>> Welcome to the webinar for the NORA Healthy Work Design and Well-being Cross-sector Council, and the NIOSH Total Worker Health program, designing workplaces that value worker and family well-being now and beyond. On behalf of NIOSH's Total Worker Health program and the NORA HW Cross-sector Council, we are delighted to have you with us today. In honor of Work and Family Month, we are hosting a two-part series of webinars on supporting worker and family well-being through healthy work design. My name is Heidi Hudson. It's my pleasure to be here with you today to kick off and moderate today's webinar. And on behalf of NIOSH's Total Worker Health program and the NORA Healthy Work Design and Well-being Council, welcome. Free continuing education credits are available for this presentation through CDC's training and education online system. We are pleased to be able to offer the following continuing education credit types, CME, APA, CNE, CP, CEU, CECH, AAVSP, RACE, and CPH. Detailed instructions on accessing the CDC TRAIN site are available for download at the website at the top of your screen. Go to www.train.org/cdc.train. Note that the blue activity number is only valid for those watching the live webinar. You will need the course access code to receive credit. The gray activity number is only to be used by those who view the webinar recording or attempt to use the CECUs after November 17th. We are recording this webinar and plan to post it on the Total Worker Health webinar page as soon as possible. As mentioned, the NORA Healthy Work Design Cross-sector Council is co-sponsoring this webinar. The NORA Healthy Work Design and Well-being Cross-sector Council focuses on protecting and advancing worker safety, health and well-being by improving the design of work, management practices, and physical and psychosocial work environment. The Healthy Work Design Well-being agenda includes seven objectives. The seventh objective seeks to promote a sustainable work and non-work interface. This is relevant to today's webinar, because working conditions affect workers' ability to function on the job, and can have consequences for their well-being. Experiences on the job also carry over to affect families and their lives outside of work. They can impact family interactions and outcomes. Children, specifically, are influenced by how much of time a parent spends at work, when they work, and whether work is flexible, provides living wages and is supportive. The Total Worker Health program is another sponsor for today's webinar. I would be remiss if I did not illustrate what a Total Worker Health approach is. Put simply keeping workers safe and establishing programs, policies and practices that make work more helpful for workers at work and away from work creates worker well-being. Briefly, the Total Worker Health program released its vision for the next decade, the third decade, suggesting research and job protections extended to all workers, regardless of injury -- industry, occupation, job title, individual or social factors, demographics or employment arrangement are important. More information can be found in this link. The broadened scope of the Total Worker Health portfolio includes bringing greater attention to the needs of working families. The CDC director also has identified young families as an agency priority in 2024 and supporting the health of young families is projected to continue in 2025 as noted here on CDC's budget request. Also, the Surgeon General of the United States Public Health Service released in August a new report, Parents Under Pressure. This report provides recommendations to U.S. employers for supporting working families. The recommendations for employers include expanding policies and programs that support the well-being of parents and caregivers in the workplace, implementing training for managers on stress management and work/life harmony, and providing access to comprehensive and affordable, high-quality mental healthcare. Now, for our feature, we are delighted to have Dr. Maureen Perry-Jenkins joining us for a special presentation on how working conditions impact family related health and well-being outcomes. Dr. Perry-Jenkins is presenting on a longitudinal study, Work and Family Transitions Project, which explores the effects of the transition to parenthood and the early return to paid employment on working-class parents' psychological well-being and personal relationships. Dr. Perry-Jenkins is the chair of the Department of Psychological and Brain Sciences at the University of Massachusetts-Amherst and is a nationally renowned scholar whose contributions on the nation, state and regional [inaudible] levels have profound impact on family research. Her work focuses on ways in which sociocultural factors, such as race, gender and social class shape the mental health and family relationships of parents and their children. Dr. Perry-Jenkins publishes regularly in professional journals, including being a member of the editorial boards for the Journal of Marriage and Family, the Journal of Family Theory and Review, Community, Work and Family, among many others. She has authored the book, Work Matters, How Parents' Jobs Shape Children's Well-being, along with numerous chapters and books on family relations. Dr. Perry-Jenkins, welcome.

>> Thank you so much. Hi, folks. Thank you for that introduction, Heidi. As Heidi said, my name is Maureen Perry-Jenkins, and I am a psychologist by training, and she did introduce me as Chair of the Psych Department, but I literally just stepped down, so I'm a much happier person right now because I'm not running the Psych Department, and I'm going to have time to talk more with you folks today and other folks about the book that's come out of our over 25 years of research on work and family. So to get us started, I just wanted to tell you a little bit about where the idea for this research started long ago, when I was actually a newly minted assistant professor, so I'm going to start there. So the beginnings of this research project, and how I talk about this, what I teach and talk to my students, is really how I learned to listen, and I think as researchers, we often go in, and I surely did, with a set idea of what I wanted to study and what the problems were and how I was going to understand them, and I learned pretty quickly that if I didn't listen to the families that I was talking to, I might go down many wrong paths. And so that actually, the genesis of this study that you're going to hear about today came from a conversation long ago with a woman that I'm going to call Joni, and I was actually working on a very different project. I was doing a study with school-age kids who had dual-earner parents, and asking kids about what their experiences were of their parents' work and how they felt like their parents' work affected them and what their parents actually did, and I also spent time talking to parents about that. And there was this one conversation that happened with this woman, Joni, that actually set the trajectory from my research for the next 25 years. And I was sitting on the back steps with Joni, talking about how her kids were doing dealing with school and activities and church and all the things she was trying to manage, and what that felt like. And Joni started telling me about how she was managing her kids' activities and her work, and she just stopped, and she said, "You know, compared to when my kids were little, this is nothing. This is a piece of cake. Going back to work after a few weeks and leaving your new baby with someone else, now that is hell." And she then looked at me, and she said, "That's the study you should be doing." And I remember being quite taken aback by that conversation and surprised. And any of you who know family literature or study psychology know that the transition of parenthood has been studied, probably one of the most studied transitions out there that families experience. So as I was driving home that day, I said we have this whole literature on the transition to parent. How could I do this study? And then I realized that whole literature on the transition to parenthood virtually overlooked the second transition that the majority of families go through, which is the transition back to work after having a baby. And in fact, most of the research on the transition to parenthood pays no attention to this issue of how parents manage to go back to work oftentimes, as Joni said, two weeks after having a baby, and figuring out the implications of that for kids and for parents. So that started my thinking about this project. And then I started thinking about the United States, and this is going to be information that many of you heard many, many times, but it just -- I want to sort of make sure we're all on the same page as I lay out how this affects our families. So this is a 2019 (the 2024 one isn't out yet) map of the United States as it compares to other countries on paid maternity leave, or for many countries, parental leave. And every picture you see, every country you see shaded in green has some sort of paid leave, and every country you see shaded in yellow has zero weeks or four or less weeks. And as you can see, starkly, what stands out here is that the United States is so far behind other countries in paid leave, and as you probably also know, our federal leave policy is still an unpaid leave, 12-week unpaid leave policy that isn't even available to all workers. So we currently have, across the U.S., 12 weeks of unpaid leave based on how long you've been in the company and how many hours you work. What's gotten very messy and very interesting for those of us who study this, because there's a lot of natural experiments going on, 13 states and Washington D.C. have currently some type of paid leave. And it's all over the place, about how much you get paid, how it's funded, how much time you get. So for researchers, it's fascinating, because I can look at one state that is 80% pay for 12 weeks, another state that is 60% pay for six weeks and then unpaid leave for 12 weeks, but for the parents who are trying to live with this, it's incredibly confusing, and in fact, I'm going to show later that many HR agencies, companies, HR groups and companies don't even know what the policy is in their state, or how it affects family leave policy, or how it should play out for their workers, so it's gotten very confusing in terms of what is available for parents, but suffice it to say, we are far behind most other industrialized countries in the world in terms of our leave policies. The other piece I want to throw out here is that when we think about workers, we need to think about the context of the workers that we're talking about, and often, a lot of that literature that I mentioned to you before about not looking at parents going back to work, is that much of our literature, for very long time, on the transition to parenthood, focused on white, middle and upper middle class families, and in fact, those folks weren't often going back to work very soon after having their babies, when, in fact, the majority of workers in this country fall within sort of what we would define as working class or working poor families who are making minimum wage or above minimum wage, but still in a bracket where the stress of work and the stress of lower incomes is very clear. So the data that I'm going to talk to you about today was collected in the 2000s when, on average, the minimum wage in the state I was looking at, which was Massachusetts, was about $9 an hour, even though it still was sitting at $7 federally. So yearly income, if you were making $9 an hour was about $18,000 in Massachusetts, almost 19, and for a two-parent family, that came out to about $37,440. So to put those numbers in context, poverty for a family of three in Massachusetts at the time was 20,000. So families, if both people were working full time in minimum wage jobs, were clearly above poverty. They were actually at about 200% of the poverty level, which is considered by many folks to be sort of the working poor and/or working class, and those labels, you know, fluctuate. The Bureau of Labor Statistics have stayed away from labels like that, but for folks like me, sociologists and psychologists who are trying to give this work meaning, those are sort of the categories that we use. So in my work, I'm primarily focused on working-class and working-poor families. That doesn't mean that what I'm going to share with you doesn't apply to higher-income families. It's just that the issues are more dramatic when you have less resources. I was a lower-income working-class kid growing up. I've now moved into a middle- and upper-class lifestyle, and having three kids was incredibly stressful for me, but nothing, I'm going to argue, compared to what it's like when you're not, don't have the financial resources to deal with some of that stress. So why low-wage work? Partly because, as I said, my own background, my parents were low-wage workers, and I kind of felt uncomfortable reading this literature where all low-wage work was characterized as bad work, as monotonous work, as mind-numbing work, as boring work, and I was asking the question, is it really the case that all low-wage work is bad work? And that's a tricky question, because I never want to argue that minimum wage is enough, but are there other things about low-wage work we should also be considering when understanding how work affects workers and how work affects their families? And the other argument is that low-wage work is unlikely to disappear anytime soon, and so we really need to know when and under what conditions are these jobs really bad for parents and kids, and other conditions where they actually we see positive outcomes for parents and kids, so that's at the sort of crux of what I was interested in studying. So as Heidi mentioned, we started this project called The Work and Family Transitions Project over 20 years -- more than 20 years ago now, and it was the study of low-income working families experiencing the transition of parenthood, and then soon thereafter, the transition back to work. And as a psychologist, I was very interested in mental health outcomes, so like parental depression, parental anxiety, overload. I was interested in how in parenting, and I was ultimately interested in kids' emotional and cognitive development. What could we understand about that? My predictor side of the model was something that psychologists often pay less attention to, especially with folks in developmental psychology, which is really digging into what about work matters? So there's hours and schedules and shifts which, I would argue, have received the most attention. And then there's all sorts of policies, parental leaves, scheduling, leaves, flexibility, sick time. And then there's the actual experience on the job, how much autonomy you have, how much self-direction you have at work. What's your supervisor relationship like? What's your relationship with your coworkers? How much stress is there at work? And those are the kinds of things I was really interested in linking to these outcomes of parental well-being, parenting quality and children's development. So this is a busy slide, so I just want to take a minute to situate you all with the kind of data that we collected. And as you can see from this slide, there were two major studies. One was called WFTP number one, which was a study of 153 two-parent, low-income families, as you can see in that top bar. And we actually went into families' homes. We spent about two to three hours with families, interviewing moms and dads separately, and in each interview, we asked the same questions, and we did a number of survey questionnaires, so we did a lot of questionnaires about well-being. We had mental depression, anxiety, stress, overload. We asked a lot about people's relationships, their marriages and/or their close relationships. We asked a lot about work, all those categories of work that I just talked to you about, and hours and schedules and experiences with supervisors and coworkers. We asked about their ideology, their beliefs about who should parent and what parenting looks like and is it gendered, a lot of questions about social support. And then after the baby was born, we asked a lot about child temperament. And as we were doing that first study, which went from the prenatal interview. We interviewed them before their babies were born, after their babies were born, at about a two-month postnatal interview, but if they were going back to work sooner than two months, we got in there because we wanted to do the interview before they were back at work. So for some of these families, literally, we were in there two weeks after the baby had been born. Then we did a return-to-work interview after parents had been back to work for a month. Then we did a six-month interview and a one-year follow-up interview. The six month was just collecting data survey interview. So I'm going to be presenting you some of the findings from that data that showed how the work experiences in that first year affect or was related to their well-being and their relationships and kids development, but as we were doing that study, it became very clear that I had limited sort of too much what that families could be like in terms of two-parent married families, when in fact, we were getting lots of families who were interested and participated who were single moms, who were cohabiting families. We also didn't have enough racial and ethnic diversity in that first sample to understand how culture might shape some of these processes. So we started WFTP number two, which was 207 new families that we repeated everything that we had done in WFTP 1, all of these interviews, five time points, but with a much more diverse sample in terms of family structure and in terms of racial and ethnic diversity. We also, at the same time we were doing those new interviews with the 207 families, went back to our families we had interviewed in WFTP 1 and interviewed them as their children were entering the first grade, so we have some longitudinal, much longer longitudinal data that looks at sort of kid outcomes in the first grade. So there's a ton of data here, and what I'm going to try and do in this talk is sort of encapsulate some of the key findings, but I'm happy to answer all the questions you might have. We have a lot of different papers that have come out of this study, as you can imagine, and I'm just trying to pick sort of the story that I think relates to this Total Worker Health initiative, but I'm happy to talk about other aspects. And I also, just to give you a sense of demographically, what these samples looked like, because they were different, the WFTP 1 sample, which was 153 couples, moms and dads were, on average, sort of mid-20s. We took no one that had higher than an associate's degree, because I was really interested in looking at families that were more classified as working class or working poor. Education is one indicator of that. A college degree opens up more doors, so we were really interested in folks who didn't have that training. The household income on average was about 43,000 but you can see the individual incomes was 29,000 and 24,000, and they worked full time. What's really important for those demographers in the audience or epidemiologists in the audience is this question of family income or household income, which in many large studies, and I've done it myself using much larger datasets than this, where you sort of control for family income and look at family income as a household-level variable. What's really important, however, in this sample is that that household income was -- 43,000 on average, was made up of two in the 20s-level income, and that story, for that kind of family where both people are working full time to get to 43,000 is a very different story, if you think about it, than a family where only one person is making the 43,000 and the other person might be home, so you're no longer having to think about how to pay for child care, right, that a lot of the family resources are being cared for by one person. So thinking about family income without understanding whether it's two workers contributing to that or one, I think, is a really important lesson we learned here, and that we need to pay attention to. The WFTP 2 sample on the right was, as you can see, more single mothers, about 89 single moms, about 85 cohabiting moms with their partners, and then 33 married mothers. Again, we limited education level to sort of hold down sort of opportunity occupationally. And as you can see, income varied widely across these family structures, and again, worked a little bit less than full time. So what about work matters in the -- what I'm going to be talking to you about in the next few minutes is three sort of different dimensions of work, or how we think about it. One is sort of this structural, if you will, or the hours, the income, the schedules that people are working in. As you probably know, there's a lot of research looking at hours and the effects on mental health and hours and effects on kids. What you may not be so aware of in the child development literature is, despite the hundreds of articles that have been done looking at the impact of particularly maternal work hours, not paternal, which we'll talk about, on kids outcomes, is the findings, if at all, are fairly weak, that hours, in and of themselves, don't tell us much about kids' developmental outcomes, and that's really important, because it doesn't mean that hours don't matter, but it means that there's things that are much more relevant about work which we're going to get to, such as policies and work conditions that impact parents and impact kids. So the second category of issues we looked at were policies, flexibility policies, paid leave policies, sick time policies, and then we also looked at work conditions, like, when you're at work, what is it like? What does your coworker support look like? What do your relationships look like with your coworkers, with your supervisor? How much autonomy do you have doing the job you do, and how much stress or urgency is in their job? So we collected all of these data multiple times, and we're interested in linking that to parent mental health and children's developmental outcomes. So here's a picture of the book that came out of this project, and there's many empirical studies listed at the end, if you wanted to look at very specific areas, but today, I'm going to highlight what I see as sort of the four big ideas that come out of this book that I think could inform our conversation about Total Worker Health and kinds of things we might want to do moving forward. So the first big idea, and I already alluded to this, is that low-wage work does not have to be bad work, and that is actually kind of a novel thought, because oftentimes we categorize work as low-wage, high-wage, good, bad, low-autonomy, high-autonomy, when in fact, there's tons of variability within low-wage work. So the popular narrative which is that low-wage jobs are demeaning and tedious and unrewarding, is true for some. Some jobs are actually very much like that, but you could maybe say there's high-wage jobs that are like that as well, but many are not. So when we listen to parents, we learned that many parents in our study talked about their work as rewarding and as meaningful, and that was really important. So, for example, we went back to our data, and I -- when I was trying to -- when we actually -- despite all the quantitative data we had, we had lots of qualitative data where we just asked people to tell us about their work after they'd answered all these little questions about it, and one of the women who had actually the highest autonomy score in our whole sample was Linda, who worked at a candle factory, which was sort of surprising to me. I'm like, wow, this, this is the woman that talked about having the most autonomy at work. What is going on? And so, I went back and because we could go back multiple times, I went back, actually, and sort of asked her about what was so great about her work. And she told me this really interesting story of how she would be packing these boxes for customers, and she started putting little notes in the boxes, basically saying, "You might like this scent," or "I noticed that you seem to like vanillas. Here's a new scent that we have," or "Here's a new product that we have." And pretty soon her boss started getting requests that she fill packages for certain companies, and he was totally surprised, and he went to her and he said, like, what's going on? Why are people asking for you? They don't even know you. And so she proceeded to tell him this, how she has started putting notes in people's boxes and that sort of thing, and now you can see this going two ways. One where the boss is going, "Well, that's -- you know, you're wasting time. That's not your job. Just fill the package," or one where he says, "Wow, that's pretty creative, and actually, that creates sort of a relationship between folks who are actually faceless in this process," right? And in fact, he was so impressed, he went to his boss and told him. She got an award. She started then teaching other workers how to sort of fill boxes and write notes, and they got -- and she started this whole process at work. She ended up feeling incredibly valued, loved her job, and when I -- this is one of her quotes. And when I say, what does good work like, she was experienced but she would define as good work. She have -- she said, "I have to say, I have it good. I have a great boss. I have great coworkers. They listen to me. They're good to me. I'm a trainer now, which is so fun. They were also so good to me when Eric was born. It wouldn't hurt to make more money, but at least I have a job where I am valued." Another example is Jerry. He was a 24-year-old refrigeration mechanic, and he talked about work is his family. Like, these guys that he worked with were his buddies. "They always have my back if I need to leave for a doctor's appointment. Or if the baby's sick, they'll cover for me, and I would do the same for them. We are like a family." So here's two jobs that if we looked at ONET and characterized these kinds of jobs, or we just sort of some objective assessment of these jobs, you wouldn't necessarily characterize them as highly autonomous or highly supportive or wonderful jobs, when, in fact, these workers were telling me how much they liked their work, partly because of their relationships and the respect that they were due. Of course, there is the other side, and these are the stories we hear much more often, and they did occur in our data as well, which is what bad work looks like. And for Emma, she was a 20-year-old certified nursing assistant. She worked the night shift. She lived in a very gritty neighborhood, and right near where the -- her -- the nursing home was so she could walk to work and walk back, and I'm going to tell you later about Emma's relationship with her baby, but basically, Emma had a terrible experience at work. She said, "I'm like a robot. I go in and most of the clients are sleeping. I walk people to the bathroom. I do paperwork. Some clients are lonely or have nightmares, and I try to talk to them, but then my boss yells at me, telling me to get to work. She also always wants me to work overtime after my shift is over, because we're short staffed, and she's not happy when I say, 'No, I have to get home to my baby.'" So I'm hoping that these examples really lay out the notion that all low-wage work isn't bad work. Some of it is very bad and some of it is very good, and that means we need to look at the variability within these jobs to understand the implications for workers. So that's my idea number two, what happens at work shows up at home. And this kind of runs counter to the idea that many workers have actually will say to me, which is, "When I leave work, I leave work. I leave work at work, and I come home and I'm there and I'm present for my babies," which may be the story we tell ourselves, but our data actually tells us a different story. So when I talk to families or I talk to employers or anybody, I want all of us to think about the job as sort of coming home and being a member of the family. The job sits there at the dinner table and gets played out in many different ways. The job gets involved in mom's and dad's relationship. The job shows up in how parents relate to their kids, and that's the processes we wanted to understand. How does that actually work, and what are the implications of it? So I'm going to focus in on parent mental health right now, and I'm particularly going to focus in on depression. So why? So because I was studying the perinatal period, we were studying the transition to parenthood, perinatal depression is one of the number one risk factors for new mothers and actually for fathers, and approximately 9% to 28% of women experience depression, either during pregnancy or in the first 12 months after pregnancy. One in seven women will get postpartum depression. That's an astounding number. And in low-income samples, like we were working with, that number rises to about one in four. And interestingly, approximately 5% to 20% of fathers also experience postpartum depression, sometimes as a result of being partnered with a depressed spouse. The other important things about pre- and postnatal depression is that 45% to 65% of ever-depressed women had their first episode during pregnancy, so it might be the first time it shows up as then, but it tends to continue. It's a strong predictor of later mental health problems. The other critical piece is that maternal depression, there's well-documented data, has a negative impact on infants' and children's cognitive development, emotional development and physical development, so it's something we really need to pay attention to, and I'm really interested in how work plays into that. Paternal depression has also received -- is starting to receive more attention. Our data points to some of this, as you'll see, and some studies have begun to link paternal depression to poor quality parenting in dads. So that's why we chose to look at depression. We have many other outcomes that I can also talk to you about, that we've looked at, but today I'm going to talk primarily about depression, and what I'm going to talk about is how work conditions across that first year of parenthood, so everything from work hours to the amount of autonomy you have at your job, to amount of urgency you have at your job or stress, the kind of relationships you have with your coworkers and supervisors, how those are related to depression across the first year of parenthood. So I'm going to show you this first picture, which basically shows when we did a hierarchal linear model of just what was going on, on average, for mothers' depressive symptoms across the first year, we got this really interesting inverted curve here, which was that prenatally, depressive symptoms were fairly high, which is fairly typical. There's a lot of stress and anxiety and depression right around when babies are born, and then, on average, you see it decline, and people return back to sort of average and normative levels of depressive symptoms, but then, and this is unique to our sample, you see depressive symptoms start to increase as parents go back as mothers -- this is for mothers; we see a similar but less dramatic graph of fathers -- as mothers go back to work, and I was surprised by this finding, because I've studied the transition of parenthood for a long time, and the story has always been depressive symptoms and conflicts sort of rise right around when the baby's going to be born, and then folks recover over the first year. And what we saw is folks started to recover, and then when they returned to work, symptoms started to come back again, and this has been overlooked in much of the literature that hasn't paid attention to that second transition of having to go back to work soon after having a baby. But what I want you to also know, that was an average picture that I just showed you, on average what happened, but if you look at any one particular mom, and this is just a scatter plot of 20 random moms in the study, you see they're all over the place. Some actually increased and then decreased. Some decreased and then increased, and that, to me, says, wow, there's a lot of different stories going on here. So there's some moms who are doing very well. There's some moms who aren't doing well at all. There's some moms who recover. There's some moms who don't. I want to understand what -- how we predict that based on the work variables that we have, so I'm going to share with you a few of the findings that we got related to that. And the first and probably the most simple and maybe most elegant finding we got was around supervisors and supervisor support. So that blue line, curvilinear line, is moms who had low supervisor support, so you can see their depression was higher at the starting point, not significantly different, but higher than the high-supervisor-support moms. They recovered after the birth, and then you see their depression levels increase significantly again after they go back to work, whereas, and importantly, for the moms who reported high supervisor support, we don't see the similar increase in depressive symptoms. So this is the first piece of evidence, and you're going to see a lot of evidence, that supervisors are critical. Supervisors make the difference no matter when you're going back in making that transition more seamless and better related to mom's mental health or highly problematic. This graph is very convoluted, so I just -- I'm going to point out two of those sort of key points about this one, because this looked at supervisor support is actually a buffer for stressful jobs. So if you remember, mom's job urgency is high stress or pressure-full jobs, and supervisor support is having supervisors who care about you and who are involved and support you. And what we see here is this dark, dark line is that mothers who reported high job urgency and low supervisor support, have depressive symptoms that don't recover. They basically stay pretty high on this dark blue line, but when you have a stressful job, but you have a great supervisor, we see the depression comes down and stays down. That's this single less-dark line, right here. So here's where things get interesting, so it doesn't mean just having a stressful job is bad. A stressful job can actually be not a bad thing. It can be even energizing if it's in the context of a highly supportive supervisor. Again, that's hugely important, because we may not be able to change the time urgency that goes with some jobs, but we can put in a buffer of a supportive supervisor. For dads, this is a really interesting graph, so these are again, high urgency, but with dads, it wasn't about supervisors. It was about coworkers. And what you see here in this study was that under conditions of high coworker support, it doesn't matter how urgent your job is, whether it's low-urgency or high-urgency, if you have good coworker support, Dad's depression was significantly lower across both of those groups. The group that actually increased, let me show you. Oh, first, I'm going to show you this group decreased. Fathers with low coworker support and low urgency had the highest levels of depressive symptoms early on, which made perfect sense, but interestingly, they declined, which we had no idea what that was about, and I'm going to going to tell you in a minute what we found. And then there was this finding that made sense to us, fathers with high job urgency and low coworker support, so you have a stressful job, you have no coworker support. These are the dads that increased in depression across the first year, but let me go back to these dads with low coworker support and low urgency, who, for some reason, are doing better over time, which didn't make sense to us. We thought they would be sort of not great doing well. But, you know, low-urgency jobs, less stressful jobs or really boring jobs, can actually be problematic for dads. And what we did is we went back to our dads who had the lowest coworker support and the lowest urgency, and we read their stories, and what we found was those dads who were in really boring jobs without any supporting coworkers around, having a baby all of a sudden gave meaning to their lives in a way they had never expected, so they could do these jobs because it had a reason to be doing. Even if it wasn't a great job, they were doing it for their baby, and it was incredibly important to them. So again, this transition time is a very significant meaning-making time for fathers. And for some fathers, it buffered the effects of being in a bad job, because at least I was doing something for my baby, and that was really important. So I also want to give you an example of another high-urgency job and a low -- with low supervisor support, because these are the most risky ones, right? These are the ones we're worried about, and this was Joelle, who was a 25-year-old banquet server at a large hotel chain, and she basically said, "Look, you just can't plan. You can't plan. S over Christmas and New Year's, I was working 60 hours a week. The job was intense. We did not have enough workers, and the pressure was crazy. I was so stressed, and my supervisor would not give me a break. She could care less if we had families. And then the holidays are over, and I'm lucky if I get 20 hours a week. The days are slow. I often get sent home early, and that's how it goes. You never know how many shifts you're going to get week to week, so you don't know how much money I'll have week to week, and it's incredibly stressful." So this, for those of us on the worker side of things and on employer side of things, is something we need to address. This is the sort of lack of predictive of what I'm going to be making, the lack of hours, the increase in hours, that having no control over that is a huge risk factors for all families, but especially families with new young infants. Idea number three, small change in work life can bring big changes in family life, and I found this message has been really important because many employers get overwhelmed and think they have to put in an onsite child care or have these leave policies that they basically feel like they can't afford. And in fact, our data shows again and again and again small changes, but multiple small changes and small changes that are informed by workers can make a huge difference for families. So two examples where, one, Maria was a grocery store worker. She was in the last months of her pregnancy. She had to stand up through this eight-hour shift, and it was becoming increasingly difficult, and she described how her boss broke the rules, and he gave her a stool to sit on during her last months of pregnancy, and he let her take breaks as needed, and she basically said, "There were really strict rules at checkout, but and you can't sit, you cannot sit down, but he broke the rules for me, and that really mattered." And I think that sounds so simple, but the fact that it sort of increased her loyalty, increased her sense of wanting to stay at this job is hugely important, and the supervisors need to be empowered to be able to make those sorts of changes. Sierra was a hair stylist, and she talked about receiving a phone call at work with news that her baby was sick and needed to be picked up right away, but she still had three clients, and her boss was like, "Just go. Of course, just go. Family comes first. We'll figure this out." That is a bit of a bigger deal to be able to manage that, but the fact that this small sort of response on any given day makes Sierra feel supported, cared about by her supervisor and ready to come back the next day is hugely important, and so when we start talking about how we empower supervisors, I think this is really critical. So this graph was from one of our papers that basically showed that if you have longer leaves, and long leaves in our country, as you know, mean about 12 weeks. In Canada, that means a year. In Scandinavia, it means a year. Here, we're talking 12 weeks, which I wouldn't call a long leave, but we do in this country, and having some good policies, which is basically being able to pick up your child when they're sick for example, is related to this bottom dotted line, which is less depressive symptoms that stay low across the first year of parenthood. In contrast, shortly, meaning two weeks, three weeks, four weeks, and having none of those policies that give you some flexibility, we see higher levels of depressive symptoms that stay high. So this is the story. This is a big part of our story, that these supportive policies, which are not huge, I'm not talking about high levels of income here. I'm talking about small policies that give folks some control over their lives, is making a difference for families in terms of their depressive symptoms. And finally, I think the point that for in our data, when people actually started listening to us, they sadly cared less about parents' mental health, but cared more about the impact on kids, and once we started getting kid outcomes, people started sort of trying to understand what was going on, so we were really interested in the consequences of parental work experience for children, and we wanted to go past sort of the huge literature on work hours to look at what about work mattered? And so I'm going to share with you some data that linked job conditions to both parenting with infants and also linked to actual child development outcomes. So first, work and infant development, so we actually, when we went and visited our families after the babies were born, we videotaped moms and dads interacting with their babies. So this is sort of the gold standard of how you measure parenting, which is sort of have sustained interactions, and then those interactions based on sort of a task you get them to do with their baby, and then we go back and use the coding system from NIH to code the responsivity and sensitivity of both mothers' and fathers' response to their infants. And we found, and we just should orient you to this graph, because we found this again and again and again, that workplace autonomy for example, so parents who are saying, "I have more control over what I do at my job. I have some say in what I do. I feel some self-efficacy," had a greater sense of control in life, just in feeling like they had some control over their lives at a very uncontrollable time when you have a newborn infant, and that predicted higher quality mother-infant interactions. So workplace autonomy contributing to an overall better sense of control in moms, which predicted better more sensitive mother-infant interactions. The same thing happened with supervisors. Having a supportive supervisor was related to a greater sense of control, which was related to more sensitive parenting, and this was for moms. Dads, the findings came out not as significant, more often related to coworker support, not supervisor support. And finally, less autonomy at work is related to greater parental distress, so this is where mental health comes into the picture again, so having autonomy was related to less maternal distress, and distress was an indicator of both anxiety and depression, which was related to Gradle maternal responsiveness. And this, for me, is hugely important, and in the book, I am not going to read it all now because I don't think we have time, but the story of the mom who worked at the nursing home, who worked night shift and would come home and be with her baby during the day, the interaction of that mom with her baby was perhaps the most distressing interaction I watched in all of these interviews, because I did that interview. And I was in her home, and I asked her if she was, you know, game to sort of interact with her baby. She'd been up all night. I had asked her if she wanted to reschedule. She's like, "Oh, no, no, I can do it," and I watched her interact with her baby for 15 minutes, and what I saw was sort of heartbreaking, because it was this young, you know, this infant, sort of sitting with her mom, playing with a rattle that we had given them, a new toy to sort of interact with their baby, and the mom was sort of holding the baby and holding the rattle in front of the baby and shaking it, but completely not connected to the baby. She was looking at her phone. She was looking off. She -- the baby was sort of reaching out at all sorts of ways, touch -- trying to touch the mom's leg, trying to get the mom's attention, and mom was just completely checked out. And this was as a stranger was in her room videotaping what she was doing. And this woman, Emma, loved her daughter, was proud of her daughter, talked to me about her daughter, but in her interactions with her baby, was so depressed and so deflated, couldn't interact with her child. Now, this may happen -- any of us on any given day, we may be videotaped with our child not looking like we're doing a great job with parenting. It's when it happens again and again and again, day after day, that we start seeing the risk for infant development as a function of parent mental health. We also had data that looked at kids, older kids, so these were kids in the first grade, as I mentioned to you, and so this is basically saying that first year of life, what happened in terms of patterns that get set up and how work is experienced by moms and by dads is related to kids' behavior problems. So this graph, and I want to orient you, so mom's supervisor support and dad's supervisor support in their first year of life, mom's work hours and dad's work hours predicted fewer -- mom who had high supervisor support predicted fewer child behavior problems five years later, as reported by teachers and moms and dads. So that's a direct sort of interesting finding of something going on in that first year that sets up patterns, I would argue, that then play out over time for kids in a positive way. So having good supervisor support makes moms more available, and what we found is that's exactly right, that there's a path where experiences at work affect parenting which then affect behavior problems. So mom's autonomy, more autonomy, she was less overreactive, less harsh in her parenting, and we saw fewer behavior problems in the first grade. Same finding for dads, more autonomy at work in their first year of life, less overreactive parenting, harsh parenting, unreliable parenting, which was related to fewer behavior problems. So not only did we find this path from early work to later kid development, we found it for dads as well, not just moms, and this is really, in my book, really important. We also looked at a positive outcome. A lot of what we do in psychology is look at that negative stuff, and we were only interested in what predicted kids who had adaptive skills? And what I mean by adaptive skills is where teachers and parents rated their children on the ability to maintain friendships, to see other perspectives, to interact with adults, to follow rules, basically, skills, you know, skills of living that you need and be able to control your emotions, some emotion regulation skills. And again, what we found is that that first year of life, moms who had good jobs were better parents. They were less reactive or less harsh. They were more involved, and this was related to kids' adaptive skills in the first grade, same with fathers. So the path is that these early work experiences are shaping parent involvement, and we know the patterns that get set up in that first year are patterns that are likely to be maintained, so hugely important that we think about how work affects parenting, but maybe even more important to think about it, especially in these early first years. So in sum, our findings suggest that parents work conditions matter. They matter for parents' mental health. They matter for the quality of their parenting, and they ultimately matter for kids' development. So what can we do? What kinds of changes can we make to sort of make work a better place for parents? My first piece of advice is to give workers a voice in the change. In some of the few studies I've been involved in that are interventions, workers know exactly what would make their work easier to do, where they'd feel more respected, where they'd feel like they had greater autonomy. In some cases, I've worked with companies that got very nervous about this and felt like we would be quote-unquote inciting union activity, but in fact, in the studies where it's actually been managed and worked, workers basically, if they're invested in the change, they make the change happen and it works. Make sure workplace policies are understood and implemented. I can't tell you how many companies are unaware of what the policy actually is in their state around paid leave or leave policies, aren't able to translate it well to their workers. We have policies in the books that folks don't know how to use. Create more flexible workplaces, and that doesn't have to be flex time, some dramatic change. It literally is available -- folks can leave early if they have to, because a child is sick, right? Or folks can have some say in when they take their time, or there's some comp-time proposals that people are allowed to use, some flexibility that allows folks to manage their families while they're managing their work, and I think this other thing is remembering that small changes can lead to big payback. Shelley Correll, who's a sociologist at Stanford has done some amazing work with companies showing little changes and adding on to those changes, small, sustainable changes are what lead to changes in culture, and it's that culture that breeds loyalty and autonomy and support for workers. So I think there's many ways we can be creative depending upon the workplace So I want to close with the words of Ann Masten, who talks a lot about resilience, and we talk a lot about resilience in the developmental literature, but people using the term all the time, and basically she said, "Children and older human individuals have an impressive capacity for resilience when basic protections are working." She argues, "Resilience isn't something like we're born with, like, I'm really resilient and you're not. Resilience comes when basic things are in place and people can act out their lives in a controllable way." So resilience comes when we have parental leaves, when we have supportive supervisors, when we have meaningful work, when we have sick time that people can use and don't have to ask permission and can be turned down, that we have schedule flexibility, that we have some autonomy in any kind of job, and you've seen any kind of job can have autonomy, and that we have coworker supports. These are kind of the basic protections I would argue are needed for parents, working parents, that are going to have huge impact, not only on their resilience, but on their baby's resilience, and ultimately, for all of us, our next generation, who we all need to be invested in. So I've gone a little bit too long, I think, so I'm going to stop there, and I'm happy now to open it up to questions or comments or discussion.

>> Excellent. Thank you very much, Dr. Perry-Jenkins, I want to open it up to questions in the Q&A box on your screen. Please feel free to enter some questions. It's been a fantastic presentation today on some eye-opening research. Thank you very much, Dr. Perry-Jenkins, for all of your work that you're doing, and I am so interested in seeing and learning more about your other work. We have a couple questions here, let's see, that are coming in. So yes, as we wait for these questions coming in, Dr. Perry-Jenkins, what's next? What are you working on now?

>> What we're working on now is some interventions, actually, at workplaces, around sort of worker mental health. So we've worked with some folks who are working on basically empowering supervisors, because supervisors are those -- so the middle managers who there's people up here and there's people down here, and supervisors, many who we've interviewed, know their workers well, know what would make a difference, but also feel like their hands are tied often in terms of doing the things that would make a difference, so trying to work on interventions that allow supervisors, empower supervisors to manage their teams in ways that they know their workers need. So that's one, and the other is this issue of giving -- helping workers come up with their own solutions, and what we find is when workers come up with their own solutions, those are the solutions that work.

>> Wonderful. Thank you. I have a question from one of our attendees, and they're asking, "Thank you for this important work. I'm wondering if you saw the same effects, even after accounting for parent trauma history and previous depression or other mental health conditions?"

>> That's a really important question. We measured trauma history, and we measured depression, prior incidences of mental health issues, and these are actually above and beyond, so those are all controlled for in here, and they -- and in the perfect analysis, I wouldn't control for them., I'd start by looking at the impact, but for these studies, we controlled for initial level and looked at change, and that's hugely important, but what's also was interesting is there's more than half of the sample had not had symptoms of depression prior to getting pregnant, and as you saw, that statistic oftentimes pregnancy is the starting point for long-term depressive symptoms, so the other issue that's really interesting is sort of personality. A lot of folks have said, "Well, some people just have more depressive personalities than others," and we do have personality measures that we've also been looking at and controlling for, and there are -- it is true there are some folks more at risk already, so those things matter. They add to the risk, but there's risk even above and -- even controlling for those initial indicators, but it's a really important variable, yes.

>> Excellent. We have a couple questions here that are asking about what, despite the US not being able to support parent leave, what are some things that the US is doing right now to move in that direction, and how can we compensate for that?

>> Well, as I mentioned, many states are taking this on, so it's the luck of the draw where you're pregnant and where you're having these babies, right, because in some states, you're going to have paid leave, and in some states you're not, which I continue to believe we need to push for a federal family medical leave that covers all states and all workers, partly because it's incredibly confusing right now, and states are doing a lot of work in recreating the wheel again and again and again, and we know what works. The data is crystal clear out there about what works. So there are still efforts at the federal level to come up with medical family leave, and everybody needs to have a voice in that, and we as researchers in that area need to have our voices there loud, but I do think even in your -- in the time being in your own states, knowing what the policies are, knowing what the current state is, almost every state in a union has some policy that they're working on if they don't already have paid leave, and we need to be there helping inform those because at the very least we need that, but it's problematic to not have a federal policy. I don't know if that answered the question.

>> Yes. Thank you. I think that there was several different questions coming in at that angle.

>> Yeah.

>> Absolutely. And one other question came in relevant to the daycare environment. I don't know if that's something that you have, but did the quality or perceived quality of daycare for a child have much of a measurable impact on the parents?

>> That is such a good question. So when I first started this, I had some very minimal daycare questions, not enough, and one of my colleagues who was a daycare researcher, was like, "Oh, my gosh, you need -- why aren't you asking more about this, because we know how expensive it is, and we know about quality?" So we do have data on daycare, and what's interesting is most of the families in our study did not use center care, partly because there's not enough infant center care in the area that we were looking at it, and they didn't trust center care, but they would use family-based care, and oftentimes unlicensed family-based care, so we had some parents paying $1 an hour, $2 an hour, but they would have eight children in this unlicensed child care center. So we -- I have a student right now who's sort of assessing -- we didn't -- we have indicators of quality, but we don't have a quality measure, so we're working with some other researchers who are helping us so we can look at how sort of quality of daycare is also playing into these outcomes, and I'm sure it is, yeah. We also, I just want to say, had a lot of families, more than a third that did split alternating shifts, so one spouse would work during the day and one spouse would work in the afternoon or night to cover childcare, which was saved a lot of money, and you didn't have to use outside care. The cost on relationships was really high. They had the highest levels of conflict and the highest levels of separation six years out.

>> Thank you. And Dr. Perry-Jenkins, on behalf of the Total Worker Health program and the Healthy Work Design and Well-being Council, thank you very much for this excellent presentation. We are so, so delighted to have you presented with us today. And that concludes our presentation for today. Folks, if you have questions, the slides will be up on the Total Worker Health website in several weeks.I also want to encourage you all to please connect with us on our websites. And Dr. Perry-Jenkins, I look forward to connecting you and encourage everyone, because I know we have a huge crowd here, encourage folks to cite your work and follow you. Thank you.

>> Thank you.