Not all hours are equal: could time be a social determinant of health?

Time can be thought of as a resource that people need for good health. Healthy behaviour, accessing health services, working, resting and caring all require time. Like other resources, time is socially shaped, but its relevance to health and health inequality is yet to be established.

Age, gender, social contacts, and psychological distress: findings from the 45 and up study.

Objective: The study examined the relationships between social contact types and psychological distress among mid-older adults.

Method: Self-completed data from 236,490 Australian adults aged 45+ years.

Results: There was a consistent relationship between increased frequency in phone contacts, social visits, and social group contacts and reduced risk of psychological distress adjusted for demographic and health factors.

Psychosocial job adversity and health in Australia: analysis of data from the HILDA Survey.

Objective: This study examines measures of psychosocial job quality developed from the Household Income and Labour Dynamics in Australia (HILDA) Survey, and reports on associations with physical and mental health.

Methods: The study used seven waves of data from the HILDA Survey with 5,548 employed respondents. Longitudinal random-intercept regression models assessed the association of time-varying and between-person measures of psychosocial job quality job adversity with physical and mental health.

The limitations of employment as a tool for social inclusion.

Background: One important component of social inclusion is the improvement of well-being through encouraging participation in employment and work life. However, the ways that employment contributes to wellbeing are complex. This study investigates how poor health status might act as a barrier to gaining good quality work, and how good quality work is an important pre-requisite for positive health outcomes.

Time limits? Reflecting and responding to time barriers for healthy, active living in Australia.

Lack of time is the main reason people say they do not exercise or use public transport, so addressing time barriers is essential to achieving health promotion goals. Our aim was to investigate how time barriers are viewed by the people who develop programs to increase physical activity or use active transport. We studied five interventions and explored the interplay between views and strategies.

Could better jobs improve mental health? A prospective study of change in work conditions and mental health in mid-aged adults.

Objectives: To investigate the extent improvement or deterioration in employee job security, control or workload is associated with a change in mental health.

Design: Self-report panel data (2000, 2004) on mental health (symptoms of depression and generalised anxiety) and job demands, control and insecurity. Changes in exposures and outcomes were calculated by subtracting wave 1 from wave 2 scores.

Job quality and inequality: parents' jobs and children's emotional and behavioural difficulties.

In the context of high and rising rates of parental employment in Australia, we investigated whether poor quality jobs (without security, control, flexibility or paid family leave) could pose a health risk to employed parents' children. We examined the extent to which both mothers' and fathers' jobs matter, and whether disadvantaged children are more vulnerable than others. Multiple regression modelling was used to analyse cross-sectional data for 2004 from the Growing Up in Australia study, a nationally representative sample of 4-5 year old children and their families (N = 2373 employed mothers; 3026 employed fathers).

Do working mothers raise couch potato kids? Maternal employment and children's lifestyle behaviours and weight in early childhood.

Alarm about the increasing prevalence of childhood obesity has focussed attention on individual lifestyle behaviours that may contribute to unhealthy weight. More distal predictors such as maternal employment may also be implicated since working mothers have less time to supervise children's daily activities. The research reported here used two waves of data from the Longitudinal Study of Australian Children to investigate whether mothers' hours in paid work shape young children's television viewing, snacking and physical activity, and through those lifestyle behaviours, children's weight at ages 4-5 years and 6-7 years.

Fluctuating awareness of treatment goals among patients and their caregivers: a longitudinal study of a dynamic process.

Background: Because increasing numbers of people now survive for months or years with advanced cancer, communication between patients, service providers, and family caregivers often continues over long periods. Hence, understanding of the goals of medical treatment may develop and change as time elapses and disease progresses. This understanding is closely related to the "awareness of dying," which has been studied in both qualitative and quantitative research.

Work demands, job insecurity and sickness absence from work. how productive is the new, flexible labour force?

Background: We investigate one aspect of productivity--sickness absence--and ask whether job insecurity and high work demands are associated with increased sickness absence and, if so, whether mental or physical health mediates this association. We further investigate if having control at work modifies these associations.

Methods: We used cross-sectional survey data from 2,248 employees aged 40-44 years living in two cities of south-eastern Australia.

Does gender modify associations between self rated health and the social and economic characteristics of local environments?

Objectives: To examine whether area level socioeconomic disadvantage and social capital have different relations with women's and men's self rated health.

Methods: The study used data from 15 112 respondents to the 1998 Tasmanian (Australia) healthy communities study (60% response rate) nested within 41 statistical local areas. Gender stratified analyses were conducted of the associations between the index of relative socioeconomic disadvantage (IRSD) and social capital (neighbourhood integration, neighbourhood alienation, neighbourhood safety, political participation, social trust, trust in institutions) and individual level self rated health using multilevel logistic regression analysis before (age only) and after adjustment for individual level confounders (marital status, indigenous status, income, education, occupation, smoking).

The lesser evil: bad jobs or unemployment? A survey of mid-aged Australians.

Paid work is related to health in complex ways, posing both risks and benefits. Unemployment is associated with poor health, but some jobs may still be worse than no job at all. This research investigates that possibility.

Impact of saliva collection methods on sIgA and cortisol assays and acceptability to participants.

In community-based studies of stress and immunity, saliva samples offer a non-intrusive way of gathering biological data. Cotton-based devices are widely used in cortisol research, but some may affect assay results. We compared assay reliability and perceived acceptability of three saliva collection methods: passive, cotton 'salivettes' and cellulose-cotton tip 'eyespears'.

The health effects of jobs: status, working conditions, or both?

Background: This study investigates whether the association of job strain and insecurity with health differs by status.

Methods: A cross-sectional study of 2,249 employed workers aged 40-44 years conducted in two regions in south-east Australia in 2000 used a self-completed questionnaire to collect data. Multivariate analyses were used to compare depression, anxiety, physical health and general practitioner (GP) visits over 12 months across categories of job strain and insecurity for three status groups (high, middle and low).

Job strain, job insecurity, and health: rethinking the relationship.

Job strain (high demands and low control) is a widely used measure of work stress. The authors introduce a new way of looking at work stress by combining job strain with job insecurity, a combination increasingly prevalent in contemporary economies, using data from a cross-sectional survey (N = 1,188) of mid-aged Australian managers and professionals. Those reporting both strain and insecurity showed markedly higher odds for mental and physical health problems (depression: odds ratio [OR] 13.

The impact of employee level and work stress on mental health and GP service use: an analysis of a sample of Australian government employees.

Background: This study sought to identify the extent to which employee level and work stressors were associated with mental health problems experienced by Australian government employees, and with their use of primary care services.

Methods: 806 government employees aged between 40 and 44 years were surveyed as part of an epidemiological study conducted in Australia. Data collected from participants included sociodemographic attributes, physical health, psychological measures and work stressors relating to job control, job demands, job security and skills discretion at work.

Around-the-clock: parent work schedules and children's well-being in a 24-h economy.

Family life in developed economies has undergone a fundamental change--shifting from single-breadwinner households (typical of the post war decades) to families where both parents are employed. Equally dramatic has been the emergence of around-the-clock economies, altering the way work is organised, especially working time. Many more children now live in households where one or both parents work non-standard hours (evenings, nights or on weekends).

Controlling diabetes, controlling diabetics: moral language in the management of diabetes type 2.

Contemporary management of diabetes places heavy emphasis on control, particularly control of blood sugars and of food consumption. Interviews with people living with diabetes type 2 show how identity and social relationships are negotiated through what is often a contradictory language of control, surveillance, discipline and responsibility. People frequently discuss diabetes-related behaviour in terms that position themselves or others as disobedient children, or as wicked or foolish adults.

General practitioner management of intimate partner abuse and the whole family: qualitative study.

Objective: To explore management by general practitioners of victimised female patients, male partners who abuse, and children in the family.

Design: Triangulated qualitative study comparing doctors' reported management with current recommendations in the literature.

Participants: 28 general practitioners attending continuing medical education about management of domestic violence.

Big yellow taxi, or, unhealthy terms of trade?

International trade agreements, including the General Agreement on Trade in Services, are central elements of globalization. These agreements are likely to have significant implications for population health in rich nations such as Australia as well as in the developing world. But the technical language of the legal agreements and the comparative secrecy of the negotiations and approval procedures make it difficult for most people to be adequately informed about them.

Familiarity breeds neglect? Unanticipated benefits of discontinuous primary care.

Background: Continuity of medical care is generally considered to be beneficial to patients.

Objective: The aim of this study was to investigate the possibility that familiarity with patients may sometimes discourage case finding.

Methods: Extensive qualitative interviews were carried out with a sample of Australian adults with type 2 diabetes, focusing in particular on their experience of diagnosis.

Family caregiver knowledge of treatment intent in a longitudinal study of patients with advanced cancer.

Goals Of Work: Caregivers have become part of a triad of care and frequently attend patient consultations in the ambulatory cancer setting. Effective caregiving and decision making require that they understand the course of the disease and the changing treatment goals. This study sought to evaluate caregiver perception of treatment intent.

The health of the Australian workforce: 1998-2001.

Objective: To describe the health of the Australian workforce in relation to occupational status.

Methods: Data on 9,167 workers, collected between 1998 and 2001, were obtained from the Campbell National Health Monitor, a cross-sectional national, health survey. Professional, white-collar and blue-collar workers were compared on five health outcomes: self-rated health, long-and short-term conditions, reduced activity days and work absences.