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1.
BMC Public Health ; 22(1): 232, 2022 02 04.
Article in English | MEDLINE | ID: covidwho-1700885

ABSTRACT

BACKGROUND: The major determinants of health and well-being include wider socio-economic and political responses to poverty alleviation. To data, however, South Korea has no related social protection policies to replace income loss or prevent non-preferable health conditions for workers. In particular, there are several differences in social protection policies by gender or occupational groups. This study aimed to investigate how hospitalization affects income loss among workers in South Korea. METHODS: The study sample included 4876 Korean workers who responded to the Korean Welfare Panel Study (KoWePS) for all eight years from 2009 to 2016. We conducted a receiver operating characteristics (ROC) analysis to determine the cut-off point for the length of hospitalization that corresponded to the greatest loss of income. We used panel multi-linear regression to examine the relationship between hospitalization and income loss by gender and employment arrangement. RESULTS: The greatest income loss for women in non-standard employment and self-employed men was observed when the length of hospitalization was seven days or less. When they were hospitalized for more than 14 days, income loss also occurred among men in non-standard employment. In addition, when workers were hospitalized for more than 14 days, the impact of the loss of income was felt into the subsequent year. CONCLUSION: Non-standard and self-employed workers, and even female standard workers, are typically excluded from public insurance coverage in South Korea, and social security is insufficient when they are injured. To protect workers from the vicious circle of the poverty-health trap, national social protections such as sickness benefits are needed.

2.
Int J Environ Res Public Health ; 19(4)2022 02 16.
Article in English | MEDLINE | ID: covidwho-1706144

ABSTRACT

The prevalence of precarious employment has increased in recent decades and aspects such as employment insecurity and income inadequacy have intensified during the COVID-19 pandemic. The purpose of this systematic review was to identify, appraise, and synthesise existing evidence pertaining to implemented initiatives addressing precarious employment that have evaluated and reported health and well-being outcomes. We used the PRISMA framework to guide this review and identified 11 relevant initiatives through searches in PubMed, Scopus, Web of Science, and three sources of grey literature. We found very few evaluated interventions addressing precarious employment and its impact on the health and well-being of workers globally. Ten out of 11 initiatives were not purposefully designed to address precarious employment in general, nor specific dimensions of it. Seven out of 11 initiatives evaluated outcomes related to the occupational health and safety of precariously employed workers and six out of 11 evaluated worker health and well-being outcomes. Most initiatives showed the potential to improve the health of workers, although the evaluation component was often described with less detail than the initiative itself. Given the heterogeneity of the 11 initiatives regarding study design, sample size, implementation, evaluation, economic and political contexts, and target population, we found insufficient evidence to compare outcomes across types of initiatives, generalize findings, or make specific recommendations for the adoption of initiatives.


Subject(s)
COVID-19 , Occupational Health , COVID-19/epidemiology , Employment , Humans , Pandemics , SARS-CoV-2
3.
BMJ Open ; 12(2): e057729, 2022 Feb 04.
Article in English | MEDLINE | ID: covidwho-1673448

ABSTRACT

OBJECTIVES: Primary care is well positioned to identify and address loneliness and social isolation in older adults, given its gatekeeper function in many healthcare systems. We aimed to identify and characterise loneliness and social isolation interventions and detect factors influencing implementation in primary care. DESIGN: Scoping review using the five-step Arksey and O'Malley Framework. DATA SOURCES: MEDLINE, CINAHL, EMBASE, COCHRANE databases and grey literature were searched from inception to June 2021. ELIGIBILITY CRITERIA: Empirical studies in English and Spanish focusing on interventions addressing social isolation and loneliness in older adults involving primary care services or professionals. DATA EXTRACTION AND SYNTHESIS: We extracted data on loneliness and social isolation identification strategies and the professionals involved, networks and characteristics of the interventions and barriers to and facilitators of implementation. We conducted a thematic content analysis to integrate the information extracted. RESULTS: 32 documents were included in the review. Only seven articles (22%) reported primary care professionals screening of older adults' loneliness or social isolation, mainly through questionnaires. Several interventions showed networks between primary care, health and non-healthcare sectors, with a dominance of referral pathways (n=17). Two-thirds of reports did not provide clear theoretical frameworks, and one-third described lengths under 6 months. Workload, lack of interest and ageing-related barriers affected implementation outcomes. In contrast, well-defined pathways, collaborative designs, long-lasting and accessible interventions acted as facilitators. CONCLUSIONS: There is an apparent lack of consistency in strategies to identify lonely and socially isolated older adults. This might lead to conflicts between intervention content and participant needs. We also identified a predominance of schemes linking primary care and non-healthcare sectors. However, although professionals and participants reported the need for long-lasting interventions to create meaningful social networks, durable interventions were scarce. Sustainability should be a core outcome when implementing loneliness and social isolation interventions in primary care.

4.
Scand J Work Environ Health ; 47(7): 509-520, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1359380

ABSTRACT

OBJECTIVE: High-quality longitudinal evidence exploring the mental health risk associated with low-quality employment trajectories is scarce. We therefore aimed to investigate the risk of being diagnosed with common mental disorders, substance use disorders, or suicide attempt according to low-quality employment trajectories. METHODS: A longitudinal register-study based on the working population of Sweden (N=2 743 764). Employment trajectories (2005-2009) characterized by employment quality and pattern (constancy, fluctuation, mobility) were created. Hazard ratios (HR) were estimated using Cox proportional hazards regression models for first incidence (2010-2017) diagnosis of common mental disorders, substance use disorders and suicide attempt as dependent on employment trajectories. RESULTS: We identified 21 employment trajectories, 10 of which were low quality (21%). With the exception of constant solo self-employment, there was an increased risk of common mental disorders (HR 1.07-1.62) and substance use disorders (HR 1.05-2.19) for all low-quality trajectories. Constant solo self-employment increased the risk for substance use disorders among women, while it reduced the risk of both disorders for men. Half of the low-quality trajectories were associated with a risk increase of suicide attempt (HR 1.08-1.76). CONCLUSIONS: Low-quality employment trajectories represent risk factors for mental disorders and suicide attempt in Sweden, and there might be differential effects according to sex - especially in terms of self-employment. Policies ensuring and maintaining high-quality employment characteristics over time are imperative. Similar prospective studies are needed, also in other contexts, which cover the effects of the Covid-19 pandemic as well as the mechanisms linking employment trajectories with mental health.


Subject(s)
Employment/statistics & numerical data , Mental Disorders/epidemiology , Substance-Related Disorders , Suicide, Attempted/statistics & numerical data , COVID-19 , Female , Humans , Incidence , Longitudinal Studies , Male , Mental Disorders/complications , Middle Aged , Prospective Studies , Risk Factors , Sex Factors , Substance-Related Disorders/epidemiology , Substance-Related Disorders/etiology , Sweden/epidemiology
5.
Syst Rev ; 10(1): 195, 2021 06 30.
Article in English | MEDLINE | ID: covidwho-1318294

ABSTRACT

BACKGROUND: Precarious employment is a significant determinant of population health and health inequities and has complex public health consequences both for a given nation and internationally. Precarious employment is conceptualized as a multi-dimensional construct including but not limited to employment insecurity, income inadequacy, and lack of rights and protection in the employment relation, which could affect both informal and formal workers. The purpose of this review is to identify, appraise, and synthesize existing research on the effectiveness of initiatives aiming to or having the potential to eliminate, reduce, or mitigate workers' exposure to precarious employment conditions and its effects on the health and well-being of workers and their families. METHODS: The electronic databases searched (from January 2000 onwards) are Scopus, Web of Science Core Collection, and PubMed, along with three institutional databases as sources of grey literature. We will include any study (e.g. quantitative, qualitative, or mixed-methods design) evaluating the effects of initiatives that aim to or have the potential to address workers' exposure to precarious employment or its effects on the health and well-being of workers and their families, whether or not such initiatives were designed specifically to address precarious employment. The primary outcomes will be changes in (i) the prevalence of precarious employment and workers' exposure to precarious employment and (ii) the health and well-being of precariously employed workers and their families. No secondary outcomes will be included. Given the large body of evidence screened, the initial screening of each study will be done by one reviewer, after implementing several strategies to ensure decision-making consistency across reviewers. The screening of full-text articles, data extraction, and critical appraisal will be done independently by two reviewers. Potential conflicts will be resolved through discussion. Established checklists will be used to assess a study's methodological quality or bias. A narrative synthesis will be employed to describe and summarize the included studies' characteristics and findings and to explore relationships both within and between the included studies. DISCUSSION: We expect that this review's findings will provide stakeholders interested in tackling precarious employment and its harmful health effects with evidence on effectiveness of solutions that have been implemented to inform considerations for adaptation of these to their unique contexts. In addition, the review will increase our understanding of existing research gaps and enable us to make recommendations to address them. Our work aligns with the sustainable development agenda to protect workers, promote decent work and economic growth, eliminate poverty, and reduce inequalities. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020187544 .


Subject(s)
Employment , Occupational Health , Humans , Systematic Reviews as Topic
7.
J Migr Health ; 4: 100048, 2021.
Article in English | MEDLINE | ID: covidwho-1240452

ABSTRACT

The main purpose of this article is to review several ways in which health care workers could either impact migrant health or be directly impacted by migration and, based on this, suggest the expansion of the current research agenda on migration and health to address a range of topics that are currently either neglected, insufficiently researched, or researched from different perspectives. To ground this suggestion and emphasize the complexity and significance of migrant health research, we start by briefly reviewing several migration-related notions including the process of migration and its key facilitators and benefits; existing barriers to the provision of migrant health care; and the intricate links between health systems, health professionals, and migrant health. The three areas of research examined in this article address (i) the specific role of health workers in providing care to migrants and refugees and their capacity to do so, (ii) the health problems experienced by health workers who become migrants or refugees, and (iii) the precarious employment conditions experienced by both migrant and non-migrant health care workers. After summarizing the current available evidence on these topics, we discuss key information gaps and strategies to address them, while also incorporating several relevant COVID-19 pandemic considerations and research implications. Expanding the focus of research studies on migration and health could not only enhance the results of current strategies by supplying additional information to support their implementation but also spearhead the development of new solutions to the migrant health problem.

8.
Int J Health Serv ; 51(2): 247-260, 2021 04.
Article in English | MEDLINE | ID: covidwho-1140420

ABSTRACT

This rapid scoping review of existing evidence and research gaps addressed the following question: what research evidence exists and what are the research gaps at global, regional, and national levels on interventions to protect jobs, small- and medium-sized enterprises, and formal/informal sector workers in socioeconomic response to the coronavirus disease 2019 (COVID-19) pandemic? The results are based on 79 publications deemed eligible for inclusion after the screening and prioritizing of 1,658 records. The findings are organized according to the 3 main categories of socioeconomic interventions-protecting jobs, enterprises, and workers-although the 3 are intertwined. Most results were derived from global-level gray literature with recommendations for interventions and implicit links to the sustainable development goals. Based on research gaps uncovered in the review, future implementation science research needs to focus on designing, implementing, evaluating, and scaling: effective evidence-based socioeconomic interventions; equity-focused, redistributive, and transformative interventions; comprehensive packages of complementary interventions; interventions to upend root causes of systemic social inequities; collaborative and participatory approaches; interventions that integrate environmental sustainability; and city-level interventions. Failing to consider the environmental dimensions of economic recovery is shortsighted and will ultimately exacerbate social inequities and poverty and undermine economic stability in the long term.


Subject(s)
COVID-19/economics , Employment , Research Design , SARS-CoV-2 , Humans , Pandemics/economics , United Nations
9.
Int J Health Serv ; 51(2): 226-228, 2021 04.
Article in English | MEDLINE | ID: covidwho-1067025

ABSTRACT

The world of work is facing an ongoing pandemic and an economic downturn with severe effects worldwide. Workers trapped in precarious employment (PE), both formal and informal, are among those most affected by the COVID-19 pandemic. Here we call attention to at least 5 critical ways that the consequences of the crisis among workers in PE will be felt globally: (a) PE will increase, (b) workers in PE will become more precarious, (c) workers in PE will face unemployment without being officially laid off, (d) workers in PE will be exposed to serious stressors and dramatic life changes that may lead to a rise in diseases of despair, and (e) PE might be a factor in deterring the control of or in generating new COVID-19 outbreaks. We conclude that what we really need is a new social contract, where the work of all workers is recognized and protected with adequate job contracts, employment security, and social protection in a new economy, both during and after the COVID-19 crisis.


Subject(s)
COVID-19 , Employment , SARS-CoV-2 , Humans , Pandemics , United States
10.
Gac Sanit ; 36(1): 32-36, 2022.
Article in Spanish | MEDLINE | ID: covidwho-1056624

ABSTRACT

The COVID-19 pandemic has hit Spain particularly hard, despite being a country with a developed economy and being praised for the robustness of its national health system. In order to understand what happened and to identify how to improve the response, we believe that an independent multi-disciplinary evaluation of the health, political and socio-economic spheres is essential. In this piece we propose objectives, principles, methodology and dimensions to be evaluated, as well as outlining the type of results and conclusions expected. Inspired by the requirements formulated by the WHO Independent Panel for Pandemic Preparedness and Response and by experiences in other countries, we detail the multidimensional aspects to be evaluated. The goal is to understand key aspects in the studied areas and their scope for improvement in terms of preparedness, governance, regulatory framework, national health system structures (primary care, hospital, and public health), education sector, social protection schemes, minimization of economic impact, and labour framework and reforms for a more resilient society. We seek to ensure that this exercise serves not only at present, but also that in the future we are better prepared and more agile in terms of our ability to recover from any pandemic threats that may arise.


Subject(s)
COVID-19 , Pandemics , Humans , Pandemics/prevention & control , Public Health , Public Policy , SARS-CoV-2
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