The quality of work and health inequalities – cross-national differences
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1) The document analyzes socio-economic inequalities in employee mental health across European countries and examines the role of gender and job quality. 2) It finds that for women, differences in mental well-being based on social class are most prominent in Continental and Southern European countries. For men, such differences are found in all European countries except Anglo-Saxon ones. 3) Gender inequalities are more widespread in Anglo-Saxon countries. Across all countries, job quality explains some of the differences in mental well-being between social classes for men.
The quality of work and health inequalities – cross-national differences
- 1. The quality of work and health inequalities – cross-national differences Deborah De Moortel Co-authored with Laia Palència, Lucía Artazcoz, Carme Borrell, Christophe Vanroelen Vrije Universiteit Brussel Agència de Salut Pública de Barcelona
- 2. BACKGROUND • Socio-economic inequalities in employee mental health? • Useful concept of "neo-Marxian" social class (NMSC) • Does not necessary assume a linear or gradational associations with health • Relates health to the structural relations of dominance and subordination in the labour process • Understanding of the way in which one's position in the labour process affects health
- 3. SOCIAL CLASS SCHEME Source: Wright, 1997
- 4. EUROPEAN CONTEXT? • Policies might influence social inequality in employee mental well-being – Korpi’s (2010) institutional typology of welfare states • Clarifies health inequalities with respect to gender AND class • The relation between NMSC and health differs by gender
- 5. WELFARE REGIMES • Combination of : Family Policy models: 1. Earner-carer • Nordic countries 2. Traditional family • Continental Europe 3. Market-oriented • Anglo-Saxon countries Social insurance models: 1. Encompassing • Nordic countries 2. State corporatist • Continental Europe 3. Basic security • Anglo-Saxon countries • The Southern and Eastern European countries are also increasingly analysed as separate welfare state regimes
- 6. OBJECTIVES 1. to analyse the association of mental well-being and NMSC among employees in Europe - Less NMSC inequalities in Nordic countries due to more redistributive social policies - More NMSC inequalities in Continental and Southern countries due to stratified generosity 2. to examine the association across genders - Less gender inequalities in Nordic countries as they promote gender equality - More gender inequality in Continental and Southern countries as they promote homemaker role for women
- 7. NEO-MARXIAN SOCIAL CLASS & QUALITY OF (UN)PAID WORK • Welfare regimes influence social inequalities in health through their impact on social determinants of health – Job quality • Unskilled workers are exposed to more hazardous working conditions than other social classes • Unskilled workers report greater job insecurity and more temporary contracts than other social classes
- 8. OBJECTIVES 3. To examine the role of job quality for explaining the association? - job quality explains association in Southern and Eastern countries due to their lower prevalence of high-quality jobs
- 9. Data & Variables • European Social Survey (ESS) 2010 (7,119 male and 6,988 female employees) • 21 European countries • Dependent variable: Good mental well-being (yes/no) • Independent variables: – Social Class position (based on occupation and skill level) – Household responsibilities – Job quality – Country groups
- 10. ● Poor mental well-being • Based upon three items of the WHO-5 Well-being index • Measure of positive emotions • Over the last two weeks I have felt cheerful and in good spirits • Over the last two weeks I have felt calm and relaxed • Over the last two weeks I have felt active and vigorous • Scale of mental well-being (range 0-10) yes/no Measures
- 11. Measures • job quality • Type of contract • full-time, (involuntary) part-time • social/regular work hours • training opportunities • High support • Representation • Skill discretion • Autonomy • Psychological demands
- 12. Measures • Social class position – International Standard Classification of Occupations (ISCO) – Skill level classification of ISCO – a question on whether the employee is responsible for supervising other employees – managers (those who worked as a manager and supervise other employees) – supervisors (non-managers who supervise other employees) – workers (all others) – within these three categories, another subdivision was made using the skill level classification of ISCED: "unskilled" (skill level 1 & 2); "semi- skilled" (skill level 3); and "experts" (skill level 4).
- 13. Measures • Country groups – (1) basic security/market oriented (Ireland and UK); – (2) encompassing/earner-carer (Denmark, Finland, Norway and Sweden); – (3) state corporatist/family support (Belgium, France, Germany and the Netherlands); – (4) Eastern European (Bulgaria, Czech Republic, Estonia, Hungary, Lithuania, Poland, Slovakia and Slovenia) and; – (5) Southern European (Cyprus, Greece, Portugal and Spain).
- 14. Statistical Analyses 1. Description of the population 2. Subsequent Robust Poisson regression model 1. Model 1: Age, year dummy, social class Objective 1 2. Model 2: Model 1 + household responsibilities 3. Model 3: Model 2 + job quality Objective 3 3. Pooled Robust Poisson regression model – good mental well-being in women compared to men stratified by NMSC Objective 2 PR and 95% confidence intervals All analyses included weights and were stratified by welfare state
- 15. % of good mental well-being 0 10 20 30 40 50 60 70 80 90 100 Con nental Anglo-Saxon Eastern Southern Nordic Men Women
- 16. 0 10 20 30 40 50 60 70 Men: Unskilled workers Women: Unskilled workers Men: Expert managers Women: Expert managers Con nental Anglo-Saxon Eastern Southern Nordic % of social class
- 17. 0.95 1 1.05 1.1 1.15 1.2 1.25 1.3 1.35 1.4 Unskilled workers Unskilled supervisors Semi-skilled supervisors Expert supervisors Managers Semi-skilled supervisors Managers Managers Unskilled supervisors Semi-skille superviso Reference Women Men Men Women Men Men Con nental Eastern Southern Nordic Prevalence ratio’s Good MWB * Only significant results at P ≤ 0.05
- 18. 0.9 1 1.1 1.2 1.3 1.4 1.5 Unskilled workers Model 1 Model 3 Model 1 Model 3 Reference Con netal men Southern women Job quality mediation: Prevalence of Good mental well-being for managers
- 19. 0.5 0.6 0.7 0.8 0.9 1 1.1 Men Unskilled workers Semi-skilled supervisors Expert managers Semi-skilled supervisors Unskilled workers reference Anglo-Saxon Eastern Southern Prevalence of good mental well-being for women * Only significant results at P ≤ 0.05
- 20. Discussion • Main Findings: 1. For women NMSC differences in mental well-being are found in Continental and Southern countries 2. For men NMSC differences in mental well-being were found in all but the Anglo-Saxon countries 3. Gender inequalities are more marked and widespread in Anglo-Saxon countries 4. In all countries job quality partly explains NMSC inequalities in mental well-being for men
- 21. Article published in Social Science & Medicine: http://www.sciencedirect.com/science/article/pii/S 0277953615000532 Email: [email protected] Thank you for your attention!