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PubMed2006

Diversity of the allied health workforce: the unmet challenge.

Although black and Hispanic people together constitute 25% of the American population, they represent only 18% of students enrolled in 4-year colleges and universities. The educational divide further widens within the health professions programs, where < 10% of enrolled students in the allied health professions are black or Hispanic. Health agencies have begun referring to the underrepresentation of minorities in the health professions as a public health crisis. Despite the increased focus that the national government is placing on underrepresented minorities, there has been little to no increase in the number of minorities enrolled in health professions programs. This report examines the roles of educational institutions, accrediting organizations, and the government in addressing diversification of the health workforce. The authors challenge stereotypes that reinforce the belief that the predominant reason for low enrollment by underrepresented minorities is inadequate numbers of qualified minorities.

Accreditation↗

PubMed2006

Dietary intakes by different markers of socioeconomic status: results of a New Zealand workforce survey.

AIM: To compare dietary nutrient and food group intakes of men and women in a work force with various measures of socioeconomic status. METHODS: Daily nutrient intakes were calculated from a self-administered food frequency questionnaire from participants in a cross-sectional health screening survey of a multiracial workforce carried out between May 1988 and April 1990. Participants comprised 5517 Maori, Pacific Island and Other workers (3997 men, 1520 women) aged 40 to 78 years. Socioeconomic measures included the New Zealand Socioeconomic Index (NZSEI), gross household income and level of education. RESULTS: In general, there were trends across socioeconomic status levels with lower NZSEI occupational classes, lower family income, and non-tertiary education groups having lower intakes of dietary fibre, calcium, and alcohol and higher intakes of dietary cholesterol. These were reflected by their lower intakes of fruit, vegetables, milk, cheese and wine, and higher intakes of eggs. However, associations were not consistent across all measures of socioeconomic status. CONCLUSIONS: Dietary intakes showed a generally more adverse pattern in the lower socioeconomic strata. NZSEI and education were associated with food group selections, whereas nutrient intakes were associated with income. More money available for food could improve nutrition. Public health programmes to improve nutrition need to be targeted at these groups and be coupled with personal support and structural changes that make "healthy choices the easy choices".

Adult↗

PubMed2005

After-hours care in Canada: analysis of the 2001 National Family Physician Workforce Survey.

OBJECTIVE: To determine family physicians' availability to their general practice patients after hours and to explore the characteristics and determinants of after-hours services. DESIGN: Secondary analysis of the 2001 National Family Physician Workforce Survey. SETTING: Canada. PARTICIPANTS: Canadian family physicians and general practitioners currently in practice (n = 10,553). MAIN OUTCOME MEASURES: Provision of after-hours care, defined as providing care to all practice patients outside of normal office hours. RESULTS: Sixty-two percent of Canadian family physicians reported providing after-hours service. The lowest rates were found in Quebec (34%) and the highest in Alberta and Saskatchewan (88%). Respondents practising in academic and community clinics, offering selective medical services (emergency care, palliative care, housecalls, after-hours care), or living outside of Ontario or Quebec were more likely to provide after-hours care. Women physicians, those practising in walk-in clinics, or physicians primarily paid by fee-for-service were less likely to do so. Urban versus rural location, organization of practice (solo or group), age of physician, country of graduation, and physician satisfaction were not found to significantly affect the likelihood of providing after-hours services. CONCLUSION: Knowledge of these factors can be used to inform policy development for after-hours service arrangements, which is particularly relevant today, given provincial governments' interests in exploring alternative payment plans and primary care reform options.

Adult↗

PubMedDate not supplied

Does a 'shadow workforce' of inactive nurses exist?

The entire population of inactive nurses in Vermont was surveyed to determine if a "shadow workforce" exists. The notion that large numbers of nurses are available to return to work is not supported by this study. Desirable benefits for those wishing to return are discussed.

Adult↗

PubMed2006

Blood pressure changes over 7 years in a large workforce cohort in New Zealand.

AIM: The aim of this study was to determine factors associated with changes in blood pressure levels over 7 years. METHODS: The baseline Workforce Diabetes Survey was carried out between 1988 and 1990 on workers predominantly aged =40 years, and a follow-up survey of 4053 participants was carried out between 1995 and 1997. RESULTS: Overall, mean systolic and diastolic blood pressure levels increased by 6.0 (5.2%) and 3.1 (4.9%) mmHg, respectively, between the two surveys. The prevalence of GP-diagnosed raised blood pressure more than doubled over the 7 years--from 16.7% at baseline to 36.4% at follow-up. The two-thirds of participants whose blood pressure increased between the two surveys had on average lower baseline blood pressure levels, and were of shorter stature compared to those whose blood pressure levels showed no change or decreased (all p<0.05). A multivariate regression model of change in blood pressure over the 7 years showed that increase in systolic blood pressure levels was associated with lower baseline blood pressure levels; male gender; higher baseline weight and urinary albumin levels and greater increase in weight and urinary albumin levels over the 7 years; being of lower stature; being a never smoker; having newly or previously diagnosed diabetes; and being on current blood pressure lowering medication. CONCLUSION: The principal modifiable factor associated with increasing blood pressure over the 7 years was higher baseline weight and a greater increase in weight during that time period. This study highlights the importance of prevention of weight gain as a key public health strategy and for managing raised blood pressure, which is one of the major determinants of the burden of CVD in New Zealand.

Adult↗

PubMed2006

Barriers to evidence based practice in accommodations for an aging workforce.

According to a recent Government Accountability Office report, the number of workers over age 55 is projected to increase significantly over the next twenty years, with this demographic group projected to comprise as much as twenty percent of the workforce by 2015 [12]. Accommodating the functional limitations of a large number of older workers may prove challenging for employers; however, policies and practices shaped over the course of the next few decades could allow aging workers to remain a valuable part of the US economy. Given these considerations, it is useful from a public policy perspective to determine the degree to which employers are currently addressing the accommodation needs of older workers. This paper presents the results of a study that attempted to determine the extent to which a sample of Fortune 500 employers was currently accommodating older workers. The study's methodology (in particular, its use of semi-structured telephone interviews) is reevaluated and new options (such as anonymous online employer surveys) are considered for the valid and reliable collection of data on accommodations for older workers.

Aged↗

PubMed2006

Socio-demographic characteristics of the healthcare workforce in England and Wales-- results from the 2001 Census.

Based on Census 2001 data, this article presents analysis of the socio-demographic characteristics of people working in the healthcare sector, focusing particularly on four key healthcare occupations: doctors, dentists, nurses and midwives. Unlike the NHS workforce statistics, which only include people directly employed by the NHS, census data also include those working in the private healthcare market and those who are self-employed. The article als examines patterns of distribution key healthcare professions per head of population by local authority and by area deprivation.

Adolescent↗

PubMed1991

Dentistry--who is in charge? Workforce and training.

The quality of dental schools and of dental education in the 1990s will continue to influence the stature of the workforce and of the profession well into the 21st century. Undergraduate and postgraduate enrollments and related recurrent funding in universities are determined by the Department of Employment, Education and Training which identifies national priority areas, particularly those with export earning potential, for preferential development. Dental schools have not benefited from these initiatives. Political agendas will be increasingly important in altering the emphasis toward education and health in the future, and leaders of the profession must actively seek greater involvement with authorities and committees which are advisory to governments.

Australia↗

PubMed1991

Prevalence of diabetes mellitus and impaired glucose tolerance in a New Zealand multiracial workforce.

A cross sectional survey was carried out among a multiracial workforce of 5677 staff aged 40 to 64 years at worksites in Auckland and Tokoroa to determine the prevalence of diabetes mellitus and impaired glucose tolerance (IGT). The prevalences of diabetes mellitus and IGT were both similar for men and women, but increased with age. The relative risks for diabetes mellitus and for IGT were both inversely associated with gross annual household income, independent of age and ethnicity, being 1.61 (95% Cl = 1.10, 2.37) and 1.80 (95% Cl = 1.21, 2.67) respectively, in the lowest income group (less than $30,000) compared with the highest (greater than $40,000). Compared with Europeans, the relative risk of diabetes mellitus was significantly increased among Maori (3.63; 95% Cl = 2.48, 5.32), Pacific Islanders (2.34; 95% Cl = 1.50, 3.66) and Asians (5.97; 95% Cl = 2.61, 13.65), after controlling for age, income and body mass index. The increased prevalence of diabetes mellitus among Maori and Pacific Islanders, but not in Asians, could be partly attributed to their increased levels of obesity compared with Europeans. However, other factors, in addition to obesity, explain the increased diabetes prevalence in nonEuropean groups.

Adult↗

PubMed1990

Prevalence of tendinitis and related disorders of the upper extremity in a manufacturing workforce.

A cross sectional survey of a randomly selected population of 2,261 textile workers form an overall population of 8,539 eligible workers was performed to evaluate the prevalence of tendinitis in related upper extremity disorders. Of the sample, 2,047 respondents (91.3%) participated in a nurse screening history and examination: 1,091 (53%) had no upper extremity symptoms or abnormalities on examination; 959 (47%) with positive findings were examined by trained physicians. Of these, 347 (36.5%) were found to have no abnormality, whereas, 548 (57.3%) workers were assigned a diagnosis. Of these 227 were considered to fall into the categories of tendinitis (n = 69) or related disorders (n = 158). The projected prevalence of tendinitis and related disorders for the overall group was 11.6% (carpal tunnel syndrome 1.1%, epicondylitis 2.0%, tendinitis 3.5%, shoulder condition 2.3%, ganglion 2.3%, neck conditions 4.0%). Tendinitis was less frequent in the older age group and those employed for a longer time. The prevalence of tendinitis was found to be statistically higher in physically demanding job categories. Ninety-four percent of ailments were of mild or moderate severity. Although our study provides prevalence data for these conditions in a large manufacturing workforce across several job categories.

Adult↗

PubMedDate not supplied

The aging workforce: implications for organizations.

Older workers may perform as well as or better than younger workers. Their accumulated knowledge, skills, and experiences, as well as their low absenteeism, turnover, and accident rates, makes them valuable employees. This chapter examines both the positive and negative effects of an aging workforce. A variety of issues regarding demographic trends, ageism, stereotyping of the older worker, appropriate health promotion strategies, elder care, and health care costs are addressed.

Age Factors↗

PubMed1990

Literacy crisis threatens hospital workforce.

If the nursing shortage was the human resource crisis of the 1980s, then the shortage of hospital employees in such areas as housekeeping, security, and data processing promises to be the hospital workforce crisis of the 1990s. In response to troubling demographic trends, some forward-looking hospitals are now in the process of "growing their own" employees by teaching basic literacy skills and exposing neighborhood youths to the hospital work ethic.

Educational Status↗

PubMed1989

Women in the medical workforce, Victoria.

A study of more detailed data on the specialist medical workforce in 1984 reveals a scarcity of female doctors in many specialties. The average hours of work of female doctors increased significantly from 1977 to 1984, thus prompting a warning that the displacement of male undergraduates by females would not make it much easier to absorb the increasing number of graduates.

Female↗

PubMed1995

Preparing the workforce for managed care.

The role of the nurse manager in preparing the workforce for managed care is explored. Traditional and emerging roles of nursing care providers are examined for their current and potential contribution to patient care. Skills and strategies to be developed, and continuing education are identified.

Education, Nursing, Continuing↗

PubMed1993

Planning for the ageing workforce.

A changing and ageing workforce will influence how occupational health services are organised in the future. Lorraine Ashton describes demographic trends affecting the labour market.

Age Factors↗

PubMed1993

Asymptomatic bacteriuria in a multiracial workforce.

Prevalence of asymptomatic bacteriuria was determined in the first morning urine specimens from 5669 people who participated in a health screening survey of a local workforce. Higher age-standardized prevalences were observed in Maori women (18.0%), compared with Pacific Island women (9.8%) and European women (8.7%). Similarly, higher prevalences were observed in Maori men (3.2%), compared with Pacific Island men (0.7%) and European men (1.3%). After controlling for age and gender, the relative risk for asymptomatic bacteriuria in Maori people was estimated to be 2.22 times that for non-Maori people (associated 95% CI: 1.54-3.18). Significant associations of bacteriuria included a past history of myocardial infarction, a past history of kidney disease, absence of tertiary education, and impaired glucose tolerance. The most common pathogens, isolated from a subsample of 1660 participants, were Escherichia coli, 27 cases (50.9%), and Streptococcal sp, 14 cases (26.4%).

Adult↗

PubMed1993

Serum lipid levels in a New Zealand multicultural workforce.

AIMS: To examine ethnic variations in serum lipid levels and to determine whether lipids are related to lifestyle variables in a New Zealand multicultural workforce. METHODS: Fasting blood samples were collected from 5671 employed people for determination of serum total and HDL cholesterol, triglycerides, and LDL cholesterol. Individual exposures over the previous three months to smoking, alcohol, leisure time physical activity were recorded, and weight and height were measured to calculate body mass index (BMI). RESULTS: Maori and Pacific Islanders had lower age-adjusted total and LDL cholesterol levels than Europeans, and these differences were increased by controlling for BMI. In contrast, age-adjusted mean (SE) HDL cholesterol levels were also lower in Maori (men = 1.17 (0.02); women = 1.38 (0.03) mmol/L) and Pacific Islanders (men = 1.17 (0.01); women = 1.30 (0.02) mmol/L) compared with Europeans (men = 1.20 (0.01); women = 1.47 (0.01) mmol/L), but when BMI, smoking and other variables were controlled, levels were significantly higher in Maori and Pacific Islanders. With serum triglycerides, the pattern was not consistent in Maori and Pacific Islanders. Age-adjusted mean levels in Maori (men = 2.25 (0.07) mmol/L; women = 1.53(0.07) mmol/L) were significantly higher (p < 0.05) than in Pacific Islanders (men = 1.82 (0.06); women = 1.34(0.05) mmol/L) of the same sex. After controlling for BMI and other variables, triglyceride levels were also significantly lower in Pacific Islanders than in Europeans and Asians. BMI and smoking were positively associated with total and LDL cholesterol and triglycerides, and negatively with HDL cholesterol, after controlling for alcohol and physical activity. CONCLUSION: Lifestyle risk factors, particularly BMI and smoking, are strongly related to serum levels of all major lipids. Ethnic variations in coronary heart disease mortality rates in New Zealand are more consistent with ethnic variations in triglycerides than with variations in the other serum lipids.

Adult↗

PubMed1993

Hypertension and its treatment in a New Zealand multicultural workforce.

AIMS: To investigate ethnic variations in blood pressure levels and the likelihood of hypertension being treated in a multicultural New Zealand workforce. METHODS: An employed population of 5651 staff aged 40 to 64 years at worksites in Auckland and Tokoroa, who recorded their current prescribed medication, were measured for blood pressure, weight and height. Body mass index (BMI) was calculated. RESULTS: Mean blood pressure levels were higher in men than women, and increased with age and BMI. Compared with Europeans, mean systolic and diastolic blood pressures were higher in Maori (by 5 to 6 mmHg), Pacific Islanders (by 4 to 6 mmHg) and Asians (by 1 to 5 mmHg) after controlling for age and blood pressure treatment. This increase in Maori and Pacific Islanders, compared with Europeans, was approximately halved after also controlling for BMI, but still remained statistically significant (p < 0.05). In contrast, ethnic differences in BMI did not explain any of the blood pressure increase in Asians. In analyses restricted to hypertensive participants, the likelihood of hypertension being treated was higher in women than men (odds ratio (OR) = 3.42; 95% CI 2.13, 5.47), and lower in Maori (OR 0.33; 95% CI 0.19, 0.58), Pacific Islanders (OR 0.27; 95% CI 0.16, 0.47) and Asians (OR 0.29; 95% CI 0.10, 0.86) than Europeans. CONCLUSION: These results suggest that the likelihood of hypertension being treated is related to sex and ethnic group; and that other unknown factors, in addition to increased BMI levels, explain the higher blood pressure levels in Polynesians compared to Europeans.

Adult↗