The effect of leaving employment on mental health: testing ‘adaptation’ versus ‘sensitisation’ in a cohort of working-age Australians

Objectives To investigate the ‘adaptation’ versus ‘sensitisation’ hypotheses in relation to mental health and labour market transitions out of employment to determine whether mental health stabilised (adaptation) or worsened (sensitisation) as people experienced one or more periods without work. Methods The Household Income and Labour Dynamics of Australia (HILDA) longitudinal survey was used to investigate the relationship between the number of times a person had been unemployed or had periods out of the labour force (ie, spells without work) and the Mental Component Summary (MCS) of the Short Form 36 (SF-36). Demographic, health and employment related confounders were included in a series of multilevel regression models. Results During 2001–2010, 3362 people shifted into unemployment and 1105 shifted from employment to not in the labour force. Compared with participants who did not shift, there was a 1.64-point decline (95% CI −2.05 to −1.23, p<0.001) in scores of the MCS SF-36 among those who had one spell of unemployment (excluding not in the labour force), and a 2.56-point decline (95% CI −3.93 to −1.19, p<0.001) among those who had two or more spells of unemployment after adjusting for other variables. Findings for shifts from employment to ‘not in the labour force’ were in the same direction; however, effect sizes were smaller. Conclusions These results indicate that multiple spells of unemployment are associated with continued, though small, declines in mental health. Those who leave employment for reasons other than unemployment experience a smaller reduction in mental health.

Area-level unemployment and perceived job insecurity: evidence from a longitudinal survey conducted in the Australian working-age population

Research significance: Job insecurity, the subjective individual anticipation of involuntary job loss, negatively affects employees’ health and their engagement. Although the relationship between job insecurity and health has been extensively studied, job insecurity as an ‘exposure’ has received far less attention, with little known about the upstream determinants of job insecurity in particular. This research sought to identify the relationship between self-rated job insecurity and area-level unemployment using a longitudinal, nationally representative study of Australian households. Methods: Mixed-effect multi-level regression models were used to assess the relationship between area-based unemployment rates and self-reported job insecurity using data from a longitudinal, nationally representative survey running since 2001. Interaction terms were included to test the hypotheses that the relationship between area-level unemployment and job insecurity differed between occupational skill-level groups and by employment arrangement. Marginal effects were computed to visually depict differences in job insecurity across areas with different levels of unemployment. Results: Results indicated that areas with the lowest unemployment rates had significantly lower job insecurity (predicted value 2.74; 95% confidence interval (CI) 2.71–2.78, P < 0.001) than areas with higher unemployment (predicted value 2.81; 95% CI 2.79–2.84, P < 0.001). There was a stronger relationship between area-level unemployment and job insecurity among precariously and fixed-term employed workers than permanent workers. Conclusion: These findings demonstrate the independent influences of prevailing economic conditions, individual- and job-level factors on job insecurity. Persons working on a casual basis or on a fixed-term contract in areas with higher levels of unemployment are more susceptible to feelings of job insecurity than those working permanently.

Intersections between disability, type of impairment, gender and socio-economic disadvantage in a nationally representative sample of 33,101 working aged Australians

Background:People with disabilities are socio-economically disadvantaged and have poorer health than people without disabilities; however, little is known about the way in which disadvantage is patterned by gender and type of impairment.Objectives:1. To describe whether socio-economic circumstances vary according to type of impairment (sensory and speech, intellectual, physical, psychological and acquired brain injury) 2. To compare levels of socio-economic disadvantage for women and men with the same impairment typeMethods:We used a large population-based disability-focused survey of Australians, analysing data from 33,101 participants aged 25 to 64. Indicators of socio-economic disadvantage included education, income, employment, housing vulnerability, and multiple disadvantage. Stratified by impairment type, we estimated: the population weighted prevalence of socio-economic disadvantage; the relative odds of disadvantage compared to people without disabilities; and the relative odds of disadvantage between women and men.Results:With few exceptions, people with disabilities fared worse for every indicator compared to people without disability; those with intellectual and psychological impairments and acquired brain injuries were most disadvantaged. While overall women with disabilities were more disadvantaged than men, the magnitude of the relative differences was lower than the same comparisons between women and men without disabilities, and there were few differences between women and men with the same impairment types.Conclusions:Crude comparisons between people with and without disabilities obscure how disadvantage is patterned according to impairment type and gender. The results emphasise the need to unpack how gender and disability intersect to shape socio-economic disadvantage.

Depression prevention, labour force participation and income of older working aged Australians: a microsimulation economic analysis

Depression has economic consequences not only for the health system, but also for individuals and society. This study aims to quantify the potential economic impact of five-yearly screening for sub-syndromal depression in general practice among Australians aged 45-64 years, followed by a group-based psychological intervention to prevent progression to depression.

Mental health following acquisition of disability in adulthood-the impact of wealth

BACKGROUND: Acquisition of a disability in adulthood has been associated with a reduction in mental health. We tested the hypothesis that low wealth prior to disability acquisition is associated with a greater deterioration in mental health than for people with high wealth. METHODS: We assess whether level of wealth prior to disability acquisition modifies this association using 12 waves of data (2001-2012) from the Household, Income and Labour Dynamics in Australia survey-a population-based cohort study of working-age Australians. Eligible participants reported at least two consecutive waves of disability preceded by at least two consecutive waves without disability (1977 participants, 13,518 observations). Fixed-effects linear regression was conducted with a product term between wealth prior to disability (in tertiles) and disability acquisition with the mental health component score of the SF-36 as the outcome. RESULTS: In models adjusted for time-varying confounders, there was evidence of negative effect measure modification by prior wealth of the association between disability acquisition and mental health (interaction term for lowest wealth tertile: -2.2 points, 95% CI -3.1 points, -1.2, p<0.001); low wealth was associated with a greater decline in mental health following disability acquisition (-3.3 points, 95% CI -4.0, -2.5) than high wealth (-1.1 points, 95% CI -1.7, -0.5). CONCLUSION: The findings suggest that low wealth prior to disability acquisition in adulthood results in a greater deterioration in mental health than among those with high wealth.

The Australian superannuation framework : implications for retirement savings

The provision of retirement income has become a challenge for governments across the world. The population is ageing as a result of lower mortality and fertility rates: this places financial stress on government budgets as welfare spending increases, further compounded by a proportional reduction in working-age taxpayers. The Australian government has introduced a compulsory superannuation charge on employers to assist retirement savings. Even though savings in superannuation have increased significantly over the years, many will still have insufficient savings to fund their retirement. Recent changes to the superannuation framework have emphasised the importance the government places on supporting future generations of Australians in retirement.

Socio-economic inequalities in mortality persist into old age in New Zealand : study of all 65 years plus, 2001-04

A number of studies have explored the relationship between socioeconomic status (SES) and mortality, although these have mostly been based on the working age population, despite the fact that the burden of mortality is highest in older people. Using Poisson regression on linked New Zealand census and mortality data (2001 to 2004, 1.3 million person years) with a comprehensive set of socioeconomic indicators (education, income, car access, housing tenure, neighourhood deprivation) we examined the association of socioeconomic characteristics and older adult mortality (65+ years) in New Zealand. We found that socioeconomic mortality gradients persist into old age. Substantial relative risks of mortality were observed for all socioeconomic factors, except housing tenure. Most relative risk associations decreased in strength with aging (e.g. most deprived compared to least deprived rate ratio for males reducing from 1.40 (95% CI 1.28 to 1.53) for 65-74 year olds to 1.13 (1.00 to 1.28) for 85+ year olds), except for income and education among women where the rate ratios changed little with increasing age. This suggests individual level measures of SES are more closely related to mortality in older women than older men. Comparing across genders, the only statistically significantly different association between men and women was for a weaker association for women for car access.

Academic libraries

Academic libraries are taken to refer here to two particular types of library: university libraries and those libraries which serve the vocational education and training (VET) sector through colleges or institutes of technical and further education (TAFE). (School libraries are dealt with in a separate chapter.) Universities cover undergraduate programs, principally Bachelors degrees, and postgraduate programs such as the Graduate Certificate, Graduate Diploma, Masters degrees and doctoral programs. The main TAFE awards are Certificate, Diploma and Advanced Diploma. Universities are largely funded by national government - the federal Commonwealth Government in Australia's case - although, as elsewhere, an increasing amount of university funding needs to come from non-government sources, particularly research funding. In Australia institutes of TAFE are funded by state and territory governments, although from 2005 the Federal Government began providing funding for the development of technical colleges outside the TAFE sector that would provide vocational education for secondary school age students. This latter development may well be affected by the change in federal government in late 2007.

The mission for academic libraries globally is to support the teaching, learning and (where appropriate) research activities of their parent institutions. In Australia and New Zealand, universities and their libraries have also had a long tradition of reaching out to the community, contributing to the cultural and intellectual life of the nation. Australia has thirty-nine universities; of which thirty-seven are public institutions and two are private. New Zealand has eight universities. The libraries supporting these institutions are diverse, of high quality and innovative. Based on 2005 figures, there are sixty-eight institutions in Australia's VET sector, with over 1,100 campuses, 1.7 million students and some eleven per cent of Australia's working age population accessing TAPE (Oakley & Vaugha 2007: 43).

The role of financial education in retirement planning

Governments in many countries are facing the challenge of providing sufficient retirement incomes for a population that is ageing as a result of lower mortality and fertility rates. An ageing population places considerable financial stress on government budgets as spending on welfare increases, further compounded by a proportional reduction in working-age taxpayers. Exposure to financial education programs can positively influence the retirement planning and savings behaviour of individuals. Research indicates that seminars, written communications and website information are effective methods in communicating financial education. In this study an investigation is conducted into the views of retirement fund members regarding elements of financial education resources made available to them through their retirement fund. Four aspects are investigated, that is, whether there are differences with respect to members’ views between the genders, older and younger members, levels of qualification, and size of superannuation balances. Empirical evidence suggests that gender and age are important factors with females and younger people less likely to utilise educational information and more at risk of not accumulating sufficient funds for retirement.

Suicide by occupation: systematic review and meta-analysis

Background Previous research has shown that those employed in certain occupations, such as doctors and farmers, have an elevated risk of suicide, yet little research has sought to synthesise these findings across working-age populations. Aims To summarise published research in this area through systematic review and meta-analysis. Method Random effects meta-analyses were used to calculate a pooled risk of suicide across occupational skill-level groups. Results Thirty-four studies were included in the meta-analysis. Elementary professions (e.g. labourers and cleaners) were at elevated risk compared with the working-age population (rate ratio (RR) = 1.84, 95% CI 1.46-2.33), followed by machine operators and deck crew (RR = 1.78, 95% CI 1.22-2.60) and agricultural workers (RR = 1.64, 95% CI 1.19-2.28). Results suggested a stepwise gradient in risk, with the lowest skilled occupations being at greater risk of suicide than the highest skill-level group. Conclusions This is the first comprehensive meta-analytical review of suicide and occupation. There is a need for future studies to investigate explanations for the observed skill-level differences, particularly in people employed in lower skill-level groups.

At what age can females consent to sexual activity? A survey of jury-eligible Australians

One suggested reason for the low conviction rates of alleged child sexual abuse offenders relates to the attitudes and beliefs the public hold about such victims; sexual interactions starting at an earlier age; and because the oversexualisation of children and teenagers portrayed in the media may have affected perceptions as to when females are capable ofgiving consent to sexual interactions. A sample of 580 jury-eligible participants completed six implicit questions via an online survey regarding females' capacity to consent. While participants had similar perceptions in response to the type of question asked, there were some differences due to respondent group. When significant differences were observed, women had significantly lower estimates of the age at which female adolescents can make informed decisions about sexual activity than men, as did respondents who had children and were older. Working with children had little impact. The legal implications of these findings are discussed.

Unwanted sexual advances at work: variations by employment arrangement in a sample of working Australians

Objective: We tested the hypothesis that the risk of experiencing unwanted sexual advances at work (UWSA) is greater for precariously-employed workers in comparison to those in permanent or continuing employment. Methods: A cross-sectional population-based telephone survey was conducted in Victoria (66% response rate, N=1,101). Employment arrangements were analysed using eight differentiated categories, as well as a four-category collapsed measure to address small cell sizes. Self-report of unwanted sexual advances at work was modelled using multiple logistic regression in relation to employment arrangement, controlling for gender, age, and occupational skill level. Results: Forty-seven respondents reported UWSA in our sample (4.3%), mainly among women (37 of 47). Risk of UWSA was higher for younger respondents, but did not vary significantly by occupational skill level or education. In comparison to Permanent Full-Time, three employment arrangements were strongly associated with UWSA after adjustment for age, gender, and occupational skill level: Casual Full-Time OR = 7.2 (95% Confidence Interval 1.7-30.2); Fixed-Term Contract OR = 11.4 (95% CI 3.4-38.8); and Own-Account Self-Employed OR = 3.8 (95% CI 1.2-11.7). In analyses of females only, the magnitude of these associations was further increased. Conclusions: Respondents employed in precarious arrangements were more likely to report being exposed to UWSA, even after adjustment for age and gender. Implications: Greater protections from UWSA are likely needed for precariously employed workers.

Psychosocial working conditions in a representative sample of working Australians 2001–2008: an analysis of changes in inequalities over time

Background A number of widely prevalent job stressors have been identified as modifiable risk factors for common mental and physical illnesses such as depression and cardiovascular disease, yet there has been relatively little study of population trends in exposure to job stressors over time. The aims of this paper were to assess: (1) overall time trends in job control and security and (2) whether disparities by sex, age, skill level and employment arrangement were changing over time in the Australian working population. Methods Job control and security were measured in eight annual waves (2000–2008) from the Australian nationally-representative Household Income and Labour Dynamics of Australia panel survey (n=13 188 unique individuals for control and n=13 182 for security). Observed and model-predicted time trends were generated. Models were generated using population-averaged longitudinal linear regression, with year fitted categorically. Changes in disparities over time by sex, age group, skill level and employment arrangement were tested as interactions between each of these stratifying variables and time. Results While significant disparities persisted for disadvantaged compared with advantaged groups, results suggested that inequalities in job control narrowed among young workers compared with older groups and for casual, fixed-term and self-employed compared with permanent workers. A slight narrowing of disparities over time in job security was noted for gender, age, employment arrangement and occupational skill level. Conclusions Despite the favourable findings of small reductions in disparities in job control and security, significant cross-sectional disparities persist. Policy and practice intervention to improve psychosocial working conditions for disadvantaged groups could reduce these persisting disparities and associated illness burdens.

Employment arrangements and mental health in a cohort of working Australians : are transitions from permanent to temporary employment associated with changes in mental health?

We investigated whether being in temporary employment, as compared with permanent employment, was associated with a difference in Short Form 36 mental health and whether transitions from permanent employment to temporary employment were associated with mental health changes. We used fixed-effects regression in a nationally representative Australian sample with 10 waves of data collection (2001–2010). Interactions by age and sex were tested. Two forms of temporary employment were studied: “casual” (no paid leave entitlements or fixed hours) and “fixed-term contract” (a defined employment period plus paid leave). There were no significant mental health differences between temporary employment and permanent employment in standard fixed-effects analyses and no significant interactions by sex or age. For all age groups combined, there were no significant changes in mental health following transitions from stable permanent employment to temporary employment, but there was a significant interaction with age (P = 0.03) for the stable-permanent-to-casual employment transition, because of a small transition-associated improvement in mental health for workers aged 55–64 years (β = 1.61, 95% confidence interval: 0.34, 2.87; 16% of the standard deviation of mental health scores). Our analyses suggest that temporary employment is not harmful to mental health in the Australian context and that it may be beneficial for 55- to 64-year-olds transitioning from stable permanent employment to casual employment.