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ObjectivesTeachers’ mental health, an important asset for society, may be impacted by security or health crises alongside more structural changes. Our primary aim was to assess 2012–2022 trends in depressive symptoms among French teachers compared to similar employees. We further examined concomitant trends in job dissatisfaction.MethodsWithin the ongoing French national CONSTANCES cohort, depressive symptoms were regularly assessed (up to four times between 2012 and 2022) using the Center for Epidemiologic Studies-Depression scale (CES-D, score 0–60). We used mixed models adjusted for sociodemographic factors to estimate mean parameters (95% CI) of CES-D variations between 2012 and 2022 among teachers (n=15 022) compared with other intermediate or managerial/professional occupations (n=21 361). We similarly studied changes in job dissatisfaction (score 1–8) from 2018 (first occurrence in questionnaires) to 2022.ResultsIn 2012, teachers’ CES-D was slightly lower on average compared with that of non-teachers (−0.66 point (−1.19 to −0.12)), but tended to increase more rapidly over the decade, particularly in the years concomitant to the COVID-19 pandemic (+0.14 point/year (0.01 to 0.27)). By 2022, the gap had closed. Job dissatisfaction followed a somewhat different pattern: slightly lower among teachers in 2018, it increased at first more rapidly compared with non-teachers, but then stabilised, in parallel with the waning of the pandemic.ConclusionsOur study highlights unfavourable long-term trends in the mental well-being of French teachers. Although clinical changes at individual levels would be mostly imperceptible, our findings concern a large population of key professionals, suggesting their growing needs for mental health support in the long run.

PurposeTo investigate the relationship between social support at work and burnout among teachers, independent of the teachers’ private social and environmental context.MethodsIn the 2013 “Teachers’ Quality of Life” population-based study (France, n = 2653), burnout symptomatology was assessed using the Maslach Burnout Inventory. The score for each dimension (emotional exhaustion, depersonalization and personal accomplishment) was dichotomized using extreme tertiles. Global score for social support at work, and subscores by source and type were derived from the Karasek Job Content Questionnaire and were categorized into tertiles (low, medium, and high). The private context was appraised through the “social relationships” and “environment” subscales of the short version of the World Health Organization Quality of Life Questionnaire. Associations between social support at work and burnout indicators were evaluated among 2473 teachers with complete data, using logistic regression models adjusted for the private context plus sociodemographic and work-related characteristics.ResultsEight percent of the teachers showed simultaneously high emotional exhaustion, high depersonalization and low personal accomplishment symptoms and were considered as burnout cases. After controlling for the private context, teachers who reported high social support at work were significantly less likely to report burnout [odds ratio (95% confidence interval) high vs. low = 0.62 (0.40, 0.98)]. When distinguishing the source of social support at work, only high social support from supervisors remained significantly associated with a lower risk of burnout [0.43 (0.27, 0.71)].ConclusionsImproving social support at work, especially from a hierarchical point of view, may be an effective target to promote teacher’s well-being.

Background Despite the increasing interest in place effect to explain health inequalities, there is currently no consensus on which kind of area-based socioeconomic measures researchers should use to assess neighborhood socioeconomic position (SEP). The study aimed to evaluate the reliability of different area-based deprivation indices (DIs) in capturing socioeconomic residential conditions of French elderly women cohort. Methods We assessed area-based SEP using 3 DIs: Townsend Index, French European Deprivation Index (FEDI) and French Deprivation index (FDep), among women from E3N ( Etude épidémiologique auprès des femmes de la Mutuelle Générale de l’Education Nationale ). DIs were derived from the 2009 French census at IRIS level (smallest geographical units in France). Educational level was used to evaluate individual-SEP. To evaluate external validity of the 3 DIs, associations between two well-established socially patterned outcomes among French elderly women (smoking and overweight) and SEP, were compared. Odd ratios were computed with generalized estimating equations to control for clustering effects from participants within the same IRIS. Results The analysis was performed among 63,888 women (aged 64, 47% ever smokers and 30% overweight). Substantial agreement was observed between the two French DIs (Kappa coefficient = 0.61) and between Townsend and FEDI (0.74) and fair agreement between Townsend and FDep (0.21). As expected among French elderly women, those with lower educational level were significantly less prone to be ever smoker (Low vs. High; OR [95% CI] = 0.43 [0.40–0.46]) and more prone to being overweight (1.89 [1.77–2.01]) than women higher educated. FDep showed expected associations at area-level for both smoking (most deprived vs. least deprived quintile; 0.77 [0.73–0.81]) and overweight (1.52 [1.44–1.62]). For FEDI opposite associations with smoking (1.13 [1.07–1.19]) and expected association with overweight (1.20 [1.13–1.28]) were observed. Townsend showed opposite associations to those expected for both smoking and overweight (1.51 [1.43–1.59]; 0.93 [0.88–0.99], respectively). Conclusion FDep seemed reliable to capture socioeconomic residential conditions of the E3N women, more educated in average than general French population. Results varied strongly according to the DI with unexpected results for some of them, which suggested the importance to test external validity before studying social disparities in health in specific populations.

ObjectivesAs a human service profession, teaching presents specific risk factors that could be intensified in socially disadvantaged schools and, ultimately, impact the service quality. The aim of the present study was to evaluate the association between school socioeconomic status and teachers’ well-being.DesignPopulation-based postal survey ‘Teachers’ Quality of Life’ (MGEN Foundation for Public Health/French Ministry of Education; 2013). To categorise the school socioeconomic status, we used the ‘Education Priority Area (EPA)’ administrative classification, which is chiefly based on the proportion of underprivileged students and is available for primary and lower secondary state schools.ParticipantsIn-service French teachers randomly selected from among the teaching staff administrative list of the French Ministry of Education after stratification by sex, age and type of school.Outcome measuresIndicators of well-being at work included a question on job satisfaction, job difficulty evolution and the Maslach Burnout Inventory. The short version of the WHO Quality of Life questionnaire was used to evaluate overall well-being. Among primary and lower secondary school teachers, we evaluated cross-sectional associations between school EPA status and indicators of well-being, using logistic or linear regressions stratified by school level and adjusted for sociodemographic and work-related characteristics.ResultsIn the adjusted models, there was no significant difference in work-related well-being between teachers in EPA and non-EPA schools, both in primary school (n=154 vs n=788) and in lower secondary school (n=113 vs n=452). Regarding overall well-being, the only significant differences were seen among primary school teachers, with teachers in EPA schools reporting a worse perception of physical health and living environment than teachers in non-EPA schools.ConclusionUsing a representative sample of French teachers, we did not observe substantial differences in work-related well-being between teachers in EPA and non-EPA schools.

ObjectiveGender inequalities in the workplace persist around the world, often to the detriment of women. In the highly feminized education sector, how is women’s well-being impacted? Our aim was to examine gender differences in teacher job satisfaction and general well-being and their stability across cultures.Material and MethodsBetween February and June 2023, 23,366 teachers from 11 territories across four continents responded online to the 2nd edition of the International Barometer of Education Staff (I-BEST): Argentina (n=1,782), Belgium (n=937), Cameroun (n=421), Canada (outside Québec) (n=765), France (n=9,595), Japan (n=532), Morocco (n=739), Québec (n=1,751), Spain (n=2,723), Switzerland (n=1,597), and United Kingdom (n=2,524). In each of these territories, we evaluated differences between male and female teachers in job satisfaction (score range: 0-9) and subjective well-being (score range: 1-8) using linear regression models adjusted for potential confounders: age, teaching level, household partner and household child(ren). Then, we formally assessed the heterogeneity in gender differences across territories using a meta-analysis approach.ResultsThe percentage of female teachers among the respondents ranged from 58% (Cameroon, Morocco) to 86% (Switzerland). Across territories, results were highly heterogeneous (I-squared>70% for both indicators), with globally a slight trend towards lower levels of general well-being among women, but no definite pattern regarding job satisfaction. More specifically, among French teachers, women scored respectively 0.12[0.04–0.21] and 0.12[0.05–0.19] points higher than men on job satisfaction and general well-being, inversely in Argentina, women scored -0.43[-0.67–-0,19] and -0.39[-0.58–-0.20] points lower respectively. In the other territories studied, no clear pattern emerged regarding gender disparities in teacher well-being.ConclusionsDepending on the territories, well-being levels could be slightly lower or, on the contrary, slightly higher among female teachers compared with their male counterparts. Multilevel analysis including demographic/economic/cultural territory-level indicators could be helpful to better understand this heterogeneity and the gendered differences in well-being across territories.FundingThis research received no external funding.

To highlight effective levers to promote teachers’ wellbeing worldwide, particularly during difficult times such as the COVID-19 pandemic, we investigated work-related factors associated with teacher wellbeing, across borders and cultures. In six countries/territories, we examined the factors that were most consistently and strongly associated with two indicators of wellbeing at work: (i) job satisfaction; and (ii) work/life balance, and three indicators of general wellbeing: (i) subjective health; (ii) mental health; and (iii) life satisfaction. Between May and July 2021, after 18 months of the pandemic, 8000 teachers answered the first edition of the International Barometer of Education Personnel’s Health and Wellbeing (I-BEST): 3646 teachers from France, 2349 from Québec, 1268 from Belgium, 302 from Morocco, 222 from The Gambia, and 215 from Mexico. For each country/territory and each wellbeing indicator, we used a forward stepwise regression procedure to identify important determinants among a carefully selected set of 31 sociodemographic, private, and professional life factors. Aside from healthcare access, the factors most consistently and strongly associated with teacher wellbeing in France, Québec and Belgium (samples whose size were ≥1000) were related to the psychosocial and the organizational dimensions of work, namely: feeling of safety at school, autonomy at work, and the quality of relationships with superiors and quality of relationships with students. In the smaller samples of teachers from the three remaining countries (Morocco, The Gambia and Mexico), exploratory analyses showed that the feeling of safety and autonomy at work were, there too, consistently associated with wellbeing indicators. During the COVID-19 pandemic, the factors most consistently associated with teachers’ wellbeing across countries were related to security and autonomy at work, supporting the importance to consider these aspects in a continuous, structural way at school. Factors associated with teachers’ wellbeing in very different contexts require further cross-cultural study.

Abstract Background Teachers, a large professional group are regularly exposed to disturbing noise at work, particularly at the primary and secondary school levels, with elevated noise peaks that may endanger their hearing. Few studies have assessed auditory consequences of occupational noise exposure among teachers and none using longitudinal data. Methods Within the French national CONSTANCES cohort, Pure Tone Average (PTA) of the better ear was calculated based on air-conduction audiometry test (0.5, 1, 2 and 4 kHz), repeated approximately every five years (up to 3 tests from inclusion) among 14,375 teachers (primary n = 5812, secondary n = 6845, university n = 1718). We used mixed effects models adjusted for socio-demographic factors (age, sex, marital, family status, rural/urban residence, financial difficulties), lifestyle (smoking and body mass index) and health conditions (hypertension, diabetes, and cardiovascular diseases) to estimate mean parameters [95% confidence interval] of PTA changes in decibel Hearing Loss (dB HL) since enrolment, by teaching level (ref=university teachers) as a proxy of noise exposure. Results The study population consisted of 67% female teachers, with an average age of 44.2 years and with PTA of 12.3±7 dB HL. The mean follow-up time between the first and last audiogram was 5.3±1.5 years. Compared with university teachers, both primary and secondary school teachers had significantly poorer hearing at baseline (0.39 dB HL [0.00-0.77], p = 0.05 and 0.48 dB HL [0.12-0.85], p = 0.01 respectively). Additionally, primary school teachers experienced a slightly faster hearing deterioration over time compared to university teachers (0.11 dB HL per year [0.02-0.20], p = 0.01). Conclusions This large prospective study uncovers how primary and secondary school teachers may be particularly at risk of hearing loss. Given its detrimental impact on both ability to teach and quality of life, our results warrants further studies. Key messages • In this prospective study, primary school teachers were at higher risk of hearing loss compared to university teachers. • Better consideration of noise which can impact teachers’ job ability and quality of life is needed.

Short-term exposure to air pollution has adverse effects among patients with asthma, but whether long-term exposure to air pollution is a cause of adult-onset asthma is unclear. We aimed to investigate the association between air pollution and adult onset asthma. Asthma incidence was prospectively assessed in six European cohorts. Exposures studied were annual average concentrations at home addresses for nitrogen oxides assessed for 23,704 participants (including 1,257 incident cases) and particulate matter (PM) assessed for 17,909 participants through ESCAPE land-use regression models and traffic exposure indicators. Meta-analyses of cohort-specific logistic regression on asthma incidence were performed. Models were adjusted for age, sex, overweight, education, and smoking and included city/area within each cohort as a random effect. In this longitudinal analysis, asthma incidence was positively, but not significantly, associated with all exposure metrics, except for PMcoarse. Positive associations of borderline significance were observed for nitrogen dioxide [adjusted odds ratio (OR) = 1.10; 95% CI: 0.99, 1.21 per 10 μg/m3; p = 0.10] and nitrogen oxides (adjusted OR = 1.04; 95% CI: 0.99, 1.08 per 20 μg/m3; p = 0.08). Nonsignificant positive associations were estimated for PM10 (adjusted OR = 1.04; 95% CI: 0.88, 1.23 per 10 μg/m3), PM2.5 (adjusted OR = 1.04; 95% CI: 0.88, 1.23 per 5 μg/m3), PM2.5absorbance (adjusted OR = 1.06; 95% CI: 0.95, 1.19 per 10-5/m), traffic load (adjusted OR = 1.10; 95% CI: 0.93, 1.30 per 4 million vehicles × meters/day on major roads in a 100-m buffer), and traffic intensity (adjusted OR = 1.10; 95% CI: 0.93, 1.30 per 5,000 vehicles/day on the nearest road). A nonsignificant negative association was estimated for PMcoarse (adjusted OR = 0.98; 95% CI: 0.87, 1.14 per 5 μg/m3). Results suggest a deleterious effect of ambient air pollution on asthma incidence in adults. Further research with improved personal-level exposure assessment (vs. residential exposure assessment only) and phenotypic characterization is needed.

Summary Education professionals play a critical role in health education, both as knowledge providers and as role-models. Drawing on the CONSTANCES French cohort (baseline 2012–19) and adjusting for important confounders, we compared education professionals (n = 14 730) with a random sample of non-education sector employees (n = 34 244) on three indicators of high-risk behaviour (at-risk drinking, current smoking, past-year cannabis use) and three indicators of unhealthy lifestyle (low physical activity, poor adherence to nutritional guidelines, overweight/obesity). Among education professionals, we distinguished between teachers (n = 12 820), school principals (n = 372), senior education advisers (n = 189), school health professionals (n = 128) and school service staff (n = 1221). Compared with non-education sector employees with similar demographic and socioeconomic profiles, teachers were less likely to be at-risk drinkers, to smoke, to have used cannabis in the past year and to be overweight/obese. Other non-teaching education professionals were also less involved in high-risk behaviours than non-education employees, but results were more mixed concerning some lifestyle indicators, with certain non-teaching education professional groups showing a higher likelihood of being physically inactive or overweight/obese. In this nationwide French study, our results suggest a window of opportunity to promote school staff health but also indirectly, that of the youth with whom they interact daily. We suggest that school staff should be supported in health matters not only through the provision of health information but also most importantly, through the development of a favourable and supportive environment enabling them to put health knowledge into practice. Lay Summary Education professionals play a crucial role in health education, notably as role-models, since they come into contact with students on a daily basis. Therefore, examining their health behaviours may be instructive. In this nationwide French study, teachers appeared to behave more healthily compared with non-education sector employees in important domains such as alcohol consumption or tobacco use. However, certain non-teaching education professional groups were more likely to be physically inactive or overweight/obese. Our results highlight opportunities for interventions aimed at raising health awareness and empowerment among school staff. A comprehensive health promotion approach integrating our findings would draw less on a vertical or top-down transfer of knowledge and depend more on participation and exchange among school staff, on teachers leading by example, as well as on the development of a supportive school environment.

Teachers’ health is a key factor of any successful education system, but available data are conflicting. To evaluate to what extent teachers’ health could be at risk, we used pre-pandemic data from the CONSTANCES population-based French cohort (inclusion phase: 2012–2019) and compared teachers (n = 12,839) included in the cohort with a random subsample selected among all other employees (n = 32,837) on four self-reported health indicators: perceived general health, depressive symptoms (CES-D scale), functional limitations in the last six months, and persistent neck/back troubles (Nordic questionnaire). We further restricted our comparison group to the State employees (n = 3583), who share more occupational similarities with teachers. Lastly, we focused on teachers and evaluated how their health status might differ across teaching levels (primary, secondary, and higher education). As compared to non-teacher employees, and even after adjusting for important demographic, socioeconomic, lifestyle, and occupational confounders, teachers were less likely to report bad perceived health and depressive symptoms but were more likely to present functional limitations. Trends were similar in the analyses restricted to State employees. Within the teaching population, secondary school teachers were more likely to report depressive symptoms but less frequently declared persistent neck/back troubles than primary school teachers. Our descriptive cross-sectional study based on a probability sampling procedure (secondary use of CONSTANCES inclusion data) did not support the idea that teachers’ health in France was particularly at risk in the pre-pandemic period. Both cross-cultural and longitudinal studies are needed to further gain information on the topic of teachers’ health around the world and to monitor its evolution over time, particularly during crises impacting the education system such as the COVID-19 pandemic.