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Last Post 25 Jun 2012 12:00 AM by  SuperUser Account
Rationale for inclusion of occupational status within datasets for WP4
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29 May 2012 10:50 AM

    As discussed at the TC of May, 29th, we would like to invite the cohorts to comment on the following rational:

    Employment is a major factor in maintaining income levels and living conditions, especially among persons with long-lasting chronic diseases. In addition, unemployment has been shown to be an independent predictor of morbidity and mortality both in the general population and among HIV-infected people.

    HIV infection most often occurs in early adulthood, and the majority of HIV-infected individuals are of working age. Therefore, employment constitutes a major dimension in the life of HIV-infected people, and understanding the ways by which the disease interferes with employment may provide insights into strategies for limiting the burden of HIV disease for individuals and society. This requires the availability of longitudinal datasets documenting both clinical, biological and socio-occupational aspects. Information on socio-occupational characteristics are generally not routinely collected in hospital databases; as a result, studies on the impact of HIV infection on employment have remained limited.

    Several reports, based on data collected earlier in the era of combined antiretroviral therapies, i.e. in the years 1996-2004, found that HIV infection weighted on the chances of maintaining in employment through various mechanisms including disease severity and experiences of HIV-related discrimination. Since 1996, the impact of HIV infection on employment may have changed as a result of the dramatic changes occurred with the sustained use of cART. Namely, as suggested in a recent paper (Dray-Spira et al, AIDS 2012, 26:207–215), the burden of HIV disease characteristics themselves on chances of maintaining in employment may have decreased. In contrast, comorbidities frequently associated with HIV disease including diabetes, hypertension and depression seem to substantially affect the chances of maintaining in employment during the course of HIV infection. Given the importance of employment issues among HIV-infected people, a predominantly working-age population, such changes are important to be documented in order to be accounted for in the implementation of comprehensive care programs, especially in the current adverse socio-economic context in Europe marked by increased unemployment and job insecurity.

    In order to correctly inform individuals’ employment status, information needs to be collected not only on situation regarding labour but also, for those employed, on the type of employment contract which constitutes a major predictor of maintain in employment. Thus, we propose to include 2 questions (see below) in participating cohorts. These questions are based on data collected by EuroStat in the various EU countries (thus allowing comparisons with the general population), and adapted to be easily informed in the context of clinical settings. Ideally, we propose to collect this information on a yearly basis.

    1. What is your current situation regarding labour?
      1. Employed as an employee
      2. Self-employed / Family worker
      3. Apprentice / trainee
      4. Unemployed and actively seeking work
      5. Student
      6. Retired / Pre-retired
      7. Homeworker
      8. Other situation
    1. If you are an employee, what is the type of your employment contract?
      1. Indefinite duration
      2. Fixed-term
      3. Apprentice or trainee
      4. Other


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    20 Jun 2012 12:00 AM


    Comment from the PISCIS Cohort about the collection of socio-economic variables:

    Could you please clarify the definition of the following:

    Family worker
    Homeworker: does it refer to Housewife/Househusband?

    Your list does not include an option encompassing those who are receiving incapacity benefit. Had you intended them to be included in the “retired” category? If so, perhaps this should be clearer.

    For your information, the PISCIS Cohort collects the following information about employment status at inclusion only:

    1- Unemployed 2- Working 3- Pensioner (receiving benefit for not being able to work) 4- Retired 5- Student 6- Housewife/Househusband 7- Do not answer 8- Missing


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    25 Jun 2012 12:00 AM


    Actually the list we propose has been updated following the last TC. Here are the last version of the two questions on occupational status:

    What is your current situation regarding labour?
    Employed as an employee
    Self-employed / Family worker
    Apprentice / trainee
    Unemployed and actively seeking work
    Student
    Retired / Pre-retired
    Homeworker
    Unable to work due to ill health
    Other situation

    If you are an employee, what is the type of your employment contract?
    Indefinite duration
    Fixed-term
    Apprentice or trainee
    Other

    As you can see, we added an additional category (question 1, item h) for those with health-related disability.

    Regarding the other points you raise:

    The definition of a family worker is the one used by EuroStat: "Family workers are persons who help another member of the family to run an agricultural holding or other business, provided they are not considered as employees." They correspond to very specific situations that may occur more particularly in the migrant populations, that's why I propose to keep this category.
    The term "Homeworker" does refer to Housewife/Househusband, but you are right it certainly needs to be clarified. This could be changed to "Engaged in family duties" as proposed in EuroStat.

    The updated list would thus be the following:

    What is your current situation regarding labour?
    Employed as an employee
    Self-employed / Family worker
    Apprentice / trainee
    Unemployed and actively seeking work
    Student
    Retired / Pre-retired
    Engaged in family duties
    Unable to work due to ill health
    Other situation

    If you are an employee, what is the type of your employment contract?
    Indefinite duration
    Fixed-term
    Apprentice or trainee
    Other

    Thank you for your comments. Rosemary Dray-Spira
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