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Work as a social determinant of health in high-income countries: past, present, and future
This paper, the first in a three-part Series on work and health, provides a narrative review of research into work as a social determinant of health over the past 25 years, the key emerging challenges in this field, and the implications of these challenges for future research. By use of a conceptual framework for work as a social determinant of health, we identified six emerging challenges: (1) the influence of technology on the nature of work in high-income countries, culminating in the sudden shift to telework during the COVID-19 pandemic; (2) the intersectionality of work with gender, sexual orientation, age, race, ethnicity, migrant status, and socioeconomic status as codeterminants of health disparities; (3) the arrival in many Organisation for Economic Co-operation and Development countries of large migrant labour workforces, who are often subject to adverse working conditions and social exclusion; (4) the development of precarious employment as a feature of many national labour markets; (5) the phenomenon of working long and irregular hours with potential health consequences; and (6) the looming threat of climate change's effects on work. We conclude that profound changes in the nature and availability of work over the past few decades have led to widespread new psychosocial and physical exposures that are associated with adverse health outcomes and contribute to increasing disparities in health. These new exposures at work will require novel and creative methods of data collection for monitoring of their potential health impacts to protect the workforce, and for new research into better means of occupational health promotion and protection. There is also an urgent need for a better integration of occupational health within public health, medicine, the life sciences, and the social sciences, with the work environment explicitly conceptualised as a major social determinant of health.
Journal Article
Controlling the obesity pandemic
The ongoing obesity pandemic threatens the health of hundreds of millions globally. However, to date, no country has had much success in limiting its growth, let alone reversing it. This commentary demonstrates the relevance to the obesity pandemic of the public health conceptual framework of epidemiologist Geoffrey Rose, first published as “Sick Individuals and Sick Populations” in 1985. That framework provides a useful way to analyze the pandemic’s prevention and control options, based on the notions of primordial, primary, secondary and tertiary prevention—the full spectrum of “more upstream and more downstream” approaches, each with its pros and cons. Based on an analysis of key studies to date, this commentary argues strongly that only the primordial prevention approach is likely to be successful against the obesity pandemic—but its onerous requirements for society-wide behavioural and cultural change may make that public health struggle a long one.
La pandémie d’obésité en cours menace la santé de centaines de millions de personnes dans le monde. Jusqu’à maintenant toutefois, aucun pays n’a eu beaucoup de succès à en limiter la croissance, et à plus forte raison à l’inverser. Notre commentaire démontre la pertinence, pour la pandémie d’obésité, du cadre conceptuel de santé publique de l’épidémiologiste Geoffrey Rose publié pour la première fois sous le titre de « Sick individuals and sick populations » en 1985. Ce cadre offre un moyen utile d’analyser les options de prévention et de contrôle des pandémies en partant des notions de la prévention primordiale, primaire, secondaire et tertiaire – tout le spectre des approches « d’amont et d’aval », chacune ayant ses avantages et ses inconvénients. Fondé sur une analyse des principales études menées jusqu’à maintenant, notre commentaire soutient fermement que seule l’approche de prévention primordiale est susceptible de fonctionner contre la pandémie d’obésité, mais que les lourds changements comportementaux et culturels que cela nécessiterait à l’échelle de la société risquent de rendre la lutte de la santé publique très longue.
Journal Article
Fighting for credibility : US reputation and international politics
\"When Bashar al-Assad used chemical weapons against his own people in Syria, he clearly crossed President Barack Obama's \"red line.\" At the time, many argued that the president had to bomb in order to protect America's reputation for toughness, and therefore its credibility, abroad; others countered that concerns regarding reputation were overblown, and that reputations are irrelevant for coercive diplomacy. Whether international reputations matter is the question at the heart of Fighting for Credibility. For skeptics, past actions and reputations have no bearing on an adversary's assessment of credibility; power and interests alone determine whether a threat is believed. Using a nuanced and sophisticated theory of rational deterrence, Frank P. Harvey and John Mitton argue the opposite: ignoring reputations sidesteps important factors about how adversaries perceive threats. Focusing on cases of asymmetric US encounters with smaller powers since the end of the Cold War including Bosnia, Kosovo, Iraq, and Syria, Harvey and Mitton reveal that reputations matter for credibility in international politics. This dynamic and deeply documented study successfully brings reputation back to the table of foreign diplomacy.\"-- Provided by publisher.
Book
Entrepreneurship education in TVET institutions and entrepreneurial intentions of female students in Ghana: the social support factor
Technical and vocational education and training (TVET) is increasingly engaging the attention of governments in both developing and developed countries as a mechanism through which skilled graduates are produced for self-employment and for the labour market. This study was undertaken to examine the objective, pedagogy, and assessment procedures of the programme and its effect on entrepreneurial intentions of female students in Ghana, taking into consideration the moderating role of social support systems. The research design used was cross-sectional survey with concurrent mixed methods approach. The sample was 376. A questionnaire and an interview guide were the instruments used for data collection. The quantitative data were analysed using Hayes moderation process analysis while the qualitative data were analysed manually using open coding. The study revealed that entrepreneurship course is able to influence female students' entrepreneurial intentions. Nevertheless, this influence becomes stronger when the students are exposed to social support systems. It is recommended to management of the universities to sustain the course and also periodically review the course by ensuring that it is more practical and need-centred. The government through its agencies can also put in place effective and targeted social support structures that will help starters to take-off with ease.
Journal Article
Extracting Signals of Snowmelt From the Surface Energy Budget at a Rocky Mountain Eddy Covariance Site
Snowmelt is a dominant hydrologic process in mountainous watersheds and western river systems, yet automatic logging of snowpack properties such as depth, density, and internal energy fluxes, especially during melt, is not done at many Rocky Mountain surface flux sites. In this study, we show that springtime variations in the surface energy budget imbalance can be used to estimate snowpack energy fluxes. Using observations from the US‐GLE AmeriFlux site, we demonstrate a data‐driven method to extract springtime energy budget anomalies and show that 83% of this anomaly is explained by the latent heat flux of melting snow when computed at a 6‐hour resolution. Additionally, we demonstrate that our model can explain this latent heat flux while preserving the statistical structure of the energy imbalance observed during the rest of the year. Our findings suggest that analysis of the surface energy budget, when tightly constrained, can reveal latent hydrologic processes, improving confidence in surface energy budget measurements and offering a low‐cost, data‐driven method for estimating snowmelt dynamics at existing flux sites without additional instrumentation.
Journal Article
APOBEC3A regulates transcription from interferon-stimulated response elements
APOBEC3A (A3A) is a cytidine deaminase that inactivates a variety of viruses through introduction of lethal mutations to the viral genome. Additionally, A3A can suppress HIV-1 transcription in a deaminase-independent manner by binding to the long terminal repeat of proviral HIV-1. However, it is unknown whether A3A targets additional host genomic loci for repression. In this study, we found that A3A suppresses gene expression by binding TTTC doublets that are in close proximity to each other. However, one TTTC motif is sufficient for A3A binding. Because TTTC doublets are present in interferon (IFN)-stimulated response elements (ISRE), we hypothesized that A3A may impact IFN-stimulated gene (ISG) expression. After scanning the human genome for TTTC doublet occurrences, we discovered that these motifs are enriched in the proximal promoters of genes associated with antiviral responses and type I IFN (IFN-I) signaling. As a proof of principle, we examined whether A3A can impact ISG15 expression. We found that A3A binding to the ISRE inhibits phosphorylated STAT-1 binding and suppresses ISG15 induction in response to IFN-I treatment. Consistent with these data, our RNA-sequencing analyses indicate that A3A loss results in increased IFN-I–dependent induction of several ISGs. This study revealed that A3A plays an unexpected role in ISG regulation and suggests that A3A contributes to a negative feedback loop during IFN signaling.
Journal Article