Structural and intermediary determinants of social inequalities in the mental well-being of European workers: a relational approach

Moortel, Deborah De; Vandenheede, Hadewijch; Muntañer, Carles; Vanroelen, Christophe

doi:10.1186/1471-2458-14-938

Cited by 75 publications

(26 citation statements)

References 40 publications

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“…The worst health status of nonskilled workers has been reported in other studies from Western countries [14, 15, 43–45]. This study adds an additional support for these prior findings in a relatively newly developed Asian capitalist country.…”

Section: Discussionsupporting

confidence: 86%

Neo-Marxian social class inequalities in self-rated health among the employed in South Korea: the role of material, behavioral, psychosocial, and workplace environmental factors

et al. 2017

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BackgroundThe aim of this study was to examine the pattern of social inequality in self-rated health among the employed using the Wright’s social class location indicator, and to assess the roles of material, behavioral, psychosocial, and workplace environmental factors as mediating factors in explaining the social class inequality in self-rated health in South Korea.MethodsThis study used data from the 4th Korea National Health and Nutrition Examination Survey from 2007 to 2009. Study subjects included the employed population of 4392 men and 3309 women aged 19–64 years. Subjects were classified into twelve social class positions based on the Wright’s social class map. The health outcome was self-rated health. Material, psychosocial, behavioral, and workplace environmental factors were considered as potential mediators in explaining social class health inequality. We calculated prevalence ratios of poor self-rated health according to social class, adjusted for age and mediating factors using Poisson regression models.ResultsNonskilled workers and petty bourgeoisie reported worse self-rated health than other social classes among men. The age-adjusted prevalence of petty bourgeoisie and nonskilled workers were about four-fold greater than that of managers. Expert supervisors in the contradictory class location had a greater prevalence of poor self-rated health than experts in men. In women, the prevalence of poor self-rated health was greater in most social classes than their male counterparts, while the differences among social classes within women were not statistically significant. Workplace environmental factors explained the social class inequality by from 24 to 31% in nonskilled and skilled workers and nonskilled supervisors, respectively, and material factors showed an explanatory ability of about 8% for both nonskilled workers and petty bourgeoisie in men.ConclusionsWe showed the inequality in self-rated health according to the Wright’s social class in an industrialized Asian country. Policy efforts to improve workplace environments in nonskilled and skilled workers and nonskilled supervisors would have a moderate effect on reducing the magnitude of social class inequality in self-rated health. Furthermore, the means to improve power relations in the workplace should be devised to further reduce the social class inequalities in health.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4269-9) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 86%

Neo-Marxian social class inequalities in self-rated health among the employed in South Korea: the role of material, behavioral, psychosocial, and workplace environmental factors

et al. 2017

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“…In our study, educational level had negligible impacts on subsequent sickness absence due to mental disorders. However, more detailed sensitivity analyses (data not shown) showed that educational groups had very similar amounts of subsequent long sickness absence, except the group with the highest education had less than others, which is in line with a previous study [21]. …”

Section: Discussionsupporting

confidence: 89%

Short sickness absence and subsequent sickness absence due to mental disorders - a follow-up study among municipal employees

et al. 2017

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BackgroundMental disorders are common diagnostic causes for longer sickness absence and disability retirement in OECD-countries. Short sickness absence spells are also common, and neither trivial for health and work ability. We studied how prior short sickness absence spells and days are associated with subsequent longer sickness absence due to mental disorders in two age-groups of municipal employees during a 2-, 5- and 9-year follow-up.MethodsThe analyses covered 20–34 and 35–49-year-old employees of the City of Helsinki in 2004. Those with prior ≥14 day sickness absence in 2002, 2003 or 2004 were excluded. Women and men were pooled together. Short, 1–13-day sickness absence spells and days were calculated per the actual time of employment during 2004. Logistic regression analysis was used to calculate odds ratios (OR) and their 95% confidence intervals (CI) for the subsequent long (≥14 days) sickness absence due to mental disorders during three follow-ups.ResultsThe risk for long sickness absence due to mental disorders increased with increasing amount of short sickness absence spells and days. 3 or more short sickness absence spells and 8–14 sickness absence days from short spells in 2004 were strongly associated with subsequent long sickness absence in all three follow-ups. The associations were strongest for the 2-year follow-up; the younger employees tended to have higher risks than the older ones.ConclusionsThree spells or 8 days of short sickness absence per year constitutes a high risk for subsequent long sickness absence due to mental disorders and preventive measures should be considered.

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“…In addition, although we focus here on the unemployed versus the employed, we recognize that within these two groups there are also important differences. For the unemployed these include, for example the duration and the reason of job loss [ 100 ], and for the employed, intrinsic and extrinsic job characteristics [ 40 , 41 ]. These differences might also be related to mental health and mental health care use.…”

Section: Discussionmentioning

confidence: 99%

Employment status and mental health care use in times of economic contraction: a repeated cross-sectional study in Europe, using a three-level model

Buffel

Straat

Bracke

2015

Int J Equity Health

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IntroductionFramed within the recent economic crisis, in this study we investigate the medical mental health care use of the unemployed compared with that of the employed in Europe, and whether the relationship between employment status and mental health care use varies across macro-economic conditions. We examine whether the macro-economic context and changes therein are related to mental health care use, via their impact on mental health, or more directly, irrespective of mental health.MethodsWe use data from three waves of the Eurobarometer (2002, 2005/2006, and 2010), which has a repeated cross-sectional and cross-national design. Linear and logistic multilevel regression analyses are performed with mental health, contacting a general practitioner, and contacting a psychiatrist for mental health problems as dependent variables. The multilevel design has three levels (the individual, the period-country, and the country), which allows us to estimate both longitudinal and cross-sectional macro-effects. The macro-economic context and changes therein are assessed using national unemployment rates and growth rates in Gross Domestic Product (GDP).ResultsThe mean unemployment rate is negatively related to mental health, although for women, this effect only applies to the employed. Among women, no relationship is found between changes in the macro-economic context and mental health. The unemployment rate, and changes in both the unemployment rate and the real GDP growth rate, are associated with men’s care use, regardless of their mental health, whereas this does not hold for women. In countries with an increase in the unemployment rate, both unemployed and employed men tend to medicalize their problems more by contacting a general practitioner, irrespective of their mental health, while the likelihood of contacting a psychiatrist is lower among employed men.ConclusionsOur findings stress the importance of taking the macro-economic context and changes therein into account when studying the mental health care use of unemployed people compared with the employed, in particular among men. Moreover, it is important to make the distinction between primary and specialized medical care use, as the impact of macro-economic conditions is dependent on the type of care, which also applies when controlling for mental health.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-015-0153-3) contains supplementary material, which is available to authorized users.

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Structural and intermediary determinants of social inequalities in the mental well-being of European workers: a relational approach

Cited by 75 publications

References 40 publications

Neo-Marxian social class inequalities in self-rated health among the employed in South Korea: the role of material, behavioral, psychosocial, and workplace environmental factors

Neo-Marxian social class inequalities in self-rated health among the employed in South Korea: the role of material, behavioral, psychosocial, and workplace environmental factors

Short sickness absence and subsequent sickness absence due to mental disorders - a follow-up study among municipal employees

Employment status and mental health care use in times of economic contraction: a repeated cross-sectional study in Europe, using a three-level model

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