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The Physical and Psychosocial Health Profile of Transit Employees by Occupational Category in Calgary Alberta University of Calgary PRISM: University of Calgary's Digital Repository Graduate Studies Legacy Theses 2009 The physical and psychosocial health profile of transit employees by occupational category in Calgary Alberta Fry, Michelle Jessica Fry, M. J. (2009). The physical and psychosocial health profile of transit employees by occupational category in Calgary Alberta (Unpublished master's thesis). University of Calgary, Calgary, AB. doi:10.11575/PRISM/15457 http://hdl.handle.net/1880/47235 master thesis University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission. Downloaded from PRISM: https://prism.ucalgary.ca UNIVERSITY OF CALGARY The physical and psychosocial health profile of transit employees by occupational category in Calgary Alberta By Michelle Jessica Fry A THESIS SUBMITTED TO THE FACULTY OF GRADUATE STUDIES IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE FACULTY OF KINESIOLOGY and DEPARTMENT OF COMMUNITY HEALTH SCIENCES CALGARY, ALBERTA May, 2009 © Michelle Jessica Fry 2009 The author of this thesis has granted the University of Calgary a non-exclusive license to reproduce and distribute copies of this thesis to users of the University of Calgary Archives. Copyright remains with the author. Theses and dissertations available in the University of Calgary Institutional Repository are solely for the purpose of private study and research. They may not be copied or reproduced, except as permitted by copyright laws, without written authority of the copyright owner. Any commercial use or publication is strictly prohibited. The original Partial Copyright License attesting to these terms and signed by the author of this thesis may be found in the original print version of the thesis, held by the University of Calgary Archives. The thesis approval page signed by the examining committee may also be found in the original print version of the thesis held in the University of Calgary Archives. Please contact the University of Calgary Archives for further information, E-mail: [email protected] Telephone: (403) 220-7271 Website: http://www.ucalgary.ca/archives/ ABSTRACT The research purpose was to investigate differences in the health profile of employees within Calgary Transit, using data collected through a contracted consulting firm. Specifically, we examined the physical and psychosocial health outcomes and Workers Compensation Board (WCB) rates between employees in three transit departments (maintenance, office, and operators/drivers) and between employees classified as blue versus white collar. Secondary analysis of a cross-sectional dataset was conducted using analysis of variance and t-tests. Overall, 18 differences were detected between department categories. Maintenance workers had the greatest health risk, while office workers had the lowest health risk. This trend was also observed when the departments were collapsed into blue and white collar categories. Despite limitations within the survey design, the overall results resemble the well-known social gradient whereby low socioeconomic status is associated with poorer health status. This research serves as a strong starting point for other Canadian studies to build on. iii ACKNOWLEDGEMENTS Over the course of my graduate program many people have helped me by providing me with assistance and support in the completion of this thesis. First, I would like to thank my supervisor, Dr. Tish Doyle-Baker and my co-supervisor: Dr. Lindsay McLaren for all of their guidance, encouragement and support. Their patient ways of teaching helped me a great deal with this thesis among many other projects. I would also like to thank the members of my committee: Dr. Ken Corbet and Dr. Claudia Emes for their feedback and assistance in this process. In addition, I would like to thank Dr. Jean Wallace for being a part of my examining committee. I would also like to thank Ms. Rosalie Kolstad, facilities Graduate Administrative Assistant for all of her help with applications, advice and encouragement throughout my graduate program. I would also like to recognise Ms. Vicki Stagg from CHS for all of her assistance getting my data set ready for analysis. Foothills Health Consultants also played a large role in my thesis and therefore I would like to thank Ms. Kelly Blackshaw for sharing this data base. I would also like to extend my appreciation to Ms. Wendy Pugh for her assistance in answering my questions regarding the data base. From Calgary Transit, I would like to thank and acknowledge all of the employees who took the time to have a health risk assessment, as well as Mr. Ed DeGroot, Ms. Deborah Todd and Mr. Stephen Hansen for providing me with WCB data reports and subsequent help along the way. I’d also like to thank Ms. Jennie Petersen and Ms. Heather Rowe for all of their help and support through out my graduate program. I would like to acknowledge my primary funding source, Workers Compensation Board of Alberta, for their financial support throughout the course of my graduate program. Last but definitely not least, I would like to thank my parents; Brian and Doreen Fry, my sisters; Kristen and Carolyn, and my fiancé Paul Robertson, for all their support and encouragement throughout my graduate program. iv TABLE OF CONTENTS APPROVAL PAGE…………………………………………………………………………….…ii ABSTRACT……………………………………………………………………………………....iii ACKNOWLEDGEMENTS………………………………………………………………………iv TABLE OF CONTENTS………………………………………………………………………….v LIST OF TABLES………………………………………………………………………….……vii LIST OF FIGURES……………………………………………………………………………….ix CHAPTER 1: INTRODUCTION………………………………………………………………….1 CHAPTER 2: BACKGROUND…………………………………………………………………...3 1. WORKPLACE AS A DETERMINANT OF HEALTH…………………………………………….….3 2. THE WORKPLACE PHYSICAL AND SOCIAL ENVIRONMENT……………………………….…...4 3. THEORIES OF WORK AND HEALTH…………………………………………………………....6 4. HEALTH OUTCOMES…………………………………………. ……………………………...9 5. SOCIOECONOMIC HIERARCHY WITHIN THE WORKPLACE……………………………………13 6. RESEARCH ON SOCIOECONOMIC HIERARCHY IN THE WORKPLACE………………………….15 7. THE PRESENT STUDY……………………………………….……………………………….20 7.1 Specific Objectives…………………………………….…………………………….….20 CHAPTER 3: METHODS………………………………………………………………………..22 1. RESEARCH DESIGN………………………………………………………………………….22 2. STUDY POPULATION………………………………………………………………………...22 3. SAMPLING…………………………………………………………………………………...25 4. DATA SOURCES……………………………………………………………………………..25 4.1 Physical Measures………………………………………………………………….......26 4.2 HRA Questionnaire……………………………………………………………………..26 4.2.1 Quality of the HRA questionnaire………………………………………………..33 4.2.2 Communication of HRA results…………………………………………………..35 4.2.2 Protection of personal information………………………………………………35 4.3 Workers Compensation Board Data…………………………………………………...36 5. DATA ANALYSIS…………………………………………………………………………...37 CHAPTER 4: RESULTS…………………………………………………………………………40 1. DESCRIPTIVE STATISTICS…………………………………………………………………...40 2. NORMALITY/DATA DISTRIBUTION………………………………………………………….44 3. RESULTS OF ANALYSES TO EXAMINE DIFFERENCES IN HEALTH PROFILE BY DEPARTMENT (OBJECTIVE 1) AND BY BLUE/WHITE COLLAR DESIGNATION (OBJECTIVE 2)……………..45 v 3.1 Objective 1: Differences between Office Workers, Drivers/Operators, and Maintenance Workers……………………………………………………………………………….45 3.2 Objective 2: Differences between Blue and White Collar Workers……………………50 4. WCB RESULTS……………………………………………………………………………...53 CHAPTER 5: DISCUSSION…………………………………………………………………….60 1. SUMMARY OF RESULTS……………………………………………………………………..60 1.1 Physical Health Measures by Department…………………………………………….60 1.2 Psychosocial Health Measures by Department………………………………………..62 1.3 Blue and White Collar Comparisons…………………………………………………..63 1.4 WCB comparisons……………………………………………………………………...64 2. INTERPRETATION OF FINDINGS……………………………………………………………...64 2.1 Difference Between Departments vs. Workplace Risk…………………………………64 2.1.1 Measured variables………………………………………………………………64 2.1.2 Self-reported variables…………………………………………………………...65 2.2 Job Characteristics……………………………………………………………………..66 2.3 Blue and White Collar Characteristics………………………………………………...68 3. STRENGTHS AND WEAKNESSES……………………………………………………………..68 3.1 Bias………………………….………………………………………………………….68 3.1.1 Confounding……………………………………………………………………...68 3.1.2 Selection bias……………………………………………………………………..70 3.1.3 Measurement bias………………………………………………………………...72 3.2 Causality and Study Design…………………………………………………………… 73 3.3 Missing Data……………………………………………………………………………74 3.4 Study Strengths…………………………………………………………………………75 4. RECOMMENDATIONS………………………………………………………………………..76 4.1 Research Recommendations……………………………………………………………76 4.2 Program Recommendations……………………………………………………………78 5. CONCLUSIONS……………………………………………………………………………….79 REFERENCES…………………………………………………………………………………...81 APPENDICES……………………………………………………………………………………95 APPENDIX A: Literature Review Summary………………………….……………………...95 APPENDIX B: Letters of support …………………………………………….…………….106 APPENDIX C: Transit workforce descriptive statistics….………………….………………108 APPENDIX D: Physical health normative values……….………………..............................112 APPENDIX E: Missing data …………………….……………………………………….....113 APPENDIX F: Variable distributions……………………………………………………….115 vi LIST OF TABLES Table 1. Literature review inclusion criteria…………………………………………………….17 Table 2. Literature review summary..…………………………………………………………...95
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