Electoral Democracy and Working-Age Mortality.

Policy Points The erosion of electoral democracy in the United States in recent decades may have contributed to the high and rising working-age mortality rates, which predate the COVID-19 pandemic. Eroding electoral democracy in a US state was associated with higher working-age mortality from homicide, suicide, and especially from drug poisoning and infectious disease. State and federal efforts to strengthen electoral democracy, such as banning partisan gerrymandering, improving voter enfranchisement, and reforming campaign finance laws, could potentially avert thousands of deaths each year among working-age adults. CONTEXT: Working-age mortality rates are high and rising in the United States, an alarming fact that predates the COVID-19 pandemic. Although several reasons for the high and rising rates have been hypothesized, the potential role of democratic erosion has been overlooked. This study examined the association between electoral democracy and working-age mortality and assessed how economic, behavioral, and social factors may have contributed to it. METHODS: We used the State Democracy Index (SDI), an annual summary of each state's electoral democracy from 2000 to 2018. We merged the SDI with annual age-adjusted mortality rates for adults 25-64 years in each state. Models estimated the association between the SDI and working-age mortality (from all causes and six specific causes) within states, adjusting for political party control, safety net generosity, union coverage, immigrant population, and stable characteristics of states. We assessed whether economic (income, unemployment), behavioral (alcohol consumption, sleep), and social (marriage, violent crime, incarceration) factors accounted for the association. FINDINGS: Increasing electoral democracy in a state from a moderate level (defined as the third quintile of the SDI distribution) to a high level (defined as the fifth quintile) was associated with an estimated 3.2% and 2.7% lower mortality rate among working-age men and women, respectively, over the next year. Increasing electoral democracy in all states from the third to the fifth quintile of the SDI distribution may have resulted in 20,408 fewer working-age deaths in 2019. The democracy-mortality association mainly reflected social factors and, to a lesser extent, health behaviors. Increasing electoral democracy in a state was mostly strongly associated with lower mortality from drug poisoning and infectious diseases, followed by reductions in homicide and suicide. CONCLUSIONS: Erosion of electoral democracy is a threat to population health. This study adds to growing evidence that electoral democracy and population health are inextricably linked.

Post-COVID-19 Status and Its Physical, Nutritional, Psychological, and Social Effects in Working-Age Adults-A Prospective Questionnaire Study.

BACKGROUND: The main objective of this study was to evaluate the evolution of physical and daily routine, dietary habits, and mental and social health in individuals with recent COVID-19 infection. METHODS: A qualitative prospective cross-sectional study was conducted from 01 October 2021 to 01 March 2022, which included 80 working-age adults from the territory of Central Serbia who had PCR-confirmed SARS-CoV-2 infection in the previous six months. Two structured pre-coded closed-ended questionnaires were submitted to the participants: a questionnaire about post-COVID-19 status (pCOVq) and a shortened version of the World Health Organization's Quality of Life Scale (WHOQOL-BREF). RESULTS: The presence of the COVID-19 disease in the previous period of 6 months among the working-age participants significantly affected the duration of aerobic, anaerobic, and high-intensity physical activities, but also the possibility of performing certain activities such as walking, which represents basic aerobic activity and a measure of general health among middle-aged participants. In the majority of cases (78%), in the post-COVID-19 period, participants indicated a decline in educational and productive activities. CONCLUSION: Post-COVID status in working-aged participants consists of reduced physical activity, lower quality of life, and similar nutritional habits. Health policies should be more focused on these findings.

Health-Risk Behaviors, COVID-19 Preventive Behaviors, and the Impact of the COVID-19 Pandemic on the Working-Age Population of Bangkok, Thailand.

Although studies have extensively discussed the effects of COVID-19 on global health behaviors, little is known about the extent of COVID-19 preventive behaviors and their negative effects on the working-age population of Bangkok, Thailand. Therefore, this study aimed to examine health-risk behaviors, COVID-19 preventive behaviors, and the impact of the COVID-19 pandemic among the Thai working-age population. An online cross-sectional survey was conducted among working-age adults through a self-administered questionnaire. Data were analyzed with descriptive statistics and stepwise multiple regression. Of the 313 Thai participants (227 females, 72.5%), 84.0% had high levels of health-risk behaviors for preventing COVID-19 infection, most respondents (89.1%) had high levels of knowledge about COVID-19, and most respondents (61.7%) had high levels of overall COVID-19 preventive behaviors. Stepwise multiple regression revealed that health-risk behaviors (ß = 0.445), knowledge of COVID-19 (ß = 0.148), gender (ß = 0.145), and age (ß = 0.133) were predictive of COVID-19 preventive behaviors. Additionally, most respondents (48.9%) had moderate overall effects from COVID-19. Based on our findings, these factors must be considered when implementing public policies to improve COVID-19 preventive behaviors among the currently employed working-age population. In addition, appropriate interventions must be established and evaluated for the pandemic's long-term effects.

Health literacy in dietary supplement use among working-age groups: systematic review and meta-analysis.

Background: Globally, dietary supplement use (DSU) is very popular against COVID19. This study aims to investigate the characteristics of research on health literacy (HL) in DSU and compare HL among working-age groups by reviewing related research between 2011 and 2021 in PubMed, SCOPUS, ClinicalKey, Google Scholar and ThaiJO. Methods: Twenty-five articles that met the inclusion criteria were selected for study and analyzed using Cohen's d. Results: The results showed that HL affected dietary supplement (DS) consumption behavior among working-age groups with an average effect size of 0.423 (95% CI = 0.249-0.598), followed by disclosure of DSU with an average effect size of 0.220 (95% CI = 0.087-0.353). No effect was found on awareness of dietary supplement advertisements. Conclusion: The discovery of such knowledge is a significant contribution to public health, leading to the development of interventions and policies for enhancing HL in DSU e.g. organizing knowledge-sharing workshops on DSU and building support networks across all sectors.

Mortality analysis of the working-age population of Yakutia

The data of state statistics on mortality of the able-bodied population in the Republic of Sakha (Yakutia) in the period from 1995 to 2020, as well as the structure of main causes of death in this category are analyzed. In the course of the work, the dynamics of changes in the structure of mortality among urban and rural residents with a gender division was studied, and the impact of a new coronavirus infection on the healthcare system in Yakutia was shown. It has been established that the mortality rate of the population of the Republic of Sakha (Yakutia) of working age during the study period has significantly decreased, but the proportion of deaths in this group to the total number of deaths is still higher than the national indicators. It is also shown that the mortality rate of men is 3.6 times higher than that of women. Since 2011, mortality in rural areas has significantly exceeded that in the urban environment, especially among the female population, which is largely determined by a decrease in the number of beds.

The Prevalence of and Factors Associated With Anxiety and Depression Among Working-Age Adults in Mainland China at the Early Remission Stage of the Coronavirus 2019 Pandemic.

Background: The Coronavirus 2019 (COVID-19) outbreak has led to a considerable proportion of adverse psychological symptoms in different subpopulations. This study aimed to investigate the status of anxiety and depression and their associated factors in the adult, working-age population in Mainland China at the early remission stage of the COVID-19 pandemic. Methods: An online study was conducted among 1,863 participants in 29 provinces in Mainland China from March 23 to 31, 2020. Their mental health was evaluated by the generalized anxiety disorder scale (GAD-7) and the patient health questionnaire (PHQ-9). Descriptive analysis, Chi-square, and multiple logistic regressions were applied. Results: About 44.5% of the participants had anxiety, 49.2% had depression, and 37.9% showed a combination of depression and anxiety. Around 83.7% of the participants claimed that the pandemic had a negative impact on their medical needs, which was the primary predictor of mental health, the degree of impact being positively related to the prevalence of anxiety and depression. More chronic diseases, moderate to bad self-rated health, severe perceived infection risk, and younger age group were the common risk factors for anxiety and depression. Having no children, unemployment, and a college-level educational background were associated with higher anxiety prevalence, whereas unmarried participants were correlated with higher depression prevalence. Conclusion: The working-age population showed a relatively high risk of anxiety and depression in Mainland China at the early remission stage of the pandemic. To improve medical services capacity for routine and delayed medical service needs should be a part of policy-makers' priority agenda during this period of crisis.

Covid-19 sequelae in working age patients: A systematic review.

Despite the SARS-CoV-2 pandemic not yet being under control, post-Covid-19 syndrome is already a challenging topic: long-term multiorgan sequelae, although increasingly described, have not yet been systematized. As post-Covid-19 syndrome can significantly impact both the working capacity and the relationship life of surviving patients, we performed a systematic review of the evidence published over the last year and currently available in medical literature search databases (MEDLINE/Pubmed) and searching clinical trial registries, to evaluate the available evidence among workers. From 31 publications that initially matched inclusion criteria, 13 studies have been considered suitable for relevance and age of subjects. A wide range of patients (16%-87%) have post-Covid syndrome; pneumological and neuropsychological symptoms were the most common disorders reported. The most frequent organic sequel found in post-Covid patients was pulmonary fibrosis. The number of symptoms during acute SARS-CoV-2 infection, severity of the disease, and high serum levels of d-dimer were related to high risk of post-Covid syndrome. In conclusion, post-Covid-19 syndrome can significantly impact the health conditions of surviving patients. Rehabilitation and follow-up in multidisciplinary rehabilitation programs should be considered for working-age patients.

Does unemployment lead to greater levels of loneliness? A systematic review.

There is evidence that loneliness and unemployment each have a negative impact on public health. Both are experienced across the life course and are of increasing concern in light of the COVID-19 pandemic. This review seeks to examine the strength and direction of the relationship between loneliness and unemployment in working age individuals, and in particular the potential for a self-reinforcing cycle with combined healthcare outcomes. A systematic search was undertaken in Medline, PubMed, PsycINFO, Embase and EconLit from inception to December 2020. PRISMA reporting guidelines were followed throughout this review, study quality was assessed using the Joanna Briggs Institute checklist and results were summarised in a narrative synthesis. English language studies evaluating the relationship between loneliness and unemployment in higher income western countries were included. Thirty-seven studies were identified; 30 cross-sectional and 7 longitudinal. Loneliness was measured by a direct question or loneliness scale while unemployment was self-reported or retrieved from a national register. A positive association between unemployment and increased loneliness was observed across all studies. Thus, across the life-course a clear yet complex relationship exists between unemployment and greater experience of loneliness. The magnitude of this relationship increases with the severity of loneliness and appears to peak at age 30-34 and 50-59. Logistic regression provided the greatest consistency at statistical significance revealing at least a 40% increase in the likelihood of reporting loneliness when unemployed. Recent longitudinal studies identified in this review found higher levels of loneliness following job loss, but also that loneliness was predictive of unemployment suggesting potential bi-directionality in the relationship. This bi-directionality may create a multiplier effect between loneliness and unemployment to form a self-reinforcing relationship and greater health concerns for those most at risk. Thus, review findings suggest the need for cross-sector awareness and intervention to tackle both loneliness and unemployment.

Gender differences in the determinants of willingness to get the COVID-19 vaccine among the working-age population in Japan.

Many factors are related to vaccination intentions. However, gender differences in the determinants of intention to get the coronavirus disease 2019 (COVID-19) vaccine have not been fully investigated. This study examined gender differences in the determinants of willingness to get the COVID-19 vaccine among the working-age population in Japan. We conducted a cross-sectional study of Japanese citizens aged 20-65 years using an online self-administered questionnaire in December 2020. Logistic regression analysis was performed. Among 27,036 participants (13,814 men and 13,222 women), the percentage who were willing to get the COVID-19 vaccine was lower among women than among men (33.0% vs. 41.8%). Age and education level showed a gender gap regarding the association with willingness to get the COVID-19 vaccine: men who were older or had a higher level of education were more willing to get the vaccine, whereas women aged 30-49 years and those with a higher level of education showed a relatively low willingness to get the vaccine. For both men and women, marriage, higher annual household income, underlying disease, current smoking, vaccination for influenza during the current season, and fear of COVID-19 transmission were linked to a higher likelihood of being willing to get the COVID-19 vaccine. These findings give important insight into identifying target groups in need of intervention regarding COVID-19 vaccination, especially among women. Providing education about COVID-19 and influenza vaccination in the workplace may be an effective strategy to increase COVID-19 vaccine uptake.

Food sufficiency and the utilization of free food resources for working-age Americans with disabilities during the COVID-19 pandemic.

BACKGROUND: Working-age people with disabilities are an economically disadvantaged population more likely than those without disabilities to live in food insecure households. OBJECTIVE/HYPOTHESIS: Compare rates of food sufficiency and utilization of free food sources between working-age persons with and without disabilities in the US during the COVID-19 pandemic. METHODS: In September 2020, an online survey was conducted with n = 13,277 working-age individuals with and without disabilities to gather information about food sufficiency prior to COVID-19 (i.e., in March 2020) and within the last seven days as well as receipt of free groceries or meals, use of food programs or pantries, and concerns with using free food sources over the past week. Descriptive and multivariate statistics were used to compare these measures for persons with and without disabilities. RESULTS: Controlling for sociodemographic characteristics, the proportion of working-age persons who were food sufficient decreased from March 2020 to September 2020 for persons with disabilities (65%-57%, an eight-percentage point decrease) and for persons without disabilities (78%-73%, a five-percentage point decrease). The rates of change were not significantly different between groups. In September 2020, higher proportions of persons with disabilities (58%) used free food resources in the past week than persons without disabilities (41%). CONCLUSIONS: The low rate of food sufficiency, the high rate of free food resource utilization, and the concerns noted by working-age persons with disabilities in using these sources suggest a need for continuing nutrition assistance policy and program development targeted towards the needs of persons with disabilities.