Transitions to Retirement: Determinants of Age of Social Security Take Up

Prior to 1987, retirement benefits under the Canada Pension Plan (CPP) were payable only at age 65. Amendments to the CPP in 1987 allowed benefits to be claimed at any time between the ages of 60 and 70, with actuarial adjustments for early or late take up. The focus of this paper is the health and welfare implications of these flexible retirement provisions, but the paper also investigates the labour-market characteristics of individuals prior to exit. Characteristics such as health status, demographics, employment prospects, labour-force attachment, and income sources are investigated in order to develop a profile of individuals who take up early. The principal contribution of this paper is that it investigates the dynamics of transition from labour force to retirement in the Canadian context. Investigating the factors influencing the retirement decision has been a popular research agenda in the U.S. labour economics and public finance literature, but is not frequently addressed in the Canadian context due to the lack of longitudinal data sets. This paper employs a large longitudinal data set from Statistics Canada called the Longitudinal Administrative Databank (LAD) to examine the factors influencing the age at which an individual begins to draw benefits from the CPP. The LAD is a longitudinal sample of Canadians that spans the period from 1982 to 1994. The results of the analysis indicate that income amounts from various sources have a significant impact on take up, as do family characteristics and markers of health status. Unattached individuals are less likely to exit to retired-worker benefits at each age than are married individuals, though the larger the family size, the less likely is exit. It appears that early exit to retired-worker benefits is more likely for: 1) low labour income earners and individuals currently out of the labour force, 2) unemployed individuals, 3) individuals receiving a private pension, and 4) individuals with spouses who are retired. There is also a significant secular trend towards early exit. The probability of exit to disability benefits is more likely for: 1) low labour income earners, 2) individuals with a disability deduction in the current year, and 3) individuals who pay union or professional dues. Overall, it appears that many individuals who pick up retired-worker benefits prior to age 65 are individuals who have higher lifetime earnings, have already exited their career jobs, are receiving private pensions, and are making a joint retirement decision with their spouse. There are also some individuals who cycle through unemployment benefits prior to pick up. These individuals may be doing so voluntarily or involuntarily due to job displacement. For men, there is indication that lack of job prospects is an incentive for exit.retirement; CPP

The Review of Economic Performance and Social Progress 2002: Towards a Social Understanding of Productivity

This chapter by Emile Tompa provides a comprehensive review of the theoretical underpinnings and empirical evidence of the health-productivity relationship with an emphasis on the public policy implications. This relationship goes well beyond the obvious effect of health on capacity to work both in terms of energy level and working time. Focusing on the Grossman model, the author describes three additional pathways through which health can affect productivity at an aggregate level. For instance, individuals with a longer life expectancy may choose to invest more in education as they receive greater returns from their investment. They may also be motivated to save more for retirement, which would lead to greater accumulation of physical capital. Finally, improvement in the survival and health of young children may provide incentives for reduced fertility and may result in increased labour-force participation.Health, Safety, Human Capital, Nutrition, Longevity, Disability, Sickness, Productivity, Labour Productivity, Labor Productivity, Growth, Life Expectancy, Healthcare, Health Care, Health Spending, Investment, Childcare, Child Care

Individual, occupational, and workplace correlates of occupational health and safety vulnerability in a sample of Canadian workers

Objective: To describe OH&amp;S vulnerability across a diverse sample of Canadian workers.Methods: A survey was administered to 1,835 workers employed more than 15 hrs/week in workplaces with at least five employees. Adjusted logistic models were fitted for three specific and one overall measure of workplace vulnerability developed based on hazard exposure and access to protective OH&amp;S policies and procedures, awareness of employment rights and responsibilities, and workplace empowerment.Results: More than one third of the sample experienced some OH&amp;S vulnerability. The type and magnitude of vulnerability varied by labor market sub-group. Younger workers and those in smaller workplaces experienced signficantly higher odds of multiple types of vulnerability. Temporary workers reported elevated odds of overall, awareness- and empowerment-related vulnerability, while respondents born outside of Canada had significantly higher odds of awareness vulnerability.Conclusion: Knowing how labor market sub-groups experience different types of vulnerability can inform better-tailored primary prevention interventions.<br /

The future of work in shaping the employment inclusion of young adults with disabilities:a qualitative study

Purpose: The world of work is changing and creating challenges and opportunities for the employment inclusion of young people with disabilities. In this article, the perceptions held by young adults with disabilities regarding participation in the future of work are examined. Design/methodology/approach: One-on-one interviews were conducted with Canadian young adults (ages 18–36 years) living with a disability. Participants were asked about their thoughts regarding the impact of the changing nature of work on their labor market involvement and career aspirations. A thematic analysis was performed to identify and examine emergent salient themes. Findings: In total, 22 young adults were interviewed; over half held secure employment. Career aspirations and work-related decisions were primarily shaped by a participant's health needs. The future of work was seen as a more proximal determinant to employment. Digital technologies were expected to impact working conditions and create barriers and facilitators to employment. Participants who indicated being securely employed held positive expectations regarding the impact of digital technology on their work. Participants working precariously held negative appraisals regarding the impact of digital technologies on employment opportunities. The role of technological and soft skills was critical to participating in a labor market reliant on advanced technology. Participants reported barriers to developing job skills related to their disability and their work arrangements. Originality/value: This research highlights the importance of considering changes in the future of work, especially the digital transformation of the economy, in the design of initiatives which promote the employment inclusion of young adults with disabilities. Despite the significance of the changing nature of work, supporting health needs and encouraging access to secure work arrangements also remain paramount.</p

Cuantificación del calcio mineral en la ateromatosis carotídea mediante angiografía por tomografía computarizada: perfil evolutivo y relación con la progresión del grado de estenosis volumétrica

Antecedentes: La cuantificación y caracterización del calcio (Ca) mineral (hidroxiapatita) en la bifurcación carotídea con AngioTC, y su relación con la sintomatología neurológica, en un estudio preliminar de casos y controles (Miralles y cols. Eur J Vasc Endovasc Surg 2006), constituye la base conceptual del presente estudio. Sus resultados, al igual que los de otras publicaciones, sugerían un posible papel protector del calcio en el desarrollo de eventos neurológicos. Sin embargo, su relación con la progresión de la ateromatosis carotídea ha sido escasamente analizado. Objetivos: Principales: 1. Diseñar un método de medición volumétrica de la ateromatosis (AE) carotídea y contenido de Ca mediante AngioTC. 2. Analizar el grado de calcificación arterial y su relación con la progresión de la ateromatosis carotídea. Secundarios: 3. Evaluar la relación entre calcificación arterial carotídea y descalcificación ósea, así como su posible conexión a través de los factores humorales implicados en la regulación del metabolismo Ca-P. 4. Estudiar un posible mecanismo genético común: relación entre los polimorfismos del gen de la OPG y la progresión de la calcificación en la placa de ateroma. Pacientes y método: Diseño: Cohortes, medidas repetidas. Pacientes: 54 pacientes, neurológicamente asintomáticos con estenosis de la arteria carótida interna (ECI) >50% (eco-Doppler). Determinaciones: Medición del grado de ECI mediante eco-Doppler y proyecciones MIP 2D de AngioTC. Medición del Volumen del molde de contraste y contenido de Ca (AngioTC cuantitativa: Agatston score modificado: volumen de Ca (mm3) x densidad radiológica (unidades Hounsfield, UH) en reconstrucción volumétrica (volume rendering) de la bifurcación carotídea (volumen de contraste entre 2 cm por debajo y 1 cm por encima de la bifurcación [VBif] y su cociente con un segmento de 1 cm en carótida primitiva [VCP]) (n=45). En todos los pacientes se repitió la exploración a los 122 meses para valorar la variación en el contenido de Ca y en el grado de estenosis volumétrica de la bifurcación, como medición indirecta de la progresión/regresión de la AE carotídea. Densitometría ósea de columna y fémur (n=32), (basal y a los 122 meses). Bioquímica y metabolismo Ca-P (Ca, P, vit D, PTH). Determinación de osteopontina (OPN) y osteoprotegerina (OPG) sérica y distribución de 7 SNPs del gen de la OPG seleccionados sobre bases bibiliométricas (n=48). Análisis estadístico: descriptivo (media [DE]); concordancia intra e interobservador (gráficos de Bland-Altman) y coeficiente de correlación intraclase (CCI), precisión eco-Doppler/AngioTC y Volumetría 3D/MIP 2D: sensibilidad (Sens), especificidad (Esp), índice kappa, curvas operador receptor (COR), comparación de medias (prueba T), análisis de regresión uni y multivariable. Resultados: 1. La medición volumétrica de la bifurcación carotídea mostró una concordancia intra e interobservador con un CCI de 0,96 (IC 95%: 0,904-0,985) y 0,94 (IC 95%: 0,822-0,977), respectivamente. El VBif/VCP del grupo de ECI50% (p=0,001). El punto de corte óptimo de la relación VBif/VCP se identificó a partir de la curva COR en 4,1 (Sens=0,75; Esp=0,75, kappa=0,46). 2. La medición mediante AngioTC demostró, a los 12 meses, un aumento del volumen promedio de pared arterial (disminución del volumen de la columna de contraste), respecto al valor basal (475,45 [155,6] mm3xUH vs 501,3 [171,9] mm3xUH, p=0,04), así como un aumento del Ca intraplaca (56,8 [52,3] vs 64,58 [57,8] mm3xUH, p=0,002). El análisis univariable demostró una correlación inversa entre el contenido basal de Ca y progresión de estenosis volumétrica de la bifurcación (r=-0,481; p<0,001). El análisis de regresión múltiple permitió ajustar un modelo de regresión lineal entre la reducción del volumen de la bifurcación (progresión de AE carotídea) y el contenido basal de Ca intraplaca, ajustado por el índice de masa corporal (IMC). 3. Se observó una disminución estadísticamente significativa de la densidad ósea respecto a la determinación basal (2,08 [0,22] vs 2,06 [0,23] g/cm2; p=0,013), así como un aumento del Ca intraplaca respecto a los valores basales (79,2 [55] vs 64,58 [49,2] mm3xUH, p=0,12). Sin embargo, se identificó una correlación positiva entre la variación relativa del contenido de Ca y la variación relativa de la densidad ósea (r=0,574, p=0,003). En otras palabras, una mayor tendencia a la osteoporosis se asoció con una menor tendencia a la progresión del calcio intraplaca. Así mismo, se observó una relación entre los niveles plasmáticos de Vit D y la densitometría basal (r=-0,459, p=0,036) y entre los niveles plasmáticos de HDL-colesterol y la variación relativa, respecto a los valores basales, de la densidad ósea (r=-0,579, p=0,009). El análisis univariable demostró una correlación inversa entre el incremento del contenido de calcio intraplaca y los niveles plasmáticos de vit D (r=0,4; p=0,025) y score Z en fémur (r=0,378; p=0,047). Sólo la concentración de P en orina presentó una correlación positiva moderada con el aumento de Ca intraplaca (r=0,488, p=0,015). Ninguna otra variable, entre los parámetros del metabolismo Ca-P, mostró relación con la calcificación arterial. 4. No se observaron diferencias entre la distribución de los SNPs en los pacientes de la muestra del estudio y el grupo control. Tampoco se observó relación entre el genotipo (SNPs) y la concentración de OPG sérica. Conclusiones: 1. La medición volumétrica de la bifurcación carotídea supone un nuevo concepto basado en la valoración de la carga de placa más que en su efecto hemodinámico o estenosis máxima. Dada su precisión en la detección de variaciones pequeñas de la luz arterial, este método puede ser de especial utilidad en estudios de progresión de placa. 2. Los resultados de este estudio sugieren que un mayor contenido de Ca confiere mayor estabilidad frente a la progresión de la AE carotídea y, eventualmente, a su capacidad para generar sintomatología tromboembólica. 3. Encontramos una tendencia independiente a la progresiva calcificación arterial y descalcificación ósea. Sin embargo, los resultados sugieren una relación temporal directa en la evolución del depósito de calcio en ambas localizaciones, por lo que no es posible descartar que su modulación se rija por mecanismos similares. 4. No se observó una relación estadísticamente significativa entre la distribución de los SNPs analizados y los niveles de la OPG o la calcificación intraplaca en los pacientes estudiados.Background: Quantification and characterization of mineral calcium (Ca) (hydroxyapatite) in the carotid bifurcation with AngioCT, and its relation with neurological symptomatology, in a preliminary case-control study (Miralles et al., Eur J Vasc Endovasc Surg 2006) Constitutes the conceptual basis of the present study. Their results, like those of other publications, suggested a possible protective role for calcium in the development of neurological events. However, its relationship with the progression of carotid atheromatosis has been scarcely analyzed. Objectives: Primary: 1. To design a method of volumetric measurement of carotid atheromatosis (AE) and Ca content by AngioCT. 2. To analyze the degree of arterial calcification and its relation with the progression of carotid atheromatosis. Secondary: 3. To evaluate the relationship between carotid artery calcification and bone decalcification, as well as its possible connection through humoral factors involved in the regulation of Ca-P metabolism. 4 To study a possible common genetic mechanism: relationship between polymorphisms of osteoprotegerin (OPG) gene and the progression of calcification in the atherosclerotic plaque. Patients and method: Design: Cohorts, repeated measures. Patients: 54 asymptomatic patients with internal carotid artery stenosis CAS>50% (duplex scanning). Determinations: Measurement of CAS grade with duplex scanning and MIP 2D projections of AngioCT. Volume measurement of contrast medium and Ca content (quantitative AngioCT: Agatston score: Ca volume (mm3) x radiological density (Hounsfield units, HU) in volume reconstruction of the carotid bifurcation [contrast volume between 2 cm below and 1 cm above the bifurcation (BifV) and its ratio with that from 1 cm segment in common carotid artery (CCV)] (n=45). In all patients, the scans was repeated at 12±2 months to assess the variation in Ca content and the degree of bifurcation volumetric stenosis as an indirect measure of carotid AE progression / regression. Bone and spine densitometry (n=32), where obtained at baseline and after 12±2 months, as well as Biochemistry and Ca-P metabolism parameters (Ca, P, vit D, PTH). Determination of plasma levels of osteopontin (OPN) and osteoprotegerin (OPG) where compared with the distribution of 7 SNPs of the OPG gene selected on bibiliometrics bases (n=48). Statistical analysis: descriptive [mean (SD)]; Intra and interobserver agreement (Bland-Altman plots and intraclass correlation coefficient (ICC), duplex scanning / AngioCT precision and 3D Volumetry / MIP 2D: Sensitivity (S), specificity (E), kappa index, ROC curves, means comparison (T test), univariate and multivariate regression analysis. Results: 1.The volumetric measurement of the carotid bifurcation showed intra and interobserver agreement with a ICC of 0.96 (95% CI: 0.904-0.985) and 0.94 (95% CI: 0.822-0.977), respectively. The BifV/CCV of the CAS > 50% group was 5.2±1.8 vs 3.8 ±1.3 in the CAS >50% group (p=0.001). The optimum cutoff point for the BifV/CCV relation was identified from the ROC curve at 4,1 (S=0.75, E=0.75, kappa=0.46). 2. AngioCT measurement showed, at 12 months, an increase in mean arterial wall volume (decrease in contrast column volume), compared to baseline (475.45 [155.6] mm3xHU vs 501.3 [171.9] mm3xHU, p=0.04), as well as an increase in intraplaque Ca (56.8 [52.3] vs 64.58 [57.8] mm3xHU, p=0.002). Univariate analysis showed an inverse correlation between basal Ca content and progression of bifurcation volumetric stenosis (r=-0.481; p<0.001). The multiple regression analysis allowed to fit a linear regression model between the reduction of bifurcation volume (carotid AE progression) and the baseline intraplaque content of Ca, adjusted for body mass index (BMI). 3. A statistically significant decrease in bone density was observed with respect to the baseline determination (2.08 [0.22] vs 2.06 [0.23] g/cm2, p=0.013), as well as increased intraplaque Ca as compared with baseline values (79.2 [55] vs 64.58 [49.2] mm3xHU, p=0.12). However, a positive correlation was identified between the relative variation of Ca content and the relative variation of bone density (r=0.574, p=0.003). In other words, a greater tendency to osteoporosis was associated with a lower tendency to progression of intraplaque calcium. Likewise, a relationship between Vit D plasma levels and baseline densitometry (r=-0.459, p=0.036) and between plasma HDL-cholesterol levels and the relative variation, relative to baseline values, were observed. Bone density (r=-0.579, p=0.009). The univariate analysis showed an inverse correlation between the basal Ca content and the progression of bifurcation volumetric stenosis (r=-0.481; p<0.001), as well as between the increase in the intra-plaque calcium content and plasma levels of vit D (R=0.4, p=0.025) and femur Z score (r=0.378, p=0.047). Only the urine P concentration presented a moderate positive correlation with the increase of intra-plaque Ca (r=0.488, p=0.015). No other variable, among Ca-P metabolism parameters, was related to arterial calcification. 4. There were no differences between the distribution of SNPs in patients and control group. There was also no relationship between genotype and serum OPG concentration. Conclusions: 1. The volumetric measurement of the carotid bifurcation is a new concept based on the assessment of the plaque load rather than on its hemodynamic effect or maximal stenosis. Given its accuracy in detecting small variations in arterial lumen, this method may be especially useful in plaque progression studies. 2. The results of this study suggest that a higher content of Ca confers greater stability against the progression of carotid AE and, eventually, its capacity to generate symptomatology. 3. We found an independent tendency to progressive arterial calcification and bone decalcification. However, the results suggest a direct temporal relationship in the evolution of the calcium deposit in both locations, so it is not possible to rule out that its modulation is controlled by similar mechanisms. 4. The results are inconclusive with regard to the role of OPG in AE plaque calcification. No significant relationship between the distribution of SNPs analyzed and OPG levels in the studied patients was observed

Fragmentation in the future of work:A horizon scan examining the impact of the changing nature of work on workers experiencing vulnerability

Introduction: The future of work is characterized by changes that could disrupt all aspects of the nature and availability of work. Our study aims to understand how the future of work could result in conditions, which contribute to vulnerability for different groups of workers. Methods: A horizon scan was conducted to systematically identify and synthesize diverse sources of evidence, including academic and gray literature and resources shared over social media. Evidence was synthesized, and trend categories were developed through iterative discussions among the research team. Results: Nine trend categories were uncovered, which included the digital transformation of the economy, artificial intelligence (AI)/machine learning-enhanced automation, AI-enabled human resource management systems, skill requirements for the future of work; globalization 4.0, climate change and the green economy, Gen Zs and the work environment; populism and the future of work, and external shocks to accelerate the changing nature of work. The scan highlighted that some groups of workers may be more likely to experience conditions that contribute to vulnerability, including greater exposure to job displacement or wage depression. The future of work could also create opportunities for labor market engagement. Conclusion: The future of work represents an emerging public health concern. Exclusion from the future of work has the potential to widen existing social and health inequities. Thus, tailored supports that are resilient to changes in the nature and availability of work are required for workers facing vulnerability

Disclosure, Privacy and Workplace Accommodation of Episodic Disabilities: Organizational Perspectives on Disability Communication-Support Processes to Sustain Employment

© 2020, The Author(s). Purpose Employers increasingly are asked to accommodate workers living with physical and mental health conditions that cause episodic disability, where periods of wellness are punctuated by intermittent and often unpredictable activity limitations (e.g., depression, anxiety, arthritis, colitis). Episodic disabilities may be challenging for workplaces which must comply with legislation protecting the privacy of health information while believing they would benefit from personal health details to meet a worker’s accommodation needs. This research aimed to understand organizational perspectives on disability communication-support processes. Methods Twenty-seven participants from diverse employment sectors and who had responsibilities for supporting workers living with episodic disabilities (e.g., supervisors, disability managers, union representatives, occupational health representatives, labour lawyers) were interviewed. Five participants also had lived experience of a physical or mental health episodic disability. Participants were recruited through organizational associations, community networks and advertising. Semi-structured interviews and qualitative content analysis framed data collection and analyses, and mapped communication-support processes. Results Seven themes underpinned communication-support process: (1) similarities and differences among physical and mental health episodic disabilities; (2) cultures of workplace support, including contrasting medical and biopsychosocial perspectives; (3) misgivings about others and their role in communication-support processes; (4) that subjective perceptions matter; (5) the inherent complexity of the response process; (6) challenges arising when a worker denies a disability; and (7) casting disability as a performance problem. Conclusions This study identifies a conceptual framework and areas where workplace disability support processes could be enhanced to improve inclusion and the sustainability of employment among workers living with episodic disabilities

Bridging the gap between the economic evaluation literature and daily practice in occupational health: a qualitative study among decision-makers in the healthcare sector

Background: Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific evidence should meet the needs of decision-makers. As a first step in bridging the gap between the economic evaluation literature and daily practice in occupational health, this study aimed to provide insight into the occupational health decision-making process and information needs of decision-makers.Methods: An exploratory qualitative study was conducted with a purposeful sample of occupational health decision-makers in the Ontario healthcare sector. Eighteen in-depth interviews were conducted to explore the process by which occupational health decisions are made and the importance given to the financial implications of OHS interventions. Twenty-five structured telephone interviews were conducted to explore the sources of information used during the decision-making process, and decision-makers' knowledge on economic evaluation methods. In-depth interview data were analyzed according to the constant comparative method. For the structured telephone interviews, summary statistics were prepared.Results: The occupational health decision-making process generally consists of three stages: initiation stage, establishing the need for an intervention; pre-implementation stage, developing an intervention and its business case in order to receive senior management approval; and implementation and evaluation stage, implementing and evaluating an intervention. During this process, information on the financial implications of OHS interventions was found to be of great importance, especially the employer's costs and benefits. However, scientific evidence was rarely consulted, sound ex-post program evaluations were hardly ever performed, and there seemed to be a need to advance the economic evaluation skill set of decision-makers.Conclusions: Financial information is particularly important at the front end of implementation decisions, and can be a key deciding factor of whether to go forward with a new OHS intervention. In addition, it appears that current practice in occupational health in the healthcare sector is not solidly grounded in evidence-based decision-making and strategies should be developed to improve this. © 2013 van Dongen et al.; licensee BioMed Central Ltd