All part of the job? The contribution of the psychosocial and physical work environment to health inequalities in Europe and the European health divide

Int J Health Serv. 2014;44(2):285-305. doi: 10.2190/HS.44.2.g.

Abstract

This study is the first to examine the contribution of both psychosocial and physical risk factors to occupational inequalities in self-assessed health in Europe. Data from 27 countries were obtained from the 2010 European Working Conditions Survey for men and women aged 16 to 60 (n = 21,803). Multilevel logistic regression analyses (random intercept) were applied, estimating odds ratios of reporting less than good health. Analyses indicate that physical working conditions account for a substantial proportion of occupational inequalities in health in both Central/Eastern and Western Europe. Physical, rather than psychosocial, working conditions seem to have the largest effect on self-assessed health in manual classes. For example, controlling for physical working conditions reduced the inequalities in the prevalence of"less than good health" between the lowest (semi- and unskilled manual workers) and highest (higher controllers) occupational groups in Europe by almost 50 percent (Odds Ratio 1.87, 95% Confidence Interval 1.62-2.16 to 1.42, 1.23-1.65). Physical working conditions contribute substantially to health inequalities across "post-industrial" Europe, with women in manual occupations being particularly vulnerable, especially those living in Central/Eastern Europe. An increased political and academic focus on physical working conditions is needed to explain and potentially reduce occupational inequalities in health.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cross-Cultural Comparison*
  • Educational Status
  • Europe
  • Female
  • Health Status Disparities*
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Occupational Diseases / epidemiology*
  • Occupational Exposure*
  • Occupations
  • Social Class
  • Socioeconomic Factors
  • Workplace*
  • Young Adult