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Social class and self-reported health status among men and women: what is the role of work organisation, household material standards and household labour?

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  • Borrell, Carme
  • Muntaner, Carles
  • Benach, Joan
  • Artazcoz, Lucía

Abstract

Social class understood as social relations of ownership and control over productive assets taps into parts of the social variation in health that are not captured by conventional measures of social stratification. The objectives of this study are to analyse the association between self-reported health status and social class and to examine the role of work organisation, material standards and household labour as potential mediating factors in explaining this association. We used the Barcelona Health Interview Survey, a cross-sectional survey of 10,000 residents of the city's non-institutionalised population in 2000. This was a stratified sample, strata being the 10 districts of the city. The present study was conducted on the working population, aged 16-64 years (2345 men and 1874 women). Social class position was measured with Erik Olin Wright's indicators according to ownership and control over productive assets. The dependent variable was self-reported health status. The independent variables were social class, age, psychosocial and physical working conditions, job insecurity, type of labour contract, number of hours worked per week, possession of appliances at home, as well as household labour (number of hours per week, doing the housework alone and having children, elderly or disabled at home). Several hierarchical logistic regression models were performed by adding different blocks of independent variables. Among men the prevalence of poor reported health was higher among small employers and petit bourgeois, supervisors, semi-skilled (adjusted odds ratio--aOR: 4.92; 95% CI: 1.88-12.88) and unskilled workers (aOR: 7.69; 95%CI: 3.01-19.64). Work organisation and household material standards were associated with poor health status with the exception of number of hours worked per week. Work organisation variables were the main explanatory variables of social class inequalities in health, although material standards also contributed. Among women, only unskilled workers had poorer health status than the referent category of manager and skilled supervisors (aOR: 3.25; 95%CI: 1.37-7.74). All indicators of work organisation and household material standards reached statistical significance, excepting the number of hours worked per week. In contrast to men, among women the number of hours per week of household labour was associated with poor health status (aOR: 1.02; 95% CI: 1.01-1.03). Showing a different pattern from men in the full model, household material deprivation and hours of household labour per week were associated with poor health status among women. Our findings suggest that among men, part of the association between social class positions and poor health can be accounted for psychosocial and physical working conditions and job insecurity. Among women, the association between the worker (non-owner, non-managerial, and un-credentiated) class positions and health is substantially explained by working conditions, material well being at home and amount of household labour.

Suggested Citation

  • Borrell, Carme & Muntaner, Carles & Benach, Joan & Artazcoz, Lucía, 2004. "Social class and self-reported health status among men and women: what is the role of work organisation, household material standards and household labour?," Social Science & Medicine, Elsevier, vol. 58(10), pages 1869-1887, May.
  • Handle: RePEc:eee:socmed:v:58:y:2004:i:10:p:1869-1887
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    Citations

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    Cited by:

    1. Richardson, Elizabeth A. & Moon, Graham & Pearce, Jamie & Shortt, Niamh K. & Mitchell, Richard, 2017. "Multi-scalar influences on mortality change over time in 274 European cities," Social Science & Medicine, Elsevier, vol. 179(C), pages 45-51.
    2. Qiu, Hanyao & Bures, Regina & Shehan, Constance L., 2012. "The inconsistent mediating effects of psychosocial work characteristics on the education–health relationship," Social Science & Medicine, Elsevier, vol. 75(8), pages 1539-1546.
    3. Huisman, Martijn & Van Lenthe, Frank & Avendano, Mauricio & Mackenbach, Johan, 2008. "The contribution of job characteristics to socioeconomic inequalities in incidence of myocardial infarction," Social Science & Medicine, Elsevier, vol. 66(11), pages 2240-2252, June.
    4. Hämmig, Oliver & Gutzwiller, Felix & Kawachi, Ichiro, 2014. "The contribution of lifestyle and work factors to social inequalities in self-rated health among the employed population in Switzerland," Social Science & Medicine, Elsevier, vol. 121(C), pages 74-84.
    5. Olsen, Karen M. & Dahl, Svenn-Åge, 2007. "Health differences between European countries," Social Science & Medicine, Elsevier, vol. 64(8), pages 1665-1678, April.
    6. Kim, Il-Ho & Muntaner, Carles & Vahid Shahidi, Faraz & Vives, Alejandra & Vanroelen, Christophe & Benach, Joan, 2012. "Welfare states, flexible employment, and health: A critical review," Health Policy, Elsevier, vol. 104(2), pages 99-127.
    7. Toni Mora, 2008. "The relevance of satisfaction with coverage for health care utilization: evidence from Catalonia," Hacienda Pública Española, IEF, vol. 184(1), pages 99-116, April.
    8. Muntaner, Carles & Borrell, Carme & Vanroelen, Christophe & Chung, Haejoo & Benach, Joan & Kim, Il Ho & Ng, Edwin, 2010. "Employment relations, social class and health: A review and analysis of conceptual and measurement alternatives," Social Science & Medicine, Elsevier, vol. 71(12), pages 2130-2140, December.
    9. Jerneja Farkas & Majda Pahor & Lijana Zaletel-Kragelj, 2011. "Self-rated health in different social classes of Slovenian adult population: nationwide cross-sectional study," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 56(1), pages 45-54, February.
    10. Heather Scott-Marshall, 2010. "The Social Patterning of Work-Related Insecurity and its Health Consequences," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 96(2), pages 313-337, April.
    11. Toni Mora, 2008. "The effects of working conditions on health status: Simultaneous decisions on health and job satisfaction domains," Revista de Economía Laboral - Spanish Journal of Labour Economics, Asociación Española de Economía Laboral - AEET, vol. 5, pages 50-72.
    12. repec:eee:socmed:v:181:y:2017:i:c:p:122-130 is not listed on IDEAS
    13. repec:gam:jsoctx:v:8:y:2018:i:3:p:45-:d:153722 is not listed on IDEAS
    14. Niedhammer, Isabelle & Chastang, Jean-François & David, Simone & Kelleher, Cecily, 2008. "The contribution of occupational factors to social inequalities in health: Findings from the national French SUMER survey," Social Science & Medicine, Elsevier, vol. 67(11), pages 1870-1881, December.
    15. De Moortel, Deborah & Palència, Laia & Artazcoz, Lucía & Borrell, Carme & Vanroelen, Christophe, 2015. "Neo-Marxian social class inequalities in the mental well-being of employed men and women: The role of European welfare regimes," Social Science & Medicine, Elsevier, vol. 128(C), pages 188-200.

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