke

Apostolopoulos

et al. 2019

IJERPH

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Work-life balance and job stress are critical to health and well-being. Long-haul truck driving (LHTD) is among the unhealthiest and most unsafe occupations in the U.S. Despite these disparities, there are no extant published studies examining the influence of work, stress and sleep outcomes on drivers’ work-life balance. The current study investigated whether adverse work organization, stress, and poor sleep health among LHTDs are significantly associated with work-life conflict. Logistic regression was used to examine how work organization characteristics, job stress, and sleep influenced perceived stress and a composite measure of work-life conflict among a sample of 260 U.S. LHTDs. The pattern of regression results dictated subsequent analyses using structural equation modeling (SEM). Perceived job stress was the only statistically significant predictor for work-life balance. Fast pace of work, sleep duration and sleep quality were predictors of perceived job stress. SEM further elucidated that stress mediates the influences of fast work pace, supervisor/coworker support, and low sleep duration on each of the individual work-life balance indicators. There is an urgent need to address work conditions of LHTDs to better support their health, well-being, and work-life balance. Specifically, the findings from this study illustrate that scheduling practices and sleep outcomes could alleviate job stress and need to be addressed to more effectively support work-life balance. Future research and interventions should focus on policy and systems-level change.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Work-Life Conflict among U.S. Long-Haul Truck Drivers: Influences of Work Organization, Perceived Job Stress, Sleep, and Organizational Support

Hege

Lemke

Apostolopoulos

et al. 2019

IJERPH

View full text Add to dashboard Cite

show abstract

“…Furthermore, employees have less control over their work conditions than that of previous generations while they work longer and more unpredictable hours and receive fewer benefits and negligible wage increases from their employers. As a result, these unfortunate shifts have negatively impacted some populations more than others—in particular those identified as having lower socioeconomic status in society and greater vulnerability to health disparities [ 1 , 3 , 8 , 9 ]. Also during these last forty years, using epidemiologic evidence, public health scholars have established causal linkages between shorter duration sleep [ 10 ], obesity [ 11 ], and increases in prevalence for both diabetes and cardiovascular disease (CVD) on a global scale [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…The study of work organization typically focuses on the impacts of upstream elements of policy and organizational decisions on downstream working conditions [ 4 , 8 , 9 ]. Numerous work organization-related factors have been shown to influence health at the level of individuals and subsequently produce health disparities across occupational sectors at the population level [ 4 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Occupational health disparities among U.S. long-haul truck drivers: the influence of work organization and sleep on cardiovascular and metabolic disease risk

et al. 2018

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ObjectiveThe organization of work has undergone vast transformations over the past four decades in the United States and has had profound impacts on worker health and wellbeing. The profession of commercial truck driving is one of the best examples. Particularly for long-haul truck drivers, changes in work organization have led to disproportionately poor physiological, psychological, and sleep health outcomes.MethodsThe present study examined disparities in cardiometabolic disease risk among long-haul truck drivers and the general population, and the influence of work organization and sleep in generating these outcomes. Researchers collected survey data from 260 drivers, and blood assay samples from 115 of those drivers, at a large highway truck stop in North Carolina. Comparisons were made for cardiovascular and metabolic risk against the 2011–2012 National Health and Nutrition Examination Survey (NHANES). In addition, logistic regression was used to explore predictive relationships between work organization and sleep and risk for cardiovascular and metabolic disease.ResultsThere were statistically significant mean differences between the long-haul truck driver sample and the NHANES sample for both cardiovascular (3.71 vs. 3.10; p <0.001) and metabolic (4.31 vs. 3.09; p <0.001) disease risk. The truck driver sample was less physically active and had lower HDL cholesterol along with greater levels of smoking, BMI, and metabolic syndrome diagnosis. More years of driving experience and poor sleep quality were statistically significant predictors for both cardiovascular and metabolic disease risk.ConclusionsStudy findings implicate elements of the occupational milieu experienced by long-haul truck drivers that induce disproportionate cardiometabolic disease risk. Sleep quality, largely compromised by poor work conditions and workplace environments, plays a significant role in increased risks for cardiometabolic disease. There is an urgent need for longitudinal studies of this critical occupational sector as well as intervention research centered on policy and systems level change.

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“…People who belong to a lower social class, such as blue-collar workers, are more likely to be exposed to adverse psychosocial working conditions throughout work life, including work-related stress, repetitive work, low influence at work, as well as physically demanding working conditions [ 13 ]. Hence, work is an area that is central to reducing inequalities in health outcomes [ 14 ]. There is also growing evidence of a long-term association between adverse working conditions and limitations in physical function in older age that persist after adjusting for socioeconomic factors [ 15 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Working conditions mediate the association between social class and physical function in older age in Sweden: a prospective cohort study

2020

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Background: Global demographics are changing as societies all over the world are aging. This puts focus on maintaining functional ability and independence into older age. Individuals from lower social classes are at greater risk of developing limitations in physical function later in life. In this study, we investigated the mediating role of working conditions in the association between occupation-based social class and physical function measured as self-reported mobility limitations and objectively measured physical impairment in older age. Methods: Two Swedish surveys, linked at the individual level, were used (n = 676-814 depending on the outcome). Follow-up time was 20-24 years. Multiple logistic regression analyses were performed with adjustments for age, sex, level of education, mobility, and health problems at baseline. This was followed by analyses of the size of the mediating effect of working conditions. Results: Working conditions seem to mediate 35-74% of the association between social class and physical impairment in older age. The pattern of mediation was primarily driven by passive jobs, i.e., low psychological demands and low control, among blue-collar workers. Working conditions did not mediate the association between social class and self-reported mobility limitations in older age. Conclusions: The results of this study indicate that working conditions are important in combating the social gradient in healthy aging, contributing to the evidence regarding the magnitude of impact exerted by both the physical and psychosocial work environment separately and in conjunction.

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The Key Role of Work in Population Health Inequities

Cited by 26 publications

References 6 publications

Work-Life Conflict among U.S. Long-Haul Truck Drivers: Influences of Work Organization, Perceived Job Stress, Sleep, and Organizational Support

Work-Life Conflict among U.S. Long-Haul Truck Drivers: Influences of Work Organization, Perceived Job Stress, Sleep, and Organizational Support

Occupational health disparities among U.S. long-haul truck drivers: the influence of work organization and sleep on cardiovascular and metabolic disease risk

Working conditions mediate the association between social class and physical function in older age in Sweden: a prospective cohort study

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