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Objectives: To examine changes in work hours, work schedules, the psychosocial work environment and job satisfaction in three Canadian provinces between 1994 and 2003-05., Methods: The study sample consisted of 46,998 respondents over four cross-sectional surveys: 1994, 2000 and 2003/05 in Quebec, Ontario and Saskatchewan. Using regression models, we examined trends in work conditions across survey cycles both unadjusted, and after adjustment for differences in age, education, gender, immigration, and method of interview., Results: Crude models observed increases in rotating shifts, long work hours and job security between 1994 and 2003-05, and decreases in physical demands and job satisfaction. When models were adjusted for changes in labour market demographics and educational capacity, we further observed decreases in skill discretion, decision authority, co-worker support and in regular scheduled work across survey cycles. We also noted differences in trends for two outcomes (decision authority and co-worker support) depending on interview method., Conclusions: Employees in Quebec, Ontario and Saskatchewan were more likely to be working longer hours, at non-standard time during the week, and to be less satisfied with their jobs between 1994 and 2003/05. In addition, it appears the labour market in these provinces has not adjusted sufficiently to accommodate the increasing number of workers with high levels of education and increasing age, with declines observed in decision authority, skill discretion and co-worker support once these changes were taken into account.

The psychosocial working environment is an important determinant of health status and health inequalities in Canada. Particular dimensions of the psychosocial work environment such as low job control, job strain and imbalances between perceived efforts and rewards have been related to cardiovascular disease (the leading cause of mortality in Canada) and poorer mental health status. Despite its importance to the health of Canadians and health inequalities in Canada, the national surveillance of the psychosocial work environment is decreasing. Currently, the surveillance of the psychosocial work environment in Statistic Canada's population health surveys is limited to convenience-based samples within particular health regions. Not including important dimensions of the health, such as the psychosocial work environment, in our population-based surveys limits the ability of these surveys to help us better understand the challenges and opportunities to reducing health inequalities in Canada.

Objective: To provide evidence-based recommendations for work-related population health indicators., Methods: Drawing on a framework of work-related experiences, we systematically reviewed studies that assess the association between these experiences and health and reviewed related measures at the population level that could be used as indicators., Results: We recommend (and grade the strength of evidence supporting our recommendation for) the following indicators for which data are already routinely collected: unemployment rate (strong), long-term unemployment rate (limited), and permanent lay-off rate (limited). As well, we recommend and grade our support for the following new indicators: insecurity associated with pending job loss (limited), with possible major organizational change (limited), and with actual major organizational change (limited); and job strain (medium)., Conclusion: These evidence-based indicators can be used to monitor work-related determinants of health and thus to inform the conceptualization, development, and evaluation of policies and programs related to these determinants.

Objective: To describe regional trends in premature mortality in Manitoba., Design: Comparison of all-cause and cause-specific mortality of persons less than age 75 in 11 Regional Health Authority populations over two time periods: 1985-89 and 1990-94., Results: The provincial premature mortality rate declined over the two time periods (4.00/1,000 to 3.72/1,000). Declines were also observed in 9 of 11 regional populations. Premature mortality increased, however, in the 2 regional populations with the highest mortality rates in the first observation period., Conclusion: Declining premature mortality in low mortality populations and rising premature mortality in high mortality populations has resulted in a widening of regional mortality rates in Manitoba. Recent policy initiatives in many provinces, including the devolution of authority for the management and delivery of health services and the implementation of population need-based funding formulas to share health care resources among regional health authorities, if implemented, have the potential to partially mitigate the processes producing these widening regional health inequalities.