Gender differences in minor morbidity among full time employees of a British university

Sickness absence among mothers caring for a child with disability: Examining the impact of mechanical and psychosocial occupational exposures

Background

Sickness absence is more prevalent among mothers caring for children with disability compared to those caring for non-disabled children. Working in a poor working environment may worsen the impact of care burden on health outcomes among mothers of children with disabilities.

Objective

The study investigated how sickness absences are associated with mechanical and psychosocial occupational exposures among mothers caring for children with and without disabilities.

Methods

The study included children born between 2005 and 2013 and their respective mothers (N = 147, 507). Using register data from Statistics Norway, a Zero-Inflated Negative Binominal Regression was fitted to estimate the relationship between mechanical and psychosocial occupational exposures and sickness absence among employed mothers.

Results

Mothers caring for children with disability had higher levels of sickness absences, even after adjusting for psychosocial and mechanical occupational exposures, and other possible confounding factors. When the occupational exposures analysed separately, both mechanical and psychosocial indices had a significant positive main effect on the number of sick days. The main effect of psychosocial exposure was no more significant in a simultaneous analysis, but mechanical exposure maintained its significant positive effect. However, we found no statistically significant differences in the number of sick absence days between mothers of children with and without disability based on their levels of psychosocial or mechanical job exposures.

Conclusions

The findings emphasize the need of providing support to mothers caring for children with disability that help them manage occupational health risks.

Stable Gender Gap and Similar Gender Trend in Chronic Morbidities between 1997-2015 in Adult Canary Population

There is little information about the trend of the gender gap in chronic morbidities and whether the trend of expansion occurs equally in the age and gender groups. The objectives were to examine the consistency and stability of the gender gap in the main self-reported chronic morbidities in the general population, and, likewise, to analyze the trend of major chronic morbidities between 1997 and 2015 in men and women across age groups. The data were extracted from the Canary Health Survey, which uses a probabilistic sampling in the population >16 years of age, for the years 1997 (n = 2167), 2004 (n = 4304), 2009 (n = 4542), and 2015 (n = 4560). The data for the twelve most frequent chronic morbidities were analyzed using logistic regression, estimating the annual change ratio between 1997 and 2015, adjusting for age and educational level. The interaction of age with the period (1997−2015) was examined to analyze the rate of change for each morbidity in the age groups. Musculoskeletal diseases, headaches, anxiety and depression, and peripheral vascular diseases showed a stable gender gap across observed years. High cholesterol and high blood pressure tended to a gap reduction, while heart disease, diabetes, and respiratory disease did not show a significant gender gap along the period. The trend of the main chronic morbidities increased similarly in men and women in all age groups, but significantly in women older than 60 years and in men older than 45 years. Aging explained a substantial part of the trend of increasing prevalence of the main chronic morbidities, but not totally. Factors other than age and education are driving the increase in chronic morbidity in older age groups.

Fit for fight - self-reported health in military women: a cross-sectional study

Background

Substantial research has found that women assess their health as poor relative to men, but the reasons for this are not fully understood. Military women are characterised by good health and the ability to work in an archetypically male culture. Thus, studies on the gender pattern of self-reported health in military personnel could generate hypotheses for future research on the possible associations between gender and health. However, such studies are rare and limited to a few countries. The aim of this study was to examine self-reported physical and mental health in Norwegian military women.

Methods

We compared responses on self-reported health of 1068 active duty military women in Norway to those of active duty military men (n = 8100). Further, we compared the military women to civilian women working in the Norwegian Armed Forces (n = 1081). Participants were stratified into three age groups: 20–29; 30–39; and 40–60 years. We used Pearson Chi-square tests, Students t-tests and regression models to assess differences between the groups.

Results

The military women in our study reported physical illness and injuries equal to those of military men, but more military women used pain relieving and psychotropic drugs. More military women aged 20–29 and 30–39 years reported mental health issues than military men of the same age. In the age group 30–39 years, twice as many military women assessed their health as poor compared to military men. In the age group 40–60 years, more military women than men reported musculoskeletal pain. Military women used less smokeless tobacco than military men, but there were few differences in alcohol consumption and smoking. Military women appeared to be more physically healthy than civilian women, but we found few differences in mental health between these two groups.

Conclusion

Most military women reported physical symptoms equal to those of military men, but there were differences between the genders in mental health and drug use. More favourable health compared to civilian women was most evident in the youngest age group and did not apply to mental health.

Relevance of Gender and Social Support in Self-Rated Health and Life Satisfaction in Elderly Spanish People

Background: Gender and social support are important social determinants of health, but the relevance of such variables in older people’s health has raised less scholarly attention than in younger age groups. This study examines the relevance of gender and social support in the self-rated health and life satisfaction of elderly Spanish people. A cross-sectional study with a sample of 702 men and 754 women aged between 60 and 94 years was conducted. All participants were evaluated through questionnaires that assess gender role traits, social support, and life satisfaction. Results: Men scored higher than women in masculine/instrumental trait and in life satisfaction whereas women scored higher than men in feminine/expressive trait. Results from multiple regression analyses indicated that women and men presenting higher social support had better self-rated health and higher life satisfaction. High scores in masculine/instrumental trait also proved to be an important predictor of men’s and women’s high life satisfaction and of women’s better self-rated health, whereas the high feminine/expressive trait predicted better self-rated health in the men group. A high educational level was associated in the women’s group with better self-rated health and higher life satisfaction. Conclusions: We conclude that gender and social support are important social determinants of health among older people.

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.

Distúrbios musculoesqueléticos em extremidades superiores distais entre homens e mulheres: resultados de estudo na indústria

Resumo Objetivo: estudar a associação entre distúrbios musculoesqueléticos em extremidades superiores distais (DMED) e a variável sexo na indústria de plástico. Método: estudo transversal com 577 trabalhadores. O DMED foi definido pela presença de dor nos últimos doze meses, com duração maior que uma semana ou frequência mensal, causando restrição ao trabalho ou busca por assistência médica, ou gravidade ≥ 3 (de 0 a 5), em pelo menos uma das regiões: dedos, punhos, mãos, antebraços e cotovelos. Covariáveis de interesse foram demandas físicas e psicossociais no trabalho, variáveis sociodemográficas e de estilo de vida, condicionamento físico e trabalho doméstico. Regressão logística múltipla analisou interação estatística e confundimento. Resultados: a ocorrência de DMED foi maior entre as mulheres, de forma independente das demandas ocupacionais e extralaborais testadas. Condicionamento físico foi variável de interação e demandas psicossociais, confundidora. Homens que referiram bom condicionamento físico apresentaram prevalência menor do que aqueles com mau condicionamento. Nas mulheres, estar bem condicionada fisicamente foi insuficiente para alterar substancialmente sua alta morbidade musculoesquelética. Conclusão: diferenças na exposição ocupacional são insuficientes para explicar a maior morbidade em mulheres. É necessário considerar a diversidade entre os sexos, seja socialmente determinada ou relativa à natureza biomecânica do corpo, com diferentes respostas frente às demandas do trabalho.

Gender differences in psychological distress in Spain

BACKGROUND AND AIMS

Epidemiological and community-based surveys consistently report gender differences in mental health. This study examines gender differences in psychological distress by analyzing the relevance of stress, coping styles, social support and the time use.

METHODS

Psychological tests were administered to a convenience sample of 1,337 men and 1,251 women from the Spanish general population, aged between 18 and 65 and with different socio-demographic characteristics, although both the women and men groups had similar age and educational levels.

RESULTS

Women had more psychological distress than men. Although psychological distress in the women and men groups have some common correlates such as more stress, more emotional and less rational coping and less social support, we find some gender differences. Work role dissatisfaction was more associated with distress in the men than in the women group. In addition, women's distress was associated with more daily time devoted to childcare and less to activities they enjoy, and men's distress was associated with more time devoted to housework and less to physical exercise.

CONCLUSIONS

Social roles traditionally attributed to women and men - and the differences in the use of time that such roles entail - are relevant in gender differences in psychological distress.

Gender roles and traits in stress and health

Women have a life-expectancy advantage over men, but a marked disadvantage with regards to morbidity. This is known as the female–male health-survival paradox in disciplines such as medicine, medical sociology, and epidemiology. Individual differences in physical and mental health are further notably explained by the degree of stress individuals endure, with women being more affected by stressors than men. Here, we briefly examine the literature on women’s disadvantage in health and stress. Beyond biological considerations, we follow with socio-cognitive explanations of gender differences in health and stress. We show that gender roles and traits (masculinity in particular) explain part of the gender differences in stress, notably cognitive appraisal and coping. Stress in turn degrades health. Implications are discussed. In conclusion, traditional socialization is advantageous for men in terms of health.

Gender inequalities in occupational health related to the unequal distribution of working and employment conditions: a systematic review

Introduction

Gender inequalities exist in work life, but little is known about their presence in relation to factors examined in occupation health settings. The aim of this study was to identify and summarize the working and employment conditions described as determinants of gender inequalities in occupational health in studies related to occupational health published between 1999 and 2010.

Methods

A systematic literature review was undertaken of studies available in MEDLINE, EMBASE, Sociological Abstracts, LILACS, EconLit and CINAHL between 1999 and 2010. Epidemiologic studies were selected by applying a set of inclusion criteria to the title, abstract, and complete text. The quality of the studies was also assessed. Selected studies were qualitatively analysed, resulting in a compilation of all differences between women and men in the prevalence of exposure to working and employment conditions and work-related health problems as outcomes.

Results

Most of the 30 studies included were conducted in Europe (n=19) and had a cross-sectional design (n=24). The most common topic analysed was related to the exposure to work-related psychosocial hazards (n=8). Employed women had more job insecurity, lower control, worse contractual working conditions and poorer self-perceived physical and mental health than men did. Conversely, employed men had a higher degree of physically demanding work, lower support, higher levels of effort-reward imbalance, higher job status, were more exposed to noise and worked longer hours than women did.

Conclusions

This systematic review has identified a set of working and employment conditions as determinants of gender inequalities in occupational health from the occupational health literature. These results may be useful to policy makers seeking to reduce gender inequalities in occupational health, and to researchers wishing to analyse these determinants in greater depth.

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.

Long-term effects of the British evacuation of children during World War 2 on their adult mental health

OBJECTIVES

This study of 870 respondents aged 62-72 years investigates possible long-term effects on adult mental health due to temporary childhood separation by evacuation in the United Kingdom during World War 2.

METHOD

Using univariate and multivariate analyses associations were examined between upbringing, evacuation experience and certain life-course variables with the lifetime incidence of depression and clinical anxiety, and also with the dependency and self-critical factors of the Depressive Experiences Questionnaire (DEQ) (Blatt, S.J., D'Affitti, J.P., & Quinlan, D.M. (1976). Experiences of depression in normal young adults. Journal of Abnormal Psychology, 85, 383-389.) were examined by univariate and multivariate analyses.

RESULTS

Those evacuated at a young age, 4-6 years, or who received poor foster care, were found to be at a greater risk of depression and clinical anxiety, with high levels of self-criticism. Compared to other groups respondents evacuated at 13-15 years age, who received good care, had reduced incidences of both affective disorders, comparable to those who were not evacuated. The quality of home nurture was also found to be significantly associated with both disorders. Structural equation models for each sex based on those variables significantly associated with depression explained 45% of the variance of the incidence of depression for males and 25% for females. The models also confirmed the relatively high levels of dependency for females and their vulnerability to these levels in terms of depression.

CONCLUSION

The study demonstrated significant associations between childhood experiences and lifespan mental health, reinforcing the importance of knowledge of childhood history in the clinical treatment of older adults.

Gender differences in respiratory symptoms-does occupation matter?

Little attention has been given to gender differences in respiratory health, particularly in occupational settings. The purpose of this paper was to evaluate gender differences in respiratory morbidity based on surveys of hospitality workers, radiographers, and respiratory therapists. Data were available from mail surveys of 850 hospitality industry workers (participation rate 73.9%; 52.6% female), 586 radiographers (participation rate 63.6%; 85% female), and 275 respiratory therapists (participation rate 64.1%; 58.6% female). Cross-tabulations by gender were evaluated by chi(2) analysis and logistic regression with adjustment for personal and work characteristics. Women consistently had greater respiratory morbidity for symptoms associated with shortness of breath, whereas men usually had a higher prevalence of phlegm. There were few differences in work exposures apart from perception of exposure to ETS among hospitality workers. Gender differences in symptoms were often reduced after adjustment for personal and work characteristics but for respiratory therapists there were even greater gender disparities for asthma attack and breathing trouble. Population health findings of elevated symptoms among women were only partially supported by these occupational respiratory health surveys. The influence of differential exposures and personal factors should be considered when interpreting gender differences in health outcomes.

State of animus among Brazilians: influence of socioeconomic context?

Preliminary results of the World Health Survey, conducted in Brazil in 2003, indicate a high frequency of self-perceived problems related to state of animus. The main objective of the present study is to investigate the hypothesis that material deprivation and job insecurity are important determinants of self-reported mental problems, such as feelings of depression and anxiety. Analysis of factors associated with self-perceived problems related to state of animus was performed with multivariate logistic regression models. Among females, key factors associated with feelings of depression and anxiety were level of education and unemployment after controlling for age, presence of long duration disease or disability and of body injury limiting everyday activities. Among males, feelings of depression were most strongly associated with unemployment, followed by poverty (as measured by a household asset indicator), with being married (or cohabiting) showed a protector effect. With regard to severe feelings of anxiety, only unemployment contributed significantly. These findings highlight the influence of social and economic contexts, beyond strictly individual characteristics, on the health of Brazilians.

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.

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.

Physical Exposures in Work Commonly Done by Women

The North American workforce is still highly sex-segregated, with most members of each sex in jobs composed primarily of workers of the same sex. This division is accentuated when jobs involve physical demands. Women have traditionally been assigned to tasks whose physical demands are considered to be light. Nevertheless, these tasks can have biological effects, sometimes serious. Phenomena related to physical demands of women's work can be considered in three categories: (a) musculoskeletal and cardiovascular demands of tasks often assigned to women in factories and service work; (b) sex- and gender-specific effects of toxic substances found in the workplace; and (c) interactions between work and the domestic responsibilities of many women. These phenomena are described, using examples recently gathered from workplaces. Effects of biological sex are distinguished, as far as possible, from effects of gender (social roles). Keywords: ergonomics, gender, occupation, anthropometry, toxicity, repetitive movements, static effort

Women and occupational lung disease: sex differences and gender influences on research and disease outcomes

We have attempted to describe the current state of knowledge regarding occupational lung disease in women. A large section of this article was devoted to describing the methodologic challenges that face researchers when evaluating gender differences in occupational lung disease. The findings of the presented studies are likely limited by many of the methodologic problems that were identified earlier. To accurately identify the true risk of occupational lung disease in women workers, these findings must be replicated in future studies with special attention paid to the various aspects of occupational lung disease research that are susceptible to gender-related bias.

Using sex differences in psychopathology to study causal mechanisms: unifying issues and research strategies

BACKGROUND

Although there is an extensive literature, both speculative and empirical, on postulated differences between males and females in their rates of particular types of disorder, very little is known about the mechanisms that underlie these sex differences. The study of mechanisms is important because it may provide clues on aetiological processes. The review seeks to outline what is known, what are the methodological hazards that must be dealt with, and the research strategies that may be employed.

METHODS

We note the need for representative general samples, and for adequate measurement and significance testing if valid conclusions are to be drawn. We put forward three levels of causes that have to be considered: a genetically determined distal basic starting point; the varied consequences of being male or female; and the proximal risk or protective factors that are more directly implicated in the causal mechanisms that predispose to psychopathology. In delineating these, we argue that three key sets of evidential criteria have to be met: a) that the risk factors differ between males and females; b) that they provide for risk or protection within each sex; and c) that when introduced into a causal model, they eliminate or reduce the sex differences in the disorders being studied.

RESULTS

A male excess mainly applies to early onset disorders that involve some kind of neurodevelopmental impairment. A female excess mainly applies to adolescent-onset emotional disorders. No variables have yet met all the necessary criteria but some good leads are available. The possible research strategies that may be employed are reviewed.

CONCLUSIONS

The systematic investigation of sex differences constitutes an invaluable tool for the study of the causal processes concerned with psychopathology.

Be the fairest of them all: challenges and recommendations for the treatment of gender in occupational health research

BACKGROUND

Both women's and men's occupational health problems merit scientific attention. Researchers need to consider the effect of gender on how occupational health issues are experienced, expressed, defined, and addressed. More serious consideration of gender-related factors will help identify risk factors for both women and men.

METHODS

The authors, who come from a number of disciplines (ergonomics, epidemiology, public health, social medicine, community psychology, economics, sociology) pooled their critiques in order to arrive at the most common and significant problems faced by occupational health researchers who wish to consider gender appropriately.

RESULTS

This paper describes some ways that gender can be and has been handled in studies of occupational health, as well as some of the consequences. The paper also suggests specific research practices that avoid errors. Obstacles to gender-sensitive practices are considered.

CONCLUSIONS

Although gender-sensitive practices may be difficult to operationalize in some cases, they enrich the scientific quality of research and should lead to better data and ultimately to well-targeted prevention programs.

Gender differences in mental health: evidence from three organisations

It is commonly observed that women report higher levels of minor psychiatric morbidity than men. However, most research fails to control for the gendered distribution of social roles (e.g. paid work and domestic work) and so does not compare men and women in similar positions. In this short report, we examine the distribution of minor psychiatric morbidity (measured by the 12 item General Health Questionnaire) amongst men and women working in similar jobs within three white-collar organisations in Britain, after controlling for domestic and socioeconomic circumstances. Data from self-completion questionnaires were collected in a Bank (n = 2,176), a University (n = 1,641) and the Civil Service (n = 6,171). In all three organisations women had higher levels of minor psychiatric morbidity than men, but the differences were not great; in only the Civil Service sample did this reach statistical significance. We conclude that generalisations about gender differences in minor psychiatric morbidity can be unhelpful, as these differences may vary depending on the context of the study.

Age, gender, socioeconomic, and ethnic differences in patients' assessments of primary health care

BACKGROUND

Patients' evaluations are an important means of measuring aspects of primary care quality such as communication and interpersonal care. This study aims to examine variations in assessments of primary care according to age, gender, socioeconomic, and ethnicity variables.

METHODS

A cross sectional survey of consecutive patients attending 55 inner London practices was performed over a 2 week period using the General Practice Assessment Survey (GPAS) instrument which assesses 13 important dimensions of primary care provision. Variations in scale scores were investigated for differences relating to age, gender, socioeconomic, and ethnic status as reported by respondents.

RESULTS

A total of 7692 questionnaires were returned (71% response rate). Valid information on age, gender, socioeconomic status, and ethnicity was available for 4819 out of 5496 adult respondents. Approximately half the respondents reported their ethnic group as "white" and most of the remaining respondents reported belonging to "black" or South Asian groups. Significant differences existed between groups of patients defined by age or ethnicity for most of the scale scores examined. Black, South Asian, and Chinese respondents reported lower scores (representing less favourable assessments) than white respondents; older respondents reported more favourable evaluations of care than younger respondents; and less affluent groups reported lower scores than more affluent groups for two of the 13 dimensions. There was no significant difference between gender groups with respect to assessment of primary care. Age and ethnicity were independent predictors of respondents' assessments of primary care.

CONCLUSIONS

Differences exist between identifiable subgroups of the population in their assessments of primary health care measured using the GPAS instrument. This work adds to the literature on variation in healthcare experience and the potential for patient assessment of primary care. Further work is required to investigate these differences in more detail and to relate them to differences in the nature and process of primary care provision. Primary care providers need to ensure that services provided are appropriate for all patient groups within their communities.