21 May 2015
Top managers most afflicted by disorders, study finds
Neo Chai Chin
SINGAPORE — Alcohol abuse is highest among business owners, while the highest proportion of smokers exists among craftsmen and trades workers. The latter group also has the highest rates of diabetes and hypertension, but among the lowest rates of depression, a study on prevalence of mental and physical disorders across occupations here has found.
Meanwhile, the proportion of people in senior or top management positions who had both mental and physical disorders was the highest. Mental disorders include major depressive disorder, anxiety disorders and alcohol abuse, while diabetes, cancer and high blood pressure are among the physical disorders.
The study, published last month, was based on data collected in the Singapore Mental Health Study in 2009 and 2010. It covered 4,361 employed participants with an average age of about 42.
It is the first such population-based study using a representative sample of residents here. Other occupational groups in the study included associate professionals and technicians, service and sales workers, and professionals.
As expected, differences in age, gender, ethnicity, education, marital status and income were observed across occupational groups, wrote the researchers from the Institute of Mental Health and Saw Swee Hock School of Public Health.
While factors such as wealth and the nature of social networks drive alcohol use and smoking behaviours in “higher” occupational categories, work-strain and stress are the influencing factors among low-skill manual occupations, they wrote.
The study highlights disparities in disease prevalence and risk factors across occupations, even after adjusting for other variables, they said. “It is important to tailor effective workplace health interventions based on risk profiles by occupational groups. In addition, business owners, craftsmen and related trades workers should be made aware of the increased risks associated with alcohol use disorder and nicotine dependence.”
Asked if he has observed rates of alcohol use disorder among business owners similar to the 12 per cent found in the study, Mr Kurt Wee, president of the Association of Small and Medium Enterprises, estimated that 10 to 15 per cent of “towkays” drink frequently, and about 20 to 30 per cent drink quite regularly.
Only a handful appear to have alcohol dependence, and Mr Wee said he is not aware of any business owner with a drinking habit that is out of control. “I think there are many people from different walks of life that enjoy their alcohol,” said Mr Wee. “But I would say probably in business dealings, there is quite a bit of lunch, dinner, drinks and entertaining that needs to be done. To some extent, it’s one of the avenues to break the ice and get on a level that is less formal with counterparties.”
Besides the ability to afford alcohol, business functions and business flights also provide opportunities to drink and increase the likelihood of alcohol use, said Dr Audrey Chia of the National University of Singapore’s Business School and Saw Swee Hock School of Public Health. “I also think stress is a contributor,” said Dr Chia, who is not among the authors of the study.
The study found almost one in four craftsmen and related trades workers — those with specific skills in construction, maintenance, machinery and handicrafts — to be smokers. Singapore Motor Workshop Association president Francis Lim said older vehicle mechanics who smoke outnumber the younger ones.
He estimated that about 60 to 70 per cent of those above 40 smoke, but the figure is about 20 to 30 per cent among the younger ones. This could partly be due to stricter workplace conditions now, said Mr Lim. His employees at BCC Automotive are not allowed to smoke while working on a car, or in front of customers, for instance. Peer pressure also plays a role, said Mr Lim.
On tailoring health interventions for various occupational groups, Dr Chia said: “I don’t think these can be standalone interventions.” To tackle social drinking, norms at business events may need to change, for instance.
Singapore Cranes Association chairman Alan Chan said many crane operators — who belong to the group with the second-highest rates of hypertension — are above 50 and it could be difficult to get the older ones to exercise. But it largely depends on an individual’s discipline, he said.
A positive approach should not just aim to control smoking or drinking, added Dr Chia. Convenient, easy, and low-cost ways of reducing stress, such as green spaces, exercise bands and music, are also needed.
The study showed clerical support workers had the lowest rates of alcohol use disorder (1.3 per cent) and smoking rates were the lowest among professionals, who included academics and accountants (1.9 per cent).
While the study presents important findings that might be helpful in understanding the health status and future healthcare needs of the workforce, it is important to note that the data presents differences by occupations without considering their industry affiliations, said one of the authors, Ms Janhavi Vaingankar of the IMH.
Information on the specific industry would have strengthened the policy implications of the findings, she said.
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