Financial Strain and Health Status Among European Workers: Gender and Welfare State Inequalities (original) (raw)
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Journal of Epidemiology and Community Health, 2008
Background: The relationship between unemployment and increased risk of morbidity and mortality is well established. However, what is less clear is whether this relationship varies between welfare states with differing levels of social protection for the unemployed. Methods: The first (2002) and second (2004) waves of the representative cross-sectional European Social Survey (37 499 respondents, aged 25-60 years). Employment status was main activity in the last 7 days. Health variables were self-reported limiting long-standing illness (LI) and fair/poor general health (PH). Data are for 23 European countries classified into five welfare state regimes (Scandinavian, Anglo-Saxon, Bismarckian, Southern and Eastern). Results: In all countries, unemployed people reported higher rates of poor health (LI, PH or both) than those in employment. There were also clear differences by welfare state regime: relative inequalities were largest in the Anglo-Saxon, Bismarckian and Scandinavian regimes. The negative health effect of unemployment was particularly strong for women, especially within the Anglo-Saxon (OR LI 2.73 and OR PH 2.78) and Scandinavian (OR LI 2.28 and OR PH 2.99) welfare state regimes. Discussion: The negative relationship between unemployment and health is consistent across Europe but varies by welfare state regime, suggesting that levels of social protection may indeed have a moderating influence. The especially strong negative relationship among women may well be because unemployed women are likely to receive lower than average wage replacement rates. Policy-makers' attention therefore needs to be paid to income maintenance, and especially the extent to which the welfare state is able to support the needs of an increasingly feminised European workforce.
Background: The mixed empirical evidence about employment conditions (i.e., permanent vs. temporary job, full-time vs. part-time job) as well as unemployment has motivated the development of conceptual models with the aim of assessing the pathways leading to effects of employment status on health. Alongside physically and psychologically riskier working conditions, one channel stems in the possibly severe economic deprivation faced by temporary workers. We investigate whether economic deprivation is able to partly capture the effect of employment status on Self-evaluated Health Status (SHS). Methods: Our analysis is based on the European Union Statistics on Income and Living Conditions (EU-SILC) survey, for a balanced sample from 26 countries from 2009 to 2012. We estimate a correlated random-effects logit model for the SHS that accounts for the ordered nature of the dependent variable and the longitudinal structure of the data. Results and Discussion: Material deprivation and economic strain are able to partly account for the negative effects on SHS from precarious and part-time employment as well as from unemployment that, however, exhibits a significant independent negative association with SHS. Conclusions: Some of the indicators used to proxy economic deprivation are significant predictors of SHS and their correlation with the employment condition is such that it should not be neglected in empirical analysis, when available and further to the monetary income. A prominent amount of theoretical and empirical literature has focused on the relationship between workers' employment condition and their well-being. Special attention has been devoted to the adverse health effects of unemployment [1] and, more recently, to understanding precarious employment and underemployment as an emerging social determinant of health [2,3]. These issues are particularly relevant in the context of the latest economic downturn, leading to an EU-28 unemployment rate of about 20% in 2015 and to an incidence of temporary employment of 40% for workers aged between 14 and 25 in 2014. Furthermore, in the same category, over 19% works less than 20 h per week [4]. Unemployment has long been found to be associated with detrimental effects on several health outcomes, especially through the engagement in riskier health-related lifestyles , following
Unemployment and health status in Europe
The present study tries to shed some light on the understanding of factors associated with unemployment in the European context. During the last decades, Europe experienced intense geopolitical transformations, with warfare and the emergence of newly independent states in its central and eastern portion, and the unification of richer western countries. The enlargement of the European Union is expected to promote development and improved social standings for candidate and future candidate countries. However, as the accession process requires adopting a common legislation, limited resources and significantly lower health status in central and eastern Europe challenge this expectation .
Health trends in the wake of the financial crisis-increasing inequalities?
Scandinavian journal of public health, 2017
The financial crisis that hit Europe in 2007-2008 and the corresponding austerity policies have generated concern about increasing health inequalities, although impacts have been less salient than initially expected. One explanation could be that health inequalities emerged first a few years into the crisis. This study investigates health trends in the wake of the financial crisis and analyses health inequalities across a number of relevant population subgroups, including those defined by employment status, age, family type, gender, and educational attainment. This study uses individual-level panel data (EU-SILC, 2010-2013) to investigate trends in self-rated health. By applying individual fixed effects regression models, the study estimates the average yearly change in self-rated health for persons aged 15-64 years in 28 European countries. Health inequalities are investigated using stratified analyses. Unemployed respondents, particularly those who were unemployed in all years of ...
International Journal for Equity in Health, 2014
In 2009, Europe was hit by one of the worst debt crises in history. Although the Eurozone crisis is often depicted as an effect of government mismanagement and corruption, it was a consequence of the 2008 U.S. banking crisis which was caused by more than three decades of neoliberal policies, financial deregulation and widening economic inequities. Evidence indicates that the Eurozone crisis disproportionately affected vulnerable populations in society and caused sharp increases of suicides and deaths due to mental and behavioral disorders especially among those who lost their jobs, houses and economic activities because of the crisis. Although little research has, so far, studied the effects of the crisis on health inequities, evidence showed that the 2009 economic downturn increased the number of people living in poverty and widened income inequality especially in European countries severely hit by the debt crisis. Data, however, also suggest favorable health trends and a reduction of traffic deaths fatalities in the general population during the economic recession. Moreover, egalitarian policies protecting the most disadvantaged populations with strong social protections proved to be effective in decoupling the link between job losses and suicides. Unfortunately, policy responses after the crisis in most European countries have mainly consisted in bank bailouts and austerity programs. These reforms have not only exacerbated the debt crisis and widened inequities in wealth but also failed to address the root causes of the crisis. In order to prevent a future financial downturn and promote a more equitable and sustainable society, European governments and international institutions need to adopt new regulations of banking and finance as well as policies of economic redistribution and investment in social protection. These policy changes, however, require the abandonment of the neoliberal ideology to craft a new global political economy where markets and gross domestic product (GDP) are no longer the main national policy goals, but just means to human and health improvements.
European workers´health and well-being: Do gender gaps persist between 2010 and 2015?
Revista de Economía Mundial
After the 2008 crisis, gender gaps in workers' health and well-being have persisted in different EU countries. Using 2010 and 2015 data from the European Working Conditions Survey, this paper estimates synthetic indicators by gender, considering workers' health status as well as environmental, organisational and psychosocial factors at work, by means of the P2distance measure. The study attempts to answer questions such as which countries evidenced the largest and smallest gender gaps in both years and where these gaps widened or narrowed in addition to what mechanisms support these results. Policies aimed at preventing and addressing occupational risks –in particular, psychosocial risks–would therefore be desirable to reduce these gaps.
Unemployment insurance and deteriorating self-rated health in 23 European countries
Journal of Epidemiology & Community Health, 2014
Background The global financial crisis of 2008 is likely to have repercussions on public health in Europe, not least through escalating mass unemployment, fiscal austerity measures and inadequate social protection systems. The purpose of this study is to analyse the role of unemployment insurance for deteriorating self-rated health in the working age population at the onset of the fiscal crisis in Europe. Methods Multilevel logistic conditional change models linking institutional-level data on coverage and income replacement in unemployment insurance to individuallevel panel data on self-rated health in 23 European countries at two repeated occasions, 2006 and 2009. Results Unemployment insurance significantly reduces transitions into self-rated ill-health and, particularly, programme coverage is important in this respect. Unemployment insurance is also of relevance for the socioeconomic gradients of health at individual level, where programme coverage significantly reduces health risks attached to educational attainment. Conclusions Unemployment insurance mitigated adverse health effects both at individual and countrylevel during the financial crisis. Due to the centrality of programme coverage, reforms to unemployment insurance should focus on extending the number of insured people in the labour force.
Unemployment and retirement and ill-health: a cross-sectional analysis across European countries
International Archives of Occupational and Environmental Health, 2008
Objective To determine the associations between diVerent measures of health and labor market position across ten European countries. Methods We studied 11,462 participants of the Survey on Health and Ageing in Europe (SHARE) who were 50-64 years old. Logistic regression was used to calculate the associations between health and other determinants and being retired, unemployed, or a homemaker. Results A large variation across European countries was observed for the proportion of persons 50-65 years with paid employment, varying among men from 42% in Austria to 75% in Sweden and among women from 22% in Italy to 69% in Sweden. Among employed workers 18% reported a poor health, whereas this proportion was 37% in retirees, 39% in unemployed persons, and 35% in homemakers. A perceived poor health was strongly associated with nonparticipating in labor force in most European countries. A lower education, being single, physical inactivity and a high body mass index were associated with withdrawal from the labor force. Long-term illnesses such as depression, stroke, diabetes, chronic lung disease, and musculoskeletal disease were signiWcantly more common among those persons not having paid employment. Conclusion In many European countries a poor health, chronic diseases, and lifestyle factors were associated with being out of the labor market. The results of this study suggest that in social policies to encourage employment among older persons the role of ill-health and its inXuencing factors needs to be incorporated.
Types of employment and health in the European Union: Changes from 1995 to 2000
The European Journal of Public Health, 2004
Background: This study compares associations between types of employment and health indicators in the Second (ES1995) and the Third European Survey on Working Conditions (ES2000) by gender, adjusting for individual and country-level confounders. Methods: Two cross-sectional surveys of a representative sample of the European Union (EU) total active population (n=15,146 workers in ES1995 and n=21,703 workers in ES2000). Based on their comparability in both surveys four health indicators were considered: job dissatisfaction, stress, fatigue and backache. Results: Non-permanent employment reported high percentages of job dissatisfaction but low levels of stress. Small employers were more likely to report fatigue and stress but less likely to report job dissatisfaction. Sole traders were more likely to report fatigue and backache. Workers in full-time employment almost always reported worse levels of health indicators than part-time. Two exceptions for part-time were found: temporary employment regarding job dissatisfaction, and in ES2000, sole traders with regard to job dissatisfaction, fatigue and backache. By and large, results by gender were similar in both surveys, although the magnitude of associations decreased in ES2000. Associations remained unchanged after adjustment. Conclusion: This study has compared for the first time the associations between various types of employment and four health indicators for the EU in ES1995 and ES2000, by gender. Overall, a slight increase in all health indicators was observed in the ES2000 compared to ES1995, and results were very consistent between both surveys. Similar findings in both surveys suggest that causal interpretation may be enhanced.
Precarious employment and health-related outcomes in the European Union: a cross-sectional study
Critical Public Health, 2019
In this cross-sectional study, we evaluated the associations between precarious employment and health-related outcomes in salaried workers from 28 countries in Europe (2014). We used data from the Flash Eurobarometer 398 among salaried workers (n = 7,702). We fitted multilevel generalized linear models (GLMM) using the Poisson family and country as the random effect, to calculate the crude (cPR) and adjusted (aPR) prevalence ratios with their 95%CI of health-related outcomes (health problems, sick leave, health and safety risks in the workplace) according to precarious employment. We found significant associations between having a precarious employment and health problems caused or worsened by the work (stress/depression/anxiety, musculoskeletal problems, infectious diseases, respiratory problems, accidents/injuries and allergies), sick leave of more than 15 days [aPR: 1.43, (CI95%: 1.09;1.87)] and exposure to violence or harassment [aPR: 1.82, (CI95%: 1.42;2.34)]. Our study shows an association of precarious employment, understood as a multidimensional construct, and negative health-related outcomes and sick leave of more than 15 days. Therefore, we recommend prioritizing legislative measures for reducing non-standard arrangements and for improving the conditions of workers in nonstandard arrangements.