Persistent staffing shortages in health care driven by years of inadequate funding and deficiencies in human resources planning, which overlooked the impacts of population aging, have converged into a crisis in health care settings. An essential consequence of the widespread and growing staffing shortfalls in health care has been increased pressure on nurses to work longer hours. The present rapid review has two major objectives: (1) to systematically review and synthesize evidence considering the health and human consequences of excessive work hours, work-related fatigue and associated occupational health and safety hazards; and, (2) to identify policies and practices that demonstrate efficacy in managing or mitigating the adverse effects of occupational fatigue. Findings show that shifts lasting longer than 12 h elevate the risk of occupational fatigue, leading to several fatigue-based hazards. Despite governmental restrictions on long work hours and occupational fatigue in safety-critical industries such as transport, aviation, and nuclear sectors, health care remains largely unregulated in this regard. Ensuring safe and high-quality care over the long term requires implementing adequate regulatory supports for work hour limits for nurses. These measures not only improve workplace satisfaction but also enhance patient outcomes, ultimately fostering a healthier and more resilient health care system.

Purpose: The purpose of this study is to compare perspectives on economic empowerment in the context of employment seeking among intimate partner violence (IPV) survivors and service providers specializing in IPV-related trauma. This study addressed the following question is: How do employment-seeking IPV survivors and service providers conceptualize and understand empowerment? Insights into how each group conceives of economic empowerment and its attainment following IPV experiences can help to inform an effective service curriculum that can be used to facilitate optimal employment outcomes among survivors. Methods: A constructivist grounded theory method was used to develop a theoretical framework for conceptualizing how economic empowerment is understood by employment-seeking survivors of IPV, and IPV service providers. Twenty-six participants were recruited (survivors, n = 16; service providers, n = 10) in a large northeastern U.S. city. Interview questions focused on how IPV survivors and service providers identify and conceptualize economic empowerment, and how support services respond to survivors’ needs around empowerment, particularly through help with employment seeking. Results: Data were coded and analyzed following data analysis stages: (a) initial coding; (b) constant comparison; and, (c) focused coding. Three main themes emerged from the narrative data: (1) structural characteristics shape individual experiences and perspectives of empowerment; (2) peer support as an integral component to empowerment; and (3) employment attainment as economic empowerment. Though perspectives on economic empowerment were often aligned, some key differences emerged. Whereas providers tended toward a more restricted, micro-level view of empowerment as primarily an attribute of the individual, survivors were inclined toward a structuralist perspective that considers how individuals’ experiences of empowerment are shaped by broader, institutional-level factors. Conclusions: Findings from this study build on prior research on the experiences of IPV survivors. The focus on experiences of empowerment in the context of employment-seeking can inform work on building more effective support services for survivors that avoid reductionist approaches that could be perceived by survivors as “victim-blaming” by incorporating a sensitivity to empowerment as derived from structural factors that shape individual experience.

Traditional work-related securities that constitute the career-job model of employment have been in steep decline for several decades, affecting workers across industries and occupations. Still, insecure employment remains unequally distributed across the working population according to the major axes of social stratification, namely age, gender, race, and socioeconomic class. This study investigates patterns of exposure to work-related insecurity across the occupational hierarchy and whether these contribute to occupational gradients in health outcomes. Drawing on data from a national panel survey of the Canadian workforce, a multilevel growth curve modeling approach is used to examine the relationship between work-insecurity exposures and workers’ self-rated health trajectories over 5 years. Findings show that work-related insecurity is associated with declines in self-rated health, although the type of insecurity as well as the magnitude, direction, and duration of the effect varies by occupational status-position. The application of pseudo-R ² tests confirmed this study’s central hypothesis that gradients in health outcomes across occupational hierarchies are due, in part, to differences in exposure to work-related insecurity. Going forward, the development of effective health promotion interventions that can modify work-related health gradients, must work toward mitigating the risk of exposure to adverse work circumstances that is systemic to occupational hierarchies.

American Journal of Public Health (AJPH) from the American Public Health Association (APHA) Structural Origin of Health Determinants: Implications for Research and Policy, an article from American Journal of Public Health, Vol 110 Issue 8

American Journal of Public Health (AJPH) from the American Public Health Association (APHA) A Political Economy Lens on Health Inequalities in the 21st Century, an article from American Journal of Public Health, Vol 111 Issue 4

Background: Workplace wellbeing has become a key focus of occupational and public health, with increasing attention to mental health, psychosocial risks, fatigue, and work–life balance. However, limited evidence compares employee and employer perspectives, distinguishes support availability from support use, or examines whether wellbeing is more closely associated with isolated interventions or the broader support environment. Method: Cross-sectional survey data were collected from public-sector employees (N = 1307) and employers (N = 321) in Ontario, Canada. Analyses compared employee and employer ratings of workplace wellbeing dimensions and supports, examined support availability and use, and assessed associations between support use and perceived workplace impact on personal wellbeing using linear regression models. Results: Employees consistently rated workplace wellbeing dimensions and supports as more important and more effective than employers. Several supports were widely available, but availability varied across sectors and did not consistently translate into use, particularly for mental health, psychological health and safety, and fatigue-related supports. Among employees using at least one support, the cumulative number of supports used was positively associated with wellbeing (B = 0.196, p < 0.01), whereas few individual supports demonstrated independent associations. Fatigue management programs showed a consistent positive association across model specifications. Conclusions: Findings suggest that workplace wellbeing is associated with the broader support environment, not only with individual programs. Employee-informed, integrated approaches that improve both access and uptake may strengthen workplace wellbeing; however, causal interpretation is limited by the cross-sectional design.