The Institute for Work & Health (IWH) is an independent, not-for-profit research organization based in Toronto, Canada. Its mission is to “promote, protect and improve the safety and health of working people by conducting actionable research that is valued by employers, workers, and policy-makers.
BACKGROUND AND OBJECTIVES:Hiding personal information from others can come at a negative psychological cost. Yet studies on workplace disclosure of a chronic or episodic disability have not differentiated between decisions not to disclose information vs actively hiding information. We examined differences in decisions around nondisclosure and active hiding of health information, and factors associated with these decisions, including workplace support and job impacts. METHODS:An online, cross-sectional survey asked workers with physical and mental health/cognitive conditions creating job limitations (disability) about disclosing and hiding health information from a supervisor. Relationships between disclosure/nondisclosure and hiding/not hiding and their associations with demographic and work context factors, perceptions of disclosure decisions, workplace support, and job outcomes were examined in multinomial regression analyses. RESULTS:Participants were 695 workers (51% men) with physical (40%), mental health/cognitive (25%), or both types of conditions (35%). Participants hiding health information (disclosure-hiding 20.9%; no disclosure-hiding 24.0%) were more likely to have mental health/cognitive conditions, avoidance goals, negative workplace perceptions, and report challenges in decision making than those not hiding information (disclosure-no hiding 37.5%; no disclosure-no hiding 17.6%). Those who had disclosed reported more workplace support, but those in the disclosure-hiding group reported more absenteeism, worse productivity, and more job disruptions. CONCLUSIONS:The findings underscore the complexity of working with a disability and that many workers report hiding information from their supervisor. Understanding reasons for nondisclosure and hiding, and its implications, has the potential to improve workplace support provision for workers with disabilities and improve work inclusivity and sustainability.
Health researchers are increasingly adopting nonprobability sampling strategies in survey studies. However, the participation mechanism in such samples is unknown and estimated target parameters and exposure-outcome associations obtained from nonprobability samples can be biased. Current approaches developed to support statistical inference from nonprobability samples are unable to accommodate more than one reference sample. In this paper, we propose a general framework to address participation bias in nonprobability samples using multiple reference surveys. Previously published methods that use one reference survey are special cases within this framework. We focus primarily on the calibration estimators, another important special case in the proposed framework. These estimators have greater flexibility in situations with limited access to survey microdata and are straightforward for practical implementation. We describe two methods for variance estimation that account for all sources of variability of the proposed estimators: (1) the Taylor linearization method, which provides an analytic formula for the variance estimator, and (2) the leave-one-out jackknife method, a replication estimator. We assess the performance of the various methods through an extensive simulation study, which demonstrated satisfactory performance of the raking ratio calibration estimator in situations with highly dispersed participation probabilities in nonprobability samples and markedly smaller variance estimates for continuous outcomes. Finally, we illustrate the application of these methods using data from a real-world study of working adults in Canada.
OBJECTIVE:To compare the physical and mental health status of workers who experienced work-related COVID-19 infections versus workers with other types of work-related injuries, 18 months after the initial work absence. METHODS:We collected survey data from 1,000 workers with workers' compensation claims between July and October 2022, and examined differences in seven self-reported physical and mental health outcomes. Potential outcome mediation models examined factors associated with observed differences in health outcomes. RESULTS:We observed better self-rated health, physical role function, and less psychological distress among respondents with COVID-19 compared to non-COVID-19 claims. Reporting a disagreement with the workers' compensation agency partially explained these differences. CONCLUSIONS:Despite concern over the long-term health impacts of COVID-19 infections, workers with COVID-19 infections reported similar or better health than those with non-COVID-19 work-related injuries, 18 months later.
BACKGROUND:The impact of presumptive coverage policies for work-related mental health disorders has not been extensively studied to date. Using data from the Association of Workers' Compensation Boards of Canada (AWCBC), our objectives were to describe the evolution of compensated mental health conditions, and to explore the association between the implementation of presumptive coverage and the number of compensated mental health conditions. METHODS:Datasets on mental health lost-time claims (LTCs) were obtained from the AWCBC for 2001-2019. The total number of all-cause LTCs was used as a denominator. Independent variables included presumptive coverage, union coverage, unemployment rate, proportion of service industry workers, proportion of working women, physicians and psychologists per 100,000 inhabitants, and workers' compensation board coverage. Regression and interrupted time series analyses were conducted. RESULTS:Over the study period, mental health LTC accounted for 0.97% of all-cause LTCs: half of the former were PTSD cases. In the multivariate analysis, presumptive coverage policies restricted to PTSD were only positively associated with the proportion of PTSD LTCs (Incidence Rate Ratio, [IRR] = 1.237, 95% CI 1.005-1.521) but not with other mental health LTCs. More lenient policies were positively associated with the proportion of PTSD LTCs (IRR = 1.211, 95% CI [1.025-1.430]), and non-PTSD mental health LTC (IRR = 1.435; 95% CI [1.001-2.058]). CONCLUSIONS:Workers' compensation presumptive coverage policies for mental health conditions have the effect of increasing claim volumes for these conditions. When restricted to coverage of PTSD, the portion of PTSD of all LTC is larger, but there is no documented ripple effect on other mental health conditions.
Against the backdrop of a severe drug toxicity crisis, this study examined socioeconomic inequities in drug poisoning mortality among working-age adults in Canada. We conducted a population-based cohort study using the 2016 Canadian Census Health and Environment Cohort (n = 4,588,745). Census respondents aged 25–64 were linked to mortality records for the period 2016–2021. We used Poisson regression models to estimate rate ratios and rate differences in drug poisoning deaths by education, household income, and employment status. Analyses were conducted separately for women and men, adjusting for various sociodemographic factors. The crude rate of drug poisoning mortality was 8.7 and 17.5 deaths per 100,000 person-years among women and men, respectively. We observed pronounced inequities in drug poisoning mortality according to education, household income, and employment status. For example, among women and men, respectively, rates of drug poisoning mortality were 7.55 (95
