Problematizing gender, work and health: the relationship between gender, occupational grade, working conditions and minor morbidity in full-time bank employees

Gender-Based Differences in Psychological, Nutritional, Physical Activity, and Oral Health Factors Associated with Stress in Teachers

The aim of this study was to analyze gender differences in stress-related factors among active teachers. A cross-sectional study was conducted to examine gender disparities in psychological, nutritional, physical activity, and oral health factors and how these habits correlate with stress and burnout in their work environment. The sample comprised 1037 teachers from Spain, Colombia, and Chile, consisting of 40.1% men and 59.9% women, with an average age of 41 years and teaching experience of 11.8 ± 9.2 and 12.2 ± 8.7 years, respectively. They were evaluated using a compilation of questionnaires with the objective of analyzing gender differences in habits that are associated with stress levels in teachers. The findings revealed that men had significantly higher levels of depersonalization and personal accomplishment, whereas women exhibited higher levels of perceived stress and conscientiousness. Regarding nutritional habits, results were more positive for women, and men exhibited healthier functional habits by engaging in more weekly sports. Regarding oral health habits, women had better oral hygiene practices, brushing their teeth more frequently. However, women showed a higher tendency to smoke than their male counterparts. We conclude that there are notable gender differences that can provide insights for developing strategies to enhance the overall well-being of teachers.

Self-reported health among immigrants in Luxembourg: insights from a nationally representative sample

Aim

Although immigrants account for nearly half of Luxembourg's population, few studies have investigated differences in self-reported health by nationality in Luxembourg. Our study aimed to explore the association between nationality and self-reported health in Luxembourg.

Subject and methods

Cross-sectional data from the 2015-2016 Panel Socio-Economique Liewen zu Lëtzebuerg (PSELL3) were used. Nationalities included Luxembourger, Portuguese, French, Italian, Belgian and German. Multivariable logistic regression analyses examined the association between nationality and three self-reported health measures: general health status, limitation in activity due to a health problem, and living with a chronic illness or condition.

Results

Of 8084 participants, 65% were Luxembourgers, 20% were Portuguese, and the remaining 15% were French, Italian, Belgian, or German. Italian nationals were more likely to report fair, poor, or very poor health [aOR = 1.54; 95% CI = 1.07, 2.22] and Portuguese nationals demonstrated both higher odds of fair, poor, or very poor health [aOR = 1.57; 95% CI = 1.28, 1.92] and limitation in activity [aOR = 1.32; 95% CI = 1.07, 1.64] compared to Luxembourgers. However, Portuguese nationals were also less likely to report living with a chronic illness [aOR = 0.79; 95% CI = 0.63, 0.98]. In education-stratified models, primary-educated Portuguese nationals were more likely to report fair, poor, or very poor health [aOR = 1.78, 95% CI = 1.36, 1.92] and limitation in activity [aOR = 1.36, 95% CI = 1.04, 1.79], but not less likely to report living with a chronic illness.

Conclusions

Nationality and education level should be considered in future studies concerning self-reported health in Luxembourg. Further research is needed to examine disparities in self-reported health among Portuguese and Italian nationals.

Sick Leave Due to Stress, What are the Costs for Dutch Employers?

Purpose Stress-related illnesses are prevalent in Western society, causing sick leave and putting a heavy economic burden on employers and society. For Dutch employers it is particularly relevant to have insight into the costs of absenteeism due to stress-related illness, as they are legally obligated to continue payment of wages. Therefore, this study assessed the duration and costs of an episode of sick leave due to stress-related illness for Dutch employers. Methods Data on sick leave due to various stress-related illnesses were obtained from a nationwide occupational health service database. Stress-related illnesses included tension complaints, burn-out, overexertion, and other reactions to stress. The duration per sick leave episode was estimated in working days, after which the average cost per sick leave period was estimated using age- and gender-specific price weights. Results During the study period, 16,676 employees took 17,338 episodes of sick leave due to stress-related illness. On average, one episode of sick leave lasted 101 working days, for which the costs for the employer were on average €19,151 per worker. Women were responsible for most episodes of sick leave and were on average 37 days more absent per episode compared to men. Moreover, of all kinds of stress-related illnesses, burn-out had the longest duration of sick leave with 313 calendar days and 163 working days, resulting in an average cost of €30,770. Conclusions Sick leave due to stress-related illness places a heavy burden on employers and thus society. Further research should be conducted on how to reduce this burden.

Sex and age differences in COVID-19 mortality in Europe

Aim

To examine the magnitude of sex differences in survival from the coronavirus disease 2019 (COVID-19) in Europe across age groups and regions. We hypothesized that men have a higher mortality than women at any given age but that sex differences will decrease with age as only the healthiest men survive to older ages.

Methods

We used population data from the Institut National D’Études Démographiques on cumulative deaths due to COVID-19 from February to June 2020 in 10 European regions: Denmark, Norway, Sweden, The Netherlands, England and Wales, France, Germany, Italy, Spain and Portugal. For each region, we calculated cumulative mortality rates stratified by age and sex and corresponding relative risks for men vs. women.

Results

The relative risk of dying from COVID-19 was higher for men than for women in almost all age groups in all regions. The overall relative risk ranged from 1.11 (95% confidence interval, CI 1.01–1.23) in Portugal to 1.54 (95% CI 1.49–1.58) in France. In most regions, sex differences increased until the ages of 60–69 years, but decreased thereafter with the smallest sex difference at age 80+ years.

Conclusion

Despite variability in data collection and time coverage among regions, the study showed an overall similar pattern of sex differences in COVID-19 mortality in Europe.

Supplementary Information

The online version of this article (10.1007/s00508-020-01793-9) contains supplementary material, which is available to authorized users.

Well-Being: Its Relationship with Work-to-Family Conflict and Burnout among Males and Females

The present study aims to apply gender-specific analyses to examine how work-to-family conflict (WFC) and burnout are related to well-being among the workers in Taiwan. A cross-sectional research design was adopted. A questionnaire was distributed to obtain information pertaining to demographic characteristics, WFC, burnout, and well-being. In total, 4259 full-time workers in the manufacturing industry were recruited. Gender-specific statistical analyses were used. The results showed that no significant gender difference occurred on WFC; however, females had higher scores on burnout compared to males. In the correlation analyses, WFC as well as burnout were negatively associated with well-being in both genders. In the regression analyses when demographic factors were controlled, burnout explained larger variances of well-being in both genders compared with WFC. WFC made a smaller contribution to the models predicting well-being in males in contrast to females. Moreover, the significant association between WFC and well-being for males disappeared when burnout was taken into account. The conclusion reached was that to improve workers’ well-being, organizations should develop relevant policies to decrease the extent of burnout for different genders. The policies that the organization adopted should consider females’ needs beyond work-related burden. Moreover, merely decreasing the extent of WFC is insufficient to enhance males’ well-being.

Health and Work in Women and Men in the Welding and Electrical Trades: How Do They Differ?

Objectives

There is little information on how work tasks, demands, and exposures differ between women and men in nominally the same job. This is critical in setting workplace standards that will protect the health of both men and those women moving into less traditional work roles. Information used in setting standards is currently based almost entirely on male workers. This paper describes differences in work and health, and the relation between them, in women and men who have undergone the same trade training for the welding or electrical trades.

Method

Four cohorts were established. Two were women across Canada in the welding and electrical trades who had been in an apprenticeship since 2005. Cohorts of men in the same trades during the same period were established in the province of Alberta, Canada. Participants completed a baseline questionnaire at recruitment and were followed up every 6 months to collect detailed information on work carried out and on their health and habits. At the end of the study (up to 5 years for women and up to 3 years for men), the cohort members completed a final questionnaire including questions on mental health, harassment, and gender.

Results

The four cohorts comprised 1001 welders (447 female; 554 male) and 885 in the electrical trades (438 female; 447 male). Follow-up information was available for 89%. Women were more likely than men to have had some post-secondary education before starting their trade and were less likely to be living as married or to have a child. More welders smoked, and more men were heavy drinkers. At recruitment, more welders than those in the electrical trades reported rhinitis (sneezing and runny nose), depression, and anxiety. Female welders reported more depression (38%) than male welders (30%), compared to 24% in the electrical trades. At first follow-up, new-onset shoulder pain was more frequent in men and new-onset asthma or wheezing in welders. Within each trade, women reported less variety in tasks. Women welders were less likely to be employed in construction than men, and women were less likely to become industrial electricians. Overall, 54% of women and 46% of men reported never using respiratory protection when welding. In the end-of-study questionnaires received to date, 49% reported bullying or harassment during the apprenticeship, with higher proportions in welding than electrical trades and in women compared with men. Such harassment was reflected in higher anxiety and depression scores.

Conclusions

This is the first report on these four cohorts and demonstrates the capacity for detailed analysis of the differences in exposure and new-onset occupationally related ill-health. While women and men in the same trades appear to be doing broadly similar work, and to have similar patterns on health at the first follow-up, there are some significant differences in the types of employment and variety of tasks. The very detailed information collected will allow more precise estimates of exposures to be correlated with health outcomes at the end of the follow-up period.

Gender bias in assessment of future work ability among pain patients - an experimental vignette study of medical students' assessment

Background and aims Pain is a prevalent problem in many countries. Women are more often on sick-leave for pain than men. Such gender differences have been explained through biological factors, different demands for on the job market, and home conditions. Fewer studies have focused on how gender stereotypes may bias the medical assessment of pain patients. The aim of the present research was to investigate if a gender bias in medical students' evaluations of chronic pain patients can contribute to explaining the gender differences in sick-leave due to pain. Specifically, we investigated whether medical students' estimates of a patient's accuracy of their own work ability and amount of domestic work differed between female and male patients, and how such estimates influenced the medical students' judgments of the patient's work ability. Methods Medical students (n=137; 60 women; 74 men; three unspecified) read a vignette describing a patient with pain and filled out a questionnaire. The vignette was identical and gender neutral, except for the name of the patient signaling gender. A between-subjects experimental design was used in which participants were randomly assigned to an experimental condition. Participants then judged the patient's work ability, the accuracy of the patient's self-assessed work ability, and the amount of domestic work they believed was performed by the patient. All ratings were made on seven-point items. Results The results showed that there was no main effect of gender on perceived future work ability of the patient, F (1,131)=0.867, p=0.353. However, male patients were considered to be more accurate in their self-assessed work ability than female patients F (1,131)=5.925 p=0.016 (Mfemale=4.87, SDfemale=1.22, and Mmale=5.33, SDmale=1.02). Moreover, female patients were thought to perform more domestic work, F (1,131)=25.56, p<0.001 (Mfemale=4.14, SDfemale=1.41, and Mmale=3.07, SDmale=1.16). Finally, perceived amount of domestic work moderated the effects of perceived future work ability for female but not for male patients, B=0.42, p=0.005. Hence, there was a positive effect of amount of domestic work performed on work ability judgments for women, such that the more domestic work they were assumed to perform, the more they were perceived to be able to work. Conclusions Gender stereotypes influenced assessments of future work ability in pain patients, mainly because women were assumed to perform more domestic work which had a positive effect on perceived work ability. Because domestic work should have a negative effect on recovery, expectations from the physician that domestic work is expected by female patients may in fact have the opposite effect prolonging sick-leave. Moreover, the students trusted the male patients' ability to assess their own work capacity more than women's. Implications It is important that medical students receive education about gender biases and how they may influence medical assessment during their training. Such education may alleviate the influence of gender stereotypes.

Constructing respectability from disfavoured social positions: exploring young femininities and health as shaped by marginalisation and social context. A qualitative study in Northern Sweden

BACKGROUND

Gender, class and living conditions shape health and illness. However, few studies have investigated constructs of femininity in relation to health and living conditions among young women who are unemployed and marginalised at an early age.

OBJECTIVE

The aim of this research was to elucidate constructs of femininities in relation to structuring living conditions and expressions of health in Northern Swedish women. The time period of interest was the transition from unemployed teenagers to young adults in a social context of high unemployment and societal change across the critical 'school-to-work-transition' period of the life course.

METHODS

Qualitative content analysis was used to analyse data from repeated interviews with unemployed young women, aged 16-33 years, during the 1980s and 1990s. These longitudinal interviews were part of a cohort study in a 'remote' municipality in Northern Sweden that began in 1981. All girls who were not in education, employment, or training were selected for interview. An inductive analysis phase was followed by a theoretically informed phase. The contextual frame is the Nordic welfare-state model and the 'caring state' with its particular focus on basic and secondary education, and women's participation in the labour market. This focus paralleled high rates of youth unemployment in northern Sweden during the study period.

RESULTS

The results are presented as the theme of 'constructing respectability from disfavoured social positions'. Within this theme, and framed by dominant norms of patriarchal femininity, we explored the constructs of normative and altruistic, norm-breaking, and troubled femininity.

CONCLUSIONS

Gender-sensitive interventions are needed to strengthen young women's further education and positions in the labour market and to preventing exposure to violence. More research on health experiences related to the multitude of constructs of femininities in various social contexts and across the life course is needed to help design and implement such interventions.

Mental health by gender-specific occupational groups: Profiles, risks and dominance of predictors

BACKGROUND

We defined gender-specific profiles of mental ill-health for the main occupational groups using three outcomes; antidepressant use, sickness absence (SA) due to depression, and suicides. We also examined which occupational groups had the highest risk of the outcomes, and compared the importance of their predictors.

METHODS

From a random register cohort of Finnish working age population, individuals in the six largest occupational groups in 2004 for men and women were included (N = 414 357). We used register data to define the first antidepressant purchase (i.e. use), the first long-term SA spell for depression, and suicide between Jan 1st 2005 and Dec 31st 2014. We assessed the risk of each outcome by occupational group with logistic regression models, and used dominance analysis to compare the relative importance of predictors.

RESULTS

In all six occupational groups for women, the prevalence of antidepressant use and SA for depression was higher than in the men's occupational groups. The opposite was observed for suicides. The risk of antidepressant use was lower, but the risk of suicide was 2-times higher among men in low vs. high-skilled occupations. Among women, a lower skill-level was associated with a higher risk of SA due to depression. Gender was the most important predictor of all outcomes.

LIMITATIONS

We lacked information on history of medication use or health problems prior to follow-up.

CONCLUSIONS

Gendered occupational status was an underlying factor explaining distinctive mental health profiles in the working population. Occupational class-dependent behavioural patterns related to mental health existed among men.

Parent's Relative Perceived Work Flexibility Compared to Their Partner Is Associated With Emotional Exhaustion

A number of studies have found that control over work conditions and hours is positively related to mental health. Still, potential positive and negative effects of work flexibility remain to be fully explored. On the one hand, higher work flexibility might provide better opportunities for recovery. On the other hand, especially mothers may use flexibility to meet household and family demands. Here, we investigated the association between parent's work flexibility, rated relative to their partner, and emotional exhaustion in interaction with gender. Additionally, gender differences in time use were investigated. Cross-sectional analyses based on responses of employed parents to the 2012 wave of the Swedish Longitudinal Occupational Survey of Health (SLOSH) were conducted (N = 2,911). Generalized linear models with gamma distribution and a log-link function were used to investigate associations between relative work-flexibility (lower, equal, or higher as compared to partner), gender, and emotional exhaustion. After control for potential confounders, we found that having lower work flexibility than the partner was associated with higher levels of emotional exhaustion as compared to those with higher relative work flexibility. Also, being a mother was associated with higher levels of emotional exhaustion, independent of possible confounders. An interaction effect between low relative work flexibility and gender was found in relation to emotional exhaustion. Regarding time use, clear differences between mothers' and fathers' were found. However, few indications were found that relative work flexibility influenced time use. Mothers spent more time on household chores as compared to fathers, while fathers reported longer working hours. Fathers spent more time on relaxation compared with mothers. To conclude, our results indicate that lower relative work flexibility is detrimental for mental health both for mothers and fathers. However, while gender seems to have a pronounced effect on time use, relative work flexibility seems to have less influence on how time is used. Generally, mothers tend to spend more time on unpaid work while fathers spend longer hours on paid work and report more time for relaxation.

Male-Female Differences in Work Activity Limitations: Examining the Relative Contribution of Chronic Conditions and Occupational Characteristics

OBJECTIVE

The aim of this study was to examine differences in activity limitations at work among men and women, and the relative contributions that chronic conditions and occupational characteristics have on these differences.

METHODS

Secondary data from the Canadian Community Health Surveys were used. Path analysis examined the role of mediating variables (chronic conditions and occupational characteristics) in male-female differences in work activity limitations.

RESULTS

The prevalence of activity limitations at work was higher in women (15.0%) than in men (12.3%). Arthritis, migraines, diabetes, heart disease, and mood disorders, as well as high physical demands and prolonged standing were associated with an increased risk of work activity limitations. The increased risk of work activity limitations among women was completely explained by mediating variables.

CONCLUSIONS

This study suggests that male-female differences in work activity limitations can be explained by differences in chronic conditions and occupational characteristics.

Public challenge and endorsement of sex category ambiguity in online debate: 'The sooner people stop thinking that gender is a matter of choice the better'

Despite academic feminist debate over several decades, the binary nature of sex as a (perhaps the) primary social classification is often taken for granted, as is the assumption that individuals can be unproblematically assigned a biological sex at birth. This article presents analysis of online debate on the BBC news website in November 2013, comprising 864 readers' responses to an article entitled 'Germany allows 'indeterminate' gender at birth'. It explores how discourse reflecting Western essentialist beliefs about people having one sex or 'the other' is maintained in debates conducted in this online public space. Comments were coded thematically and are presented under five sub-headings: overall evaluation of the German law; discussing and disputing statistics and 'facts'; binary categorisations; religion and politics; and 'conversations' and threads. Although for many the mapping of binary sex onto gender was unquestionable, this view was strongly disputed by commentators who questioned the meanings of 'natural' and 'normal', raised the possibility of removing societal binary male-female distinctions or saw maleness-femaleness as a continuum. While recognising that online commentators are anonymous and can control their self-presentation, this animated discussion suggests that social classifications as male or female, even if questioned, remain fundamental in public debate in the early 21^st century.

Gender differences in Reasons for Sickness Presenteeism - a study among GPs in a Swedish health care organization

Background

It is common that physicians go to work while sick and therefore it is important to understand the reasons behind. Previous research has shown that women and men differ in health and health related behavior. In this study, we examine gender differences among general practitioners who work while sick.

Methods

General practitioners (GP’s) working in outpatient care in a Swedish city participated in the study (n = 283; women = 63 %; response rate = 41 %). Data were obtained from a large web-based questionnaire about health and organization within primary care. Two questions about sickness presenteeism (going to work while sick) were included; life-long and during the past 12 months, and five questions about reasons. We controlled for general health, work-family conflict and demographic variables.

Results

Female physicians reported sickness presenteeism more often than male physicians. Work-family conflict mediated the association between gender and sickness presenteeism.

Women reported reasons related with “concern for others” and “workload” more strongly than men. Men reported reasons related with “capacity” and “money” more strongly than women. These differences are likely effects of gender stereotyping and different family-responsibilities.

Conclusions

Gender socialization and gender stereotypes may influence work and health-related behavior. Because sickness presenteeism is related with negative effects both on individuals and at organizational levels, it is important that managers of health organizations understand the reasons for this, and how gender roles may influence the prevalence of sickness presenteeism and the reasons that female and male GPs give for their behavior.

Surviving in Dangerous Places: Lesbian Identity Performances in the Workplace, Social Class and Psychological Health

This article examines the ways in which the psychological health of women may be influenced by workplace sexual identity performances and social class positioning. It draws on UK research through in-depth interviews with 24 women who self-defined as mainly lesbian and/or gay. The article demonstrates that, for the women in the study, sexual identity performances at work involved negotiating employment settings that render heterosexuality compulsory and thus lesbian/gay performances a risk. As a result, the women engaged in risk-assessment strategies that were psychologically demanding. The women's narratives also suggest that the psychological effects of managing an ‘othered’ sexual identity in work was mediated by social class. The working-class women were more likely to be employed in settings where heterosexuality was heavily regulated and their ‘practices of survival’ were potentially more detrimental to their psychological health.

Self-reported health and gender: The role of social norms

The role of social norms in accounting for the different attitudes of men and women with respect to health is still an open issue. In this research, we investigate the role of social norms associated with specific gender environments in the workplace in accounting for differences in health-reporting behaviours across men and women. Using the 2010 European Working Conditions Survey, we build a database containing 30,124 observations. We first replicate the standard result that women report worse health than men, whatever the health outcome we consider. We then proxy social norms by the gender structure of the workplace environment and study how the latter affects self-reported health for men and women separately. Our findings indicate that individuals in workplaces where women are a majority tend to report worse health than individuals employed in male-dominated work environments, be they men or women. These results are robust to controlling for a large array of working condition indicators, which allows us to rule out that the poorer health status reported by individuals working in female-dominated environments could be due to worse job quality. This evidence suggests that social norms associated with specific gender environments play an important role in explaining differences in health-reporting behaviours across gender, at least in the workplace.

The status of social well-being in Iranian nurses: a cross- sectional study

INTRODUCTION

Social well-being is one of the important aspects of individual's health. However, the social aspect of health, or social well-being, has not been attended to as equally as the other aspects. Social well-being is people's perceptions and experiences in social circumstances as well as the degree of successful responses to social challenges. The aim of the study was to investigate the social well-being of a sample of Iranian nurses.

METHODS

This study was a cross- sectional conducted in 2013. The study population consisted of all 1200 staff nurses working in all hospitals located in Ardabil, Iran. We invited a random sample of 281 practicing nurses to respond to the 33-item Keyes's Social Well-Being Questionnaire and the possible range of the total score is 33-165. Higher score reflect better SWB. The quantitative analysis of this study used the Statistical Package for Social Science SPSS version 13.0.

RESULTS

The results showed that Participants' mean score of social well-being was 105.45 (15.87). Social well-being was significantly related to participants' age, gender, work experience, satisfaction with working in hospital and with income, familiarity with nursing prior to entering it, official position, and type of employment. However, there was no significant relationship between nurses' social well-being and their marital status, their parents and spouses' educational status, as well as the type of hospital.

CONCLUSION

Nurses' social well-being deserves special attention. Effective well-being promotion strategies should be executed for promoting their social well-being particularly in areas of social integration and social acceptance. Moreover, nurses, particularly female nurses, need strong financial, emotional, informational, and social support for ensuring their social well-being.

Are reports of psychological stress higher in occupational studies? A systematic review across occupational and population based studies

OBJECTIVES

The general health questionnaire (GHQ) is commonly used to assess symptoms of common mental disorder (CMD). Prevalence estimates for CMD caseness from UK population studies are thought to be in the range of 14-17%, and the UK occupational studies of which we are aware indicate a higher prevalence. This review will synthesise the existing research using the GHQ from both population and occupational studies and will compare the weighted prevalence estimates between them.

METHODS

We conducted a systematic review and meta-analysis to examine the prevalence of CMD, as assessed by the GHQ, in all UK occupational and population studies conducted from 1990 onwards.

RESULTS

The search revealed 65 occupational papers which met the search criteria and 15 relevant papers for UK population studies. The weighted prevalence estimate for CMD across all occupational studies which used the same version and cut-off for the GHQ was 29.6% (95% confidence intervals (CIs) 27.3-31.9%) and for comparable population studies was significantly lower at 19.1% (95% CIs 17.3-20.8%). This difference was reduced after restricting the studies by response rate and sampling method (23.9% (95% CIs 20.5%-27.4%) vs. 19.2% (95 CIs 17.1%-21.3%)).

CONCLUSIONS

Counter intuitively, the prevalence of CMD is higher in occupational studies, compared to population studies (which include individuals not in employment), although this difference narrowed after accounting for measures of study quality, including response rate and sampling method. This finding is inconsistent with the healthy worker effect, which would presume lower levels of psychological symptoms in individuals in employment. One explanation is that the GHQ is sensitive to contextual factors, and it seems possible that symptoms of CMD are over reported when participants know that they have been recruited to a study on the basis that they belong to a specific occupational group, as in nearly all "stress" surveys.

[Impact of Nd: YAG capsulotomy on quality of life in pseudophakic patients]

OBJECTIVE

To determine whether visual acuity (VA) improvement in patients with posterior capsule opacification (PCO), accepted after the capsulotomy, is followed by positive changes in the perception of their quality of life.

METHOD

A total of 130 patients with PCO were examined before and after capsulotomy. In addition to the ophthalmic examination, the EuroQol questionnaire was completed. We analyzed the influence of demographic characteristics on the outcome of the test.

RESULTS

The mean binocular visual acuity (BVA) and the mean scores in the EuroQol dimensions and EQ-VAS improved significantly after capsulotomy. VA did not have the same effect on daily common tasks. After treatment, the problems in the usual activities dimension have seen the largest reduction. Mobility is still the dimension with more problems regarding patients after capsulotomy.

CONCLUSIONS

Decreased VA induced by PCO is associated with difficulties performing daily living activities. Capsulotomy results in a gain in VA and functional ability of the majority of patients, improving the perception of their quality of life.

The differential impact of job isostrain and home-work interference on indicators of physical and mental health in women and men

OBJECTIVES

To evaluate (1) whether the physical and mental health of male workers differs from that of female workers, and, if so, whether (2) this is affected by the interplay between work and nonwork burden.

METHODS

We pooled two large Belgian databases (BELSTRESS III, SOMSTRESS) comprising data on 4810 (2847 women). Gender-specific logistic regressions were performed using a four-level variable as predictor. This combined two predictors: isolated job strain (isostrain) and home-work interference (HWI).

RESULTS

Male workers are at greater risk of chronic fatigue when they experience high isostrain but not high HWI. Although accumulated high isostrain and high HWI affect women mainly via chronic fatigue, the same pattern has a greater impact on men's perceived health. There was no difference for the other patterns.

CONCLUSIONS

To improve workers' well-being, organizations should develop work and nonwork balance policies specific for men and women.

Conflict between the work and family domains and exhaustion among vocationally active men and women

Exhaustion is consistently found to be more prevalent in women than in men. Women suffer from job strain more often, which may constitute a partial explanation for this phenomenon, but experienced shortcomings in combining work and family demands may also contribute to ill health. The aim of this study was to investigate, and analyse by gender, how work-related and family-related factors, as well as the interface between them, i.e. work-to-family conflict (WFC) and family-to-work conflict (FWC), are related to exhaustion. The study was cross-sectional with self-administered questionnaires assessing exposures and outcome with previously well-validated instruments. The participants were 2726 men and 2735 women, aged 45-64, vocationally active, and residing in Malmö, Sweden. Sixteen percent of the women and 8% of the men considered themselves exhausted. WFC, FWC, job strain, and low job support were all strongly correlated to exhaustion in both genders. In the multivariate analyses, adjusting for other work and family risk factors, WFC and FWC remained statistically significant risk factors for exhaustion in both men and women. Job strain, low job support, and having a somatic disorder were also independently associated with exhaustion. While WFC was more prevalent among men, it was more strongly associated with exhaustion in women than in men. In women, WFC and FWC contributed to a larger part of the explanatory power of the model, which amounted to 22% of the variance in women and 14% in men. The results imply that the concept of 'work stress' should be regarded in a wider context in order to understand gender related issues of exhaustion among vocationally active individuals.

Working conditions, job dissatisfaction and smoking behaviours among French clerks and manual workers

OBJECTIVE

To study the relationships between working conditions, job dissatisfaction and smoking behaviors among clerks and manual workers.

METHODS

We used data from the French Health Barometer, a cross-sectional telephone survey conducted among a national random sample (N = 4825). Regarding working conditions, the questionnaire dealt with reported job satisfaction, psychological demands and mental workload, physical demands, latitude decision and work schedule.

RESULTS

Manual workers and clerks who reported strong dissatisfaction toward unhealthy working conditions also reported more frequently current smoking, tobacco dependence, potential alcohol dependence and perceived stress. After adjusting for socio-demographic confounders, perceived working conditions and job dissatisfaction remained correlated with smoking and tobacco dependence.

CONCLUSIONS

Poor working conditions may heavily contribute to health inequalities, as they are likely to fuel both stress and unhealthy behaviors, which combine to increase morbidity and mortality.

Differences between women's and men's socioeconomic inequalities in health: longitudinal analysis of the Canadian population, 1994-2003

BACKGROUND

Socioeconomic inequalities in health are ubiquitous in developed countries; however, whether these inequalities differ between women and men over time is less clear.

OBJECTIVE

To estimate the potentially different health effects of changes in socioeconomic position (SEP) on changes in health for working-age women and men over a 10-year period. Three main questions were addressed: (1) are there health differences between women and men over time, (2) do changes in SEP lead to health inequalities and (3) do changes in SEP impact health differently for women and men?

METHODS

Generalised estimating equations models were used to analyse cycles 1-5 of the Canadian National Population Health Survey for four measures of health, number of chronic conditions, self-rated health, functional health and mental distress, and three measures of SEP, income, education and employment status.

RESULTS

Health inequalities by sex/gender and by changes in SEP were present for all four outcomes in age-adjusted models; however, after controlling for time-dependent social structure, behaviour, and psychosocial factors the relationships persisted only for chronic conditions and psychological distress. There was no evidence that these effects differed, over time, between women and men.

CONCLUSIONS

Men and women in this nationally representative sample of Canadians do not differentially embody changes in SEP, although both sex/gender and changes in SEP independently impact health.

Sex-specific health deterioration and mortality: the morbidity-mortality paradox over age and time

The traditional sex morbidity-mortality paradox that females have worse health but better survival than males is based on studies of major health traits. We applied a cumulative deficits approach to study this paradox, selecting 34 minor health deficits consistently measured in the 9th (1964) and 14th (1974) Framingham Heart and 5th (1991-1995) Offspring Study exams focusing on the 55-78 age range. We constructed four deficit indices (DIs) using all 34 deficits as well as subsets of these deficits characterizing males' (DI(M)) and females' (DI(F)) health disadvantages, and no relative sex-disadvantages. The DI(34)-specific age patterns are sex-insensitive within the 55-74 age range. The DI(34), however, tends to selectively increase the risk of death for males. The DI(F)-associated health dimension supports the traditional morbidity paradox, whereas the DI(M)-associated dimension supports the inverse paradox, wherein males have worse health but better survival than females. The traditional paradox became less pronounced, whereas the inverse paradox became more pronounced from the 1960s to the 1990 s. The sex-specific excess in minor health deficits may vary according to particular set of deficits, thus providing evidence for traditional and inverse morbidity paradoxes. The time-trends suggest the presence of a strong exogenous effect modifier affecting the rate of health deterioration and mortality risk.

[Self-perceived health status: an approach of the elderly in Mexico]

OBJECTIVE

To evaluate health status of the elderly in Mexico through their self-perception and to describe social, organizational and health-related factors.

METHODS

A study was carried out on secondary data from the 2000 National Health Survey in Mexico. Multiple logistic regression models were used. The dependent variable health status was measured through self-perception. The independent variables included were: sociodemographic characteristics, risk behaviors, accidents, disease diagnosis and clinical measures.

RESULTS

A total of 7,322 adults aged 60 years and older were studied, which represents 7% of the total population in that age group in Mexico. Of them, 19.8% reported poor or very poor health status. Factors found to be associated to poor health were age, female sex, having no social security, being divorced, homemaker, disabled, unemployed, tobacco consumption, having a health condition, accidents and diagnosed with chronic diseases.

CONCLUSIONS

The study allowed to identifying factors that may contribute to poor health status in the elderly. These findings could be taken into account in the development of actions and health care programs for this population in Mexico.

How might we understand men's health better? Integrating explanations from critical studies on men and inequalities in health

For researchers interested in understanding men's health, there are two main literatures to harvest. The first is research on men's health arising from the study of men and masculinities. The second is the broader study of inequalities in health, including gender inequalities in health. However, these literatures have remained distinct. This paper seeks to develop a model of understanding men's health from both of these literatures. In order to achieve this integration, this paper argues that studies of men's health should be based on 'critical studies on men' which emerges from feminist theory. Critical studies on men's health is then integrated into the broader explanatory options identified in the health inequality literature in order to provide a more fulsome account of variance within men's health and between the health status of men and women. Given the amenability of men's health issues to interrogation within this resulting framework, it is argued that the inequalities literature should start to include men's health issues in its work.

Exploring men's and women's experiences of depression and engagement with health professionals: more similarities than differences? A qualitative interview study

Background

It is argued that the ways in which women express emotional distress mean that they are more likely to be diagnosed with depression, while men's relative lack of articulacy means their depression is hidden. This may have consequences for communicating with health professionals. The purpose of this analysis was to explore how men and women with depression articulate their emotional distress, and examine whether there are gender differences or similarities in the strategies that respondents found useful when engaging with health professionals.

Methods

In-depth qualitative interviews with 22 women and 16 men in the UK who identified themselves as having had depression, recruited through general practitioners, psychiatrists and support groups.

Results

We found gender similarities and gender differences in our sample. Both men and women found it difficult to recognise and articulate mental health problems and this had consequences for their ability to communicate with health professionals. Key gender differences noted were that men tended to value skills which helped them to talk while women valued listening skills in health professionals, and that men emphasised the importance of getting practical results from talking therapies in their narratives, as opposed to other forms of therapy which they conceptualised as 'just talking'. We also found diversity among women and among men; some respondents valued a close personal relationship with health professionals, while others felt that this personal relationship was a barrier to communication and preferred 'talking to a stranger'.

Conclusion

Our findings suggest that there is not a straightforward relationship between gender and engagement with health professionals for people with depression. Health professionals need to be sensitive to patients who have difficulties in expressing emotional distress and critical of gender stereotypes which suggest that women invariably find it easy to express emotional distress and men invariably find it difficult. In addition it is important to recognise that, for a minority of patients, a personal relationship with health professionals can act as a barrier to the disclosure of emotional distress.

The Impact of Sociodemographic Factors vs. Gender Roles on Female Hospital Workers' Health: Do We Need to Shift Emphasis?

The aim of the present study was to evaluate the physical and mental health status of female workers from five different occupational groups and to identify possible sociodemographic and gender-coded family-related factors as well as work characteristics influencing women's health. The identified predictors of health status were subjected to a gender-sensitive analysis and their relations to one another are discussed. A total of 1083 female hospital workers including medical doctors, technical and administrative personnel, nurses and a group mainly consisting of scientific personnel and psychologists completed a questionnaire measuring work- and family-related variables, sociodemographic data and the Short-form 36 Health Questionnaire (SF-36). Data were analysed by multivariate regression analyses. Female medical doctors reported highest scores for all physical health dimensions except General Health. Our study population showed general low mental health status among administrative personnel and the heterogeneous group, others, scored highest on all mental health component scores. A series of eight regression analyses were performed. Three variables contributed highly significantly to all SF-36 subscale scores: age, satisfaction with work schedule, and the unpaid work variable. Age had the strongest influence on all physical dimensions except General Health (beta=-0.17) and had no detectable influence on mental health scores. The unpaid work variable (beta=-0.23; p<0.001) exerted a stronger influence on General Health than did age. Nevertheless, these variables were limited predictors of physical and mental health status. In all occupational groups the amount of time spent daily on child care and household tasks, as a traditional gender-coded factor, and satisfaction with work schedule were the only contributors to mental health among working women in this study. Traditional sociodemographic data had no effect on mental health status. In addition to age, these factors were shown to be the only predictors of physical health status of female workers. Gender coded-factors matter. These findings underline the importance of including gender-coded family- and work-related variables in medical research over and above basic sociodemographic data in order to describe study populations more clearly.

Depression and activity limitations: examining gender differences in the general population

BACKGROUND

This study examines the relationship between major depression, subclinical depressive symptomatology and activity limitation in a representative sample of Canadian men and women, with a particular emphasis on examining gender differences.

METHODS

Over a 4-year period, the three waves of data were collected from a representative sample of Canadian adults aged 18-60 beginning in 1994. A brief diagnostic interview for major depression, current limitations in home, work, and other activities (e.g., leisure), presence of each of 13 chronic medical conditions, and other sociodemographic information were gathered. Regression analyses adjusted for potential confounding of time-dependent and time-invariant covariates. These analyses were performed separately for men and women.

RESULTS

Major depression had a significant adverse impact on all types of activities for the entire community sample, and this impact was generally robust when controlling for potential confounders. Gender differences were observed for leisure activities with depressed men showing a higher likelihood of limitation in these activities than depressed women.

CONCLUSIONS

The findings provide further evidence that major depression leads to impairments in a range of daily activities. Gender differences in the impact of depression on leisure activities may be important to consider in depression treatment.

Constructing health and sickness in the context of motherhood and paid work

Changes in the labour market, especially the rise in the employment of women (lone or partnered) with children, alongside an increased policy emphasis on work as a component of active citizenship for men and women, have stimulated the development of research examining the balance between work and home. Although sociologists have long been interested in the interface between the spheres of paid work and domestic life, understandings of the subjective experience of health and illness have tended to keep the domains of family and work separate. This paper addresses the construction of health and illness as operating at the interface between the worlds of work and home. Interviews were conducted with 30 mothers in paid work and having primary school aged children; the study was located in Edinburgh, Scotland. Through an analysis of the interview accounts, this paper examines respondents' experiences and constructions of health, sickness and wellbeing in themselves and in their children. Four areas are discussed: respondents' accounts of the effects of caring and providing on their own health; respondents' accounts of the influence of workplace relationships in the construction of sickness; respondents' accounts of negotiating absence for their children's sickness and how they made sense of and defined child sickness. We argue that managing sickness, itself an anticipated but unpredictable event, gives analytical purchase to understanding the values and practices that characterise the interrelationship between work and family life. The intersections of home and work operate powerfully in respondents' constructions of health and sickness, and the analysis demonstrates how these are played out in everyday life, at home and at work.

Symptom reporting and self-rated health among women in mid-life: the role of work characteristics and family responsibilities

This study investigated how socioeconomic factors and psychosocial conditions are related to self-reported health among 43-year-old women representing the general Swedish population (N = 569). Odds ratios and multiple logistic regression analyses were used for associations and effect modification, adjusted for symptom reporting in adolescence. Poor self-reported health was predicted by low income, financial worries, and job strain, as well as combined exposure to a high level of unpaid household work and job strain (double burden). In conclusion, poor psychosocial conditions related to working life, as well as to the combined impact of paid and unpaid work were revealed to be risk factors for poor self-reported health among middle-aged women. These results highlight the need for improving women's work conditions, as well as designing family policies that promote a better sharing of unpaid household tasks and responsibilities between spouses.

Does occupational gender segregation influence the association of effort-reward imbalance with myocardial infarction in the SHEEP study?

The objective of this study was to investigate whether occupational gender segregation moderates the association between job stress in terms of effort-reward imbalance and the risk of myocardial infarction. This analysis was conducted in 1,381 cases and 1,697 referents of the Swedish SHEEP case control study aged 45-70 years. Information on myocardial infarction and biological coronary risk factors (e.g. hypertension, blood lipids) was achieved from clinical screenings. Information on socio-demographic variables, effort-reward imbalance, behavioral coronary risk factors (e.g., smoking), and additional coronary risk factors (e.g., diabetes, family history of coronary heart disease) was derived from well-tested standardized questionnaires. After adjustment for confounders the strongest association between overcommitment (the intrinsic component of effort-reward imbalance) and risk of belonging to the myocardial infarction group was found among women in male-dominated jobs (odds ratio [OR] = 2.71, 95% CI = 1.13-6.52) as compared to the remaining group (OR = 1.52, 95% CI = 1.01-2.31). Moreover, a significant interaction between pronounced overcommitment and male domination in relation to myocardial infarction was observed among women (OR = 2.44, 95% CI = 1.05-5.67). In men, an association between the ratio of effort and reward (the extrinsic component of the model) and risk of myocardial infarction was found for the majority, that is the group not working in women-dominated jobs (OR = 1.39, 95% CI = 1.04-1.86). Despite methodological limitations, this study gives preliminary evidence of a moderating effect of occupational gender segregation on the association of effort-reward imbalance (i.e., the intrinsic model component overcommitment) with acute myocardial infarction risk among women, but not among men.

Association of personality and work conditions with depressive symptoms

BACKGROUND

Previous studies have found a relationship between job-related stress and depressive symptoms in different occupational groups, and that personality may modify the risk of developing depressive symptoms. We aimed to examine the association of personality and other individual and work conditions with depressive symptoms.

SUBJECTS AND METHOD

A sample of 498 teachers answered a questionnaire concerning individual and work characteristics, some job-related perceptions, and the wish to change jobs. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression scale (CES-D) and personality was measured by the Temperament and Character Inventory (TCI-125).

RESULTS

Depressive symptoms were associated with female gender, age, low job satisfaction, high job stress, the wish to change jobs, working at a public school, and with higher scores on harm avoidance and novelty seeking and lower scores on self-directedness.

CONCLUSIONS

Our results underline the influence of personality traits on the development of depressive symptoms independently of other individual characteristics and the occupational context.

Men and health help-seeking behaviour: literature review

AIM

This paper reviews the key research literature regarding men's health-related help seeking behaviour.

BACKGROUND

There is a growing body of research in the United States to suggest that men are less likely than women to seek help from health professionals for problems as diverse as depression, substance abuse, physical disabilities and stressful life events. Previous research has revealed that the principle health related issue facing men in the UK is their reluctance to seek access to health services.

METHOD

The investigation of men's health-related help seeking behaviour has great potential for improving both men and women's lives and reducing national health costs through the development of responsive and effective interventions. A search of the literature was conducted using CINAHL, MEDLINE, EMBASE, PsychINFO and the Cochrane Library databases.

RESULTS

Studies comparing men and women are inadequate in explaining the processes involved in men's help seeking behaviour. However, the growing body of gender-specific studies highlights a trend of delayed help seeking when they become ill. A prominent theme among white middle class men implicates "traditional masculine behaviour" as an explanation for delays in seeking help among men who experience illness. The reasons and processes behind this issue, however, have received limited attention.

CONCLUSIONS

Principally, the role of masculine beliefs and the similarities and differences between men of differing background requires further attention, particularly given the health inequalities that exist between men of differing socio-economic status and ethnicity. Further research using heterogeneous samples is required in order to gain a greater understanding of the triggers and barriers associated with the decision making process of help seeking behaviour in men who experience illness.

Awkward work postures: association with occupational gender segregation

BACKGROUND

Segregation of men and women into different jobs is often cited as one of the most plausible explanations for gender differences in exposure and musculoskeletal disorders.

METHODS

Direct measurements of sitting, arm, and trunk postures were taken with two different technical instruments on 156 subjects (78 matched pairs of one female and one male worker) over one full workday in diverse labor markets.

RESULTS

Exposure differences between workers were strongly associated with vertical occupational segregation (measured as level of status/authority). The results showed that this association was strongest for female-dominated jobs. Workers in female-dominated jobs with a low status/authority experienced longer duration in standing posture (P = 0.001), and higher frequency of arm elevation (P = 0.028 and 0.040 for the dominant and the non-dominant arm, respectively). They also had longer duration of work with bent trunk compared to corresponding workers with high status/authority (P = 0.035). The association was less pronounced for male-dominated jobs, and no such association was found for gender-integrated jobs.

CONCLUSION

The findings have implications for prevention as well as for future research.

Gender, work-home conflict, and morbidity amongst white-collar bank employees in the United Kingdom

Most research on work-home conflict focuses solely on women. This study compares men and women's perceptions of the extent to which paid work interferes with family life, and examines associations between work-home conflict and health. Data were collected from 2,176 full-time white-collar employees of a British bank. We did not find any significant gender differences in perceptions of work-home conflict. However, predictors of work-home conflict did vary by gender; having children and being in a senior position were more strongly related to work-home conflict for women than for men, while working unsociable hours was more important for men than for women. Work-home conflict was strongly associated with reporting fair or poor self-assessed health, a high number of reported physical symptoms and minor psychological morbidity (GHQ-12). These associations were equally strong for men and women. Our results suggest that work-home conflict is a problem for men as well as women.

Socio-demographic determinants of self-rated health in Brazil

Self-rated health has been used extensively in epidemiologic studies, not only due to its importance per se but also due to the validity established by its association with clinical conditions and with greater risk of subsequent morbidity and mortality. In this study, the socio-demographic determinants of good self-rated health are analyzed using data from the World Health Survey, adapted and carried out in Brazil in 2003. Logistic regression models were used, with age and sex as covariables, and educational level, a household assets index, and work-related indicators as measures of socioeconomic status. Besides the effects of sex and age, with consistently worst health perception among females and among the eldest, the results showed pronounced socioeconomic inequalities. After adjusting for age, among females the factors that contributed most to deterioration of health perception were incomplete education and material hardship; among males, besides material hardship, work related indicators (manual work, unemployment, work retirement or incapable to work) were also important determining factors. Among individuals with long-term illness or disability, the socioeconomic gradient persisted, although of smaller magnitude.

The Social Context of Women's Health

HEALTH ISSUE: The discussion of health emphasizes the importance of analyses of social determinants of health. Social determinants permit the targeting of policies towards the social factors that impair or improve health. Two broad questions are considered: (i) what do we know about the social determinants of women's health? (ii) are there gender-related differences in health problems, and how we might explain them? KEY FINDINGS: While 'sex' may be used to denote the biological difference between women and men, it is an imperfect measure of 'gender'. It is argued that a single measure cannot hope to capture the complexity of gender nor the ways in which gender relations change over time and give rise to or exacerbate health problems. The literature on the social determinants of health shows the importance of placing a primary emphasis on addressing the social and economic sources of ill health at national, provincial and community levels. DATA GAPS AND RECOMMENDATIONS: Recent studies of gender differences in health point to a lack of data and to the importance of understanding changing gender relations; differences in power and access to resources between women and men, and changing expectations of appropriate gender roles and behaviours. Poverty, social exclusion, unemployment, poor working conditions and unequal gender relations have a profound influence on patterns of health and illness. We suggest some material markers of change that might be used in health surveillance. With a more complete understanding of gender's role in shaping daily lives, these markers could be refined and expanded.

Women, work and musculoskeletal health

Why are employed women at increased risk for upper limb musculoskeletal disorders and what can this tell us about the way work and family life shape health? Despite increases in women's labour force participation, gender differences in work-related health conditions have received little research attention. This appears be the first study to examine why employed women are much more likely than men to experience upper body musculoskeletal disorders. A mailed self-report survey gathered data from 737 Australian Public Service employees (73% women). The majority of respondents were clerical workers (73%). Eighty one per cent reported some upper body symptoms; of these, 20% reported severe and continuous upper body pain. Upper body musculoskeletal symptoms were more prevalent and more severe among women. The gender difference in symptom severity was explained by risk factors at work (repetitive work, poor ergonomic equipment), and at home (having less opportunity to relax and exercise outside of work). Parenthood exacerbated this gender difference, with mothers reporting the least time to relax or exercise. There was no suggestion that women were more vulnerable than men to pain, nor was there evidence of systematic confounding between perceptions of work conditions and reported health status. Changes in the nature of work mean that more and more employees, especially women, use computers for significant parts of their workday. The sex-segregation of women into sedentary, repetitive and routine work, and the persisting gender imbalance in domestic work are interlinking factors that explain gender differences in musculoskeletal disorders.

Gender Differences in Time Spent during Direct Observation of Doctor-Patient Encounters

BACKGROUND

Despite increasing recognition of women's health needs, little is known about how primary care physicians spend time with women. Therefore, we examined differences in time use and preventive service delivery during outpatient visits by male and female patients.

METHODS

As part of a multimethod study of 138 family physicians, 3384 outpatient visits by adults were directly observed, medical records were reviewed, and patient surveys were performed. Time use was assessed by the Davis Observation Code, which classifies every 15 seconds into 20 behavioral categories. Receipt of health habit counseling recommended by the U.S. Preventive Services Task Force was assessed by direct observation, and eligibility was determined by chart review. Logistic regression and multivariate analysis of variance (ANOVA) were used to compare time use and preventive service delivery in visits by women vs. men.

RESULTS

Sixty-four percent of adult visits were from women. Women reported poorer physical health, had higher rates of anxiety (12.5% vs. 7.4% in men), and depression (21.9% vs. 8.4% in men), a higher percent of visits for well care (10.2% vs. 8.8% in men), and more drugs prescribed (64.8% vs. 61% in men) and raised more emotional issues than men (14.7% vs. 7.5%). After controlling for visit and patients characteristics, visits by women had a higher percent of time spent on physical examination, structuring the intervention, patient questions, screening, and emotional counseling. Visits by men involved a higher percent of time spent on procedures and health behavior counseling. More eligible men than women received exercise, diet, and substance abuse counseling. Patients of female physicians exhibited gender differences in only one category of how time was spent (substance abuse), whereas among patients of male physicians, gender differences were noted in 10 of the 20 categories.

CONCLUSIONS

Outpatient visits by women differ from those of men in ways that reflect women's unique healthcare needs but also raise concern about unequal delivery of health habit counseling for diet and exercise.

Women, work, and well-being 1950–2000:

In this research synthesis, we summarize 161 measures of the effects of women's employment on well being reported between 1950 and 2000. Variations in the conceptualization and measurement of employment and health outcomes and the difficulty in distinguishing social selection from social causation limit the inferences that can be drawn from the evidence. Therefore, we distinguish two types of studies. Longitudinal studies measuring relevant covariates at the first measurement occasion and statistically controlling them in multivariate analyses providing effect-size information are classified as Type II studies. The remaining studies are classified as Type I studies. The main findings were that (1) results from methodologically sound Type II studies confirm the cross-sectional finding that paid employment has no adverse effects on women; (2) the outcome groups psychological distress, subjective health, cardiovascular risks and disease, and mortality do not converge completely.

Age and the gender gap in distress

Women report more psychological distress than men and recent evidence suggests that this gap increases with age. It has been argued that the widening differential in distress reflects the progressive and cumulative nature of women's disadvantaged work and family roles. Drawing on the cumulative disadvantage hypothesis and social stress theory, we test: (1) whether exposure to chronic stress accounts for an increasingly larger proportion of the gender effect on distress with age; and (2) whether women are increasingly more vulnerable to the effects of chronic stress on distress with age. Data are from the 1994 wave of the Canadian National Population Health Survey, a national probability sample of women and men aged 20 and older (N = 13,798). Exposure to long-term stress helps us understand gender differences in distress for those in their pre-retirement years. However, contrary to the cumulative disadvantage hypothesis, the model became increasingly less likely to explain such differences with age. Gendered vulnerability to long-term stress was not evident in the sample. The implications of these findings are discussed with particular reference to our ongoing efforts to understand health in the context of social structure and subjectivity.

Social role occupancy, gender, income adequacy, life stage and health: a longitudinal study of employed Canadian men and women

Social role researchers are increasingly going beyond simply asking whether role occupancy is associated with health status to clarifying the context in which particular social role-health relationships emerge. Building on this perspective, the present study investigates the relationship between social role occupancy and health status over time in a sample of employed Canadian men and women who vary by family role occupancy, life stage, and income adequacy. Results indicated that compared to triple role women (defined as those who are married, have children living at home and are in the workforce), single and double role occupants in 1994/95 were significantly more likely to report poorer self-rated health and the presence of a chronic health condition in 1996/97. This relationship held true for women in varying life stage and economic circumstances. While family role occupancies were not as strongly related to the health status of men as women, one exception emerged: for older men, single and double role occupants reported significantly poorer self-rated health status than triple role men. Methodological limitations of the study are discussed, and the need for added specificity in the study of social roles and health status emphasized.