Effects of gaps in priorities between ideal and real lives on psychological burnout among academic faculty members at a medical university in Japan: a cross-sectional study

Abstract Background Accumulating evidence from medical workforce research indicates that poor work/life balance and increased work/home conflict induce psychological distress. In this study we aim to examine the existence of a priority gap between ideal and real lives, and its association with psychological burnout among academic professionals. Methods This cross-sectional survey, conducted in 2014, included faculty members (228 men, 102 women) at a single medical university in Tokyo, Japan. The outcome of interest was psychological burnout, measured with a validated inventory. Discordance between ideal- and real-life priorities, based on participants’ responses (work, family, individual life, combinations thereof), was defined as a priority gap. Results The majority (64%) of participants chose “work” as the greatest priority in real life, but only 28% chose “work” as the greatest priority in their conception of an ideal life. Priority gaps were identified in 59.5% of respondents. A stepwise multivariable general linear model demonstrated that burnout scores were associated positively with respondents’ current position (P < 0.0018) and the presence of a priority gap (P < 0.0001), and negatively with the presence of social support (P < 0.0001). Among participants reporting priority gaps, burnout scores were significantly lower in those with children than in those with no children (P interaction = 0.011); no such trend was observed in participants with no priority gap. Conclusions A gap in priorities between an ideal and real life was associated with an increased risk of burnout, and the presence of children, which is a type of “family” social support, had a mitigating effect on burnout among those reporting priority gaps

Is Sprawl Associated with a Widening Urban–Suburban Mortality Gap?

This paper examines whether sprawl, featured by low development density, segregated land uses, lack of significant centers, and poor street connectivity, contributes to a widening mortality gap between urban and suburban residents. We employ two mortality datasets, including a national cross-sectional dataset examining the impact of metropolitan-level sprawl on urban–suburban mortality gaps and a longitudinal dataset from Portland examining changes in urban–suburban mortality gaps over time. The national and Portland studies provide the only evidence to date that (1) across metropolitan areas, the size of urban–suburban mortality gaps varies by the extent of sprawl: in sprawling metropolitan areas, urban residents have significant excess mortality risks than suburban residents, while in compact metropolitan areas, urbanicity-related excess mortality becomes insignificant; (2) the Portland metropolitan area not only experienced net decreases in mortality rates but also a narrowing urban–suburban mortality gap since its adoption of smart growth regime in the past decade; and (3) the existence of excess mortality among urban residents in US sprawling metropolitan areas, as well as the net mortality decreases and narrowing urban–suburban mortality gap in the Portland metropolitan area, is not attributable to sociodemographic variations. These findings suggest that health threats imposed by sprawl affect urban residents disproportionately compared to suburban residents and that efforts curbing sprawl may mitigate urban–suburban health disparities