Small Business Health Research Articles

"The case for clean indoor air"

In 2004, a Tsunami in South Asia killed more than 180,000 people and the world recoiled in shock and disbelief. In 2005 an earthquake in Pakistan killed close to 100,000 and the world was devastated. These are truly terrible disasters that continue to claim lives, and we are rightly horrified by their scope and scale.

Healthy and Unhealthy Stress Unwinding: Promoting Health in Small Businesses

Workers can relax and unwind from stress through positive behaviors (e.g. exercise, meditation, reading) or substances (alcohol, medication, drugs, or tobacco). This study explored unwinding and prevention training among small business workers (N = 539). Personal and workplace protective factors contributed to greater positive unwinding and less substance unwinding. Employees were randomly assigned to one of two prevention trainings (Team Awareness-SB or Choices in Health Promotion) or a control group. Regression analyses indicated both trainings improved positive unwinding (compared to controls) beyond the effects of protective factors. Positive unwinding is an important resource with potential relevance to small businesses.

APA Advocacy Agenda Focuses on Access Issues

APA Advocacy Agenda Focuses on Access Issues

米国フィットネス産業関連法案の背景と内容分析

In the U.S. the Healthy People policy has been promoted as a core health-related policy. In order to assist Healthy People, some important reports were published from the second half of the 1990s to 2001, such as the Surgeon General Reports in 1996 and 2001, CDC Guidelines for School and Community Programs Promoting Lifelong Physical Activity in 2000, and a report to the President from the Secretary of Health and Human Services and the Secretary of Education, also in 2000. It is clearly described in these reports that not only public resources, but also those from private sectors, should be utilized to implement those policies. The purpose of this paper is to analyze and study the fitness industry activities in the U.S. including: 1) its political activities 2) its lobbing activity partners 3) recent bills supported by the industry. The following are the findings:1) There are two lobbyists working for the industry in Washington. There are four types of fund to assist the political/lobbing activities, such as IHRSA Fund, Independent Club Council (ICC), Industry Leadership Council (ILC) and Political Action Committee (PAC).2) There are three significant lobbing partners. They are the National Coalition for Promoting Physical Activity (NCPPA), Sporting Goods Manufacturers Association (SGMA) and National Federation of Independent Business (NFIB).3) There are three laws in the health-related area. They are the Eating Disorders Awareness, Prevention, and Education Act (HR873), Obesity Prevention Act (HR2227) and Improved Nutrition and Physical Activity (IMPACT) Act (HR716, S1172). In the health insurance area, there are two laws, which are the House Concurrent Resolution 34, Insurance company (HRC34) and Small Business Health Fairness Act (HR660). In the tax-related area, there are twoof them. They are the Workforce Health Improvement Provision (WHIP) (HR1818, S1491) and the Death Tax Repeal Permanency Act (HR8, S169). In aother category, there is one law called the ADA Notification Act (HR728).

A region addresses patient safety

The Pittsburgh Regional Healthcare Initiative (PRHI) is a coalition of 35 hospitals, 4 major insurers, more than 30 major and small-business health care purchasers, dozens of corporate and civic leaders, organized labor, and partnerships with state and federal government all working together to deliver perfect patient care throughout Southwestern Pennsylvania. PRHI believes that in pursuing perfection, many of the challenges facing today's health care delivery system (eg, waste and error in the delivery of care, rising costs, frustration and shortage among clinicians and workers, financial distress, overcapacity, and lack of access to care) will be addressed. PRHI has identified patient safety (nosocomial infections and medication errors) and 5 clinical areas (obstetrics, orthopedic surgery, cardiac surgery, depression, and diabetes) as ideal starting points. In each of these areas of work, PRHI partners have assembled multifacility/multidisciplinary groups charged with defining perfection, establishing region-wide reporting systems, and devising and implementing recommended improvement strategies and interventions. Many design and conceptual elements of the PRHI strategy are adapted from the Toyota Production System and its Pittsburgh derivative, the Alcoa Business System. PRHI is in the proof-of-concept phase of development. (Am J Infect Control 2002;30:248-51.)

The effect of first aid training on objective safety behaviour in Australian small business construction firms

A 24 week experiment was conducted to determine the effect of first aid training on the occupational health and safety behaviour of participants in small business construction firms in Australia. A purposeful sample of 22 small business construction industry participants was identified. A simplified multiple baseline across workplace settings experimental design was used to introduce first aid training to workplace settings on a staggered basis. Objective measurement of occupational health and safety behaviour was conducted, by a researcher directly observing the workplace, before and after participants received first aid training. Individual performance was measured using a 14-item ‘individual safety measure’ (ISM) and global safety performance was measured using a 21-item ‘global site safety measure’ (GSSM). Pre-training and post-training performance scores for each category of safety performance were analysed using paired samples t-tests. The results were mixed. Performance improved in three of the four categories of safety performance measured by both the GSSM and ISM. The statistical significance of these improvements varied between performance categories. The results suggest that first aid training has a positive effect on occupational health and safety behaviour in Australian construction industry small businesses in the categories of personal protective equipment and housekeeping.

Broken Promises: Fraud by Small Business Health Insurers

Broken Promises: Fraud by Small Business Health Insurers

Book Review: Broken Promises: Fraud by Small Business Health Insurers

Book Review: Broken Promises: Fraud by Small Business Health Insurers

Broken promises: fraud by small business health insurers

Broken promises: fraud by small business health insurers

Robert Tillman, Broken Promises: Fraud by Small Business Health Insurers

Robert Tillman, Broken Promises: Fraud by Small Business Health Insurers

Characteristics of work, life and health analyzed in a survey of a hundred thousand employees of small companies and self-employed persons

A study of business performance, life and health in small businesses by means of checklist consisting of 22 items and 66 subitems was done by All Commercial Union Mutual Aids Association from September through November, 1995. We analyzed 8 items related to "health." One representative person in each enterprise answered the questionnaire anonymously. The total number of responders was 97,527. Women comprized 18% of those study. 55% of responders were working in companies with only one or two employees. Compared to the government statistics, this study population was comparable to other industrial divisions with the exception of the engineering and construction industry which was three times as large and the wholesale and retail industry which was one-fourth the size. Workers with longer working hours a day reported lesser amounts of sleep. Those workers complained of uneasiness about their health and tended to work on holidays. They also carried their exhaustion over to the next day and did not have regular health examinations. The larger the decrease in sales compared with the previous year, the more the workers showed anxiety about their health and went to the hospital regularly. There was a strong correlation between the percentage of workers who answered "yes" for long working hours and "yes" percentage for a large decrease in sales. An often heard response was, "A doctor tells you to take a rest, but it's impossible to do so because of the job requirements." Among those who responded, there was a large group who were presently hospitalized.

Small businesses and OH&S advisors

Traditionally occupational health and safety (OH&S) enquiry has viewed the world of work as if it comprised of blue-collar male workers employed on a full-time basis in large organisations. However, to continue to analyze workplace health and safety within the narrow confines of unionized labour situated in large organisations is to ignore the health and safety in non-unionised small businesses. Therefore, this paper challenges existing OH&S research by investigating the compliance experiences of small businesses. The paper also demonstrates that small business employers are becoming increasingly reliant on their accountant to provide a range of compliance advisory services, including OH&S. However, the notion that small accounting firms act as ‘intermediary advisors’ between the OH&S regulatory agencies and the small business sector may influence the way in which regulatory agencies achieve OH&S compliance in small workplaces. Finally, the study reinforces the need for a more flexible approach to OH&S in the small business sector.

STRATEGIC MANAGEMENT AND ENTREPRENEURIAL ORIENTATION IN SICK, MARGINAL, AND HEALTHY SMALL BUSINESSES

ABSTRACT This study examined the perceived importance of Strategic Management tasks and Entrepreneurial Orientation for 239 operators of small businesses in Saskatoon, Saskatchewan, Canada. Both the Strategic Management and Entrepreneurial Orientation constructs were found to differentiate between sick, marginal, and healthy small businesses. However, only two of the eleven individual Strategic Management items were significant, focusing on the operationalization of strategy. On the other hand, five of six Entrepreneurial Orientation items were found to be significant. This suggests that stressing entrepreneurial traits more is better for small business health than further emphasizing strategic management initiatives.

Regional planning in rural Manitoba: a study of the ‘health’ of a prairie region

Regional planning has commonly been concerned with large units at the expense of small, and often treats these areas as more or less homogeneous entities, rather than as regions that might vary internally, in their economic and social well-being. In contrast, this paper discusses a survey of agricultural and small business soundness and vitality, or ‘health’, conducted in the relatively small North Central Plains Region of Manitoba, Canada. It was found that serious problems of agricultural health occur in this area of Manitoba, which make many rural communities less ‘sustainable’, although there are also great variations in potential well-being within the region. In particular, the family farm is still largely dependent upon family labour input, but it is also critically dependent upon outside income sources; without these the farm unit could not function. Small businesses were found, however, to be much healthier and much more optimistic about the future, although many only survived as a result of unpaid family labour and outside employment. In conclusion, we thus have a conundrum. Agricultural health was poor and deteriorating, and yet small business health was quite good and seemed to be improving, despite the fact that the latter has traditionally been dependent upon, and a reflection of, the former. Interestingly, many of the problems of this rural area are similar to those observed in other countries, which suggests that solutions, or at least decision-making towards solutions, could be more universally applied than in the past.

Small-Business Health Insurance: Only The Healthy Need Apply

Several private and public programs and countless proposals have targeted the estimated twenty-two million full-time workers and their dependents who lack health insurance. Most of these programs rely on financial incentives designed to encourage employers to provide health benefits to their employees. Unfortunately, because of existing insurance company underwriting practices, incentive-based programs would miss a significant proportion of uninsured workers. This is particularly true for employees of small businesses, which are more susceptible to these practices. To date, reports of the barriers faced by small businesses have been based largely on anecdotal information about the underwriting practices of health insurance companies. In our study of health insurance benefits in small businesses, undertaken as part of our evaluation of The Robert Wood Johnson Foundation’s (RWJF’s) Health Care for the Uninsured Program, we surveyed health insurance companies and agents. We found strong evidence to support the assertions made by several small-business interest groups that insurance companies routinely use a variety of underwriting techniques to control the amount of financial risk to which they may be exposed in the small-business market. One of the largest companies doing business in this market summarized its underwriting guidelines: “Insurability is determined by many factors, including the nature of the business . . ., and most importantly, the good health of all employees and dependents.” Redlining. Enrollment of high-risk firms is limited through a practice known as redlining, in which specific types of industries are considered ineligible for enrollment, at any premium. Redlined industries include those characterized by an older work force (over age fifty-five) or high employee turnover, those engaged in seasonal work or exposed to hazardous working conditions, those lacking an employer/ employee rela-