Most people do not make any connection between unemployment and health. Jobs, unemployment, inflation, recession, and depression are all terms that have to do with the Departments of Labor and Commerce and the discipline of economics. They are, it is thought, separate from health, illness, disease, hospitalization, and the Department of Health, Education, and Welfare. Rarely, it seems, are these two areas connected in public debate, legislative discussions, or executive deliberations. Recently in suggesting solutions, economists, have repeatedly expounded on overall unemployment rates of 7%, 8%, and 9%, and black unemployment rates of 14%, 16%, and 18%. They have intellectualized on inflation, recession, depression, and occasionally, on recovery. All of the high-powered discussions on various economic and labor-market theories somehow seem to avoid the reality of human suffering that is associated with being unemployed. What is the association between unemployment and other sociological problems? What form do these problems take?

Unemployment and health.

Improving Social Needs Intervention Research: Key Questions for Advancing the Field.

Walkability and livability in cities can be enhanced by creating comfortable environments in the streets. The profile of an urban street canyon has a substantial impact on outdoor thermal conditions at pedestrian level. This paper deals with the effect of asymmetrical street canyon profiles, common in the historical centre of Camaguey, Cuba, on outdoor thermal comfort. Temporal-spatial analyses are conducted using the Heliodon2 and the RayMan model, which enable the generation of accurate predictions about solar radiation and thermal conditions of urban spaces, respectively. On these models, urban settings are represented by asymmetrical street canyons with five different height-to-width ratios and four street axis orientations (N-S, NE-SW, E-W, SE-NW). Results are evaluated for daytime hours across the street canyon, by means of the physiologically equivalent temperature (PET index) which allows the evaluation of the bioclimatic conditions of outdoor environments. Our findings revealed that high profiles (facades) located on the east-facing side of N-S streets, on the southeast-facing side of NE-SW streets, on the south-facing side of E-W street, and on the southwest-facing side of SE-NW streets, are recommended to reduce the total number of hours under thermal stress. E-W street canyons are the most thermally stressed ones, with extreme PET values around 36 °C. Deviating from this orientation ameliorates the heat stress with reductions of up to 4 h in summer. For all analysed E-W orientations, only about one fifth of the street can be comfortable, especially for high aspect ratios (H/W > 3). Optimal subzones in the street are next to the north side of the E-W street, northwest side of the NE-SW street, and southwest side of the SE-NW street. Besides, when the highest profile is located on the east side of N-S streets, then the subzone next to the east-facing facade is recommendable for pedestrians. The proposed urban guidelines enable urban planners to create and renovate urban spaces which are more efficient in diminishing pedestrian thermal stress.

Effect of asymmetrical street canyons on pedestrian thermal comfort in warm-humid climate of Cuba

Housing conditions have been an enduring focus for public health activity throughout the modern public health era. However, the nature of the housing and health challenge has changed in response to an evolution in the understanding of the diverse factors influencing public health. Today, the traditional public health emphasis on the type and quality of housing merges with other wider determinants of health. These include the neighbourhood, community, and “place” where a house is located, but also the policies which make access to a healthy house possible and affordable for everyone. Encouragingly, these approaches to policy and action on housing have the potential to contribute to the “triple win” of health and well-being, equity, and environmental sustainability. However, more effective housing policies (and in public health in general) that adopt more systemic approaches to addressing the complex interactions between health, housing, and wider environment are needed. This paper illustrates some of the key components of the housing and health challenge in developed countries, and presents a conceptual model to co-ordinate activities that can deliver the “triple win.” This is achieved by offering a perspective on how to navigate more effectively, inclusively and across sectors when identifying sustainable housing interventions.

https://www.mdpi.com/1660-4601/15/11/2345/pdf

Making the Case for “Whole System” Approaches: Integrating Public Health and Housing

Many scholars have addressed the concept of place-making, yet there is still little formal knowledge about how major societal changes have influenced place-making. The fall of the Berlin Wall in 1989 is an earthshaking event that changed the world, with regard to geopolitics and the internationalisation of our cities and places, thus generating many urban and tourism developments. Therefore, this paper aims to analyse how the term “place-making” has been variously defined and developed as a concept since the time of the fall. Furthermore, it intends to assess whether such analysis can reveal potential competition and synergy for places between tourism and urban developments.,To address these two questions, a systematic quantitative literature review of research published between 1991 and 2016 has been used, providing a 25 years overview that reveals the current trends in the research on this topic and highlights the gaps in the existing literature.,Findings concerns the variety of definitions, demonstrating the complexity of place-making; four emerging topics (place-making and globalisation; participation; conflicts/challenges; and trendy strategies); and a lack of synergy between tourism and urban development regarding place-making.,The major limitation to this research is the language criterion, restricted to English, thus automatically eliminating articles written in any other languages.,This paper can help key stakeholders to re-assess the place-making strategies in light of the findings.,This research demonstrates the emergence of new trends in place-making that need to be addressed to fulfil societal demands and own changes. It can be used as a basis to start reflection and further development for communities and a wide variety of stakeholders.,The originality of this research resides in the 25-year overview that displays gaps and trends around place-making.

Trends and Gaps in Place-making in the context of urban development and tourism: 25 Years of Literature Review

Examining the role of urban street design in enhancing community engagement: A literature review

PURPOSE Employment is a key social determinant of health People who are unemployed typically have worse health than those employed Illness and disability can result in unemployment and be a barrier to regaining employment We combined a systematic review and knowledge synthesis to identify both studies of employment interventions in health care settings and common characteristics of successful interventions METHODS We searched the peer-reviewed literature (1995–2017), and titles and abstracts were screened for inclusion and exclusion criteria by 2 independent reviewers We extracted data on the study setting, participants, intervention, methods, and findings We also conducted a narrative synthesis and iteratively developed a conceptual model to inform future primary care interventions RESULTS Of 6,729 unique citations, 88 articles met our criteria Most articles (89%) focused on people with mental illness The majority of articles (74%) tested interventions that succeeded in helping participants gain employment We identified 5 key features of successful interventions: (1) a multidisciplinary team that communicates regularly and collaborates, (2) a comprehensive package of services, (3) one-on-one and tailored components, (4) a holistic view of health and social needs, and (5) prospective engagement with employers CONCLUSIONS Our findings can inform new interventions that focus on employment as a social determinant of health Although hiring a dedicated employment specialist may not be feasible for most primary care organizations, pathways using existing resources with links to external agencies can be created As precarious work becomes more common, helping patients engage in safe and productive employment could improve health, access to health care, and well-being

https://www.annfammed.org/content/annalsfm/16/5/447.full.pdf

Employment Interventions in Health Settings: A Systematic Review and Synthesis

Background: The COVID-19 pandemic has highlighted the role of personal support workers (PSWs) in health care, as well as their work conditions. Our study aimed to understand the characteristics of the PSW workforce, their work conditions and their job security, as well as to explore the health of PSWs and the impact of precarious employment on their health. Methods: Our community-based participatory action research focused on PSWs in the Greater Toronto Area. We administered an online, cross-sectional survey between June and December 2020 using respondent-driven sampling. Data on sociodemographics, employment precarity, worker empowerment and health status were collected. We assessed the association between precarious employment and health using multivariable logistic regression models. Results: We contacted 739 PSWs, and 664 consented to participate. Overall, 658 (99.1%) completed at least part of the survey. Using data adjusted for our sampling approach, the participants were predominantly Black (76.5%, 95% confidence interval [CI] 68.2%–84.9%), women (90.1%, 95% CI 85.1%–95.1%) and born outside of Canada (97.4%, 95% CI 94.9%–99.9%). Most worked in home care (43.9%, 95% CI 35.2%–52.5%) or long-term care (34.5%, 95% CI 27.4%–42.0%). Although most participants had at least some postsecondary education (unadjusted proportion = 83.4%, n = 529), more than half were considered low income (55.1%, 95% CI 46.3%–63.9%). Most participants were precariously employed (86.5%, 95% CI 80.7%–92.4%) and lacked paid sick days (89.5%, 95% CI 85.8%–93.3%) or extended health benefits (74.1%, 95% CI 66.8%–81.4%). Nearly half of the participants described their health as less than very good (46.7%, 95% CI 37.9%–55.5%). Employment precarity was significantly associated with higher risk of depression (odds ratio 1.02, 95% CI 1.01–1.03). Interpretation: Despite being key members of health care teams, most PSWs were precariously employed with low wages that keep them in poverty; the poor work conditions they faced could be detrimental to their physical and mental health. Equitable strategies are needed to provide decent work conditions for PSWs and to improve their health.

Precarious work among personal support workers in the Greater Toronto Area: a respondent-driven sampling study

Applying a human rights lens to mental health and well-being will improve the systems that govern and operate U.S. society. Achieving this requires learning from successful approaches and scaling up the implementation of effective strategies that promote equity by actively addressing determinants and barriers across systems that impede overall health. As a country, the U.S. has shown significant success in innovation but has failed at taking successful programs and initiatives to scale. Having endured over a year of loss in education, social connection, and routines, the COVID-19 pandemic illuminated America's deeply rooted structural inequities that have worsened population mental health and well-being. Integrating mental health into institutions and systems, while recovering and rebuilding, must be at the forefront to provide a path for transformation. Three recommendations are derived from the strategies and initiatives described throughout this article that offer tangible steps for achieving wellbeing as a human right: 1. Embed mental health within and across all systems, and expand its definition across the continuum; 2. Prioritize prevention and health promotion through person-centered and community-driven strategies; and 3. Expand the diversification and training of the mental health workforce across sectors. The inequities addressed in this article are not the products of a global pandemic. Instead, they result from historical oppression, injustice, and inaction, exacerbated by the current context. Embedding a human rights approach to mental health in the United States is fundamental to individual and community well-being. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Centering mental health in society: A human rights approach to well-being for all.

During the height of the COVID-19 pandemic, personal support workers (PSWs) were heralded as healthcare ‘heroes’ as many of them cared for high-risk, vulnerable older populations, and worked in long-term care, which experienced a high number of COVID-19 outbreaks and deaths. While essential to the healthcare workforce, there is little understanding of PSW working conditions during the pandemic. The aim of our study was to examine the working conditions (including job security, work policies, and personal experiences) for PSWs in the Greater Toronto Area during the COVID-19 pandemic from the perspectives of PSWs. This study used a mixed-methods design. From June to December 2020, we conducted a survey of 634 PSWs to understand their working conditions during the COVID-19 pandemic. Semi-structured interviews with 31 survey respondents were conducted from February to May 2021 to understand in greater depth how working conditions were impacting the well-being of PSWs. We found PSWs faced a range of challenges related to COVID-19, including anxiety about contracting COVID-19, reduced work hours, taking leaves of absences, concerns about job security, and losing childcare. While the COVID-19 pandemic highlighted the PSW workforce and their importance to the healthcare system (especially in the long-term care system), pre-existing poor work conditions of insecure jobs with no paid sick days and benefits exacerbated COVID-19–related challenges. Despite these hardships, PSWs were able to rely on their mental resilience and passion for their profession to cope with challenges. Significant changes need to be made to improve PSW working conditions. Better compensation, increased job security, decreased workload burden, and mental health supports are needed.

/pdf/the-working-conditions-for-personal-support-workers-in-the-3owrvqdc.pdf

Nadha Hassen

Papers

Examining the role of urban street design in enhancing community engagement: A literature review

Employment Interventions in Health Settings: A Systematic Review and Synthesis

Precarious work among personal support workers in the Greater Toronto Area: a respondent-driven sampling study

Centering mental health in society: A human rights approach to well-being for all.

The working conditions for personal support workers in the Greater Toronto Area during the COVID-19 pandemic: a mixed-methods study