BACKGROUND: Socio-economic health inequalities are well documented, but efforts to explain health inequalities are less. However, previous studies suggest that working conditions provide potential explanations for inequalities in health. METHODS: Cross-sectional questionnaire survey data, collected from municipal employees of the City of Helsinki, aged 40-60 years (n = 8960, response rate 67%) in 2000-02, were examined using binomial regression analysis. Socio-economic position was measured by six occupational social classes ranging from top managers to manual workers, and the outcome was self-rated health (SRH). Key physical and psychosocial working conditions and work arrangements were included as explanatory factors for inequalities in health. RESULTS: Occupational class inequalities in SRH were clear among women [prevalence ratio (PR) 1.89, 95% confidence interval (CI) 1.54-2.32] and men (PR 1.78, 95% CI 1.40-2.25). Heavy physical workload explained a half of the health inequalities among women and almost one-third among men. Physical and chemical exposures at work explained one-fifth of the health inequalities among women and a half among men. Job control explained 24% of the men's and 40% of women's inequalities, whereas job demands widened the inequalities by 13-14%. The effects of shift work and working hours were negligible. In the fully adjusted model, 60% of the women's and 32% of the men's inequalities in SRH were explained. CONCLUSION: Physical working conditions explained a large part and job control, a somewhat smaller part of socio-economic inequalities in SRH. Improving physical working conditions and increasing job control provide potential routes to reduced inequalities in health among employees.
BACKGROUND: Socio-economic health inequalities are well documented, but efforts to explain health inequalities are less. However, previous studies suggest that working conditions provide potential explanations for inequalities in health. METHODS: Cross-sectional questionnaire survey data, collected from municipal employees of the City of Helsinki, aged 40-60 years (n = 8960, response rate 67%) in 2000-02, were examined using binomial regression analysis. Socio-economic position was measured by six occupational social classes ranging from top managers to manual workers, and the outcome was self-rated health (SRH). Key physical and psychosocial working conditions and work arrangements were included as explanatory factors for inequalities in health. RESULTS: Occupational class inequalities in SRH were clear among women [prevalence ratio (PR) 1.89, 95% confidence interval (CI) 1.54-2.32] and men (PR 1.78, 95% CI 1.40-2.25). Heavy physical workload explained a half of the health inequalities among women and almost one-third among men. Physical and chemical exposures at work explained one-fifth of the health inequalities among women and a half among men. Job control explained 24% of the men's and 40% of women's inequalities, whereas job demands widened the inequalities by 13-14%. The effects of shift work and working hours were negligible. In the fully adjusted model, 60% of the women's and 32% of the men's inequalities in SRH were explained. CONCLUSION: Physical working conditions explained a large part and job control, a somewhat smaller part of socio-economic inequalities in SRH. Improving physical working conditions and increasing job control provide potential routes to reduced inequalities in health among employees.
Authors: Pekka Varje; Anne Kouvonen; Lauri Kokkinen; Aki Koskinen; Ari Väänänen Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2017-12-13 Impact factor: 4.328
Authors: Åse Marie Hansen; Matias Brødsgaard Grynderup; Reiner Rugulies; Paul Maurice Conway; Anne Helene Garde; Eszter Török; Eva Gemzøe Mikkelsen; Roger Persson; Annie Hogh Journal: Int Arch Occup Environ Health Date: 2018-01-30 Impact factor: 3.015
Authors: Marie Murcia; Jean-François Chastang; Christine Cohidon; Isabelle Niedhammer Journal: Int Arch Occup Environ Health Date: 2012-06-08 Impact factor: 3.015
Authors: Samson Y Gebreab; Ana V Diez-Roux; DeMarc A Hickson; Shawn Boykin; Mario Sims; Daniel F Sarpong; Herman A Taylor; Sharon B Wyatt Journal: Soc Sci Med Date: 2012-07-13 Impact factor: 4.634