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OBJECTIVE: This study aimed to develop a preliminary guide to culturally and contextually relevant indicators to assess community resources in the 14 communities of the Inuit territory of Nunavik, Quebec. METHODS: As part of the Community Component of Qanuilirpitaa? of the 2017 Nunavik Health Survey, data were collected from 354 organizations located across Nunavik. Data were collected via short structured interviews with representatives of the organization. An inductive qualitative analysis was conducted to identify emerging themes describing the contexts that influence organizations, how key informants conceptualized what is a successful resource, and the facilitators and needs to achieving these indicators of success. Inuit partners were involved throughout the project to offer insight and to ascertain its pertinence and validity. RESULTS: Interviews revealed structural and community realities that influenced organizations. Three main indicators were used to describe successes: (1) team efficiency and dynamics; (2) accessibility of the resource; and (3) ability to impact clients and the community. The third indicator was by far the most discussed indicator of success. Participants and leaders offer suggestions as to how to achieve these indicators and advocate for the conditions necessary for organizational sustainability. CONCLUSION: This data-driven framework suggests that the measures of success that are frequently used by funding agencies (e.g., number of people reached, number of activities) may not fully represent the potential of local services in a given community. Indeed, services may be creating job opportunities for Inuit, instilling pride, offering cultural opportunities, and increasing capital (human, economic, health) within the community, all of which are equally important indicators of success that may more adequately further improve the social determinants of health among communities.

RéSUMé: OBJECTIF: Cette étude visait à élaborer un guide préliminaire d'indicateurs culturellement et contextuellement pertinents pour évaluer les ressources communautaires dans les 14 communautés du territoire inuit du Nunavik, au Québec. MéTHODES: Dans le cadre du volet communautaire de Qanuilirpitaa? de l'Enquête sur la santé au Nunavik de 2017, des données ont été recueillies auprès de 354 organisations situées dans tout le Nunavik. Les données ont été collectées via des entretiens courts et structurés avec des représentants de l'organisation. Une analyse qualitative inductive a été menée pour identifier les thèmes émergents décrivant les contextes qui influencent les organisations, la façon dont les informateurs clés ont conceptualisé ce qu'est une ressource réussie, ainsi que les facilitateurs et les besoins pour atteindre ces indicateurs de réussite. Des partenaires inuits ont été impliqués tout au long du projet afin d'offrir leur point de vue et d'en vérifier la pertinence et la validité. RéSULTATS: Les entrevues ont révélé des réalités structurelles et communautaires qui ont influencé les organisations. Trois indicateurs principaux ont été utilisés pour décrire les réussites : 1) l'efficacité et la dynamique de l'équipe; 2) l'accessibilité de la ressource; et 3) la capacité d'avoir un impact sur les clients et la communauté. Le troisième indicateur était de loin le plus discuté des indicateurs de succès. Les participants et les dirigeants offrent des suggestions sur la façon d'atteindre ces indicateurs et plaident en faveur des conditions nécessaires à la durabilité organisationnelle. CONCLUSION: Ce cadre axé sur les données suggère que les mesures de réussite fréquemment utilisées par les organismes de financement (par exemple, le nombre de personnes atteintes, le nombre d'activités) peuvent ne pas représenter pleinement le potentiel des services locaux dans une communauté donnée. En effet, les services peuvent créer des possibilités d'emploi pour les Inuit, susciter la fierté, offrir des possibilités culturelles et accroître le capital (humain, économique, santé) au sein de la communauté, autant d'indicateurs de réussite tout aussi importants qui peuvent contribuer de façon plus adéquate à améliorer les déterminants sociaux de la santé au sein des communautés.

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OBJECTIVES: The COVID-19 pandemic has been an extraordinary moment of uncertainty and rapid transformation. The effects lockdowns had on youths' mental and physical health, as well as the challenges they posed for young peoples' learning, were of great concern. It quickly became clear that government responses to COVID-19, in particular regarding the social determinants of health, were not equally experienced across all social groups. This paper adopts an interdisciplinary lens at the intersection of health and education and uses Max Weber's lifestyle theory to analyze the inequitable experience of the COVID-19 pandemic. We examine most directly social inequities in education during the first wave of COVID-19 and explore long-term effects on youths' educational opportunities, health, and well-being. METHODS: We use focus group materials collected from our Spring 2020 study. This study explored how youth were differentially experiencing the pandemic. Participants included 18 youth between the ages of 13 and 18 (11 girls, 7 boys). Participants were stratified by private and public secondary schools and we ran focus groups in which experiences of the pandemic were discussed. RESULTS: Our results show (1) clear differences in early access to education for youth who attended public and private institutions in Quebec during the COVID-19 pandemic; (2) access to the internet and computers offset learning opportunities for students across Quebec throughout the COVID-19 pandemic; and (3) few of the differences experienced during the pandemic were based on youth's behaviours, or life choices, but rather stemmed from differences in material and structural opportunities, based largely, but not solely, on what type of school the youth attended (public or private). CONCLUSION: The way in which the COVID-19 pandemic was handled by the Quebec education system deepened existing social inequities in education between private and public school attendees. Given the importance of education as one of the main determinants of health, particularly during transition periods such as adolescence, we must ensure that future policies do not repeat past mistakes.

RéSUMé: OBJECTIFS: La pandémie de la COVID-19 a été un moment d'incertitude et de transformation rapide hors du commun, soulevant des questions inédites sur les effets du confinement sur la santé mentale et physique des jeunes ainsi que sur les défis engendrés en termes d'apprentissage chez les jeunes. Il s'est rapidement avéré que les réponses du gouvernement à la COVID-19, en particulier en ce qui concerne les déterminants sociaux de la santé, n'étaient pas vécues de la même manière dans tous les groupes sociaux. Cet article adopte une optique interdisciplinaire à l'intersection de la santé et de l'éducation et utilise la théorie du mode de vie de Max Weber pour analyser l'expérience inéquitable de la pandémie de COVID-19. Nous examinons plus directement les inégalités sociales dans l'éducation pendant la première vague de COVID-19 et explorons les effets à long terme sur la santé et le bien-être des jeunes. MéTHODES: Nous utilisons les données recueillies lors de notre étude du printemps 2020 qui a exploré comment les jeunes vivaient différemment la pandémie. Les participants sont 18 jeunes âgés de 13 à 18 ans (11 filles, 7 garçons). Les participants ont été stratifiés par écoles secondaires privées et publiques et nous avons organisé des groupes de discussion dans lesquels les expériences de la pandémie ont été discutées. RéSULTATS: Nos résultats montrent 1) de nouvelles et profondes inégalités sociales dans le système d'éducation qui ont été créées par les mesures de confinement gouvernementales au Québec et 2) un accès inéquitable aux ressources mobilisées pour s'adapter aux mesures gouvernementales. CONCLUSION: L'étude du cas des inégalités sociales en contexte d'éducation pendant la pandémie offre d'importants apprentissages sur les inégalités sociales en général. Nous concluons cette étude en réfléchissant à l'espace intersectoriel important entre l'éducation et la santé pour les jeunes.

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The increasing mental health inequalities between women and men following the COVID-19 crisis represent a major public health concern. Public health measures to mitigate the pandemic could severely impact populations with high prevalence of mental health problems such as graduate students. We aimed to document the gendered experience of the lockdown and its association with depressive symptoms among graduate students in Quebec. We contrast two hypotheses: whether inequalities in depressive symptoms between women and men could be linked to their differential exposure or vulnerability to work, family and study conditions, with the mediating role of work-to-family interference (WIF) and family-to-work interference (FIW). This observational study used path analysis to test our hypotheses using a cross-sectional data collected from 1,790 graduate students from three universities in Quebec. The exposure hypothesis received more support. Women reported more stress regarding new teaching methods, which was associated directly with more depressive symptoms, and indirectly through WIF. Women were more worried about COVID-19, which was associated with more depressive symptoms, and indirectly through WIF and FIW. However, women reported less FIW and more emotional support, both respectively associated with less depressive symptoms. The policy measures taken after the COVID-19 were not gender-neutral. This study demonstrates the importance of taking the potentially gendered effects of policies into consideration, and points to mitigating actions that can forestall the exacerbation of gendered inequalities in mental health.

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AIM: The aim of this study was to assess the work-related physical demands of long-distance truck drivers employed by a large gas delivery company in Canada. METHODS: A total of 15 truck drivers participated in a data collection that included self-reporting assessments, field observations, and direct measurements to describe daily tasks organization, postural demands, physical workload, and force exertions. RESULTS: Truck drivers' work was characterized by long working days ranging from 9.9 to 15.1 h (mean = 11.4 h), with half (49%) of the total working time spent behind the wheel. The overall workload as measured by relative cardiac strain (18.7% RHR) was found excessive for the long term given the shift duration. Peaks of heart rate in excess of 30 beats per minute above the daily average occurred mainly while operating valves and handling heavy hoses during gas deliveries. The task of delivering gas at a client's site required a moderate work rate on average (8.3 mlO2/kg/min) requiring 24.4% or maximum work capacity on average. CONCLUSION: Based on multiple data sources, this study highlights the risks of over-exertion and of excessive physical fatigue in the truck drivers' work that are coherent with the high prevalence of self-reported musculoskeletal pain in this group of workers.

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AIM: This study assessed the work-related physical demands of short-distance truck drivers employed by a large gas delivery company in Canada. METHODS: A total of 19 truck drivers participated in the data collection, which included a combination of self-reports, field observations and direct measurements to report on the work shift task composition, postures, physical workload, and force exertions. RESULTS: Driving (mean of 43% of daily work shift) and delivering gas cylinders to customers (28%) were the main tasks of the truck drivers. Delivering gas cylinders measured as moderate level work and daily work duration was not excessive with respect to mean cardiac strain for most drivers. However, manual handling and force exertion activities were frequent and deemed unsafe most of the time with respect to existing guidelines on manual materials handling. CONCLUSION: This study documents physical risk factors that are consistent with musculoskeletal pain prevalence reported for short-distance truck drivers.

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AIM: This study investigated and compared the associations between self-reported exposures to individual as well as work-related physical and psychosocial risk factors for musculoskeletal (MS) disorders and the prevalence of MS symptoms in different body areas among short- (P&D) and long-distance (Bulk delivery) truck drivers working for the same large gas delivery company in Canada. METHODS: 123 truck drivers nationwide participated in this questionnaire-based cross-sectional study. Univariate and multivariate logistic regression analyses were performed. RESULTS: 43.1% of drivers reported MS pain in at least one body area over the past 12 months and 26.8% over the past 7 days. Bulk drivers had a significantly higher prevalence of MS pain than P&D drivers for both periods. When P&D and Bulk drivers were pooled together, belonging to the Bulk subgroup emerged as the strongest factor for low back pain (OR = 8.45, p = 0.002), for shoulder pain (OR = 3.70, p = 0.027) and for MS pain in any body area (OR = 4.05, p = 0.006). In Bulk drivers "High effort-reward imbalance" was strongly associated with MS pain in any body area (OR = 6.47, p = 0.01), with shoulder pain (OR = 4.95, p = 0.016), and with low back pain (OR = 4.51, p = 0.02). In P&D drivers MS pain in any body area was strongly associated with "Working with hands above shoulders" (OR = 6.58, p = 0.009) and "Whole-body vibration" (OR = 5.48, p = 0.018), while shoulder pain was strongly associated with "Hand-arm vibration" (OR = 7.27, p = 0.041). CONCLUSIONS: Prevalence of MS pain was higher among industrial gas delivery truck drivers than in the general Quebec male worker population, and higher for Bulk drivers compared to P&D drivers. MS pain in Bulk drivers was mainly associated with psychosocial risk factors and lifestyle; MS pain in P&D drivers was mainly associated with physical risk factors.

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Aim: Burnout is a pervasive mental health problem in the workforce, with mounting evidence suggesting ties with occupational and safety outcomes such as work injuries, critical events and musculoskeletal disorders. While environmental [work and non-work, work-to-family conflict (WFC)] and individual (personality) pathways to burnout are well documented, little is known about how gender comes to influence such associative patterns. The aim of the study consisted in examining gendered pathways to burnout. Methods: Data were derived from the SALVEO study, a cross-sectional study of 2026 workers from 63 workplaces from the province of Québec (Canada). Data were analyzed using multilevel path analysis. Results: Direct effects of gendered pathways were evidenced for work (e.g. decision latitude) and non-work (e.g. child-related strains) environmental pathways, as well as for individual pathways (i.e. internal locus of control). Indirect effects of gendered pathways were also evidenced, with women reporting higher levels of burnout compared to men due to lower levels of decision latitude and of self-esteem, as well as higher levels of WFC. Women also reported lower burnout levels through investing more time into domestic tasks, which could represent a recovery strategy to highly demanding work. WFC further mediated the associations between working hours and burnout, as well as the between irregular work schedules and burnout. These result suggest than men distinctively reported higher levels of burnout due to the specific nature of their work contract negatively impacting on WFC, and incidentally, on their mental health. Conclusion: Study results supported our hypotheses positing that gender distinctively shapes environmental and individual pathways to burnout. OHS prevention efforts striving for better mental health outcomes in the workforce could relevantly be informed by a gendered approach to burnout.

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Objectives The aim of this study consists in describing the nature of mental health comorbidity among workers. Precisely, we seek to examine the presence of concomitant associations between burnout (cynicism, emotional exhaustion, professionnal inefficacy) and psychoactive substance use (heavy episodic drinking, above low-risk drinking guidelines, and psychotropic drug use).Methods The SALVEO study is based on a cross-sectional sample of 1966 workers from the province of Québec, Canada. Latent class analyses were performed in order to identify typical patterns corresponding to distinct forms of mental health comorbidity in the data. Multinomial logistic regressions on latent classes were performed using covariables pertaining to work and non-work domains and workers' individual characteristics.Results Four typical patterns in mental health comorbidity were found: 1- "Severe burnout and psychotropic drug use"; 2- "At risk drinking and cynicism"; 3- "Emotional exhaustion and professional inefficacy"; and 4- "Relatively healthy state". Of all four patterns, the "Severe burnout and psychotropic drug use" pattern presented the highest number of cumulative risks (environmental and individual).Conclusion Comorbidity in mental health is a matter of importance in workplaces from the province of Québec. The severity in the different patterns of mental health comorbidity expressed a cumulative effect of risk factors from the work and non-work domains, as well as individual characteristics.

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OBJECTIVE: The aim of this study was to evaluate the contribution of work, nonwork, and individual factors to self-reported heart disease, and to evaluate gender-related differences over a period of 16 years among Canadian workers aged 40 years and more. METHODS: Using the National Population Health Survey (NPHS, 1994 to 2010), we estimated multilevel logistic regression models (N = 2996). RESULTS: Couple-related strains, being a man, age, hypertension, and body mass index, are associated with an increased risk of heart disease. In analysis stratified by gender, physical demands at work and having high child-related strains were associated with heart disease specifically among women. Psychotropic drug use increased the risk of heart disease only in men. CONCLUSION: Our study suggests that work stressors measured by Statistics Canada NPHS are largely not associated with the risk of heart disease, except in women exposed to physical demands at work.

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OBJECTIVE: Research has shown that employed women are more prone to depression than men, but the pathways linking gender to depression remain poorly understood. The aim of this study was to examine how work and family conditions operated as potentially gendered antecedents of depression. It evaluated more specifically how differences in depressive symptoms in women and men could be explained by their differential vulnerability and exposure to work and family conditions, as well as by the mediating role of work-to-family conflict (WFC) and family-to-work conflict (FWC). METHODS: Data were collected in 2009-2012 from a sample of 1935 employees (48.9% women) nested in 63 workplaces in the province of Quebec (Canada). Data were analyzed with multilevel path analysis models to test for the differential exposure hypothesis, and stratified by gender to test for the differential vulnerability hypothesis. RESULTS: Results supported both hypothesizes, but only WFC played a mediating role between work-family stressors and depression. Regarding the vulnerability hypothesis, WFC was more strongly associated with women depressive symptoms, and the magnitude of the association between family income and WFC was stronger for women. Overall, the differential exposure hypothesis seemed to reach a greater empirical support. After accounting for work and family stressors as well as WFC, differences in depressive symptoms in women and men were no longer significantly, as WFC, working hours, irregular work schedule and skill utilization acted as mediators. WFC associated with higher depressive symptoms and skill utilization with lower depressive symptoms. WFC related to higher working hours and irregular work schedule. Compared to men, women reported higher WFC, but lower working hours, less irregular work schedule and lower skill utilization at work. CONCLUSION: Women's higher rate of depression is intrinsically linked to their different social experiences as shaped by a gendered social structure and gendered organizations.

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OBJECTIVE: This study aimed to evaluate the contribution of work, non-work and individual factors to obesity with regard to gender-related differences, and to clarify the mediating role that psychological distress plays in these dynamics in Canada from 1994 to 2008 using the Canadian National Population Health Survey (NPHS). DESIGN: Longitudinal. SETTINGS: The NPHS is a randomised longitudinal cohort study with biennial interviews of the Canadian adult population from 18 to 64. PARTICIPANTS: 5925 non-obese workers in cycle 1 (49% were women). MEASUREMENTS: Obesity was measured using the body mass index (BMI), with a threshold of BMI >30 kg/m(2). BMI was corrected in accordance with the recommendations of Connor Gorber et al to adjust for gender bias in responses. RESULTS: Of the work characteristics evaluated, only decision authority was associated with obesity for women but not for men. Living as a couple, child-related strains, psychotropic drug use, hypertension, being physically inactive and low psychological distress were obesity risk factors but were not moderated by gender. Overall, psychological distress did not mediate the associations that work factors have on obesity. CONCLUSIONS: Our study suggests that men and women differ little in the extent to which work, non-work and individual factors predict obesity. However, for women, the level of decision authority is associated with a lower obesity risk. In addition, psychological distress did not mediate the contribution of work factors and actually seems, contrary to expectations, to decrease the obesity risk when work, non-work and individual factors are taken into account.

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BACKGROUND: In the past years, cumulative evidence has convincingly demonstrated that the work environment is a critical determinant of workers' mental health. Nevertheless, much less attention has been dedicated towards understanding the pathways through which other pivotal life environments might also concomitantly intervene, along with the work environment, to bring about mental health outcomes in the workforce. The aim of this study consisted in conducting a systematic review examining the relative contribution of non-work determinants to the prediction of workers' mental health in order to bridge that gap in knowledge. METHODS: We searched electronic databases and bibliographies up to 2008 for observational longitudinal studies jointly investigating work and non-work determinants of workers' mental health. A narrative synthesis (MOOSE) was performed to synthesize data and provide an assessment of study conceptual and methodological quality. RESULTS: Thirteen studies were selected for evaluation. Seven of these were of relatively high methodological quality. Assessment of study conceptual quality yielded modest analytical breadth and depth in the ways studies conceptualized the non-work domain as defined by family, network and community/society-level indicators. We found evidence of moderate strength supporting a causal association between social support from the networks and workers' mental health, but insufficient evidence of specific indicator involvement for other analytical levels considered (i.e., family, community/society). CONCLUSIONS: Largely underinvestigated, non-work determinants are important to the prediction of workers' mental health. More longitudinal studies concomitantly investigating work and non-work determinants of workers' mental health are warranted to better inform healthy workplace research, intervention, and policy.

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