Protective action in the workplace in the time of COVID-19: The role of worker representation.

BACKGROUND: This study addresses the contribution of worker representation to health and safety in the pandemic context. To do so, we examine whether the self-reported presence of representatives in workplaces is associated with the implementation of anti-COVID-19 protective action and with which type of measures their existence is most strongly associated (individual, collective or organizational). The article also explores how the presence of worker representatives and anti-COVID-19 protective measures are distributed according to workers' socio-professional characteristics and company features. METHODS: This is a cross-sectional study based on an online survey conducted in Spain (n = 19,452 workers). Multiple Correspondence Analysis was used for the multivariate description while the association between worker representation and protective measures was assessed by robust Poisson regressions. RESULTS: The maps resulting from the Multiple Correspondence Analysis allow for the identification of patterns of inequalities in protection, with a clear occupational social class divide. The regression models show that protective measures are applied more frequently where worker representatives exist, this association being particularly strong in relation to organizational measures. CONCLUSIONS: The presence of worker representation is systematically associated with a greater presence of protective measures, which could have implications for the reduction of social inequalities resulting from labor-management practices.

Time poverty, health and health-related behaviours in a Southern European city: a gender issue.

BACKGROUND: Despite its growing interest, time poverty is a neglected issue in public health analysis and policies. The objectives of this study were: (1) to analyse gender differences in paid, unpaid and total working time; (2) to identify gender differences in the factors related to time poverty; and (3) to examine gender differences in the relationship between time poverty, health and health-related behaviours in the city of Barcelona (Spain). METHODS: Cross-sectional study based on salaried workers aged 16-64 years interviewed in the 2021 Barcelona Health Survey (695 men and 713 women). Time poverty was defined as the top tercile of the total paid and unpaid work. Dependent variables were self-perceived health status, mental health, sleep time, sleep quality and leisure time physical activity. RESULTS: Women were more likely to be time poor. In both sexes, time poverty was related to the number of children. Whereas among men time poverty was not associated with any health indicators, among women it was related to poor mental health status (aOR=2.11, 95% CI 1.39 to 3.20), short sleep (aOR=1.54, 95% CI 1.05 to 2.25), poor sleep quality (aOR=1.83, 95% CI 1.25 to 2.68) and low leisure time physical activity (aOR=1.50, 95% CI 1.00 to 2.26). CONCLUSIONS: This study suggests that time use can be an important social determinant of health and of gender inequalities in health. At the local level, in many European cities, time poverty could be reduced, among other interventions, by increasing affordable and good quality public services for the care of dependent persons.

Care continuity across levels of care perceived by patients with chronic conditions in six Latin-American countries / La continuidad de la atención entre niveles percibida por pacientes con enfermedades crónicas en seis países latinoamericanos

Objective: To analyse the care continuity across levels of care perceived by patients with chronic conditions in public healthcare networks in six Latin American countries (Argentina, Brazil, Chile, Colombia, Mexico and Uruguay), and to explore associated factors. Method: Cross-sectional study by means of a survey conducted to a random sample of chronic patients in primary care centres of the study networks (784 per country) using the questionnaire Cuestionario de Continuidad Asistencial Entre Niveles de Atención (CCAENA)©. Patients had at least one chronic condition and had used two levels of care in the 6 months prior to the survey for the same medical condition. Descriptive analysis and multivariable logistic regression were carried out. Results: Although there are notable differences between the networks analysed, the results show that chronic patients perceive significant discontinuities in the exchange of clinical information between primary care and secondary care doctors and in access to secondary care following a referral; as well as, to a lesser degree, regarding clinical coherence across levels. Relational continuity with primary care and secondary care doctors and information transfer are positively associated with care continuity across levels; no individual factor is systematically associated with care continuity. Conclusions: Main perceived discontinuities relate to information transfer and access to secondary care after a referral. The study indicates the importance of organisational factors to improve chronic patients' quality of care. (AU)

Objetivo: Analizar la continuidad asistencial entre niveles de atención percibida por pacientes con enfermedades crónicas en redes sanitarias públicas de seis países latinoamericanos (Argentina, Brasil, Chile, Colombia, México y Uruguay) y explorar los factores asociados. Método: Estudio transversal mediante una encuesta realizada a una muestra aleatoria de pacientes crónicos en los centros de atención primaria de las redes de estudio (784 por país) utilizando el Cuestionario de Continuidad Asistencial Entre Niveles de Atención (CCAENA©). Los pacientes presentaban al menos una afección crónica y habían utilizado dos niveles de atención en los 6 meses anteriores a la encuesta por el mismo motivo. Se realizaron un análisis descriptivo y una regresión logística multivariante. Resultados: Aunque existen diferencias notables entre las redes analizadas, los resultados muestran que los pacientes crónicos perciben discontinuidades significativas en el intercambio de información clínica entre médicos de atención primaria y secundaria, y en el acceso a la atención secundaria tras una derivación, así como, en menor medida, en la coherencia clínica entre niveles. La continuidad de relación con los médicos de atención primaria y secundaria, y la transferencia de información, se asocian de manera positiva con la continuidad asistencial en ambos niveles; ningún factor individual se asocia sistemáticamente con la continuidad asistencial. Conclusiones: Las principales discontinuidades percibidas se relacionan con la transferencia de información y el acceso a la atención secundaria después de una derivación. El estudio indica la importancia de los factores organizativos para mejorar la calidad de la atención de los pacientes crónicos. (AU)

Care continuity across levels of care perceived by patients with chronic conditions in six Latin-American countries.

OBJECTIVE: To analyse the care continuity across levels of care perceived by patients with chronic conditions in public healthcare networks in six Latin American countries (Argentina, Brazil, Chile, Colombia, Mexico and Uruguay), and to explore associated factors. METHOD: Cross-sectional study by means of a survey conducted to a random sample of chronic patients in primary care centres of the study networks (784 per country) using the questionnaire Cuestionario de Continuidad Asistencial Entre Niveles de Atención (CCAENA)©. Patients had at least one chronic condition and had used two levels of care in the 6 months prior to the survey for the same medical condition. Descriptive analysis and multivariable logistic regression were carried out. RESULTS: Although there are notable differences between the networks analysed, the results show that chronic patients perceive significant discontinuities in the exchange of clinical information between primary care and secondary care doctors and in access to secondary care following a referral; as well as, to a lesser degree, regarding clinical coherence across levels. Relational continuity with primary care and secondary care doctors and information transfer are positively associated with care continuity across levels; no individual factor is systematically associated with care continuity. CONCLUSIONS: Main perceived discontinuities relate to information transfer and access to secondary care after a referral. The study indicates the importance of organisational factors to improve chronic patients' quality of care.

Employment and Labor Market Results of the SOPHIE Project: Concepts, Analyses, and Policies.

This article reports evidence gained by the SOPHIE Project regarding employment and labor market-related policies. In the first step, quality of employment and of precarious and informal employment in Europe were conceptualized and defined. Based on these definitions, we analyzed changes in the prevalence and population distribution of key health-affecting characteristics of employment and work between times of economic prosperity and economic crisis in Europe and investigated their impact on health outcomes. Additionally, we examined the effects of several employment and labor market-related policies on factors affecting health equity, including a specific analysis concerning work-related gender equity policies and case studies in different European countries. Our findings show that there is a need to standardize definitions and indicators of (the quality of) employment conditions and improve information systems. This is challenging given the important differences between and within European countries. In our results, low quality of employment and precarious employment is associated with poor mental health. In order to protect the well-being of workers and reduce work-related health inequalities, policies leading to precarious working and employment conditions need to be suspended. Instead, efforts should be made to improve the security and quality of employment for all workers.

Protege, y defiende tu salud también en el trabajo / Protect, and defend your health in the workplace too

No disponible

Safety representatives' views on their interaction with workers in a context of unequal power relations: an exploratory qualitative study in Barcelona (Spain).

BACKGROUND: The interaction between workers and safety representatives (SRs), a factor that determines SRs' effectiveness, is an unexplored issue within occupational health research. METHODS: We undertook a qualitative exploratory interpretative-descriptive study by means of semi-structured interviews with SRs from Barcelona (Spain) to analyze the SRs' perspective on the interaction with workers and its determinants RESULTS: SRs' interaction with workers is mainly limited to information processes and to identifying occupational hazards. Prominent factors determining this interaction are associated with the way SRs understand and carry out their role, the firm sector and size, and workers' fear of dismissal, exacerbated by changes in the labor market and the current economic crisis. CONCLUSIONS: Interaction with workers is influenced by a more prevalent technical-legal view of the SRs' role and by unequal power relations between workers and management. Poor interaction with workers might lead to decreasing SRs' effectiveness.