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Health Behaviors in the Service Sector: Substance Use Among Restaurant Employees

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Abstract

Restaurant workers in the United States exhibit high levels of alcohol and drug use. However, there is a scant amount of qualitative research uncovering how and why restaurant employees use and abuse legal and illegal substances. Examining restaurant workers’ self-reported risky health behaviors is important for improving employee and occupational quality of life. The purpose of this article is to investigate the health behaviors of restaurant workers and pathways to such outcomes. Specifically, this article explores the question of what social conditions and processes within restaurants relate to employee adverse health behaviors. Drawing on qualitative data collected between 2009 and 2014, this article focuses on a case study of restaurant employees, detailing their substance use and the ways in which they discuss and talk about taking health risks. An analysis of 52 in-depth, semistructured interviews with restaurant workers broadens the theoretical explanation for deviant health behaviors in the service sector. Results indicate that workplace characteristics—such as occupational socialization, norms and values, job stress and coping mechanisms, social networks and friendships, and personnel policies—permit and encourage substance use and risky health behaviors. Research implications include underscoring service industry adverse health behaviors and recommendations for positive social change in terms of personal, social, and job-related well-being.

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A review of the many attempts to establish an association between occupations and alcoholism reveals that most do not deal with data about clinically defined alcoholism but instead use data about cirrhosis mortality, self-reported alcohol problems, and frequent and heavy drinking. The present study establishes an association between occupations and diagnoses of Alcohol Dependence Disorder and Alcohol Abuse Disorder, using data from a large population-based household interview study. Statistical adjustment using logistic methods reveals that apparent associations between occupations and alcohol-related disorders previously reported in the literature are due to characteristics of those employed in various occupations. The prevalence of alcohol dependence and abuse in two high risk industries, construction and transportation, is confirmed. More than one in four construction laborers and one in five skilled construction trades workers received a DIS/DSM-III diagnosis related to alcohol abuse. In the transportation industry one in six heavy truck drivers and material movers received an alcohol diagnosis. Analyses of the data from individuals currently employed and not employed in their occupation reveals reduction in risk for those who leave some occupations and increased risk for those who leave other occupations. Evidence is presented that employment in some occupations may be protective for Alcohol Dependence. The findings support the view that occupation may be associated with Alcohol Dependence and Alcohol Abuse independent of demographic variations. Previously proposed explanatory models for associations between occupations and alcohol problems are called into question because they do not take into account the demographic characteristics and employment status of workers.
Article
Data were drawn from a subsample of the National Health and Nutrition Examination Survey I, 1971 to 1975, consisting of persons 25 years of age and older who stated they were employed in one of roughly 400 US Census three-digit occupations (n = 8130). Occupations with fewer than five persons were excluded from the analysis. Diastolic and systolic blood pressures were calculated for each of 244 occupations, simultaneously adjusting for age, gender, and body mass in an analysis of covariance model. A disproportionately high number of craft, operative, laboring, and farming jobs have incumbents with higher than average blood pressures, and a disproportionately low number of professional, managerial, and clerical jobs have incumbents with higher than average blood pressures. Jobs whose incumbents have especially high blood pressures include bartenders and dry cleaning operatives. Whether jobs cause high blood pressure or persons with high blood pressure choose those particular jobs remains unknown.
Article
Mortality risks among bartenders, waiters and waitresses were examined through a proportional mortality ratio (PMR) analysis of British Columbia death registrations from 1950 through 1978. Amongst male bartenders and waiters the predominant mortality profile involved alcohol- and tobacco-related causes of death. Significantly elevated PMRs (p < 0.01) were found for cancers of the mouth (PMR = 341), esophagus (PMR = 250), larynx (PMR = 440) and lung (PMR = 133). Deaths due to bronchitis and emphysema (PMR = 164), cirrhosis of the liver (PMR = 305), accidental poisoning due to drugs or alcohol (PMR = 218) and homicide (PMR = 235) also showed significantly increased PMRs. The results for female waitresses and bartenders were comparable. A more detailed assessment of the relative contribution of different lifestyle and environmental factors as mortality risks among bartenders, waiters and waitresses is recommended as it is relevant to public health concerns.
Article
This study examined personal and contextual predictors of active and avoidance coping strategies in a community sample of over 400 adults and in a sample of over 400 persons entering psychiatric treatment for unipolar depression. Sociodemographic factors of education and income (except for active-cognitive coping), personality dispositions of self-confidence and an easy-going manner, and contextual factors of negative life events and family support each made a significant incremental contribution to predicting active and avoidance coping. Among both healthy adults and patients, active and avoidance coping were positively associated with negative life events. Individuals who had more personal and environmental resources were more likely to rely on active coping and less likely to use avoidance coping. Moreover, for both groups, most of the predictors continued to show significant relations with active and avoidance coping strategies even after the stable component in coping was controlled in a longitudinal design. A comprehensive framework to understand the determinants of coping can be of practical value in suggesting points for therapeutic interventions aimed at fostering more adaptive coping efforts.
Article
It is frequently alleged that hotel and restaurant personnel drink more than other groups in the service industry, although only indirect evidence has been presented to substantiate this allegation. This paper reports data from two surveys concerning alcohol use in different segments of the service industry. In the first study 84 students at three different colleges in the Stavanger region were interviewed concerning their alcohol habits using the screening instrument AUDIT (Alcohol Use Disorders Identification Test). The second survey concentrated on service employees in the Rogaland area. One hundred and five respondents answered the AUDIT questionnaire in this study. The results showed that hotel and restaurant affiliated individuals scored significantly higher on the AUDIT than the other respondents. The first survey indicated that students at the Norwegian College of Hotel Management obtained significantly higher AUDIT scores than other groups of students, whereas the second survey indicated that restaurant workers scored significantly higher than employees in other branches of the service industry. Implications of these results, as well as future research demands were indicated.
Article
Mortality rates were drawn from the California Occupational Mortality Study (COMS) to analyze liver cirrhosis deaths within occupations and industries from 1979 to 1981. Age-adjusted Standardized Mortality Rates (SMRs) were made available by the State of California for separate analyses of women, men, blacks and whites. Rankings of occupations with narrow confidence intervals were strikingly similar for blacks and whites. Within occupations, the highest female SMRs were for waitresses, telephone operators, cosmetologists, dress makers, hospital orderlies, textile workers, and laborers. The lowest female SMRs were for skilled crafts workers and teachers. High male occupations included water transportation workers, bartenders, loggers, laborers, roofers, construction workers, farm workers, iron workers, and painters. Low male occupations included teachers, physicians and dentists, managers, factory supervisors, business sales workers, heavy equipment operators, and other professionals. High female industries included eating and drinking places, laundry/dry cleaning, nursing and personal care facilities, aerospace, beauty shops, and entertainment. Low female industries included wholesale trades and education. High male industries included water transportation, military, guard services, eating and drinking places, iron and steel mills, and railroads. Low male industries included research/engineering labs, education, and computer manufacturing. This study was descriptive. It remains unknown whether certain jobs cause excessive drinking and cirrhosis, or whether people who are prone to develop cirrhosis select certain jobs.
Article
The role of social modelling and structural factors of the work-place in predicting the probability of heavy drinking was investigated in a sample of 3267 Norwegian male and female waiters and cooks. In the logistic regression analysis, the probability of heavy drinking was increased by two social modelling factors and one structural factor. Having co-workers who, at least weekly, took an end-of-work drink at the work-place gave an odds ratio for heavy drinking of 2.8 (95% CI 1.9-4.1), and having co-workers who went out after work at least every week gave an odds ratio of 1.8 (95% CI 1.2-2.8). Working at a place with a liberal alcohol policy gave an odds ratio 1.5 (95% CI 1.1-2.2). Among the background factors, only household type significantly predicted heavy drinking. As compared with living with children, the odds for heavy drinking when living alone was 4.3 (95% CI 2.9-6.4). The results indicate that preventive measures in the restaurant business should not only concentrate on the individual, but also deal with factors related to the occupational activity that promote and sustain heavy drinking.