OBJECTIVE: We sought to examine the independent and interactive effects of common mental health disorders and chronic pain conditions on employment and work outcomes among individuals younger than 65 years of age. METHODS: We analyzed cross-sectional data from the second wave of Healthcare for Communities (HCC2), a household telephone survey of U.S. civilian adults conducted in 2000 to 2001 (N=5328). Common mental disorders were assessed using the short-form versions of the World Health Organization’s Composite International Diagnostic Interview (CIDI-SF). Chronic pain conditions and labor market outcomes were identified by self report. Logistic and linear regression analysis was used to provide estimates for work impairment based on the presence of a mental health disorder and/or a chronic pain condition. RESULTS: The interaction between presence of a mental health disorder and presence of a chronic pain condition was significantly associated with no work for pay in the past 12 months (OR 2.3 [1.2–4.2]) and number of days of work missed in the past month due to health (regression coefficient 1.5 [0.6]). In stratified analyses, this effect persisted in women but not men. The presence of a mental health disorder or chronic pain condition were each independently associated with limitations in work and any work missed in the past 30 days due to health, although the interaction was not significant. CONCLUSION: Mental health disorders and chronic pain are each associated with work disability. Mental health disorders are more highly associated with some work disability outcomes when accompanied by chronic pain, especially in women.

Background Recent concerns about population growth and its consequences in Sydney and Melbourne have added momentum to the debate on ways to achieve a more even geographic distribution of population. However, there is little contemporary evidence about the impact of regionally-focused immigration policies in delivering positive migrant outcomes and easing pressures in major cities.Aims The aim of this paper is to compare migration, employment and settlement outcomes between permanent and temporary skilled migrants to South Australia (SA) as well as the factors influencing migrants’ decisions to move into and out of the State. Data and methods Data in this paper draws on the South Australian General Skilled Migrant survey of State-sponsored skilled migrants conducted by The University of Adelaide in 2015. Results Lifestyle and employment factors were important in decisions to come to, stay or leave SA. Permanent migrants were more likely to choose SA as a destination because it was perceived as a good place to raise a family, while temporary migrants were more likely to cite employment. Temporary visa holders had relatively poor employment outcomes. Conclusions Temporary and permanent visa holders experienced different settlement and employment outcomes, demonstrating that a more detailed understanding of migrant characteristics and outcomes may be useful in designing and evaluating regionally-focused migration initiatives.

Forty-five patients (50 hands) who had undergone secondary carpal tunnel surgery participated in a telephone questionnaire survey. The mean follow-up time from the second carpal tunnel surgery was 31 months (range, 9-92 mo). Only 24 patients (53%) reported significant improvement in their symptoms. Thirty-nine patients were unemployed workers who had experienced an average time off work of 28.7 months (+/- 4) before their secondary carpal tunnel surgery. Eleven of the 39 previously unemployed workers (28%) returned to work after the secondary carpal tunnel surgery. Factors associated with poor subjective and employment outcome included worker's compensation case involvement (p < 0.003). Occupations associated with repetitive hand movements or vibrating tools were associated with poor employment outcomes (p < 0.006). Although secondary surgery for carpal tunnel syndrome can be effective in relieving symptoms, patients and surgeons must have realistic expectations of the procedure, especially with respect to long-term employment goals.

<h3>Background</h3> Education is recognised as a strong determinant of health. Yet there is increasing concern that health in adolescence may also influence educational attainments and future life chances. We examined...

This study examines employment and educational outcomes for justice-involved adolescents with and without mental health disorders in the Pathways to Desistance study. We examine the patterns of education and employment and the effects of several factors, including the presence of a mental health disorder, on these positive outcomes. Three findings emerge: (a) youth with mental health problems have a relatively high number of other criminogenic risk factors, (b) education and employment patterns do not differ by disorder status, and (c) the presence of a mental health disorder is not independently linked to poorer employment outcomes, but educational achievement is. These analyses provide information needed to target services for these adolescents in the juvenile justice system, who are at high risk for poor educational and employment outcomes. Results indicate a need for increased emphasis on higher levels of academic attainment as a way to promote positive employment outcomes in these youth.

BackgroundEducation is recognised as a strong determinant of health. Yet there is increasing concern that health in adolescence may also influence educational attainments and future life chances. We examined associations...

Many cancer survivors face challenges remaining at work during treatment or returning to work posttreatment. Workplace supports can ease the strain associated with managing the cancer-work interface. Limited research has examined the employment experiences of low-wage earning survivors, who are less likely to have access to workplace supports, overlooking a factor that may influence survivors' employment outcomes. This study assessed differences in employment experiences between working poor (WP) and working nonpoor (WNP) cancer survivors in the United States. Data from the 2011 Medical Expenditure Panel Survey (MEPS) and the 2011 MEPS Experiences with Cancer Survivorship Supplement were analyzed to evaluate differences in workplace supports, cancer-related psychological job distress, productivity, and employment outcomes between WP and WNP cancer survivors. The sample included adults diagnosed with cancer within 5years prior to survey completion and engaged in paid employment since diagnosis. Working poor respondents had income below 200% of the poverty level. Chi-square tests assessed differences between WP (n=57) and WNP (n=164) cancer survivors' demographic, cancer, and employment characteristics; cancer-related psychological job distress; employee productivity; and employment outcome measures. Multiple logistic regression analyses determined the independent association between WP status and these same variables controlling for sociodemographic confounders. Working poor survivors were more likely to take unpaid time off, change from full-time to part-time, to report cancer-related psychological job distress, negative influences on job productivity and employment outcomes, and less likely to have health insurance. In logistic regression analyses, those who took unpaid time off were more likely to be WP; being WP was also associated with poorer employment outcomes, after controlling for sociodemographics differences between WP and WNP. Working poor survivors had fewer workplace supports and poorer employment outcomes than WNP survivors, highlighting important occupational disparities for cancer survivors. Areas for future research are discussed.

Autism spectrum disorder (ASD) is the most commonly diagnosed neurological disorder in children. Adults with ASD have some of the poorest employment outcomes in comparison to others with disabilities. While data in Canada is limited, roughly 25 per cent of Americans living with ASD are employed and no more than six per cent are competitively employed. Most earn less than the national minimum hourly wage, endure extended periods of joblessness and frequently shuffle between positions, further diminishing their prospects. Poor employment outcomes result in lower quality of life and often lead to steep economic costs. Governments are wise to pay attention to the poor employment outcomes as the high numbers of children now diagnosed with ASD will become adults in the future in need of employment opportunities. Improving employment outcomes for those living with ASD is an important policy objective. Work opportunities improve quality of life, economic independence, social integration, and ultimately benefit all. Adults with ASD can succeed with the right supports. Fortunately, there are many emerging policy and program options that demonstrate success. This paper conducts a review of studies and provides policy recommendations based on the literature, to help governments identify appropriate policy options. Some key factors are both those that are unique to the individual and the external supports available; namely school, work, and family. For example, factors that contribute to successful employment for people living with ASD may include IQ, social skills and self-determination, but for all, even for the less advantaged, external assistance from schools, employers and family can help. Inclusive special education programs in high school that offer work experiences are critical as are knowledgeable employers who can provide the right types of accommodation and leadership. In the work environment the use of vocational and rehabilitative supports, from job coaching to technology-mediated training are a few of the work related factors that enhance success. Information in this paper provides policy makers with a way to move forward and enhance the current employment situation for those living with ASD ultimately improving quality of life and economic independence.

The cohort consists of all psychiatric patients (n = 53) admitted for the first time in 1972 from a well-defined catchment area with a population of 582,000 inhabitants aged 15 years and over. Furthermore, they were all registered with the diagnosis schizophrenia in the nation-wide psychiatric register at least once during an observation period from the day of the first admission in 1972 until August 31, 1983. The entire cohort was followed up on average 13 years after their first admission. Poor employment outcome (79%), poor social contact outcome (55%), and poor overall social outcome (76%) characterized the living conditions of the 42 patients alive at follow-up. Good employment outcome was predicted by "born in rural area." Good social contact outcome was predicted by full remission at first discharge and poor outcome by male sex. Good overall social outcome was predicted by "born in rural area" and of marginal significance by high social status at first admission. A comparison of parents' highest social group and patients' social group at follow-up supports previous findings on social drift.

Older adults returning to community settings after incarceration face a number of challenges, including food insecurity, difficulty finding housing, and adverse health outcomes. A number of qualitative studies have suggested poor employment outcomes among formerly incarcerated older adults; however, there have been few quantitative inquiries related to employment outcomes for these older adults. The purpose of this study was to understand associations between history of incarceration and employment outcomes among older adults. We used pooled data from the 2012 and 2014 waves of the Health and Retirement Study to examine associations between history of incarceration and employment outcomes among community-dwelling older adults aged &amp;gt;50 (n=4,985). History of incarceration and employment outcomes were assessed via self-report. While there were no associations between history of incarceration and employment status in the sample, employed older adults with a history of incarceration had more physically demanding jobs and reported more work stress and more work-related discrimination than their counterparts. They also reported less work satisfaction and less supervisor support than never-incarcerated older adults. Gender moderated the association between history of incarceration and several employment outcomes, with associations observed among women but not men. Taken together, our findings suggest that history of incarceration is associated with significant differences in employment outcomes, primarily among women. Future studies should explore factors contributing to poor employment outcomes in order to design interventions that improve outcomes in this population.

There were 9.7 million Native Americans (American Indian, Alaska Native-AI/AN- these acronyms will be used interchangeably with Native Americans throughout the paper) in 2019 comprising 2.9% of the U.S. population. Native American populations have disproportionately higher rates of mental illnesses compared to other racial groups in the U.S. Mental health is a significant public health concern for this population, impacting different areas of their lives including employment. Additionally, Native Americans continue to experience significant disparities in access to Vocational Rehabilitation (VR) services and have poor employment outcomes. However, little is known about the relationships among demographic factors, vocational rehabilitation services, and employment outcomes of Native Americans with mental illness. Consequently, the current study examined how demographic factors and VR services are related to successful employment outcomes for Native American VR clients with mental illnesses using data from the Rehabilitation Services Administration (RSA) program year (2019) Case Service Report (9-11). Both descriptive analysis and data mining approaches were used to answer the research questions. Chi-square Automatic Interaction Detector (CHAID) analysis was used to determine which of the VR services could best predict the successful employment outcome of Native Americans with mental illness. The findings of the data mining approach revealed that among all the vocational rehabilitation services, job placement assistance was the strongest predictor of successful employment among Native American clients with mental illnesses. The second most important service predicting successful employment for those who received job placement assistance was shown to be maintenance. Implications for rehabilitation counselors and future research are discussed.

Former foster youth: Employment outcomes up to age 30

Although there are now over 400 veterans treatment courts (VTCs) in the country, there have been few studies on participant outcomes in functional domains. Using national data on 7931 veterans in the Veterans Affairs (VA) Veterans Justice Outreach program across 115 VA sites who entered a VTC from 2011 to 2015, we examined the housing, employment, income, and criminal justice outcomes of VTC participants; and identified veteran characteristics predictive of outcomes. VTC participants spent an average of nearly a year in the program and 14% experienced a new incarceration. From program admission to exit, 10% more participants were in their own housing, 12% more were receiving VA benefits, but only 1% more were employed. Controlling for background characteristics, a history of incarceration predicted poor criminal justice, housing, and employment outcomes. Participants with property offenses or probation/parole violations and those with substance use disorders were more likely to experience a new incarceration. Participants with more mental health problems were more likely to be receiving VA benefits and less likely to be employed at program exit. Together, these findings highlight the importance of proper substance abuse treatment as well as employment services for VTC participants so that they can benefit from the diversion process.

This study explores non-modifiable risk factors associated with poor post-school competitive employment outcomes for students with disabilities. A classification tree analysis was used with a sample of 2,900 students who were in the second National Longitudinal Transition Study–2 (NLTS2) up to 6 years following school exit to identify groups of youth with poor employment outcomes based on characteristics that are unable to be modified through an intervention. Post-school employment was related to the disability characteristics of the student (disability type, ability to understand what is being said, general health status), family characteristics (yearly income, community setting), and youth characteristics (race).The classification tree analysis identified four groups of students who were at greatest risk for poor outcomes. Future research will be directed toward modifiable variables that mitigate risks for those groups that may potentially lead to school- and home-based interventions.

BackgroundEarly adverse childhood experiences (EACES) such as child maltreatment between the ages of 0 to 3, has significant impact on a child’s cognitive development and behaviour. Negative experiences and even...