Annals of Occupational and Environmental Medicine

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A socioecological framework for research on work and obesity in diverse urban transit operators based on gender, race, and ethnicity: BongKyoo Choi, Peter Schnall, Marnie Dobson, Haiou Yang, Dean Baker, YoungJu Seo; Ann Occup Environ Med 2017;29:15. Published online May 17, 2017; DOI: https://doi.org/10.1186/s40557-017-0171-2

Urban transit (bus and rail) operators, totaling nearly 700,000 persons, are one of the heaviest occupational groups in the United States (US). Little is known about occupational risk factors for weight gain and obesity and their interrelationship with health-related behaviors, particularly among female minority (African Americans and Hispanics) transit operators who are at greater risk for obesity. As a step towards developing successful obesity interventions among urban transit operators, this paper aims to present a new socioecological framework for studying working conditions, chronic strain, health-related behaviors, weight gain/obesity, and obesity disparity in diverse urban transit operators based on gender, race, and ethnicity. Our framework is a synthesis of several different theories and disciplines: the resource-work load model (work stress), occupational ergonomics, the theory of intersectionality, and worksite health promotion. The framework was developed utilizing an extensive literature review, results from our on-going research on obesity, input from focus groups conducted with Los Angeles transit operators as well as interviews and meetings with transit operator stakeholders (management, unions, and worksite transit wellness program), and ride-along observations. Our hypotheses highlighted in the framework (see Fig. 1) are that adverse working conditions, largely characterized as a combination of high demands and low resources, will increase the risk for weight gain/obesity among transit operators directly through chronic strain and hypothalamic dysfunction (hyper-and hypo-activations), and indirectly through health-related behaviors and injuries/chronic severe pain. We also hypothesize that the observed increase in adiposity among female minority operators is due to their greater exposure to adverse occupational and non-occupational conditions that reflect their intersecting social identities of lower social class and being a minority woman in the US. Our proposed framework could greatly facilitate future transit worksite obesity studies by clarifying the complex and important roles of adverse working conditions in the etiology of weight gain/obesity and obesity disparity among transit operators and other working populations.

Citations

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Facilitators and barriers to achieving dietary and physical activity goals: focus group interviews with city bus drivers and counseling dietitians
Yongmin Jo, Suhyeun Cho, Young-Hee Han, Taisun Hyun
Korean Journal of Community Nutrition.2023; 28(5): 376. CrossRef
Primary Prevention of Weight Gain Among New Bus Operators
Ryan Olson, Sean P. M. Rice, Talya N. Bauer, Brad Wipfli, W. Kent Anger, Todd Bodner, Peter Graven, Leah S. Greenspan
Journal of Occupational & Environmental Medicine.2023; 65(2): 128. CrossRef
Bus Operators’ Body Weight Changes During Their First 2 Years of Work
Ryan Olson, Sean P.M. Rice, Layla R. Mansfield, Brad Wipfli, Todd Bodner, W. Kent Anger, Talya N. Bauer
Journal of Occupational & Environmental Medicine.2021; 63(12): 1093. CrossRef
Burden of tobacco, kola nut and alcohol consumption and its association with periodontal disease, potentially malignant lesions and quality of life among bus drivers, Lagos State, Nigeria
Afolabi Oyapero, Oyejoke Oyapero, Aliru Akinleye
Population Medicine.2020;[Epub] CrossRef
Pilot test of an interactive obesity treatment approach among employed adults in a university medical billing office
Rachel G. Tabak, Jaime R. Strickland, Bridget Kirk, Ryan Colvin, Richard I. Stein, Hank Dart, Graham A. Colditz, Ann Marie Dale, Bradley A. Evanoff
Pilot and Feasibility Studies.2020;[Epub] CrossRef
Obesity and Socioeconomic Disparities
Cecilia M. Jevitt
Journal of Perinatal & Neonatal Nursing.2019; 33(2): 126. CrossRef
Complejidad de la expresión de genes asociados a obesidad en el tejido adiposo humano
Alejandra Rodríguez, Carlos Echandía, Adalberto Sánchez, José María Satizábal, Julio César Montoya, Felipe García Vallejo
Revista Med.2019; 26(1): 14. CrossRef
The Key Role of Work in Population Health Inequities
Paul A. Landsbergis, BongKyoo Choi, Marnie Dobson, Grace Sembajwe, Craig Slatin, Linda Delp, C. Eduardo Siqueira, Peter Schnall, Sherry Baron
American Journal of Public Health.2018; 108(3): 296. CrossRef
Work stress and health problems of professional drivers: a hazardous formula for their safety outcomes
Sergio A. Useche, Boris Cendales, Luis Montoro, Cristina Esteban
PeerJ.2018; 6: e6249. CrossRef
Work organization, health, and obesity in urban transit operators: A qualitative study
Marnie Dobson, BongKyoo Choi, Peter L. Schnall
American Journal of Industrial Medicine.2017; 60(11): 991. CrossRef

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Research Article

Participation inequality in the National General Health Examination based on enterprise size: Young Joong Kang, Jong Heun Park, Huisu Eom, Bohwa Choi, Seyoung Lee, Ji-Won Lee, Jun-Pyo Myong; Ann Occup Environ Med 2017;29:3. Published online February 22, 2017; DOI: https://doi.org/10.1186/s40557-017-0159-y

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Background

Health examinations are performed so that diseases can be identified and treated earlier. Several studies have evaluated the determinants of participation in health examinations including cancer screening, but few have evaluated the relationship between the size of the enterprise and their participation in Workers’ General Health Examinations (WGHE). The aim of the present study was to estimate the association of WGHE participation with the size of the enterprise and the type of policyholder.

Methods

The eligible population from 2006 through 2013 was extracted from the National Health Insurance Service (NHIS) database. The population size ranged from 14–17 million. After adjustment for age and gender, multiple logistic regression analysis was performed to estimate the odds ratios of participating in the WGHE (by age group) based on the type of policyholder (reference: public officers) and the size of the enterprise (reference: enterprise size ≥300 employees), respectively.

Results

Workers employed at enterprises with <50 persons were less likely to participate in WGHEs than those employed at enterprises with ≥300 persons. After policyholders were stratified by type (non-office workers vs. public officers), a disparity in the WGHE participation rate was found between the different types of policyholders at enterprises with <50 employees (reference: those employed at enterprises with ≥300 employees); the odds ratios for subjects in their 40s and 50s were 0.2–0.3 for non-office workers vs. 0.8–2.0 for public officers.

Conclusion

Workplace policyholders at small enterprises comprised a vulnerable group less likely to participate in WGHEs. Efforts should be made to raise the WGHE participation rate among the vulnerable employees belonging to small enterprises, as well as among their dependents.

Citations

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Income-based inequality in nationwide general health checkup participation in Japan
A. Shimoda, Y. Saito, C. Ooe, N. Kondo
Public Health.2021; 195: 112. CrossRef
Employment conditions and use of gastric cancer screening services in Korea: a nationwide survey
Hye-Young Shim, Jae Kwan Jun, Ji-Yeon Shin
BMC Public Health.2019;[Epub] CrossRef
Factors Associated with General Health Screening Participation among Married Immigrant Women in Korea
Jinhee Jeong, Yunhee Lee, Sung Hee Kwon, Jun-Pyo Myong
International Journal of Environmental Research and Public Health.2019; 16(20): 3971. CrossRef
Healthcare consumers’ sensitivity to costs: a reflection on behavioural economics from an emerging market
Quan-Hoang Vuong, Tung-Manh Ho, Hong-Kong Nguyen, Thu-Trang Vuong
Palgrave Communications.2018;[Epub] CrossRef
The roles of doctors, nurses, and industrial hygienists in the healthcare management services in Korea: a comparison of the opinions of specialized health management institutions and entrusted enterprises
Bo-Young Jang, Dong-Mug Kang, Young-Ki Kim, Se-Young Kim, Kyung-Sun Ko
Annals of Occupational and Environmental Medicine.2018;[Epub] CrossRef

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Original Article

Comparison of the Self-rated Health Status of Wage Workers in Korea according to Income Index by Gender: Dae Ho Kim, Dong Mug Kang, Jong Eun Kim, Young Ki Kim, Jin Kon Sul, Soon Choy; Korean Journal of Occupational and Environmental Medicine 2011;23(4):360-370. Published online December 31, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.4.360

Abstract PDF

OBJECTIVES
This study aims to find differences that reflect the magnitude of health disparities in wage workers in Korea according to income index(personal income, household income, equivalized income) by gender.
METHODS
Data was obtained from the 11th wave of Korean Labor and Income Panel Survey in 2008. This study analyzed 4,205 subjects(2,570 males and 1,635 females) aged 19-65 years. To compare the health effects of each income index by gender, unconditional multiple logistic regression, health-related behaviors, and working conditions were used. The unconditional multiple logistic regression was adjusted by socio-demographic characteristics. All statistics were estimated using SAS survey procedures.
RESULTS
According to unconditional multiple logistic regression, significant differences in ORs between men and women were observed in this study for those wage workers who self-rated their health status to be poor. This was consistent between each income index. Men had an OR of 1.76 (95% CI, 1.28~2.43) by personal income, 1.70 (95%CI, 1.25~2.32) by household income and 1.69 (95% CI, 1.23~2.31) by equivalized income. Women had an 2.09 (95% CI, 1.47~2.97) by household income and OR of 1.95 (95% CI, 1.36~2.79) by equivalized income, but personal income did not have a significant effect on OR for women.
CONCLUSIONS
The study of occupational and environmental medicine should consider that each income index has different effects on the self-rated health status according to gender. Household income index and equivalized income index would represent a health status for women.

Citations

Citations to this article as recorded by

Working Poverty and Health Disparities in Korean Workers
Jin-Hwa Lee, Bokim Lee
Journal of Korean Academy of Community Health Nursing.2020; 31(4): 514. CrossRef
Job Stress and Mental Health of Female Household Head Workers
Hyung Seon Kim, Min Kwon, Jinhwa Lee
Korean Journal of Occupational Health Nursing.2016; 25(4): 249. CrossRef

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