The relationship of occupational injury and use of mental health care

Introduction: Symptoms of depression and anxiety are a common consequence of occupational injury regardless of its cause and type. Nevertheless, mental health care is rarely covered by workers’ compensation systems. The aim of this study was to assess the use of mental health care post-injury. Methods: We used a subsample of patient-care workers from the Boston Hospital Workers Health Study (BHWHS). We matched one injured worker with three uninjured workers during the period of 2012–2014 based on age and job title (nurse or patient-care associate) and looked at their mental health care use pre- and post-injury using medical claims data from the employer sponsored health plan. We used logistic regression analysis to assess the likelihood of mental health care use three and six months post-injury controlling for any pre-injury visits. Analyses were repeated separately by job title. Results: There were 556 injured workers between 2012 and 2014 that were matched with three uninjured workers at the time of injury (n = 1,649). Injured workers had a higher likelihood of seeking mental health care services than their uninjured counterparts during the six months after injury (OR = 1.646, 95% CI: 1.23–2.20), but not three months post-injury (OR = 0.825, 95% CI: 0.57–1.19). Patient-care associates had a higher likelihood to seek mental health care post-injury, than nurses (OR: 2.133 vs OR: 1.556) during the six months period. Conclusions: Injured workers have a higher likelihood to experience symptoms of depression and anxiety based on their use of mental health care post-injury and use is more predominant among patient-care associates; however, our sample has a small number of patient-care associates. Practical Applications: Treating depression and anxiety as part of the workers’ compensation system has the potential of preventing further physical ailment and improving the return to work process regardless of nature of injury.     

Assessing disabling and non-disabling injuries and illnesses using accepted workers compensation claims data to prioritize industries of high risk for Oregon young workers

Introduction: Young workers are especially vulnerable to occupational injuries and illnesses. There is a continued need to investigate injury burden among young workers across demographics and industry to inform targeted interventions. Workers compensation (WC) claims are important for quantifying work-related injuries and illnesses, however published studies have focused on disabling claims. This study extended previous research on Oregon young workers by including the most recent WC claims data to identify patterns of injury and high risk industries. Methods: We obtained all accepted disabling claims (N = 13,360) and a significant portion of non-disabling claims (N = 24,660) on workers aged 24 years and under from 2013 to 2018. Claim count, rate and cost were calculated by year, age, gender, industry, and injury type. A prevention index (PI) method was used to rank industries in order to inform prevention efforts. Results: Average annual disabling and non-disabling claim rates were 111.6 and 401.3 per 10,000 young workers. Workers aged 19–21 (disabling: 119.0 per 10,000 and non-disabling: 429.3) and 22–24 years (115.7 and 396.4) and male workers (145.3 and 509.0) had higher claim rates than workers aged 14–18 (80.6 and 297.0) and female workers (79.8 and 282.9). The most frequent injury types were “struck by/against” (35.6%) and “work-related musculoskeletal disorders (WMSDs)” (19.5%). High risk industries included agriculture, construction, and manufacturing for both genders combined. For female young workers, the highest risk industry was healthcare. Conclusions: This study demonstrated the added value of non-disabling WC claims data. Using both disabling and non-disabling data and PI method, agriculture, construction, manufacturing and healthcare industries were identified as priority workplaces to prevent common and costly injuries among Oregon young workers. Practical Applications: While the industries identified are considered hazardous for all workers, findings in this study can guide targeted research and prevention efforts specific to young workers.     

Land Claims and Comanagement of Protected Areas in South Africa: Exploring the Challenges

Comanagement has recently become the most popular approach for reconciling land claims and biodiversity conservation in South Africa and beyond. Following the resolution of land claims on protected areas in South Africa, comanagement arrangements have been created between the relevant conservation authorities and the land claimant communities who are legally awarded tenure rights to the land. However, it is doubtful that these partnerships constitute success for the former land claimants. Using the case of a “resolved” land claim in Mkambati Nature Reserve, Eastern Cape Province, as well as insights from comanagement literature, this paper identifies and discusses three key possible reasons for the unimpressive performance of comanagement in reconciling land restitution and conservation. The first one is the origins of the comanagement idea in the conservation of high value natural resources (e.g., fisheries, forestry), rather than in or including concerns for resource rights. The second reason is the neglect of key conditions for successful comanagement, as discussed in the comanagement literature. The final reason is the ambiguity in settlement agreements, including the use of terminology and concepts that reinforce unequal power relationships, with the state emerging as the powerful partner. This paper concludes that, unless there is a serious reassessment of the comanagement idea as a way of reconciling land reform and conservation, and a possible review of settlement agreements that have relied on comanagement, both the integrity of the “successful land claimant’s rights” and that of conservation remain under threat.     

Efficacy of insurance for organisational disaster recovery: case study of the 2010 and 2011 Canterbury earthquakes

Insurance is widely acknowledged to be an important component of an organisation's disaster preparedness and resilience. Yet, little analysis exists of how well current commercial insurance policies and practices support organisational recovery in the wake of a major disaster. This exploratory qualitative research, supported by some quantitative survey data, evaluated the efficacy of commercial insurance following the sequence of earthquakes in Canterbury, New Zealand, in 2010 and 2011. The study found that, generally, the commercial insurance sector performed adequately, given the complexity of the events. However, there are a number of ways in which insurers could improve their operations to increase the efficacy of commercial insurance cover and to assist organisational recovery following a disaster. The most notable of these are: (i) better wording of policies; (ii) the availability of sector‐specific policies; (iii) the enhancement of claims assessment systems; and (iv) risk‐based policy pricing to incentivise risk reduction measures.     

Regulating Functional Foods in the European Union: Informed Choice versus Consumer Protection?

Due to the rise of functional foods,the distinction between foods and medicines hasbecome increasingly blurred. A new EUregulation covering health claims and otherclaims on food and drink products is on thedocks. A basic motive of legal regulation oflabeling and advertising is to inform andprotect the consumer. Promotion of informedchoice and consumer protection may, however, beconflicting objectives. A further problemsprings from the fact that choice, likeconsent, is a propositional attitude andtherefore opaque. Thus it is extremelydifficult for regulators to fasten onparticular formulations of claims. Despite theprofessed respect for the autonomy of theconsumer, paternalism is never far away andeasily enters in various guises.     

A case for urban liveability from below: exploring the politics of water and land access for greater liveability in Kampala,Uganda

ABSTRACT

Improving urban liveability and prosperity is commonly set as a priority in urban development plans and policy around the world. Several annual reports produced by international consulting firms, media, and global agencies rank the liveability of cities based on a set of indicators, to represent the quality of life in these cities. The higher is the ranking, the more liveable is the city. In this paper, we argue that such quantitative approaches to framing and addressing urban liveability challenges leave little room to reflect on people's experiences of this liveability, which cannot be expressed through numbers. To illustrate our argument, we draw on empirical evidence of urban liveability challenges in access to water and land in Kampala, the capital city of Uganda, ranked recently as the most liveable East African city by various global agencies and media outlets. By showing that increasing the number of water connections does not guarantee improved access to water and sanitation in the long run, first, we demonstrate how urban liveability challenges are tightly linked with land-title issues in the city. Second, we highlight the political game-playing between the central government, the opposition, the traditional leadership, and the slum dwellers in governance processes of service delivery. Finally, by arguing that urban liveability can be enhanced by broadening political participation in city development planning, we discuss some of the strategies that can be used by communities to make collective claims towards improving their quality of life and the environment.